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Commentary: Expanded police powers don’t have to mean ‘three steps forward, two steps back’ for mental health in Singapore

Posted on 19 Mar 2024

Written by
Dr Jared Ng, Connections MindHealth

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  • Likes, Shares, and Mental Health Woes — Is Social Media Driving Youth Mental Health Decline?

Likes, Shares, and Mental Health Woes — Is Social Media Driving Youth Mental Health Decline?

This article hopes to examine the relationship between social media usage and mental health while exploring the detrimental effects of excessive digital engagement on psychological well-being.

Posted on 13 Mar 2024

Written by
Dr Jared Ng, Connections MindHealth

In the digital age, the omnipresence of social media in the lives of young individuals has sparked a global debate on its impact on mental health. This discourse, however, is not without precedent; it mirrors historical anxieties surrounding new “technologies” and their potential effects on youthful minds. Reflecting on the 18th and 19th centuries, as books and novels became accessible en masse, similar fears emerged. Critics voiced concerns that these “novel” forms of entertainment might captivate too intensely, risking harm to the pliable minds of the young. In 1907, an editorial titled “Do Boys Read Too Much?” questioned the impact of mass-market fiction on the mental acuity and focus of young readers, foreshadowing today’s worries that perhaps, in an ironic twist, young people now read too little. This historical perspective underscores the cyclical nature of societal concerns regarding the impact of media on youth, setting the stage for the contemporary debate on social media’s role in shaping mental health.

Singapore’s Deputy Prime Minister Lawrence Wong, on February 7, announced an initiative [1] that brings this debate into the modern era, launching a comprehensive research project aimed at understanding the escalating mental health issues among youth, focusing on social media’s role. This initiative underscores the complex relationship between digital engagement and psychological well-being, marking a renewed interest in exploring how platforms designed to connect and inspire might also be sources of stress, anxiety, and feelings of inadequacy.

Recent research [2] points to a complex picture. It suggests that while social media has the power to connect and inspire, it also harbours the potential to induce stress, anxiety, and feelings of inadequacy. This article hopes to examine the relationship between social media usage and mental health while exploring the detrimental effects of excessive digital engagement on psychological well-being. 

social media and distress
Social media’s pervasive influence is increasingly linked to heightened distress among youth, which exacerbates mental health challenges. 
The Double-Edged Sword of Social Media

Social media, in its essence, is a paradox. On one hand, it’s a revolutionary tool that has transformed how we connect, communicate, and consume information. It has democratised content creation, gathered global communities around niche interests, and provided platforms for traditionally marginalised voices. The ability to instantly connect with anyone, anywhere, has made the world smaller and more accessible. For youths, social media can be a vibrant space for self-expression, learning, and exploration. It offers a sense of belonging, a place to find like-minded individuals, and opportunities for activism and social change.

However, the flip side of this connectivity is its capacity to impact the mental health of young users negatively. For a vivid illustration, consider the story of a patient I encountered during my time in the hospital, whom we’ll call John for confidentiality. John’s tale is a stark reminder of social media’s potent influence over self-esteem and mental well-being. After his social media account was suspended for “buying” followers, John experienced profound emotional distress, so severe that he contemplated suicide. During our clinical interview, he confessed that his self-worth had become inextricably linked to the number of “likes” and followers on his profile. This dependency on digital validation for self-esteem is not an isolated phenomenon but a reflection of the broader challenges posed by social media’s role in our lives.

This constant quest for validation [3] through likes, comments, and followers can transform social media into a perilous game where self-worth hangs precariously on online approval. John’s story exemplifies how this relentless pursuit of digital acknowledgement can exacerbate feelings of anxiety and depression, creating a cycle of dependence challenging to escape. Furthermore, the impact of social media extends beyond psychological effects, manifesting in real life through disrupted sleep patterns and sedentary behaviour, which can further erode mental and physical well-being.

social media effects
Social media is a double-edged sword, allowing for self-expression and connectivity but also cyberbullying and false ideation.

Reflecting on this, it’s essential to recognise the natural human desire for validation, a sentiment that transcends the digital realm. Just as we observe the counters on our social media profiles—likes, reposts, shares, followers—we find parallels in the academic and professional worlds. For instance, scientists, doctors, and researchers derive a form of validation from seeing their journal publications cited. This desire for acknowledgement and affirmation is a fundamental aspect of human nature. However, the key difference lies in the context and the extent to which this need for validation governs our self-esteem and overall mental health.

Caught in the “Comparison Trap?” How Social Media Affects Mental Health

Central to the discourse on social media’s impact on mental health is the pervasive role of comparison and expectation. This phenomenon, deeply embedded in the fabric of online interaction, fuels much of the anxiety and dissatisfaction experienced by young users. With endless feeds of curated content, social media platforms craft an environment where the lives, achievements, and appearances of others are constantly showcased. This setting primes what psychologists refer to as “social comparison theory” [4], the idea that individuals determine their own social and personal worth by comparing themselves to others.

The “comparison trap” [5] on social media is particularly insidious. It extends beyond comparing oneself to friends and family, reaching into the realms of celebrities, influencers, and strangers with massive followings. These comparisons are rarely fair or realistic, pitting the everyday realities of one’s life against the polished highlight reels of others.

Photos and stories are meticulously selected and edited to highlight the best moments, accomplishments, and aspects of people’s lives, side-lining the ordinary, mundane, and challenging experiences everyone faces. For young people, whose self-identity and self-esteem are in critical phases of development, this distorted reality can cultivate feelings of inadequacy, low self-worth, and the perception of falling short of peers’ standards online.

Moreover, social media doesn’t just facilitate comparison; it amplifies unrealistic expectations. Users, particularly youths, are inundated with portrayals of exceptional lifestyles, bodies, and successes, creating a vast divide between expectation and reality. The urge to meet these online personas’ standards can lead young individuals to chase unattainable ideals, fostering frustration, self-criticism, and mental distress.

fake social media
Social media often portrays carefully curated images showcasing edited images and unrealistic lifestyles.

The consequences of this relentless comparison and the clash between expectation and reality are profound. Studies [6] have linked excessive social media use to increased rates of anxiety, depression, and other mental health issues among adolescents and young adults. The mechanism is straightforward: when individuals, especially youths, gauge their worth by the standards of online portrayals, they are predisposed to disappointment and psychological strain. The gap between how they perceive their own lives and the lives of others online can expand, potentially leading to feelings of isolation, envy, and diminished self-esteem.

In my talks about youth mental health, I often discuss the effects of social media, drawing from personal observations and professional experience. As a member of “Gen X” (yes, that shows my age), my comparators in youth were classmates, neighbours, or friends from the local playground. Today, the range of comparators for young people has expanded globally, courtesy of social media. This boundless arena for comparison magnifies the pressure and challenges they face, emphasising the urgent need for awareness, education, and strategies to navigate the complex web of online social interaction healthily and positively.

In sharing the story of a patient, John (not his real name), who spiralled into extreme emotional distress after his social media account was suspended for buying followers, the real-world implications of these dynamics become starkly evident. John’s admission that his self-worth was entirely tied to “likes” and followers underscores the dangerous potential of social media to influence mental health negatively. This quest for approval, when rooted in the ephemeral and often superficial metrics of social media, can lead to profound psychological distress.

By drawing on these examples and integrating the broader context of social comparison from my youth to the present, we can better understand the complex landscape of social media and its impact on mental health. It’s a call to action for individuals, families, and professionals to engage in meaningful dialogues and interventions that can steer young people towards healthier, more balanced interactions with social media.

Cyberbullying and Online Harassment Another Threat to Mental Well-Being

As a result of the increased use of social media, cyberbullying and online harassment have become widespread problems, which significantly affect the mental health of many young people. While a boon for privacy and freedom of expression, the anonymity afforded by social media platforms also serves as a double-edged sword, which causes some users to engage in behaviour they might not otherwise exhibit in person. 

Unlike traditional bullying, cyberbullying offers no respite; victims can be reached at any time and place, which makes it an omnipresent source of stress and anxiety. Studies [7] have consistently shown a troubling correlation between cyberbullying and an increased risk of mental health problems, including depression, anxiety, and even suicidal ideation. The relentless nature of online harassment can erode self-esteem, amplify feelings of isolation, and trigger a cascade of psychological distress.

Moreover, the vastness of the internet and the sheer volume of interactions on major platforms pose significant challenges to monitoring and enforcing guidelines against bullying and harassment. While social media companies have made strides in developing algorithms and reporting tools to combat such behaviour, the reactive nature of these measures often means that the harm has already been done. The delay in response, combined with the difficulty in tracing anonymous accounts, further exacerbates the problem, which leaves victims feeling helpless and unsupported.

cyberbullying and mental health
Cyberbullying and online harassment amplify feelings of vulnerability and distress, which pose significant threats to the mental well-being of youth. 
The Impact of Screen Time on the Mental and Physical Well-Being of Youths 

Research [8] suggests that excessive screen time is increasingly concerning for its detrimental impact on the physical and mental health of youth. Staring at screens late into the night interferes with melatonin production, the hormone responsible for regulating sleep-wake cycles. This disruption to the body’s natural rhythm makes it harder for individuals to fall asleep and significantly diminishes the quality of rest they receive. The consequences of this lack of restorative sleep extend beyond mere fatigue, affecting cognitive functions and mood and leading to heightened levels of stress and anxiety. Moreover, the allure of screens often detracts from physical activity, fostering a sedentary lifestyle that can amplify health issues like obesity, which, in turn, impacts mental well-being.

Additionally, the surge in screen time has markedly curtailed opportunities for face-to-face social interactions, which are pivotal in developing and maintaining robust social skills. This decline in direct human contact may culminate in feelings of isolation and loneliness, adversely affecting social health and overall mental well-being. The skills garnered through in-person interactions—such as empathy, interpreting non-verbal cues, and expressing emotions effectively—are vital for personal development and sustaining healthy relationships. As screen time usurps these invaluable interactions, young individuals may find it increasingly challenging to forge and maintain meaningful connections, further affecting their mental health in an era where connectivity, paradoxically, should be at its zenith.

Furthermore, it is crucial to acknowledge that our time is finite; we only have 24 hours a day. Time spent in front of screens is time not spent sleeping, engaging with friends in person, or participating in physical exercise. In a world where digital engagement is omnipresent, recognising and managing how we allocate our time is more critical than ever. Every hour spent online is an hour less for activities that nurture our physical health, mental well-being, and real-world relationships. Time is a commodity we cannot manufacture or purchase; thus, it’s essential to prioritise how we spend it to ensure a balanced, healthy lifestyle in the digital age.

screen time mental health
Excessive screen time disrupts sleep patterns and exacerbates mental health issues among youth

Balancing the Scale: Strategies to Mitigate Social Media’s Impact on Youth Mental Health

A multifaceted strategy is essential to effectively mitigate social media’s adverse impacts on youth mental health. This approach encompasses enhancing digital literacy, offering parental guidance, enforcing platform responsibility, and advocating a balanced lifestyle between the online and offline worlds.

Central to this strategy is the education of youths in digital literacy. They need to learn how to assess and navigate the vast array of online content critically. Understanding the mechanics behind social media algorithms and recognising the curated nature of digital personas enables young individuals better to manage the psychological effects of their digital interactions. This knowledge empowers them to differentiate between realistic and manipulated portrayals of life online, fostering a healthier relationship with social media.

Parental guidance also plays a critical role in moderating the impact of social media on young minds. Parents should initiate open dialogues with their children about the benefits and challenges of online engagement. Together, they can establish healthy boundaries around screen time. Importantly, if parents choose to use devices and apps to monitor their children’s screen time, this should be done transparently. Monitoring activities should always be conducted with the child’s knowledge and consent to maintain trust and foster open communication within the family. Covert surveillance can erode the foundational trust between parent and child, leading to further issues.

Recognising that children are at various developmental stages is crucial in tailoring approaches effectively. What might be appropriate for younger children, such as direct supervision and structured screen time, may not suit teenagers navigating the path toward independence. For teenagers, it’s about negotiating boundaries that respect their autonomy while ensuring their safety online. This nuanced approach acknowledges their need for privacy and independence, fostering a sense of responsibility and self-regulation in their digital interactions.

Social media platforms themselves must shoulder responsibility for creating safer online spaces. Implementing stringent policies against cyberbullying, enhancing privacy settings, and making reporting tools more accessible are essential measures to protect young users from the potential harms of online engagement.

Encouraging a balanced life is equally important. Young people should be motivated to engage in offline activities and face-to-face interactions. This not only mitigates the risks associated with excessive screen time but also promotes a well-rounded social and emotional development. It’s about finding harmony between digital connections and real-world experiences, ensuring youths develop healthy social skills and maintain physical activity.

Mental health professionals are integral to addressing the nuanced challenges posed by social media on youth mental health. By integrating discussions of social media use into therapy, creating digital wellness resources, and advocating for mental health-focused policy reforms, they play a key role in fostering a safer digital environment. Importantly, they recognise that excessive engagement with digital platforms may sometimes stem from underlying conditions such as addiction or social anxiety. This insight enables them to provide targeted therapeutic interventions, addressing the symptoms and root causes of unhealthy digital habits.

Furthermore, these professionals offer crucial support to parents and youths, guiding them through the complexities of digital behaviour and its impacts. By treating underlying mental health issues and educating families about healthy digital practices, mental health experts significantly improve overall digital wellness and promote healthier relationships with technology. Their efforts ensure a comprehensive approach to mental health in the digital age, highlighting the importance of addressing both immediate and underlying issues related to social media use.

Ultimately, developing resilience in young people to navigate the digital world confidently requires collaborative efforts among educators, parents, platforms, and mental health experts. By promoting digital literacy, engaging in open and honest conversations, respecting the developmental needs of young people, and encouraging a balanced lifestyle, we can create a supportive environment that enables youths to thrive online and offline.

References 
  1. Anto, A., Asif, R. O., Basu, A., Kanapathipillai, D., Salam, H., Selim, R., Zaman, J., & Eisingerich, A. B. (2023). Exploring the impact of social media on anxiety among university students in the United Kingdom: Qualitative study. JMIR Formative Research, 7, e43037. https://doi.org/10.2196/43037 
  2. Correspondent, G. Y. H. (2024, February 7). Research to look at surge in youth mental health issues; causes could include social media use. The Straits Times. https://www.straitstimes.com/singapore/politics/research-to-look-at-surge-in-youth-mental-health-issues-causes-could-include-social-media-use 
  3. Using social media for reassurance and validation | psychology today. (n.d.). Retrieved February 29, 2024, from https://www.psychologytoday.com/intl/blog/liberate-yourself/202111/using-social-media-reassurance-and-validation 
  4. How social comparison theory influences our views on ourselves. (n.d.). Verywell Mind. Retrieved February 29, 2024, from https://www.verywellmind.com/what-is-the-social-comparison-process-2795872 
  5. The comparison trap | psychology today. (n.d.). Retrieved February 29, 2024, from https://www.psychologytoday.com/us/articles/201711/the-comparison-trap 
  6. Hilty, D. M., Stubbe, D., McKean, A. J., Hoffman, P. E., Zalpuri, I., Myint, M. T., Joshi, S. V., Pakyurek, M., & Li, S.-T. T. (2023). A scoping review of social media in child, adolescents and young adults: Research findings in depression, anxiety and other clinical challenges. BJPsych Open, 9(5), e152. https://doi.org/10.1192/bjo.2023.523 
  7. Li, C., Wang, P., Martin-Moratinos, M., Bella-Fernández, M., & Blasco-Fontecilla, H. (2022). Traditional bullying and cyberbullying in the digital age and its associated mental health problems in children and adolescents: A meta-analysis. European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-022-02128-x 
  8. Nakshine, V. S., Thute, P., Khatib, M. N., & Sarkar, B. (n.d.). Increased screen time as a cause of declining physical, psychological health, and sleep patterns: A literary review. Cureus, 14(10), e30051. https://doi.org/10.7759/cureus.30051   

Caregiver Fatigue: What You Need to Know

According to a recent survey, in Singapore, caregivers invest approximately seven hours daily in tending to their loved ones, and more than 40% of them are susceptible to depression due to various challenges, including inflation and the impact of COVID-19.

Posted on 8 Mar 2024

Written by
Dr Jared Ng, Connections MindHealth

In the heart of caregiving lies a paradox of strength and vulnerability, a journey marked by unwavering devotion and unforeseen trials. One of them on this journey is Mrs Tan (not her real name), a 56-year-old woman emblematic of the silent army of caregivers who navigate the turbulent waters of caring for loved ones with debilitating conditions. Tasked with the care of her 85-year-old father, who is battling dementia, Mrs Tan’s story unfolds as a testament to the emotional and physical challenges that punctuate the caregiving experience. From the awkwardness of personal care tasks to the confrontation with aggression when her father, lost in the fog of dementia, reacted violently to her attempts to bathe him, her narrative is a vivid illustration of the daily realities faced by many in similar situations.

Mrs Tan’s reluctance to seek help, rooted in her role as the eldest child and a deeply ingrained sense of filial piety, underscores a critical issue in the caregiving community: the pervasive sense of isolation and the formidable weight of responsibility that many caregivers carry, often alone. Her story, while unique in its details, reflects a universal theme among caregivers — the struggle to balance the demands of caregiving with one’s own needs and the internal battle between seeking help and maintaining a facade of self-sufficiency.

Caregivers often find themselves submerged in responsibilities, grappling with feelings of being overwhelmed. The emotional toll can be disheartening, and if left unaddressed, it may take a significant toll on their health, relationships, and state of mind. This accumulating strain can lead to a critical juncture known as burnout [1] — a state marked by emotional, mental, and physical exhaustion that not only affects you but also impacts the person under your care.

caregiving singapore
Caregiving is a full-time commitment requiring continual dedication to the well-being of a loved one.

According to a recent survey, in Singapore, caregivers invest approximately seven hours daily in tending to their loved ones, and more than 40% of them are susceptible to depression due to various challenges, including inflation and the impact of COVID-19 [2]. 

Recognising the severity of this issue is crucial. Caregiver burnout is not a mere inconvenience; it’s a pervasive condition that alters your attitude, transforming positivity and compassion into negativity and apathy. In the midst of this struggle, it is essential to grasp a fundamental truth: self-care is not a luxury but a necessity. Taking care of your emotional and physical well-being is as vital as ensuring your loved one attends medical appointments or takes prescribed medications. 

This journey is a marathon, not a sprint, and understanding the signs and consequences of caregiver burnout is the first step toward breaking the cycle of chronic exhaustion, stress, anxiety, and depression. This article aims to explore the multifaceted aspects of caregiving, from understanding the triggers of burnout to implementing strategies to alleviate the burden on caregivers. By bringing to light stories like Mrs Tan’s, we hope to foster a greater appreciation for the challenges caregivers face and the critical role of support systems in sustaining them through their journey.

Breaking Point: Understanding the Triggers of Caregiver Burnout

Providing care for a loved one is an expression of deep affection and commitment. Still, it comes with challenges that can gradually erode a caregiver’s well-being, leading to what is commonly known as caregiver burnout. This state of physical, emotional, and mental exhaustion doesn’t happen overnight; it is an accumulation of stressors and demands. Let’s dig deep into the causes that contribute to caregiver burnout:

Extended Duration of Care: The Wear and Tear on Resilient Caregivers

Caring for a loved one is more than a short-term commitment; it’s a journey that can extend over years or even decades. While the dedication of caregivers is commendable, the continuous and prolonged nature of caregiving can gradually erode the resilience of even the most steadfast caregivers.

As time passes, the caregiving demands persist; as a result, caregivers face a series of challenges that can accumulate and take a toll on their physical and emotional well-being. The wear and tear associated with the extended duration of care can often lead to heightened stress levels [3], emotional fatigue, and a sense of being constantly on alert. The strain arising from the responsibility’s ongoing nature emphasises the need for support systems and self-care practices to sustain caregivers on this extended journey.

caregiver burnout singapore
Enduring the extended duration of care takes a toll on even the most resilient caregivers. 
Uncertain Prognosis: Emotional Turbulence in Caregiving

When facing an uncertain prognosis, caregivers find themselves amid emotional turbulence. When there is little hope for the improvement of the care recipient’s health or when their condition continues to deteriorate despite the caregiver’s relentless efforts, it can take an emotional toll and lead to demotivation.

The emotional turbulence that accompanies caregiving is profoundly illustrated by the journey of Mr and Mrs Ravi (not their real names), parents to a pair of adult twins with Autism Spectrum Disorder (ASD). Their daily reality is a testament to the emotional strain that uncertainty can bring. The twins, in their late 20s, are non-verbal and prone to aggression, presenting a continuous challenge with no clear prognosis for improvement. Despite Mr. and Mrs. Ravi’s dedicated efforts and unwavering hope, the absence of significant progress in their sons’ condition exemplifies the deep emotional toll such uncertainty can exact on caregivers. Their story underscores the pervasive emotional burden that comes with caring for loved ones when the path forward is clouded with unpredictability.

Overwhelmed by Responsibilities: Managing the Juggling Act of Caregiving

Caregivers often find themselves grappling with an extensive list of responsibilities. From administering medications to facilitating daily activities, the demands can become a relentless juggling act. This constant sense of being “in over one’s head” is a key contributor to heightened stress levels among caregivers.

The Ravis’ situation also highlights the overwhelming nature of caregiving responsibilities. Managing the complex needs of their twins, from ensuring their safety during aggressive episodes to addressing their daily care requirements, embodies the relentless juggling act many caregivers face. This constant state of being “in over one’s head” not only elevates stress levels but also fosters a profound sense of inadequacy and frustration. For Mr. and Mrs. Ravi, the physical tasks of caregiving are interwoven with the emotional challenges of seeing their children struggle, illustrating the multifaceted burden caregivers bear.

overwhelmed caregiver
Navigating the juggling act of managing multiple responsibilities often leaves caregivers feeling overwhelmed and overburdened.
Isolation in Caregiving: The Detrimental Impact of a Lack of Support

The emotionally exhausting and demanding journey of being a caregiver can become even more challenging for those working without a support system [4]. Caregivers who find themselves without a network of assistance or fail to receive the necessary help are at a heightened risk of burnout. 

Perhaps most striking in the Ravis’ narrative is the isolation felt in the absence of a robust support system. The challenges of caring for their adult twins with ASD are compounded by the lack of external assistance, leaving them to navigate the complexities of their sons’ care alone. This isolation not only magnifies the stress and exhaustion inherent in their caregiving role but also highlights the critical need for support that transcends mere physical help. The absence of a community to lean on, coupled with the daunting task of coordinating care and managing aggressive behaviors without respite, paints a vivid picture of the detrimental impact that isolation can have on caregivers.

The stories of Mrs. Tan and Mr. and Mrs. Ravi serve as poignant reminders of the diverse yet universally challenging experiences of caregivers. Through their narratives, we see the essence of caregiving – a role marked by love, resilience, and an often overwhelming sense of responsibility. Recognising the need for support, understanding, and resources for caregivers becomes not just a compassionate imperative but a necessary step in addressing the challenges they face daily.

Dealing with the Financial Tightrope of Caregiving: The Toll of Financial Strain

The responsibility of providing care can place a substantial burden on a caregiver’s financial resources [5]. Balancing the costs associated with medical care, medications, and other necessities can give rise to a sense of financial strain, amplifying stress and anxiety within the caregiving experience.

The financial challenges caregivers face are multi-faceted. From out-of-pocket expenses for medical appointments and prescription medications to the potential loss of income due to reduced work hours or leaving the workforce altogether, the financial toll can be considerable. The financial strain may even permeate other aspects of life, impacting the caregiver’s ability to meet their needs and potentially compromising their financial stability.

Mdm Rosmah’s (not her real name) narrative poignantly highlights the financial burdens that can beset caregivers, especially when unforeseen circumstances exacerbate an already precarious situation. After her husband was posted overseas for work, Mdm Rosmah made the significant decision to quit her job, dedicating herself to caring for her daughter with severe bipolar disorder. This sacrifice not only impacted her career but also placed her in a vulnerable financial position. The situation took a turn for the worse during one of her daughter’s relapses, which led to thousands of dollars being spent on clothes and cosmetics using Mdm Rosmah’s credit card. This incident not only exemplifies the direct costs associated with caregiving but also the potential for unexpected financial challenges that can deepen the strain on a caregiver’s resources.

This part of Mdm Rosmah’s journey underscores the multifaceted nature of financial challenges in caregiving, blending the tangible aspects of financial management with the unpredictable elements of caring for someone with a mental health condition. It highlights the critical importance of financial planning, the need for accessible resources, grants, or support programs, and the necessity of contingency plans to manage such crises.

financial burden caregiving
Financial strain can be the breaking point for some caregivers.
The Weight of Caregiver Guilt and Obligation: Balancing Self-Care Amidst Internal Conflict

The emotional and familial turmoil Mdm Rosmah faces further illuminates the internal conflicts many caregivers experience. When confronted with her daughter’s actions, not only did she face the financial repercussions, but she also encountered a profound moral and emotional dilemma. Her refusal to report her daughter to the police, despite her eldest son’s insistence, reflects the deep-seated sense of obligation and protection caregivers feel towards their care recipients, even in the face of personal harm and financial loss. This decision led to her eldest son moving out, adding to the sense of her family disintegrating, and exacerbating feelings of isolation, guilt, and the weight of her caregiving responsibilities.

Many individuals providing care grapple with feelings of guilt when contemplating taking time for themselves rather than solely dedicating every moment to meeting the needs of their loved ones. The sense of obligation to provide constant care can lead to internalised guilt when considering personal needs or moments of respite. This internal conflict can manifest as a perpetual emotional tug-of-war, contributing to heightened stress and emotional fatigue.

Acknowledging and addressing feelings of guilt and obligation is a pivotal aspect of supporting caregivers. By fostering a more balanced perspective on caregiving responsibilities, caregivers can deal with the challenges with greater emotional resilience, which can help them ensure a healthier and sustainable caregiving experience for both themselves and their loved ones.

Understanding these underlying causes of caregiver burnout is essential in developing strategies to prevent or mitigate caregiver burnout. By recognising these stressors, caregivers can take proactive steps to safeguard their well-being while providing the best care for their loved ones.

The Warning Signs: Recognising Caregiver Burnout Early On

Caregiver burnout is a state of physical, emotional, and mental exhaustion that can result from the prolonged and overwhelming stress of caregiving. Recognising the signs of caregiver burnout is crucial for taking proactive steps to address and prevent its impact. Here are common signs of caregiver burnout:

Physical symptoms:
  • Persistent fatigue and lack of energy
  • Frequent headaches or physical ailments
  • Changes in sleeping patterns, either insomnia or excessive sleep
Emotional signs:
  • Overwhelming feelings of sadness or helplessness
  • Increased irritability or frustration
  • Persistent feelings of anxiety  or worry
  • Loss of interest in activities once enjoyed
Cognitive impact:
  • Difficulty concentrating or making decisions
  • Forgetfulness or absentmindedness
  • Cognitive fatigue and mental fog
Behavioural changes:
  • Withdrawal from social activities and isolation
  • Increased use of alcohol or other substances
  • Neglecting personal responsibilities and self-care
Physical health deterioration:
  • Weakened immune system and increased susceptibility to illness
  • Unexplained weight loss or gain
  • Chronic health issues [6] exacerbated by stress
Shift in attitude:
  • Increased cynicism or negativity
  • Decreased empathy and patience
  • A sense of hopelessness or helplessness
Strained relationships:
  • Tension and conflicts with family members, friends, or the person being cared for
  • Social withdrawal and difficulty maintaining relationships
Neglecting self-care:
  • Ignoring personal needs and well-being
  • Difficulty taking breaks or seeking support
  • Feeling guilty when considering personal time or self-care
Impact on work or other responsibilities:
  • Decline in job performance or inability to focus at work
  • Difficulty managing other responsibilities outside of caregiving
Increased health concerns:
  • Elevated blood pressure or other stress-related health issues
  • Compromised immune system leading to frequent illnesses

Recognising these signs early on is essential for preventing burnout and maintaining the caregiver’s well-being. Seeking support, prioritising self-care, and implementing strategies to alleviate stress are crucial steps to address caregiver burnout effectively.

Preventing Caregiver Burnout: Essential Strategies for Well-being

Preventing caregiver burnout is crucial for maintaining the overall well-being of those undertaking the demanding role of caregiving. The responsibilities associated with providing care can be emotionally, physically, and mentally taxing, making it essential for caregivers to adopt proactive strategies to safeguard their own health while ensuring the best possible care for their loved ones.

self-care
Taking care of yourself is not a luxury; it’s a necessity.
1. Prioritise Self-Care

Taking care of oneself is crucial for preventing caregiver burnout. Schedule regular self-care activities such as exercise, meditation, or hobbies. Ensure you are getting enough sleep and maintaining a healthy diet. By prioritising your own well-being, you’ll be better equipped to handle the challenges of caregiving.

2. Set realistic expectations

It’s important to be realistic about what you can accomplish as a caregiver. Understand your limitations and accept that you may not be able to do everything. Set achievable goals and focus on what truly matters. Setting realistic expectations helps reduce feelings of frustration and inadequacy, contributing to long-term well-being.

3. Seek and Accept Support

Building a strong support network is essential for preventing burnout. Connect with friends, family, or caregiver support groups to share your experiences. Don’t hesitate to ask for help when needed, whether with caregiving tasks or emotional support. Feeling understood and supported can significantly alleviate the burden of caregiving.

4. Establish Boundaries:

Establishing clear boundaries is crucial for maintaining balance in your life. Learn to say no when necessary and communicate your limits to others. This may involve delegating tasks to other family members or hiring professional help. By setting boundaries, you protect your own well-being and ensure that caregiving responsibilities do not become overwhelming.

5. Take Regular Breaks

It’s essential to schedule regular breaks to avoid burnout. Allow yourself time away from caregiving responsibilities to relax and recharge. Whether it’s a short walk, a hobby, or a weekend getaway, taking breaks is vital for maintaining mental and emotional health. Breaks provide perspective and help prevent the constant stress that can lead to burnout.

mental fatigue singapore
Taking a break can help prevent caregiver burnout and ease caregiver mental fatigue.
6. Utilise Respite Care Services

Explore respite care options [7] to give yourself extended breaks from caregiving. Respite care provides temporary relief, allowing you to rest and attend to personal needs. Whether through professional services, friends, or family members, incorporating respite care into your routine is a proactive strategy to prevent burnout.

7. Seek Professional Assistance

In addition to relying on personal networks, seeking professional assistance is a crucial strategy for preventing caregiver burnout. Healthcare professionals, such as psychiatrists, can provide valuable guidance on managing stress, addressing emotional challenges, and maintaining overall well-being. Counsellors specialising in caregiver support can offer coping strategies, stress management techniques, and a safe space to express feelings.

8. Practice Stress-Relief Techniques

Integrating stress-relief techniques into your daily routine is fundamental for preventing caregiver burnout. Embracing practices like deep breathing, meditation, or yoga can significantly alleviate the physical and emotional strain associated with caregiving. These techniques are not only accessible but can be easily incorporated into even the busiest schedules. Regularly practising stress-relief techniques helps manage immediate feelings of tension and builds resilience over time, enabling caregivers to fulfil their responsibilities with greater ease and endurance.

stress-relief techniques
Stress-relief techniques, such as deep breathing or yoga, can help caregivers overcome exhaustion and burnout. 
9. Utilise Technology

In the modern era, leveraging technology [8] can be a powerful strategy to mitigate the challenges of caregiving. Explore various technological solutions [9] designed to streamline caregiving tasks and reduce the likelihood of burnout. Utilise medication reminder apps to ensure timely administration and tracking of medications. 

Online support forums and communities can provide a virtual space for caregivers to connect, share experiences, and gain valuable insights. Additionally, consider incorporating telehealth options for medical consultations. This facilitates convenient access to healthcare professionals and minimises the logistical challenges associated with in-person appointments. 

Moreover, some medical conditions necessitate specialised care, and technology addresses these distinct needs. For instance, applications such as Alzheimer’s Society’s Talking Point cater to caregivers of individuals with Alzheimer’s or dementia by offering a dedicated online community. These condition-specific apps provide tailored resources, advice, and a supportive environment designed to address the unique challenges caregivers face in these situations.

Conclusion: Nurturing Caregivers for Sustainable Care

Selflessness often takes center stage in caregiving, with the well-being of loved ones prioritised above all else. Yet, as the journeys of Mrs. Tan, Mr. and Mrs. Ravi, and Mdm Rosmah poignantly illustrate, the sustainability of care is deeply intertwined with the health and well-being of the caregivers themselves. Each story, unique in its challenges and triumphs, underscores a universal truth: preventing caregiver burnout is not just an act of self-preservation but a crucial component of providing continuous, quality care.

Mrs. Tan’s struggle with the emotional and physical demands of caring for her father with dementia, Mr. and Mrs. Ravi’s relentless dedication in the face of their twins’ unpredictable behaviors, and Mdm Rosmah’s financial and emotional turmoil while supporting her daughter—all highlight the multifaceted challenges caregivers face daily. Yet, within these narratives, there is a thread of hope and resilience that shines brightly. These caregivers, in recognising their limits and seeking support, embody the very essence of strength.

By embracing self-care, establishing boundaries, and leveraging technological aids, caregivers can navigate their journey with greater assurance and less strain. Mrs. Tan’s, Mr. and Mrs. Ravi’s, and Mdm Rosmah’s stories serve as powerful reminders that acknowledging the need for help is not a weakness but a step toward a more balanced, healthy caregiving experience. Through open communication and attending to their emotional needs, caregivers can find solace and strength in a community that understands and supports them.

The path of caregiving, filled with challenges and rewards, calls for a collective effort to ensure it is one marked by support, understanding, and hope. By uniting in this cause, we pave the way for a future where caregiving is not a solitary struggle but a shared journey, illuminated by the compassion and resilience of those who walk it.

References 

1. Tan, Gregory Tee Hng, et al. “Factors Associated with Caregiving Self-Efficacy among Primary Informal Caregivers of Persons with Dementia in Singapore.” BMC Geriatrics, vol. 21, no. 1, Jan. 2021, p. 13. BioMed Central, https://doi.org/10.1186/s12877-020-01951-8

2. YingCorrespondent, Lee Li. “Over 40% of Caregivers at Risk of Depression amid Challenging Environment: Survey.” The Straits Times, 6 Apr. 2023. The Straits Times, https://www.straitstimes.com/singapore/over-40-of-caregivers-at-risk-of-depression-amid-challenging-environment-survey

3. Schulz, Richard, and Paula R. Sherwood. “Physical and Mental Health Effects of Family Caregiving.” The American Journal of Nursing, vol. 108, no. 9 Suppl, Sept. 2008, pp. 23–27. PubMed Central, https://doi.org/10.1097/01.NAJ.0000336406.45248.4c

4. Bruening, Rebecca, et al. “Connecting Caregivers to Support: Lessons Learned From the VA Caregiver Support Program.” Journal of Applied Gerontology, vol. 39, no. 4, Apr. 2020, pp. 368–76. DOI.org (Crossref), https://doi.org/10.1177/0733464818825050

5. Lai, Daniel W. L. “Effect of Financial Costs on Caregiving Burden of Family Caregivers of Older Adults.” SAGE Open, vol. 2, no. 4, Oct. 2012, p. 215824401247046. DOI.org (Crossref), https://doi.org/10.1177/2158244012470467

6. JD, Ron Ingber. “Caregiver Stress Syndrome.” Caregiver.Com, 2 Feb. 2023, https://caregiver.com/api/content/361e1fc0-fcc1-11e8-8be9-120e7ad5cf50/

7. Bernstein, Susan, and Shawna Seed. “Respite Care.” WebMD, https://www.webmd.com/cancer/what-is-respite-care.  Accessed 5 Feb. 2024. 

8. Lindeman, David A., et al. “Technology and Caregiving: Emerging Interventions and Directions for Research.” The Gerontologist, vol. 60, no. Suppl 1, Feb. 2020, pp. S41–49. PubMed Central, https://doi.org/10.1093/geront/gnz178

9. 6 Indispensable Tech Tools for Family Caregivers | VirginiaNavigator. https://seniornavigator.org/article/75065/6-indispensable-tech-tools-family-caregivers.   Accessed 5 Feb. 2024.