Living on edge from grief, depression

NST: They are among modern-day heroes, picking up the emotional pieces after personal tragedies — without professional help. Many pull through with innate courage, determination and strength. But things are set to change next year when "para-counsellors" make their appearance.
KUALA LUMPUR: They may appear fine on the outside but grief and depression are tearing them apart inside.
If nothing is done to help them, they may descend deeper into a psychotic state that may eventually lead to suicidal feelings.
Those most susceptible to this are people who have lost their loved ones, especially in tragic circumstances.
According to Prof Dr T. Maniam of Universiti Kebangsaan Malaysia’s psychiatry department, they are likely to experience a myriad of emotions and psychological trauma.
He said they needed to be counselled by trained professional counsellors, psychologists or psychiatrists.
More often than not, however, they are given no such help.
In a society where a stigma is still attached to the act of seeking psychiatric help, many go through life after suddenly losing a loved one without professional help.
Some seek solace in family members while others distance themselves from those around them.
In most cases, Dr Maniam said, people who lost a loved one to disease or old age only needed the support of family and friends.
However, in some cases, especially where the death occurs in tragic and especially horrendous circumstances, there was every possibility that the experience may be psychologically traumatising.
There was also the possibility of the person feeling guilty for having survived if indeed they were involved in the incident.
"All this can give rise to what is called acute stress disorder. They may have anxiety attacks or feel fear.
"They may try to avoid any situation which bears any sort of resemblance to the traumatic experience.
"They may have flashbacks and intrusive memories.
"In most cases, they get over this in a few weeks.
"But if it continues for more than a month, then psychiatrists will diagnose this as post-traumatic stress disorder (PTSD) which needs professional assistance," he said.
Dr Maniam said grief sometimes led to depression.
"Those suffering from PTSD or depression should seek some sort of counselling."
He said family members and friends need to recognise certain tell-tale signs of people under psychological stress.
There may be bouts of depression, the person may not be able to function properly or may have psychotic symptoms such as hearing voices or suicidal tendencies.
"If these should happen, then it is not just normal grieving any more. It has become an illness," he said.