“How are you today?”

“Which movies did you watch yesterday?”

“What’s your favourite food?”

Questions like these were usually met with a smile or a silent nod. Dan (not his real name) was an older gentleman who seldom spoke to anyone at the psychiatric hospital. Spending an hour with Dan leaves one lost and helpless due to his paranoia and delusions. I was directed to a thick white binder filled with Dan’s past medical charts and records.

Dan was diagnosed with Schizophrenia in his early 20s. After weeks of psychotherapy, Dan trusted me enough to share his chronic struggles with auditory and visual hallucinations. I also learned about his persecutory (e.g., “the authorities are after me!”) and somatic delusions (e.g., chronic foot pain). Dan’s long forensic history made it difficult for him to find any meaningful employment. Even when he had stable employment, they were cut short due to Dan’s paranoia about his supervisor poisoning the drinking water. Dan’s experience with Schizophrenia was unique to his life history, with delusions and hallucinations closely resembling the early traumatic experiences in his life.

Dan attended the outpatient program for psychiatric support, psychotherapy and the supported employment program (SEP). Therapists who supervised Dan described him as a hard-working, focused, and thoughtful individual who worked well with his co-workers. Dan remained active in this program to this day.

One’s courage to bounce back, a strong support system, and working with a treatment team you trust can better your prognosis. Quoting Dan’s wise words, “experiencing Schizophrenia is one of the scariest things for me, so no one should go through it alone.” I agree with Dan, what about you?

Alex (not his real name) was an expatriate in Singapore. Although he lived a wealthy life with a happy family, he wasn’t happy because he was deeply troubled by his seemingly endless racing thoughts. “My mind is always racing from one topic to another, I feel like I am out of control!” Alex shared during our first session.

Despite the absence of complaints at work, Alex constantly worried about losing his job. “I will make a mistake at work, I will lose my job and won’t be able to pay for my house, I will get into trouble for a joke I made at work, my boss will find out that I go to therapy” and etc. Alex had to struggle tenaciously with his anxiety thoughts and his concentration at work deteriorated. He felt so mentally drained, helpless, and irritable every day.

His anxiety thoughts did not leave him alone even when Alex was on holiday. While he was spending time with his kids, he was distracted by the thought that they will have problem fitting in and will get bullied in school. Alex knew that his anxiety was robbing his life when he found himself losing quality time with his family and having difficulty sleeping. When he was resting on the sofa, Alex felt an urge to do something productive instead. He could never fully relax. With his wife’s encouragement, Alex decided to seek professional help.

Alex was diagnosed with Generalized Anxiety Disorder (GAD), a condition characterized by persistent, excessive, and unrealistic worry for longer than 6 months. The worries were experienced as hard to control, which affects one’s day-to-day activities. GAD is a very common anxiety disorder with high prevalence locally and internationally. Yet, it is usually overlooked when one’s struggled is dismissed or minimized as “overthinking”. Certainly, all of us experience anxiety at some point in our lives but if you noticed that your worry has become out of proportion, it does no harm to seek professional opinion. GAD is treatable with therapy and/or medication.

In the course of five months, Alex attended therapy regularly. Alex understood that he has a strong family history of anxiety and his childhood traumas made him excessively cautious and hypervigilant in order to avoid trouble. His anxiety was learned to keep him safe from possible threats. Through therapy, Alex processed his past emotional distress and learned coping strategies to manage his anxiety. At the end of therapy, Alex no longer reacts by worrying excessively. He is able to recognize his unrealistic worry and react appropriately. Alex is  now back to his native country and living a life he enjoys living.