Archive for the ‘Mental Illness’ Category

Tomorrow is world bipolar day. It falls on 30th March every year and this date was chosen as it was the birthday of Vincent Van Gogh, who was posthumously diagnosed to probably have bipolar disorder. There is not alot of understanding about bipolar disorder in Singapore. It seems that most people are more familiar and enamored with this concept of ‘split personality’, no doubt as a result of the grossly erroneous representation of mental illness seen all too often in Mediacorp’s channel 8 dramas. Tsk tsk. According to a study done in 2012, about 1 in 100 Singaporeans have bipolar disorder. Which, if you think about it, is probably more common than we think and in our lives, we probably know of a family member or friend, or friend of a friend who has this condition.

Bipolar disorder was known by a different name not so long ago. Before the 80s, it was more frequently described as ‘manic-depressive illness’ to illustrate the dual polarity that distinguishes people with this condition from people who are predominantly depressive. Aretaeus of Cappadocia, who was a physician in ancient Greece, was one of the first to make an observation of patients who ‘laugh, play, dance night and day, and sometimes go openly to the market crowned, as if victors in some contest of skill’ only to be ‘torpid, dull and sorrowful’ at other times (see a short history of bipolar disorder). It was only in 1896 that a German psychiatrist, Emil Kraepelin, used the term ‘manic depressive psychosis’ to distinguish a bipolar patient cycling between periods of mania (a long period of elevated sense of ‘high’ or euphoria, sleeping very little, exhibiting high levels of creativity and grandiosity, extreme irritability etc.) to periods of depression (a long period of feeling sad or sense of hopelessness, thoughts of suicide, feeling tired and lethargic etc.). Emil Kraepelin observed that these two periods were often separated by intervals during which the person can be seen to be acting in a perfectly normal way.

My first encounter of bipolar disorder was with a close friend of mine back when I was in my early 20s. This friend was an extremely creative person. Whenever anyone needed help with wedding decorations, they would always call upon her to be the wedding planner. I remember always marveling at how she didn’t need any sleep and she would just go on and on, creating one thing after another and she would get really excited and hyper. She was also of high intellect and was very highly valued at her work place. However, she would also go through times when she would not return calls and she would just curl up at home and not want to talk to any of us. She would appear really tired and sad and we wouldn’t really understand what was bothering her. I remember during one of those ‘low’ moments, she walked into her boss’ office with the pile of paperwork that was due, dumped it on her desk, told her she is quitting and walked out. At that time, we just figured that she’s burned out from work or something was stressing her out and causing severe mood swings. It was only much later, when she was diagnosed with bipolar disorder, that the pieces all started to come together. She received treatment for her disorder and though I haven’t really been very good at keeping in touch with her, the last I heard she was in a job she enjoys and things were much better for her.

I think many of us may have a similar story like this, but we just don’t talk about it because of the stigma that can surround mental health conditions. Which is why I think it’s great that there are days like ‘world bipolar day’ that reminds us of the importance to know better, to understand better, so we can support our family and friends better. Bipolar disorder is a highly treatable condition. If you think you or your friends may have bipolar disorder, you can use this self checklist by the black dog institute to find out more and speak with a mental health professional about your concerns. You can also check out this movie titled ‘no letting go’ on caring for a child/teenager with bipolar disorder.

I had a black dog

Posted: September 15, 2014 in Mental Health, Mental Illness
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I bought this illustration book by Matthew Johnstone recently and he used the clever analogy of the black dog to describe what life is like living with depression. The black dog was a term first coined to describe Winston Churchill’s bouts of depression. With World Mental Health Day round the corner, I thought I’d post this youtube video that Matthew Johnstone created to help people understand what depression is about and how to feel better. I like the part when he said ‘never be afraid to ask for help…there is no shame in doing so. The only shame is missing out on life’.

We’re coming to the end of the Term. I told a teacher this morning that my mind is willing but my flesh is weak…my mind told me I needed to come to work but my flesh wanted to stay in bed! So I can imagine how tired some of you must be feeling both in mind and body. I’m hopeful that you can at least get some semblance of rest this June break even if it’s just for a couple of days to really really chill. 🙂
I wanted to blog about this article that I read in ‘Mind Your Body’ a couple of weeks ago but never got around to it till now. It’s about how young people between the ages of 18-29 have a higher risk of developing mental health disorders compared to older people in Singapore according to a study conducted by IMH in 2010. 1 in 14 young people has major depressive disorder, 1 in 27 has obssessive compulsive disorder and 1 in 33 has alcohol abuse problems. That’s staggering statistics if you ask me considering how debilitating these disorders can be. When asked why Singapore youths are at such high risk, Dr. Chong Siow Ann from IMH says that ‘adolescence and young adulthood are crucial periods in a young person’s life when he has to make important decisions about almost every aspect of life…further studies, starting a career, forming romantic attachments…’ and such change and transitions can be very stressful. As a counsellor in a junior college, I see that to be true in the students I’ve seen for counselling. We often assume that since you’re no longer a young child you should be able to deal with things on your own and stick it through when things get tough. But we forget that this is a transition period that can be so stressful because there’s so much on the line and the decisions you make now can have such a long-term impact on how life may turn out for you.
Another possible reason cited for the high incidence of mental disorders in young people is the fact that our Singaporean collective culture puts so much emphasis on achievement – you are rewarded only when you perform well. Dr. Jasmine Pang from CGH says that ‘people learn from a young age that they should be hardworking and perform well in their studies and work. When they do not meet the high demands they place on themselves they tend to become anxious and depressed’. Dr. Daniel Fung also explained that ‘when they (young people) do not meet the expectations of important people in their lives, they become stressed and, over time, may develop symptoms of anxiety and depression’. 

I see that in my god-nephews who are just 5 and 4 years old this year. The younger one’s personality is more chill-lax but the older one is like a mini-me. He reminds me of me when I was his age – perfectionistic, places high and rigid demands on himself to perform well, can’t take failure etc. He has enrichment lessons every day (including weekends) on top of going to kindergarten and I worry about his mental health when he grows abit older. So I remind him as often as I can that he is loved regardless of whether he performs well or not and that life is so much more than academic achievement. 

Many young people with mental health disorders don’t seek help until it’s too late. The study showed that 2 in 3 never seek help which has serious implications on their chance for recovery and complicates the treatment process. I’ve listed some helpful resources on the site so do check it out and also come by the counselling room to have a chat with me whenever.  

Okay I have no life.  During Chinese  New Year instead of shamelessly collecting ang pows (shameless considering my age) I was reading an article titled ‘arresting psychosis in the young’ in The Straits Times just this past weekend. In this article, it talked about a large-scale research study that the Institute of Mental Health (IMH) initiated in a bid to find out more about the difference between normal and at-risk persons for a mental health condition known as psychosis.

Psychosis is little know among many of us. We are familiar with terms such as clinical depression, anxiety disorder and anorexia/bulimia but considering that psychosis that leads to schizohprenia is most likely to start between the ages of 15 and 29, it’s palpable how little we know. Psychosis is a condition of the mind and a person suffering from psychosis can experience hallucinations (seeing or hearing things that are not there), delusions (e.g. thinking that people are watching you) or other abnormal behavior (e.g. talking or smiling to yourself).  You can see that some of these symptoms can be a bit ‘scary’ for some people  especially family members and friends of persons suffering from psychosis.  Often it has been mistaken as demonic possession or as the Chinese puts it ‘Gui Shang Shen’.  No doubt this is attributed to ‘The Exorcist’ and other horror films depicting demonic possession and in some cases these ‘spirits’ or ‘demons’ can even jump from person to person! What then happens is that instead of receiving psychiatric treatment, these people suffering from psychosis are brought to mediums or priests who could help to ‘cast out’ the demons and ‘cure’ the person.

I’ve been asked what my views are of possession, whether I believe there’s such a thing.  I think that’s really missing the point because it doesn’t matter what my views are of possession.  What matters is that many of these cases are really incidents of psychotic episodes which is highly treatable with medication if it’s detected early. Really what is needed more is information, knowledge and empathic understanding. Do check out the Early Psychosis Intervention Program (EPIP) website to find out more.

I’m not sure why it’s helpful to know celebrities who had to battle clinical depression. Perhaps it makes us feel that “okay…if this person who is so successful, rich and famous had depression then it’s okay that I too am battling depression”. Perhaps there are miscontrued mindsets about people who get depression, that they must be weak, crazy or “flawed” in some fundamental ways to “fall prey” to depression in the first place. So it surprises (perhaps even shock) us when we come to know of celebrities who had depression and then perhaps it helps to redefine what we think of people with depression.

I’m not the biggest fan of harry potter but I was rather inspired by JK Rowling’s rags-to-riches story. She was number 2 on Forbes list of 20 riches women in entertainment in 2007 (2nd only to Oprah Winfrey). Not bad at all for a single mother who was taking care of 3 children and living on welfare. Another known fact about JK Rowling was her struggle with depression. She has been very open about it in the hope that it would help remove the stigma surrounding mental illness. At one of her darkest moments, she contemplated suicide but stopped herself and went to see a counsellor. Click this link to read more about her story on BBC news website.

Another oft-quoted celebrity who also openly struggled with his depression is Jim Carrey. I for one was surprised when I did some research on the internet and his name popped up. I’ve always known Jim Carrey as the comedian with the incredible rubber face and his 1994 hit movie “The Mask” (some of you were still babies at that time!!).  Reading about his life story and how he overcame depression gave me new meaning for resilience in adversity.

I feel sad when friends or students who are experiencing clinical depression put themselves down or think they are inferior and abnormal or think that people will look down on them. Some refuse to seek treatment as a result of this inaccurate perception of self and what depression is. And I feel indignant when the community shuns them (whether in fear or ignorance) and fails to offer the support that they would normally give another friend in need. Let’s educate ourselves on these issues and perhaps right here at YJ we can build a community of care, understanding and inclusivity.

What is Depression?

Posted: June 29, 2010 in Mental Illness

You might have heard the word ‘depression’ being bandied around sometimes. You might also have heard your classmate say, ‘I feel so depressed I don’t feel like coming to school’. There are lots of information available online on what depression really is but I thought I would write about it anyway because the way I see it there is still a number of half-truths out there. What I write, however,  is by no means a substitute for proper assessment and diagnosis by a medical doctor so in cases when you’re not sure please consult a doctor or come and see me. 🙂

The National Institute of Mental Health (NIMH) in America defines depression as a medical illness that is different from just feeling upset or abit down once in awhile. Some signs and symptoms of depression may include a combination of persistent feelings of sadness or emptiness (and persistent means more than 2 weeks), social withdrawal, loss of interest in things that you used to enjoy doing, loss in appetite, disruption of sleep (insomnia or early wakefulness), feelings of hopelessness, lethargy and even thoughts of suicide.

Person with depression is not crazy or has lost his or her mind. I think that’s a point that I often try to make with parents, students and teachers alike. Just as we wouldn’t discriminate against somebody with diabetes who seeks treatment from an endocrinologist and say he/she is ‘something wrong’, we shouldn’t discriminate against someone with depression who seeks treatment from a psychiatrist. I mean what century do we live in right? And it can happen to any of us. In Singapore, a 1998 survey on ‘The Mental Health of a Nation’ reports depression prevalence rates of 8.6% among those aged 13-65!

Depression is highly treatable with medication and therapy. Again, these medication do not ‘make you crazy’ and do not make you an addict. It works on our brain chemicals specifically the neurotransmitters such as serotonin and neopinephrine (I’m sure I’m spelling this wrong) to restore its balance. To find out more about what is depression and how it’s treated, check out the 4 minute video above and also check out the NIMH website.

I’ve been wanting to write a series on mental illness for some time coming now. You can say it’s one of my pet topics apart from youth issues and I’m oddly passionate about educating people with regards to mental illness. Maybe it’s because there are so many misconceptions surrounding mental illness and there’s still so much stigmatization pervasive in our society that the closet Martin Luther King in me just wants to leap out and speak out. I remember 2 years ago I even joined the inaugural World Mental Health Day walk-for-a-cause down Orchard Road wearing T-shirts emblazoned with Charlie Chaplin’s face with a tagline that read ‘people with mental illness enrich our lives’.

So in the next couple of weeks, I would write a series on Mental Illness covering some basic stuff on common ailments such as depression, anxiety and early psychosis etc. I hope with greater knowledge and awareness that people would let go of their stigmas and biases so we could all aspire towards a community marked by compassion and equanimity. I would also write about destigmatization and bring up a few examples of famous people who have struggled with mental illness some of whom I think would come as a surprise to some of us. Please feel free to comment. I think bringing questions out into open dialogue is yet another way to demystify issues surrounding mental illness. 🙂