Clinical depression can be treated, but the stigma associated with the illness could be preventing people from seeking help.

SINGAPORE: When Madam Junainah Eusope was first diagnosed with depression almost 15 years ago, shame was the first thing she felt. “I asked the doctor what illness I had, and he said it was a mental illness. And that’s when it hit me,” she recounted.

“I used to visit patients in Woodbridge Hospital, and I used to laugh at them. Was I now one of them?” she said. She was afraid her extended family members would mock her and say she was “mad”, so she hid her diagnosis from them. Only her husband knew about her condition.

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Life was not easy for Mdm Junainah and her family. She was in and out of hospital for treatment, and had to leave her nursing job. Her husband also had to quit his job as a seaman to take care of her. “There were times we did not have any rice to eat, and (my children) didn’t go to school because I couldn’t provide them with expenses,” said the 60 year-old mother of four. “It was really a tough time for us.”

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She did not dare look for work, as she was worried that the stress would cause her to have a relapse. Potential discrimination from employers was also a real fear. “Suppose the employer gets to know that we have this illness … that’s it. Nobody wants to employ us,” she said.

SUFFERING IN SILENCE

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Mdm Junainah’s diagnosis is not uncommon: according to statistics from the Institute of Mental Health, more people have been coming forward to seek treatment for Major Depressive Disorder (MDD), or clinical depression.

The Institute of Mental Health (IMH) saw about 1,800 new patients diagnosed with MDD last year, an increase of about 7 per cent from 2014. There has been an annual increase of about 7 per cent in the number of new patients for the past three years. Increased awareness of the condition and a small increase in population could have contributed to the rise in numbers, IMH told Channel NewsAsia.

Based on the Singapore Mental Health Study conducted in 2010 by IMH, as many as 1 in 17 people have suffered from MDD at some time in their life.

But this could only be a fraction of those who have the condition, with many unwilling to seek treatment for fear of being shunned by society. “Many people with depression do tend to delay in seeking help from the professionals,” said Dr Radiah Salim, president of Club Heal, a charity that helps those with mental illnesses like depression and schizophrenia. “They think they’re depressed because there’s a weakness in their character, or a personal defect.”

“If they apply for a job, they’re also unlikely to declare their condition to the employer,” she added. “They’re worried that having the illness will work against them and the prospective employers will not want to hire them knowing they have depression.”

“Employers do not realize that it’s not a character defect, but a real illness. And people do recover from it and function well if given half a chance.”

Dr Mok Yee Ming attributes this to a fear of the unknown. “If you seek help for a physical illness like bad flu, or an arm fracture, people understand what happened,” said the head of IMH’s Mood Disorder Unit. “But being near someone who has a mind problem; many people have this fear... Is this person able to do his job, and can he be trusted?”

Some people may also not know they have the condition, he added.

“I didn’t know what depression was until I tried to kill myself and was forced to see a psychiatrist,” said 63 year-old Elaine Ng, who was diagnosed when she was in her forties. “That turned out to be a good thing for me, because I got the treatment I needed.”

“I would come home and look it up, find out what the medication does, and the side effects, and I would always give a report to my doctor to tell him what worked, and what didn’t,” she added.

Facebook video: Mdm Elaine Ng on overcoming depression



“After three years, I was out of my depression, and since then I have never had Major Depressive Disorder again.”

FIGHTING STIGMA

But Singapore has come a long way in fighting the stigma against depression, according to IMH’s Dr Mok. “More patients are coming forward to share their experiences, and what they have made of their lives.”

“This brings to light not only the difficulties they face, but the hurdles they have overcome, and I hope this will encourage other people who suffer from the same illness.”

Club Heal also gives public talks, and publishes books and newsletters to raise awareness about depression and other mental illnesses.

They are also walking the talk, as Dr Radiah elaborated: “All our programme executives have had mental illness, and some of our former clients are now working with us. We want to be the ideal employer for people with depression.”

And while discrimination is a real fear, companies like Courts told Channel NewsAsia that the condition is not a barrier to getting a job: “We are an equal opportunity employer and do not discriminate against employees afflicted by physical or mental disabilities as long as they can competently perform their duties to the scope of work required,” said Kiran Kaur, Chief Talent Officer of Courts Asia Limited. But due to insurance requirements, prospective employees will need to declare their health history when they apply to the company.

Those applying for a job in the public service will also need to declare their existing medical conditions, including clinical depression, according to a spokesperson from the Public Service Division. But the spokesperson added that this does not disqualify a candidate from being considered from a position in the public service.

“Our recruitment is based on merit, through a fair and open process. Public agencies will select the candidate with the best overall fit for the job, taking into account his skills and qualifications, relevant work experience and personal attributes.”

MOVING FORWARD

Mdm Junainah now trains clients at Club Heal in pottery-making. (Photo: Lianne Chia)

It was not an easy road to healing for Mdm Junainah, who struggled to provide for her family, and dealt with about 15 relapses till her last one in 2009. “My counsellor almost gave up on me,” she recalled.

But blessing came in an unexpected form: while undergoing treatment at a day rehabilitation centre, a counsellor noticed Mdm Junainah was good with her hands, and encouraged her to take up glass painting. “It helped occupy my time and distract me from the negative thoughts. But to my surprise, I got an income from this as well,” she said.

She mastered the skill within a year, and also picked up pottery and jewellery-making.

From someone who once attempted suicide multiple times, Mdm Junainah has come a long way and is now using her life to help others.

She now works as a peer specialist and programme coordinator at Club Heal, where she provides support and a listening ear to clients with mental illness. She also teaches them glass painting and pottery-making.

“I’m considered a living testimony, and since I can understand what it’s like to go through depression, I can listen to them and help them stand on their own two feet,” she said. “My counsellor always told me I am very talented, and I shouldn’t waste my life.”