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Submitted by PatientsEngage on 28 October 2019

Here is a real life narrative of three sisters who rally around their fourth sibling who has severe depression and schizophrenia to save and support her from spiralling out of control and giving her a purpose in life.

*** Trigger Warning

We are four sisters. My third sister (Ranu*) suffers from depression and schizophrenia. We have been taking care of her since our earliest recollection.

The Early Years

We had a very difficult childhood. We lost our father early. He was a patient of depression also. Those days depression was not really understood or recognised. Everyone thought that he didn’t do well in life, that’s why he was a recluse. He was in sales first and then he started his own business. But he was not cut out for business at all. He literally lost everything.

After my father passed away, my mother and we four sisters were literally living a hand-to-mouth existence. We were in Chennai at that time and we used to walk nearly 6 km to our school because we had no money for transport. We received funds from charitable trusts, some educational waivers and hand me down books and managed to pass through school.

Our hardships and struggle toughened me and my elder sister. Maybe because we were the eldest, and needed to take care of our two younger siblings, we learnt to face all odds. In a way, we became fighters. The early phase was bitter for us too, but somehow we sailed through it.

Third sister hit hard

But my third sister was hit hard by the bitter circumstances. It had a huge impact on her. She grew up to be an absolute recluse. She wouldn’t mix up with people; she didn’t want to make friends or go out. Most her teenage years were spent in a disturbed state and in depression. As an adolescent, I remember her sitting in one corner and crying and sobbing most of the time. I don’t think my mother, or any of us, understood that she was suffering from depression and needed to see a doctor. We didn’t even recognise any of the symptoms. We were all young. We didn’t have the energy, time or understanding to know what was happening with her. We thought it was the insecurities that were bothering her, and left it at that.

After school, she completed her graduation through correspondence. Her low moods continued and she grew up to be a loner with little or no social activity or friends.

At 22, she got a government job. She had to shift to Delhi where she was allotted a one room accommodation. We were happy with the development because I was married and lived with my family in Delhi. My home was about 12 km away from her house. But since I had no vehicle and my daughter was young, I was able to meet her only once a week.

Unexpected meltdown

For nearly a decade she was doing her job well. But one day, when I accidentally met her in the market, I was in for a shock. She was walking around in a dishevelled state, her hair was unkempt and she was just barely able to recognise me. I immediately took her home and told her to rest for a few days. Even then I did not recognise that this was a case of clinical depression.

Some days later, I went over to her house. I was quite sure she would have gone to office. It was a week day. Under normal circumstances, I wouldn’t have expected her to be there because she was working. But I knew she was inside because I could hear faint sounds inside and her door was not latched from outside. I kept knocking and calling out her name for a long time. After a long time, she opened the door and she literally collapsed.

Attempting suicide

I think she had literally dragged herself to open the door from wherever she was inside the house.  When she saw me, she just started crying uncontrollably. And I could her mumbling, ‘I wish I had had ****.’ I saw that there were two bottles lying in her room – one of **** and an empty bottle of **** which she had consumed in an attempt to die by suicide.

I instantly rushed her to the doctor. There, for the first time, she was diagnosed with clinical depression. When my elder sister learnt about her depression, we took her Bombay and started her treatment. She was in a bad state. She had forgotten her name, she was totally blank. She would walk out of the house. So we had to ensure the doors were locked. She was then diagnosed with Schizophrenia. Her condition was so bad that it required electroconvulsive treatment. It took my sister nearly six months to get back to normal.

When we were confident that she could get back to work, we returned to Delhi. Her bosses were really considerate, patient and accommodated her in every way. They understood her condition and gave her work that suited her. I would make sure I would chat with her daily. During weekends she would come home and stay with us. She would also be in touch with the doctor in Bombay, and he would keep adjusting the dosage according to how she felt. The medicines were really suiting her. She had started taking interest in her life, in her job.

Diary of destruction

Two years later, she had another bout of schizophrenia and depression. Again we rushed her to Bombay and she was advised second round of electro convulsive therapy. Both times of ECT was under general anasthesia. But her health never stabilised fully. There would be phases of improvement and deterioration. Sometimes she would scream, shout and have huge anger bouts. At times, we thought we may have to admit her to mental hospital. Once we happened to see her diary. As we leaved through its pages, it left us very disturbed. It was scribbled with dark, negative thoughts of destruction, devastation and death. We really felt scared because we didn’t know where her mind was leading. She was in her 40s. Finally, we sisters decided that she should give up her job and stay with my sister, who had now moved to Bangalore.

We sisters tried to give her all the love, affection and support that we could muster, financially and emotionally. My eldest sister now took complete charge of her.

Taking care of mother

Ranu is 53 years old now. She is in much better health. For the last 4 years, she and my mother have been living separately in a flat close by. The doctor had suggested that she be given some responsibility that will heal her better. As she is extremely close to mother, we thought she would look after mother. lf. We sisters thought, we should try out this arrangement and, believe me, it has worked out wonderfully.

Ranu takes care of mother with full responsibility. Our mother is 91, but she is independent, brave and does all her work. There was a point when we couldn’t leave my mother alone with her because she would push or attack her. She was going through an aggressive phase. But for the last four years she has been taking care of my mother remarkably. She cooks daily for mother. She keeps in mind my mother’s requirement and makes soft food for her and buys soft fruits like banana for her. My mother wears hearing aids, so she keeps a check to see that the batteries are working. If she is unwell at any point, she will call my sister. She is particular about her needs and looks after her diligently. There is no negligence on her part. Once or twice a year, we hear about her breakdown – when she has yelled at the watchman, or the neighbours without any provocation. But the neighbours are aware of her health condition, and they are considerate. Right now, it is all working perfectly. She has been taking care of my mother more or less independently. My eldest sister visits them daily. If there is anything, she provides for them.

Caregiver Learnings

One of the most challenging parts was that initially she did not accept she needed treatment. Infact, the need for second round of ECT was because she was not regular with medication. Being in constant touch with her and making her feel that it was just a chemical imbalance, talking to her constantly and cajoling her helped. 

Now my older sister has the stock of medicines and she prepares a box with her daily dosage. Moreover, she is aware and has taken responsibility to stay well and for that she is aware medication is a must. I believe faith too plays an important role.

As caregiver, I would say that taking care of a person with mental illness can be extremely taxing. The caregiver has to be emotionally strong and stable. You have to look for ways to keep yourself emotionally upbeat. That ray of hope that things will be fine. I know I could have gone into depression. In fact I was in depression myself till I found Buddhism.

(Name changed to protect identity)