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Psychiatric counseling may be introduced at some stage to complement and follow up on the healing process as the patient’s psychiatric condition shows signs of improvement through medical treatment.
Such sequencing is key to the healing process. Any attempt to rush the process could lead to failure, given the emotional highs and lows experienced by the patient, especially in cases of bipolar disorder. Abrupt changes in thoughts can disrupt progress, making it crucial to use medication to stabilize emotions before moving forward with therapy.
There are cases where bipolar depression holds everyone hostage, especially when family members are unfamiliar with the condition and its diagnosis by a professional. If the patient has developed a gambling addiction, family relationships may become strained, worsening the situation further.
Part of the problem arises when family members communicate with the patient as if they were a ‘normal’ person. Before long, they find the path to be bumpy, as their hopes turn into misery, despair, and frustration. They struggle to understand why their loved one is not sticking to promises and resorts to telling lies to avoid facing the truth. Everyone ends up feeling hurt, disheartened, and unsure of what to do next.
The situation would be more productive if the family showed empathy and accepted that the patient is not emotionally prepared at this stage. Restoring their mind to a state of calmness is key to ensuring that everyone’s efforts bear fruit, as the patient would then be more receptive to guidance and support.
Identifying the patient’s current stage is crucial. Failure to do so can negate efforts, poison hope, and lead to shattered expectations, making it seem as though the patient is refusing to change. Until effective conditions for communication are established, both sides risk being caught in a frustrating stalemate. That is why we strongly advocate stabilizing the patient’s emotions with medication before moving on to counseling.
At this point, some may ask: why is psychiatric counseling so important? Firstly, we must understand that depression does not happen overnight but develops in stages. Along the way, various situational factors may contribute to psychological distress, creating deep-seated issues that worsen over time if left unaddressed. Psychiatric counselors play a critical role in identifying the root cause of depression and helping the patient untangle these complexities before they become overwhelming.
In one case, a patient’s psychological distress was traced back to childhood trauma caused by their own family. This truth only came to light after persistent efforts from the counseling team. This can be compared to the early development of cancer cells, which multiply and metastasize if left untreated. The earlier we intervene, the better the chances of recovery. It is crucial to clear harmful emotional residues before reaching a point of no return.
Counselors facilitate this process effectively. Complete healing will only occur once the missing piece of the puzzle is found and put in place.
Some patients are averse to using medication due to concerns about long-term side effects. However, recovery from depression can only be as thorough as the extent to which unresolved issues are addressed during counseling. Consider the case of an elderly woman who visited a mental hospital regularly for years, believing that depression was incurable. It later became evident that she had been unable to receive proper counseling because no doctor at the time could communicate with her in her native dialect. Due to this missing piece, she relied solely on medication rather than benefiting from a comprehensive therapeutic approach.
Electroconvulsive therapy (ECT) is also available as a treatment option. This involves passing an electric current through the brain and is typically used for severe cases with immediate results. It is a specialized procedure requiring collaboration between psychiatrists, anesthetists, and mental health nurses to be effective.
Aside from ECT, patients with milder symptoms—such as those lasting just a week or two—often do not require medication. Early-stage cases can sometimes be addressed by making environmental adjustments, such as increasing exposure to sunlight for seasonal depression.
I recall a patient who visited my clinic with mild depressive symptoms but could not understand his own condition. His symptoms gradually disappeared after he regularly attended family gatherings, where the warm and supportive atmosphere contributed to his recovery.
It is clear that depression patients benefit from professional psychiatric support and counseling. However, this does not diminish the importance of support from family and friends. In fact, they play parallel roles in the recovery process, providing companionship and emotional reinforcement. Working alongside professional counselors, loved ones can help patients spend meaningful time in ways that promote healing.
That said, the patient’s inner drive to recover is crucial. I have encountered cases where patients seem to enjoy being cared for more than they desire to heal. One case involved a graduate designer who, after falling into depression, was pampered by his family and had no interest in recovery—only in the comfort of staying home without responsibilities.
Ultimately, no amount of effort from family members can replace the patient’s inner willpower. Their determination and motivation are key factors in recovery.
Clinical observations indicate that patients in a consistently good mood tend to recover more quickly. Those who take the initiative to rebuild their self-worth and envision themselves in a state of well-being often experience faster healing.
Furthermore, caregivers must prioritize their own health while supporting loved ones. Moods are contagious, and caregivers may find themselves emotionally drained if they neglect self-care. Recognizing that maintaining one’s own well-being is essential to providing effective support helps prevent burnout and emotional fatigue.
Caregivers should take breaks, avoid overextending themselves, and arrange for temporary assistance when necessary. Just as flight attendants instruct passengers to secure their oxygen masks before helping others, caregivers must first ensure their own well-being before tending to others.
“Prevention is better than cure.” This saying is especially relevant during vulnerable periods, such as pregnancy and the postnatal stage. Mothers experiencing postnatal depression should seek help rather than attempting to manage everything alone. This ensures they can recover before fully taking on their maternal role. Fathers should also step up and share responsibilities during this period.
To lower risks and prevent postnatal depression, immediate action should be taken to arrange support for the mother. Infants and young children are highly sensitive to their surroundings, making it essential to maintain a healthy emotional environment.
We must also learn to be kind to ourselves. Setting unrealistic expectations or striving for perfection can lead to stress and increase the risk of depression. Accepting both successes and failures as part of life’s journey is essential for mental well-being.
Similarly, those who rely heavily on others should develop independent living skills. Making time for personal growth, friendships, and self-care helps prevent emotional dependency and ensures a stable support system.
Effective communication and a strong support network within families and social circles make it easier to navigate emotional challenges. In a truly supportive environment, family and friends can help each other adjust and stay resilient through difficult times.
Dr. Wei-Jen Huang, a clinical psychologist at Northwestern University Feinberg School of Medicine, has developed a course on managing emotional fluctuations. His work highlights the importance of equipping individuals with skills to handle their own emotions while supporting others.
While depression is treatable, there is no guarantee of complete immunity from relapse. However, sharing experiences and learning from others who have overcome depression can serve as a powerful source of encouragement. Former patients who document their journeys—whether through books or public talks—help others find hope and resilience.
In conclusion, I urge everyone to persevere with a proactive mindset. Our brains have an incredible ability to learn and adapt, much like a symphony orchestra coming together in harmony. By fostering a positive outlook and structured lifestyle, we can combat depression and move toward a brighter future.
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