Saturday, September 15, 2007

Family strain: A mum and her daughter's illness

15 Sep 2007, ST

MADAM Shankar, a bank clerk in her 40s, and her two children, 24 and 17, live in an old three-room Housing Board flat. Her husband, a doctor, is an Indian citizen who comes only occasionally to visit his Singaporean wife and children.

Madam Shankar has been struggling as a single parent for more than two decades, with just a little financial help from her husband.

She is feeling the stress of working, being a mother and giving continuous emotional support to her older child, Janice, who has schizophrenia.

Madam Shankar: The first time I noticed Janice behaving extraordinarily was after her Primary School Leaving Examination. 'She did well in all subjects except for Maths where she got a C grade. She was so upset, in tears, as though she had failed.

'She was posted to a neighbourhood school. After orientation, I found her downstairs sweeping the playground. I knew immediately that something was wrong.

I took her to a doctor, and she was treated at the child guidance clinic. For four years, she was on and off her medicine. Her O-level results were good and she went on to junior college.

She was very confident she was well and refused to continue with the medicine. She would be tense during exams, but she took part in active sports. So I thought it was all right.

But when she couldn't get into the law course at university, she started getting upset again.

Janice: My grades were good enough for university, but not law. So I went for a private law course instead. There was a lot to memorise, and I was not able to cope. I knew within the month that I couldn't make it.

I was very stressed with law school. I felt that the lecturer was repeating whatever I had read, that somebody was tape recording whatever I was reading or saying. They knew what I was thinking about. So I quit the school although I had already paid $7,000.

One day, I suddenly told myself, it was like a prophecy, that a road would collapse. And Nicoll Highway collapsed. I really thought it was me, because I said it and it happened.

'I then found that whatever I said would come to pass. One time, I predicted that a $10 note I would give to a shopkeeper would turn into a $2 note.

'That afternoon, my mother gave me $10 to buy bread, but the shopkeeper told me it was only $2. I told my mother what happened, but she said she gave me only $2. I was very sure it was $10 - I saw it was a $10 note.'

Madam Shankar: Janice would cry and cry for no reason. I wanted her to see a doctor but she refused, saying there was nothing wrong. I finally got her to the Institute of Mental Health. I thought it was depression. I didn't know anything about psychosis.

The doctor wanted to observe her, and had her admitted for two days. But she didn't even stay a day.

Janice: Everyone in the ward was making noise. They're really mad people. At least I am aware of my surroundings. Those people really had mental problems. I couldn't stay there.

Madam Shankar: The doctor gave her anti-depressant medicine. But getting her to take her medicine became a real struggle for me. She became violent.

Janice: I believed I was okay. I didn't want to be addicted to the medicine. I preferred to be counselled.

Madam Shankar: I pressed her to get a job. She didn't want to study or work. If she wanted to stay home, at least she should do some housework.

Janice: She didn't want me to stay at home. She wanted me to go to a care centre. I don't give her any problems.

Madam Shankar: She would sleep all the time, doing nothing.

Janice: So what if I sleep all the time? Did I give her any problems? I was minding my own business. I never trouble her in any way. And she couldn't take it. She must get rid of me.

The Hougang Care Centre run by the Anglican Society is a step-down care facility for psychiatric patients. Janice spent three months there following her discharge from IMH in 2005. She has lived at home since.

Madam Shankar: I thought if she was there, she would be engaged in activities instead of sleeping all the time.

Janice: At the care centre, the people are really mental. What they do are sewing and other menial jobs. I find that meaningless. I can't do that. I didn't like the food as well.

Madam Shankar: She was so stubborn and rebellious. I wanted to admit her to hospital.

Janice now works at a busy hospital clinic, preparing case notes for doctors, and appointments for patients. Her employer does not know of her mental illness.

Janice: I'm working and I'm having a really hard time. Every day I struggle. When I come home, I cry to God: Please help me. I don't know how I'm going to face tomorrow.

I find my job very difficult, though it is a simple job. I just need to stick the label on the form, chop the doctor's stamp and get the case sheet.

Sometimes the case sheets are not given to us and we have to trace the case sheets all over the hospital. Doctors get upset when there are no case sheets.

My probation report was not good. It said I'm slow and not capable of running a heavy clinic. They want us to multi-task. There are lots of calls coming in and that's very distracting. Other girls can pick up the calls and continue doing their work. I can't do that.

Madam Shankar: Every day she comes home and cries. She tells me that after her one-year bond is over, she's going to stay home and not work any more.

Janice: I now have this wish, to get married so I don't have to work any more.

Madam Shankar: Getting married is not so easy. It will not solve all the problems.

Janice: A few days ago, my job was just too much for me. I came home and told my mother and she said: 'I cannot live like this, you know. My life is going to be shortened because of you.'

If I had a choice, I would not have come into this world. Even now, I pray to God, can you please take my life, I find it too difficult. But I can't take my own life. That's a sin.

Madam Shankar: It's very difficult bringing up two children without my husband here.

When she comes home and says she cannot cope, it makes me feel very stressed. Because I worry for her, I'm also very stressed. I want her to settle down in her job and get better.

But she is getting better. Before this, she had suicidal thoughts. She refused to understand what was happening. Now when I tell her something, she understands. She takes her medicine and she can sleep.

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