At an inquest on Friday, we heard how a man had ended his life. He had spent his final years caring for several relatives and was clearly a devoted family man.
The impact of caring for three family members, his severe worries about their deteriorating health, and his financial concerns all compounded.
I was at the coroner's court as part of research which our charity is undertaking into deaths by suicide. We hope that this research will help prevent future deaths.
After an inquest, the journalists and court officials often talk together to express sorrow at the circumstances of the death and to comment briefly. This time, we were all silent. I think there was a sense of such desperate sadness that no one felt able to comment. We were lost in our own thoughts. The circumstances of his death were extremely harrowing.
One of his daughters gave evidence to the court. She explained how he had become exhausted and overwhelmed, caring for three different members of his family. She said he didn't want any help, though.
Caring for someone can be incredibly protective against suicide. It gives a powerful reason for living. Nurturing, protecting, supporting a loved one - it is one of the most rewarding things in life. You are needed and your life has purpose. It is a privilege to care for family members and there are many moments of joy. Indeed carers may be most at risk of suicide if the person for whom they are caring dies. However, for some of us, circumstances combine in such a way that we reach crisis point while we are caring for someone.
I was a full-time carer for a member of my family. I recall it as a time when love was abundant, and we lived a life of quiet contentment. It is only now, though, that I can look back and see how my mental health deteriorated during her last few weeks. Like the man whose inquest was on Friday, I carried on alone. I didn't talk to anyone about the inner turmoil I was experiencing. The person I was caring for deteriorated rapidly. The combination of deep love for a family member, profound distress at her deterioration, and my inability to prevent it from happening - it all accumulated.
An acute lack of sleep further impacted upon my ability to cope. Carers are often getting up several times a night to tend to their loved one.
Food had always been one of her great loves and comforts. In her final weeks, she barely ate. I would cook a meal, she would refuse it, and so I cooked a whole other meal. Still she had no appetite for it. I would walk up and down supermarket aisles trying to find something tempting she might like. My mind was constantly trying to find a food she would eat. If I just thought hard enough, surely I would come up with a new idea. She was fading rapidly - I had to find something. It was a source of such anguish. My brain wouldn't switch off from it.
I had been known for being patient and calm. But not now. I felt I was going to explode. One day, I reached the limit of what I could take, went upstairs, lay face down on the floor in exhaustion and bit the carpet to avoid screaming. Never in my life had I done anything like that.
It didn't occur to me to ask for help, even at that point.
Ten days after our loved one died, a random traumatic experience plunged me into a psychotic episode and a suicidal crisis. I had no history of serious mental illness or suicide attempts.
It wasn't until last year that a psychiatrist told me that he felt that my fragile mental health in the weeks before the traumatic event contributed very significantly to the severity of my response to it. I guess I had no reserves left, at that point.
The man who died had been having paranoid thoughts in the weeks before his death. The combination of stress, feeling overwhelmed, exhaustion, the emotional impact of seeing the person or people you love suffering - all of this can impact so severely on your mental health.
Having been a carer, and having experienced such a deterioration of my own mental health, I can say without reservation that it was not the caring role which made me so ill. It was that I did it without support. I had no idea that continuing to care alone would have had such an effect on my health. Like the man who died, I had had no serious mental illness previously.
During a fairly routine visit to our loved one at home, our GP saw me break down in tears when I was alone with him. It was perhaps at that point that I should have been referred for help. I know how under pressure and overstretched GPs are, though.
I am with a different GP surgery now, and feel extremely supported there.
I cherish the time which I spent as a carer for our loved one. They were years of profound contentment. Carers need to be supported, though, during the caring years. We need to ensure that their mental health is protected, when pressures accumulate and become overwhelming.
Joy runs a Suicide Crisis Centre in Gloucestershire. For information about the charity contact: http://www.suicidecrisis.co.uk
Help and support for carers, including a national phone line, is available from Carers UK: http://www.carersuk.org/help-and-advice
Information about getting a break from caring and details of other support for carers: Carers Trust: http://carers.org/cy/node/98