Reprinted from "Wellness" issue of Visions Journal, 2013, 7 (4), pp. 19-20
Over the course of my experiences, I’ve had opportunities, both personally and professionally, to interact with many people who are affected by mental health-related issues. I have, however, been particularly affected by two journeys: those of my sister Gabriella* and my close friend Chris.*
All in the family: Depression from a sibling’s perspective
Gabriella has been struggling with depression and obsessive-compulsive disorder for over a decade now. My sister is eight years older than I am, so I first noticed her symptoms when I was quite young, about 12. She cared for me like I was her own child, when I was little. As I matured, our relationship developed and my sister and I became best friends.
There were a lot of red flags visible to me, regarding Gabriella’s mental health issues. These included her obsession with food and exercise. For example, she became extremely rigid, only eating and exercising at specific times of the day. If anything conflicted with her eating or exercise times, she’d become irrationally angry, yelling and screaming, and then extremely emotional, crying, almost panicking.
My parents, who are first-generation immigrants from India, were unaware of mental health–related issues. As a result, my parents didn’t properly acknowledge Gabriella’s struggles for years. My sister performed exceptionally well in school, so my parents thought she was just going through a “phase.”
During one of our yearly medical checkups—my immediate family scheduled consecutive appointments—our family doctor noticed Gabriella’s drastic weight fluctuation. He opened up a dialogue on mental health issues with my sister and me; we had gone into the doctor’s room together.
Initially, Gabriella was diagnosed with disordered eating by our family doctor. Despite treatment at various eating disorder clinics, my sister’s symptoms worsened because her underlying issues were not yet identified.
My sister was then accepted by a university in Toronto to pursue her PhD. While I supported her academic growth, I expressed concern to her about living in a different province, while she was still struggling. Despite this, she decided to move.
Gabriella lost all balance in her life while she was away, though I couldn’t see this fully until she moved back home two years later, even though we talked on the phone almost daily. My parents continued to think that she was thriving because she was still performing extremely well academically.
By the time Gabriella returned home, I was in my late teens and able to immediately recognize how much she needed support. My sister is 5 feet 8 inches and at that point weighed only 90 pounds.
Gabriella and I spent evenings looking at a lot of research online, including academic articles. The articles were dry and hard to understand, but the ones that seemed to relate to my sister’s symptoms pointed at depression. We printed these out and brought them to our family doctor, so he could help us understand the information. Eventually he properly diagnosed Gabriella with depression and obsessive-compulsive disorder. My sister finally received appropriate medication and was referred to a therapist. That was about three years ago.
For a long time my parents did not acknowledge or discuss Gabriella’s struggles outside of our immediate family, not even with extended family. This caused my sister to become ashamed of her experiences. But over the past three years, they have started discussing my sister’s mental health with my aunt, a psychiatrist, and as a result are better informed. They are now able to engage in a conversation with my sister when she discusses her challenges—and that, to me, is progress.
Gabriella’s journey has been particularly difficult for me since I was, and continue to be, the primary source of support for her. I often asked the health care providers my sister saw—including our family doctor and my sister’s therapist—what I could do as her sibling, but I was always disregarded. Perhaps because my sister's struggles were deemed a priority over my concerns. But if my family and I had been equipped with the proper information and resources to help us better understand how to help Gabriella, I believe she may have recovered more quickly.
Through all of this, my sister and I were always able to talk openly and honestly about her journey. I’m a firm believer that owning one’s own struggles leads to self-empowerment. Whether Gabriella would confide in me, or I would specifically ask her how she was feeling mentally, it was always turned into a conversation. This dialogue, I believe, was instrumental to her achieving balance and wellness amidst her struggles.
Although her illness will always be a part of her life, my sister has recovered and is now stable.
Suicide and the importance of dialogue
In 2011, Chris, a long-time university friend of mine died by suicide. I honestly didn’t realize he was struggling with depression until he bluntly told me his doctor had prescribed antidepressant medication for him. I offered him my love and support, but he never revealed that he was hurting as badly as he must have been to take his own life.
I remember when I received the call that my friend had passed away; I was in Ontario, studying for an exam. I was shocked; so were his friends and family. It became clear to me that none of us had been aware of the extent of his struggles. Who, then, had he confided in? From what I have gathered, no one.
Something needed to happen to prevent this death from happening. Personally, I think it was a conversation—an open, honest, candid conversation where my friend could acknowledge his struggles.
I think it’s difficult for a person to provide adequate support unless he or she understands the extent support is required. In Chris’s case, there was an obvious disconnect between what was provided to him by those of us around him and what he needed. I only wish that we had been able to recognize he was in trouble and had known how to provide him with a stigma-free, safe ‘space’ in which he could open up and share his struggles.
My personal pursuit of mental health
The most valuable lesson I’ve learned to date is that I need to manage my own wellness. Unless I’m mentally well, I won’t be able to fully support others through their journey.
I used to focus all of my attention on those around me who were affected by mental health issues, and I quickly lost sight of my own mental wellness. After Chris died, I quickly decided to resume my regular life. This was, in hindsight, a careless decision, because soon thereafter I became quite anxious and stressed. I noticed this change in myself and decided to withdraw from my legal studies to focus on my mental wellness. I decided to devote a certain period of time to my journey and myself.
Now, to deal with the stressful nature of life and maintain my own mental health, I strive for balance: balance between time spent on others and on myself; balance between physical, mental and social activities; and balance between work and play. I accomplish this by never underestimating the importance of a schedule. My organizational skills enable me to balance my personal and professional lives so I’m not constantly overwhelmed. I also spend time doing yoga, meditating and writing—three activities I find extremely empowering.
I constantly need to remind myself about maintaining this balance. While I may never achieve a perfect balance among all of the aspects of my life, I will continue to strive for it.
I realize now that that mental wellness is fluid, constantly in need of attention and consideration. I have come to understand and accept that external circumstances, which are often beyond one’s control, can intensely impact mental health.
I’ve also learned to appreciate and understand the power of a conversation.
If learned, these two lessons—self-care and dialogue—are instrumental to supporting loved ones in their pursuit of mental wellness.
About the author
Isabella, an advocate for various social justice issues, is from Vancouver. She graduated from Simon Fraser University with an Honours BA and is presently pursuing her legal education. Isabella has a particular passion for Aboriginal law