In this story, Lucas (not his real name) tells us about his experience with psychosis and how early treatment together with support from his caregivers aided his recovery. Consistent research has shown that early intervention reduces the duration of untreated psychosis and produces better outcomes in the long run.
At 26 years old, upon starting his internship, the overwhelming stress and heavy workload caused Lucas to have vivid dreams that disturbed his sleep. He heard voices – some of which were angry and condescending, and some that mimicked his relatives’ nagging voices.
According to the Institute of Mental Health (IMH), psychosis is a psychiatric syndrome that most commonly occurs in young adults. A person who has a psychotic illness may have delusions, hallucinations, disordered thinking or abnormal behaviour.
When Lucas started hearing voices, he couldn’t tell whether they were real or fake. “I felt scared and confused; did they expect me to respond?” he says. He tried to cope with the hallucinations by repeatedly telling himself that the voices weren’t real, but the tipping point came when one day, the constant chatter of voices in Lucas’ head caused him to lose his way to work. “I alighted each time the train stopped, and boarded the train heading in the opposite direction. This continued for a while until I asked for help and my Dad came to pick me up,” he explained. “At that point, I wasn’t thinking straight anymore.”
The next day, Lucas started sobbing uncontrollably. His mom, fearing that he has a physical ailment, brought him to the nearby polyclinic. Upon hearing what happened, the doctor sent Lucas to Ng Teng Fong General Hospital in an ambulance, where he was warded for 10 days.
At the hospital, Lucas was diagnosed with Psychotic Disorder and placed under the care of a psychiatrist who prescribed him daily medication. “I was relieved when the psychiatrist told me that my mental health issue could be managed, and that recovery was possible,” he says. “Finally, there was an explanation to the weird experiences I faced.” However, after being discharged, Lucas started to worry about his future. Having to give up his internship to focus on his mental health recovery, Lucas was thrown into a state of uncertainty. “I kept asking myself, 'what am I going to do?'”.
Journey of recovery
His parents’ efforts at keeping him engaged while recuperating helped Lucas shift his focus. The medication made him sleepy and unable to concentrate, but instead of letting him stay in bed all day and having his sleep cycle disrupted, his parents filled his days with small things to keep him occupied, such as simple chores.
“They also made sure that we spent family time together,” he recalls. In an attempt to help him find meaning and purpose in place of idling at home, Lucas and his mom also volunteered together at the Salvation Army for a few months. This helped Lucas slowly reintegrate into the community.
Progressing well into his recovery, Lucas then sought advice from a job coach and was able to secure a permanent job. He now works at a social service organisation as an Operations Admin and Support Executive, doing reporting, data analysis and other operations-related tasks.
Treatment adherence and social support is key
According to the latest survey by IMH, 1 in 43 people in Singapore had a diagnosis of psychotic disorder in their lifetime. While the treatment gap of psychotic disorders was relatively small, with about 80% of the individuals affected having sought help for their symptoms, the severe nature of these disorders emphasises the need for continued outreach and early diagnosis and treatment.
Today, Lucas is still on anti-psychotic medication, but his adherence to treatment and the support he receives from his caregivers has freed him from relapse for 2 years and counting. “The medication helps me sleep better at night and improves my mental state throughout the day,” he says. When it comes to psychiatric medication, many are still apprehensive, but Lucas thinks that it is time to normalise it. “It’s not any different from having to take hypertension medication to keep your blood pressure at normal levels; you take it so you can continue to live life as usual.”
Following his management team’s encouragement, Lucas joined and recently completed the Peer Support Specialist Programme. The PSS programme equips persons with mental health conditions with peer support skills to leverage their lived experience to support others on their recovery journeys. The programme connected Lucas with like-minded peers and helped him in his recovery.
Lucas is thankful to have the support of his family and friends, and hopes to help others in their recovery journey as a Peer Support Specialist.
 https://pubmed.ncbi.nlm.nih.gov/17278908/  https://www.imh.com.sg/clinical/page.aspx?id=258  https://www.imh.com.sg/uploadedFiles/Newsroom/News_Releases/21%20May%202021_%20Prevalence%20of%20Schizophrenia%20and%20Other%20Psychotic%20Disorders%20in%20Singapore.pdf