Having too much fun — why we shouldn’t drink to that

Problem drinking

“Alcohol dependence” and “teenagers” aren’t words we would normally put in a single sentence.

But drinking more than double the lower risk guidelines for alcohol consumption is gaining notoriety in some parts of the island. Having 5 drinks for men and 4 drinks for women in a single session at least once in the previous two weeks – known as binge drinking – is increasingly common: A 2012 study reported that 10% of young adults aged 18 to 34 binge drink, and that 5 in 100 have alcohol-use problems

Statistics from a 2004 WHO report put alcohol dependence among local residents at .06% (based on a 2000-2001 study). According to 2004 statistics, 3% of the population had problems with alcohol abuse and only 5% of them sought help. Figures from 2012 indicated that over 3% of the population had alcohol-use problems (in contrast, 5% of young adults did).

And the problem’s not exactly going away. A local article in Nov 2013 indicated an increase in the demand from clients wanting to address their alcohol-use problems. Another thing that’s on the climb is anecdotal evidence about excessive drinking.

Excessive alcohol is bad for our physical and mental health. Not surprising, really. Too much alcohol over the long-term does not just do invisible things to us, such as cause scarring of the liver and inflammation of the pancreas. But overconsumption of alcohol also impacts us in ways we can appreciate: It impairs our memory capacity and cognitive function.

We would faintly recall that when we had too much alcohol, we would have had difficulty making good decisions and coordinating our eyes, brain, and limbs in a cogent manner. But we might not recall a blackout or memory loss (well the fact is, we couldn’t remember). Too much alcohol is also responsible for permanent brain damage (though fret not — brain cells can be recovered through aerobic exercise).

More lethal effects of alcohol abuse and dependence are the risks of head and neck cancers, liver cancer, and colorectal cancers, which arise from heavy drinking.

But here are some other facts you may not be aware of:

1. The proportion of young men (aged 18 to 29 years) who were binge drinkers in 2012 was 18.7%. It’s not a dissimilar proportion from that reported in 2004, which was 18.9%.

2. The proportion of young women (aged 18 to 29 years) who were binge drinkers in 2012 was 12.2%, which is higher than the proportion reported in 20014, which was 9.4%.

3. Studies show that university students who binge drink are much more likely to miss classes and fall behind in their work and grades

4. But not everyone has a drink problem. The first step is to find out if problem drinking is an issue: Try this quiz or this self-assessment.

5. There are other ways to get high and to de-stress: There’s no shortage of suggestions in this, this, and this post. One can also try exercise which doesn’t feel like “exercise”.

6. Parents can have a major impact on their children’s drinking if they talk to their children about it in the preteen and early teen years or before they go to university.

7. Everyone should know the risks of drinking and driving. The standard unit of .6 ounces of alcohol (a glass of wine, a shot of vodka, or a can of beer) is within the legal limit, but the lesson about not mixing drink and driving is one that should be learnt early (here’s a fact sheet).

8. Cognitive behavioural therapy (CBT) has been shown to be an effective intervention for changing drinking habits (CBT is explained here). Motivational Interviewing (MI) has also been found to be effective as a brief intervention for reducing drinking behaviours (more about MI here).

9. A mega meta-analysis in 2002 made it clear that interventions which combined CBT and MI with craving-reducing medications (more about them here), are more effective than abstinence programmes, even with adolescents.

Did you get it right?

So you took the quiz!


  1. TRUE. Depression is a mood state which goes well beyond temporarily feeling sad. Read up here.
  2. FALSE. Experts recognise three (not two) types of depression: major depression, dysthymia, and bipolar disorder, as described here and here.
  3. TRUE. Feelings of hopelessness and worthlessness are symptoms of depression.Other symptoms include irritability, fatigue and loss of energy, difficulties with concentration, memory, and decision-making, insomnia or not feeling rested despite adequate hours of sleep, overeating or loss of appetite, aches and pains, and headaches.
  4. TRUE. Prolonged exposure to stress does contribute to depression. Taking steps to manage one’s stress levels reduces one’s risk of depression.
  5. FALSE. Hormones which help to regulate our mood (neurotransmitters) are typically not functioning as well in someone with depression.
  6. TRUE. Family history of depression does increase one’s risk of depression. But so does experiencing a stressful life event, such as the death of a parent, child, or spouse.
  7. TRUE. According to the findings of the Singapore Mental Health Survey, depression is most common among adults. But children, adolescents, and older adults (seniors) can also have depression.
  8. FALSE. St John’s Wort is not a recommended treatment for major depression. Use caution and read the warnings about this herb.
  9. FALSE. Cognitive behavioural therapy (CBT) is an effective treatment for anxiety and depression. More information about CBT can be found here.
  10. FALSE. As this Health Xchange article notes, the Singapore Mental Health Survey found 5.8% of the population to have had depression at some point in their lifetime. That’s means over 5 in 100 persons have had depression before.
  11. FALSE. The myths and facts about depression are explained on HPB‘s website. Medication is not the only treatment option. In fact, combining medication with CBT is effective in treating mild or moderate depression.
  12. FALSE. The risk for depression is higher for women than men.
  13. TRUE. Individuals with depression are taught mindfulness techniques to help make treatments like CBT and/or medication more effective.
  14. TRUE. It’s easy to find out more about depression: NIH has fact sheets in many languages including Chinese.
  15. TRUE. Depression was featured on the local TV programme Body and Soul in 2014 (not 2011). Gotcha. But you can watch it again on XInMSN!
  16. FALSE. Loss of interest in things which once used to be of interest is another sign of depression. Individuals with depression may have difficulty “getting out of bed“.They may not be motivated to participate in sports or to continue their hobbies (though some have used creative outlets to express themselves — read more in this post on the NY Times blog on photography and mental illness).

How many answers did you get right?

Above 12:   Congratulations! Get more news here about a study which piloted a simple waiting room test for depression, and the latest research on how those who display neurotic behaviours are more likely to suffer from depression and anxiety.

8-11:           Well done! You can stay up-to-date by reading about new research developments on medications and therapies for depression here.

Below 8:     Good attempt! You can find out about how depression affects your performance at work…and how you can look after yourself to stay well. Keep it up!

Know the facts about depression? Take this quiz!


You’d have heard all about depression by now. Specifically, a major depressive illness. About the treatments for depression. The facts about depression. The link between depression and comedy. About the 2014 study (here’s the science) about comedians and their personality traits which lend themselves to comedy but also have similarities to traits in people with psychosis (fact sheet about psychosis here). That significant life events can play an important role. That depression is not merely sadness. That work and cycling can be coping strategies.

So you should have no difficulties answering these questions. True or False?

  1. Depression is a mood state which goes well beyond temporarily feeling sad.
  2. There are two types of depression.
  3. Feelings of hopelessness and worthlessness are symptoms of depression.
  4. Chronic stress can lead to depression.
  5. Mood-regulating hormones are likely to be functioning well for someone who has with depression.
  6. Family history of depression increases one’s risk of depression.
  7. Depression is most common among those aged 18 to 40 years.
  8. St John’s Wort is not a recommended treatment for major depression.
  9. Cognitive behavioural therapy (CBT) is effective for treating anxiety but not depression.
  10. Every 4 in 100 Singapore residents have had depression in their lifetime.
  11. Medication is the best treatment option if one has mild/moderate depression.
  12. The risk for depression for women is equally high as it is for men.
  13. Mindfulness is a technique which is useful in the treatment of depression.
  14. It’s easy to find out about depression in other languages (e.g., Chinese).
  15. Depression was featured on the local TV programme Body and Soul in 2011.
  16. Someone with depression is likely to maintain an interest in sports or hobbies.

Find the answers from these resources: 1) NAMI, 2) ADAA, 3) NIHM, 4) Black Dog Institute (BDI), 5) Harvard Medical, 6) standford.edu, 7) Singapore Mental Health Survey, 8) Medline Plus, 9) RCPsych, 10) Health Xchange, 11) HPB or nice.org.uk, 12) umn.edu 13) BDI Fact Sheet, 14) NIH, 15) XInMSN, 16) Health Xchange.

FInd out the answers at the end of the week!

That’s what friends are for

Living in a dense city apparently is bad for our health, according to news reports (“Mental health experts say city dwellers more prone to stress-related disorders“, Channel News Asia, 24 March 2014). It could be our competitive work ethic. It could be that our corporate culture lacks emphasis on work-life balance.

Young Man with His Hand on His Forehead

Whatever the reason, we typically experience an elevated amount of stress. Even though some report that we’re happy (read this report), there are indications that many aren’t happy at work (read this Straits Times report and this Today article).

And we should know the negative impact stress has on our mental and physical health. Because Mediacorp’s Channel 5 programme, Body and Soul, channelled all its energies into explaining mental health in its 8th episode (“Behind the curtain of depression” on 1st April 2014 9pm).

Despite this education campaign about mental health, the public’s awareness and understanding about depression will likely remain poor. And relatively few who need support for mental health problems seek professional help (here’s why). Those are the same reasons why there is a need to document Singaporeans’ understanding of mental health and the factors which motivate them to seek professional help (see these Today published on 19th and 20th March 2014).

But awareness campaigns work best through word of mouth. Friends these days are useful for providing entertainment through their lifehacks and buzzfeed posts, and for creating social envy among friends through the multitude of food pictures they post on their facebook. But they sometimes also provide emotional support to friends in need.

So on this World Suicide Prevention Day, it’s important that friends have the facts:

What Is Depression?

Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness.

Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications, psychotherapies, and other methods can effectively treat people with depression.

What are the signs and symptoms of depression?

People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.

Signs and symptoms include:

  • Persistent sad, anxious, or “empty” feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

I started missing days from work, and a friend noticed that something wasn’t right. She talked to me about the time she had been really depressed and had gotten help from her doctor.

How can I help a loved one who is depressed?

If you know someone who is depressed, it affects you too. The most important thing you can do is help your friend or relative get a diagnosis and treatment. You may need to make an appointment and go with him or her to see the doctor. Encourage your loved one to stay in treatment, or to seek different treatment if no improvement occurs after 6 to 8 weeks.

To help your friend or relative

  • Offer emotional support, understanding, patience, and encouragement.
  • Talk to him or her, and listen carefully.
  • Never dismiss feelings, but point out realities and offer hope.
  • Never ignore comments about suicide, and report them to your loved one’s therapist or doctor.
  • Invite your loved one out for walks, outings and other activities. Keep trying if he or she declines, but don’t push him or her to take on too much too soon.
  • Provide assistance in getting to the doctor’s appointments.
  • Remind your loved one that with time and treatment, the depression will lift.

Taken from the US NIMH Depression publication; the PDF is available here.

And friends don’t keep good information to themselves. They will want to spread the word.

Happy Teachers’ Day!

It’s that time of year when teachers get to relax and enjoy the flowers, chocolates, and brownies bestowed on all teachers this day. But perhaps with all that time on hand, it’s also a good time to find ways to help be a more effective and efficient classroom manager and wielder of pedagogical tools and technological advances.

Teaching pedagogy

Here’s a cheat sheet to help you stay on top of your game:

1. Lessons in motivation

2. New to the job?

3. Making technology your friend

4. Don’t be bullied

5.  Parenting skills for teachers