I must feel shameful to tell people that due to my own ignorance, my dentist brother committed suicide about 15 years ago. I did not know what is bipolar depression and I did not know that my younger brother had bipolar depression. If I knew I could have saved his life.

Biography of Mark Kon Liew Ming

The Japanese invaded Malaya in 8 Dec 1940. Just before the invasion, for safety my father brought the whole family to stay with my uncle who was the assistant manager of a British rubber estate in Pick Dickson. When the British manager went back to UK, we occupied his big bungalow and inherited his big car.   

A Japanese troop landed in Port Dickson. When a few Japanese soldiers came by bicycles to find women, my pregnant mother and the servant were hiding on top of the garage. The servant was so frightened that she jumped down and ran. The soldiers chased and raped her. Fortunately, my mother was safe.

When the leader of the Japanese army came to confiscate the car, he gave us a receipt which was so useful. Whenever the soldiers came, my father would show them the car receipt.

Soon after that my mother gave birth to my brother and named him Liew Ming which means “Refugee” in Chinese.     

He was very intelligent. Moreover, he had the dexterity with both hands. He could write with his right hand as well his left hand.

Singapore University Dentistry

He studied Dentistry in Singapore University. He was so good in his practical work that as soon as he graduated, the Dean of Medicine Professor Lim Kok Ann appointed him as a demonstrator in the Dental department. Professor Lim was famous for his discovery of the Asian flu virus. His daughter Stella who had completed MA, felt in love with my brother and they eventually got married.

Both of them decided to go to UK to further their studies.  Professor and I told them that they should start working to make some money to support themselves instead of asking us for more money. They refused to accept our advice and went to study in Sussex University. By that time, they already had a son. To support themselves, my brother worked parttime. To work and study was not easy. As a result, they came back to work. Soon Stella gave birth to another son.

While my brother was working in Kampar, he employed a young lady dentist to assist him. They had many patients. Soon the young dentist felt in love with my brother. When Stella knew about it, she left and went back to Singapore with her 2 sons.   

Within a short time, the young dentist left to marry another dentist. As a result, my brother went into mental depression. I took him to see a psychiatrist. He was given anti depression drug which he should take every day. He did not take his anti-depression drug regularly. As a result, he went into deeper mental depression that the anti- depression drugs could not cure.

He sold his practice and retired. Soon he became very religious and was baptised to a Catholic with a Christian name Mark. He rented a house directly opposite the Fathima Church, in Ipoh Garden. His immediate neighbour was Father Rudy Wong. He attended Church service every morning. Soon he got well and he did not take his anti- depression drug.

Unfortunately, after a few months, he got so ill that he could not even talk as if he lost his mind. I took him to see the psychiatrist in Fathima Hospital. The doctor said if he were to take the anti-depression drug, he could only get well in 2 weeks. The fastest way was to give him 3 electric shock treatments. Just to make sure, I rang my daughter who was a psychiatrist in UK. She agreed with the proposed treatment.

How did my brother commit suicide?

My brother got his first electric shock treatment on Monday. Immediately after the first treatment he could communicate intelligently. On Wednesday, he was so keen to get his second electric shock treatment that he asked Father Rudy Wong to take him to hospital. Father took him to get his second electric shock treatment and brought him home. I rushed to the hospital and was told that Father Rudy took him home. I rushed to his house and I was shocked to see that my brother committed suicide.

After the second electric shock treatment, he was able to untie the wire from an electric fan to secure it on the staircase hand rail and hang himself.

I rang my daughter and she said the psychiatrist should not allow the patient to go about so freely after electric shock treatment. The patient should be confined with 24 hours surveillance. If this case happened in UK, the psychiatrist would have to face a medical board of enquiry and most likely he would not be allowed to practise medicine.  

All the newspapers published this sensational episode. When a lady school teacher from Kuching read the newspaper, rang to tell me that her husband, an accountant also had mental problem and committed suicide by jumping down from a 10-storey building. She had 3 sons and her first son was called Andrew Tan. I gave full scholarships to Andrew and his younger brother. Both of them graduated as accountants from UTAR. Andrew graduated in December 2010 and his brother graduated in 2013. Since their graduation, they have not contacted me. I hope they will read this article and contact me.

Why most people are ungrateful?   

Out of 300 of my scholarship recipients, only a few graduates would get in touch with me regularly. Almost all of them do not even send New Year cards or WhatsApp well wish messages.  

People who are ungrateful tend to be characterized by an excessive sense of self-importance, arrogance, vanity, and an unquenchable need for admiration and approval. Narcissists reject the ties that bind people into relationships of reciprocity. They expect special favours and feel no need to pay back or pay forward.

I regret that I did not know about bipolar mental depression. If I knew, I could have saved his life.          

What is bipolar depression?

Bipolar disorder, formerly known as manic-depressive illness, is a brain and behaviour disorder characterized by severe shifts in a person's mood and energy, making it difficult for the person to function. More than 5.7 million American adults or 2.6 percent of the population age 18 or older in any given year have bipolar disorder. The condition typically starts in late adolescence or early adulthood, although it can show up in children and in older adults. People often live with the disorder without having it properly diagnosed and treated.

What are the symptoms?

Bipolar disorder causes repeated mood swings, or episodes, that can make someone feel very high (mania) or very low (depressive). The cyclic episodes are punctuated by normal moods.

Mania Episode Signs and Symptoms:

• Increased energy, activity, restlessness
• Euphoric mood
• Extreme irritability
• Poor concentration
• Racing thoughts, fast talking, jumping between ideas
• Sleeplessness
• Heightened sense of self-importance
• Spending sprees
• Increased sexual behaviour
• Abuse of drugs, such as cocaine, alcohol and sleeping medications
• Provocative, intrusive or aggressive behaviour
• Denial that anything is wrong
•  

Depressive Episode Signs:

• Sad, anxious or empty-feeling mood
• Feelings of hopelessness and pessimism
• Feelings of guilt, worthlessness and helplessness
• Loss of interest or pleasure in activities once enjoyed, including sex
• Decreased energy, fatigue
• Difficulty concentrating, remembering or making decisions
• Restlessness and irritability
• Sleeplessness or sleeping too much
• Change in appetite, unintended weight loss or gain
• Bodily symptoms not caused by physical illness or injury
• Thoughts of death or suicide
•  

HOW IS BIPOLAR DISORDER DIAGNOSED?

Bipolar disorder cannot yet be diagnosed physiologically by blood tests or brain scans. Currently, diagnosis is based on symptoms, course of illness, and family history. Clinicians rule out other medical conditions, such as a brain tumour, stroke or other neuropsychiatric illnesses that may also cause mood disturbance. The different types of bipolar disorder are diagnosed based on the pattern and severity of manic and depressive episodes.  Doctors usually diagnose brain and behavior disorders using guidelines from the Diagnostic and Statistical Manual of Mental Disorders, or DSM. According to the DSM, there are four basic types of bipolar disorder:

• Bipolar I Disorder is mainly defined by manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, the person also has depressive episodes, typically lasting at least two weeks. The symptoms of mania or depression must be a major change from the person’s normal behaviour.
• Bipolar II Disorder is defined by a pattern of depressive episodes shifting back and forth with hypomanic episodes, but no full-blown manic or mixed episodes.
• Bipolar Disorder Not Otherwise Specified (BP-NOS) is diagnosed when a person has symptoms of the illness that do not meet diagnostic criteria for either bipolar I or II. The symptoms may not last long enough, or the person may have too few symptoms, to be diagnosed with bipolar I or II. However, the symptoms are clearly out of the person's normal range of behaviour.
• Cyclothymic Disorder, or Cyclothymia, is a mild form of bipolar disorder. People who have cyclothymia have episodes of hypomania that shift back and forth with mild depression for at least two years. However, the symptoms do not meet the diagnostic requirements for any other type of bipolar disorder.
• Some people may be diagnosed with rapid-cycling bipolar disorder. This is when a person has four or more episodes of major depression, mania, hypomania, or mixed symptoms within a year.

HOW IS BIPOLAR DISORDER TREATED?

While no cure exists for bipolar disorder, it is treatable and manageable with psychotherapy and medications. Mood stabilizing medications are usually the first choice in medication.  Lithium is the most commonly prescribed mood stabilizer. Anticonvulsant medications are usually used to treat seizure disorders, and sometimes offer similar mood-stabilizing effects as antipsychotics and antidepressants. Bipolar disorder is much better controlled when treatment is continuous. Mood changes can occur even when someone is being treated and should be reported immediately to a physician; full-blown episodes may be averted by adjusting the treatment.

In addition to medication, psychotherapy provides support, guidance and education to people with bipolar disorder and their families. Psychotherapeutic interventions increase mood stability, decrease hospitalizations and improve overall functioning. Common techniques include cognitive behavioural therapy, psychoeducation, and family therapy.