SINGAPORE: Walking home from her part-time job late at night, Ms Fauziah Aman began discarding her belongings, even her identity card.
“I was walking from one end of Bukit Batok to another end, and dropping my things along the way in the middle of the night,” she said, describing her first manic episode.
“Before I reached home, somebody returned my IC to my mum, so she was wondering what happened.”
At the time, she was struggling with her university studies and in therapy for depression. After that manic episode in 2004, she was diagnosed with bipolar disorder.
People with bipolar disorder can experience episodes of mania – when their thoughts race and they feel “high”; these alternate with periods of depression, when they feel down and lack energy.
Both extremes can be disruptive to their daily lives and strain relationships with their families.
With medication, Ms Fauziah’s condition stabilised for many years – she dropped out of school and found work, then got married and had a daughter.
RELAPSE
But facing pressure from family members during her second pregnancy, she had a relapse.
“I got stressed when I was pregnant with the second one … it was not an easy pregnancy,” said Ms Fauziah, who also had problems in her marriage back then.
She had thoughts of harming herself and her daughter, although she did not act on them.
“(My younger daughter) was taken care of by my sister-in-law because I was grappling with … accepting her.”
She and her husband have since divorced. When Ms Fauziah tried to have her younger daughter come back to her home on weekends, she had another relapse.
“I would have a lot of energy, a lot of ideas. I would feel this grandiosity, that I was linked with supernatural powers and things like that. At the acute stage I would hear voices … (but) before it reaches that stage, I would be hospitalised,” she said.
When hospitalised at the Institute of Mental Health (IMH), she could not see both her children for months. During these times, she relied on her family to take care of them, and spoke to her elder daughter on the phone every day.
While her manic episodes and hospital stays were disruptive, the depressive periods were harder to overcome. When the depression takes over, Ms Fauziah said she feels lethargic, sleeps a lot and just doesn’t have the energy for daily tasks and household chores.
“When (my younger child) was born … I couldn’t get up to play with her (but) they need attention … I just had to push myself to play with her,” she said.
PARENTS WHO STRUGGLE
Now 41, Ms Fauziah works at the Singapore Association for Mental Health as a peer specialist and social work assistant. Her work includes helping others with mental health conditions reintegrate into the community.
She is better at managing her condition and wants to help others like herself.
These struggles are faced by many parents with mental health conditions, said medical social workers Vera Chua and Jonathan Mark in a separate interview.
For parents who are bipolar, in their “high” state, they may speak very quickly and “want to do everything”. Signs of mania vary by individual, ranging from agitation to profligate spending or making grand, often unrealistic, plans.
The children wonder why their parents are suddenly behaving differently, said Mr Mark. Then, when depression hits, their behaviour takes a rapid U-turn that raises even more questions for their kids.
“They cannot understand why (when the parent is depressed), all she wants to do is to sleep and sleep and sleep, just keep sleeping,” he said.
The social workers use books specially written for children to help explain different mental health conditions, ranging from depression to schizophrenia, and why their parents behave the way they do.
The risk is that some kids become resigned to the way things are and become the ones to take care of their parents, said Mr Mark. “So instead of children being children, they become parents.”
EXTREME CASES
In extreme cases, when the parents hear voices and lose touch with reality, the children can end up getting hurt.
These can be seen in some court cases that have been in the news, such as that of a mother with untreated schizophrenia, who killed her eight-year-old daughter after voices told her that her daughter was an evil spirit.
In another case, a woman cut her son’s arm with scissors and hit her daughter. The children were found to be suffering from trauma.
Therapists CNA spoke to said that such cases can happen when the parent’s mental health problems have deteriorated to an extreme state, and advised people to seek early treatment before this happens.