Are you a collector or a hoarder?

A collection of lego

After a trip to the supermarket, we usually have a pile of plastic bags, which we’ll stash somewhere safe in the kitchen. We probably have fewer plastic bags these days because we’re into recycling and using our own cloth or non-woven bags. And you can save 10 cents by bringing your own bag. But we typically get a bag when we buy something. And we’ll stack these neatly in a pile somewhere at home. And that something that we’ve bought often comes in a box, which we’ll keep because it’ll come in useful some day.

Or perhaps you’re the sort that just throws everything away and recycles all the paper and cardboard products as soon as you get home to unwrap your new toy. Because you’re afraid of accumulating too much stuff and of becoming a hoarder. Because you know someone who is one.

It seems hard to imagine how one can keep so many things that the home becomes too cluttered to move or clean, even to the extent that a clean-up team from the Housing Development Board and National Environment Agency is required. But it’s a problem that’s much more common than you may think. As many as 1 in 50 show hoarding behaviours in Singapore, according to a 2015 study. And it’s a problem not simply solved with a clean up. Those who hoard have “a persistent difficulty discarding or parting with possessions because of a perceived need to save them” (Mayo Clinic). As such, they usually need professional help.

Although hoarding was previously categorized as an Obsessive Compulsive Disorder or OCD, experts now recognize hoarding to be distinct from OCD (see also the DSM-V).

A 2012 study found that the brains of those who hoard were overstimulated when tasked with deciding whether to discard or keep junk mail that was addressed to them. In contrast, the same brain area was inactive for the same task involving junk mail addressed to a third party — a research lab. These findings speak volumes about the crippling indecision that those who hoard face when forced to clean up their homes.

Those who compulsively hoard tend to place much greater value on things that they keep and they place value on many more things that others would. And their anxiety which stems from trying to make discard-or-keep decisions, is a huge obstacle to gaining control over their cluttered homes. It’s no surprise that hoarding is without exception “always accompanied by anxiety“.

Perhaps we’re not quite there yet. We can claim to be collectors of plastic bags and cardboard boxes because they’re still sitting neatly in a drawer and a cupboard. But it may be useful to acknowledge when our collecting behaviours are turning into hoarding ones (refer to this Fact Sheet for signs and symptoms). Ask yourself these questions:

Do you feel overwhelmed by the clutter in your home?
Is the clutter preventing you from using your furniture or appliances?
Do you avoid having visitors so that they won’t see the clutter?

If yes, it may be time for you or your loved one to seek help. Professional help in the form of intensive cognitive-behavioural therapy or CBT, with a therapist who has experience with hoarding behaviours, has been shown to be effective in helping hoarders.

Here are some resources for helping those who hoard to help themselves: Start by setting realistic and small goals (e.g., aim to clear one shelf). It’s never too late: Here are some top tips to help contain the clutter.

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Your children playing 4D and Toto: What are the odds?

The next World Cup is in 2018 and in Russia. Local anti-gambling ads will perhaps be less eager to give out hot tips which get extra airtime and special attention on US talk shows. But majong tables will likely make their annual appearance at Chinese New Year celebrations next year. And the lure of the national lottery is evergreen anyway.

Dicey games

The prevalence of problem gambling is declared to be stable at 1% of the adult population in the States. And that’s the number that’s been documented for locals too: The 2011 report by the National Council on Problem Gambling estimates 1.4% of the adult population to be probable pathological gamblers (read this review for information about the worldwide trends in problem gambling). In contrast, problem gambling is on the rise in UK where there is access to remote or online gambling (local legislation is likely to deter such gaming).

Although only 1 in 100 or so are pathological gamblers, it’s a problem which affects as many as 24,000 locals (and possibly more). According to H2 Gambling Capital, the amount that the average adult resident lost through gambling last year was S$1,189 (see the graph from the 2011 Economist article “The biggest losers”). Not a terribly small sum.

True, there are relatively few problem gamblers – these are people who show more and more interest in gambling, who feel the need to bet more money more often to experience the excitement and/or make up for previous losses, who experience withdrawal symptoms such as irritability when they try to stop, and feel a loss of control as they gamble even when faced with serious adverse consequences.

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

1. Recent estimates put problem gambling among young adults in the States at 6 to 9 percent. Although only 3 in 100 local youths are problem gamblers, according to a 2007 local study, it is still a higher proportion, relative to adults.

2. One third of problem gamblers seeking treatment were exposed to gambling before their 18th birthday.

3. Betting on poker-cards, mahjong, and the national lottery starts at the average age of 14 years.

4. A 2014 study found that those with initial losses at horse-racing and football (soccer) bets were more likely to lose in their subsequent bets, and that the likelihood of them winning was even lower than chance! Another 2014 study suggests betting behaviour has a genetic basis involving genes which regulate the pleasure-producing hormone known as dopamine.

5. Signs and symptoms of a young problem gambler include an unexplained need for money, unexplained charges on credit card bills, withdrawal from friends/family, depressed mood, feelings of anxiety, sudden decline in grades, and/or loss of interest in things which he/she was previously interested in.

6. Problem gambling is more likely for teens with a parent with a gambling problem, who engaged in gambling at an earlier age, and/or who are given to impulsivity (risk factors listed here).

7. Cognitive behavioural therapy (CBT) and motivational interviewing (MI) are found to be effective in treating problem gambling (read this fact sheet). Using as a complementary therapy with CBT and MI, mindfulness can be effective in helping individuals reducing their gambling behaviours.

8. Most games are based purely on chance. Here’s a look at how they work. And if that’s not convincing, play this game and take this gambling IQ quiz to understand how the house always wins.

9. Ways to help someone with a problem gambling concern, include providing emotional and social support and listening without being judgemental. Here’s a guide on how to talk to others (including your children) about problem gambling in the family.

10. Interventions are available with the National Addictions Management Service and the National Problem Gambling helpline. But parents may want to start by talking to their kids about gambling in a loving and caring way (here’s a fact sheet).

The odds? The answers are all here.

Did you get it right?

So you took the quiz!

Answers!

  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!

puzzle

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!

What’s the deal with mental wellbeing?

Mental wellbeing, what is it? It is, according to the World Health Organization, “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. But what’s the deal with mental wellbeing? Well, here are some facts about mental wellbeing:

  1. Employee wellbeing is lower than that of the general population.

    A media report last year (“Mental well-being of working adults 13% lower than general population”, Asiaone, 3 Aug 2012) revealed that mental wellbeing among employees in Singapore was 13% lower than that of the general population. Results from the HPB survey comprising a 1,000 respondent sample showed that working adults were more likely to experience higher levels of stress than non-working adults.

  2. Is employee wellbeing just a “nice-to-have”?

    It’s been established in research that employees’ mental wellbeing is indicative of their engagement and work performance. This view is supported by findings that “employees who are dissatisfied and unhappy are also more likely to be disengaged, absent without valid reasons, cynical, non-cooperative and more likely to engage in counter-productive behaviour” (“The importance of employee well-being”, Business Times, 25 Sep 2013).

  3. Mental wellbeing constructs include psychological resilience, social-emotional intelligence and cognitive capacity

    The definition of mental wellbeing proposed by the local authority on health and wellness, Health Promotion Board, comprises psychological constructs which include self-esteemsocial intelligence, psychological resilienceemotional intelligence, and cognitive efficacy. Positive outcomes such as life satisfaction are closely associated with higher scores on measures of these constructs. As such, it’s worth knowing how to improve one’s self-esteem, social and emotional intelligence, resilience, and cognitive competencies.

  • Some self-esteem is desirable

    Correlational evidence indicate that self-esteem, based on self-report measures, is positively associated with mental wellbeing. That is, having low self-esteem likely reflects poorer life satisfaction and mental wellbeing. However, other findings also indicate that it may be important to not view self-esteem as a goal but rather a by-product of psychological wellbeing. As noted in a Harvard Mental Health Letter, it may be also important to examine implicit self-esteem, rather rely on an explicit measure of self-esteem such as self-report. Another way to think about this is that it’s important to develop self-esteem, but it’s also critical that self-esteem arises from positive reinforcement which is provided to reward real improvements in work competence and/or academic performance. This Psychology Today article, “Parenting: The Sad Misuse of Self-esteem” provides useful tips for parents. There are also strategies to help those with low self-esteem: This November 2013 press release by the Association of Psychological Science suggests that touch may be one such useful strategy.

  • Social intelligence is the ability to navigate social interactions

    The ability to thrive in the social world depends on our ability to understand and interpret social situations and act appropriately. In keeping with in this textbook definition of social intelligence, our understanding and ability to manage complex social interactions is what helps us manage at the workplace and at home. Psychology Today provides tips for developing social intelligence, while social intelligence can be observed to have business applications, as this article in the Bangkok Post business section suggests. But the concept of social intelligence does overlap with that of emotional intelligence, so read on!

  • Emotional intelligence is rooted in the ability to perceive and manage one’s or other people’s emotions

    The authors of emotional intelligence propose that people with high emotional intelligence are those who are able to solve problems relating to emotions (Salovey & Mayer, 1990). One such example cited in Mayer’s clarification on what emotional intelligence is (and is not) in Psychology Today, is the ability to accurately identify people’s facial emotion. A consequence of having emotional intelligence is the capacity to respond appropriately to perceived emotions, thus facilitating one’s ability to manage emotions in oneself and others. More recent empirical research supports the importance of emotional intelligence to successful relationships at home and at the workplace (Salovey & Grewal, 2005). Programmes to build up emotional intelligence are not only catching on at schools, a topic which a New York Times article documents and a Huffington Post report explores, but they are also being implemented at the workplace. Reassuringly, cognitive-behavioural approaches to training up our emotional intelligence are shown to be effective (“Can you really improve your emotional intelligence?”, Harvard Business Review, 29 May 2013). But first, perhaps you might want to find out what your EQ is? Try this quiz!

  • Psychological resilience is key

    Resilience is key to boosting mental wellbeing. While self-esteem and cognitive abilities likely reflect our capacity to realize our own potential, and social and emotional intelligence help us live productively and fruitfully, resilience plays an important role in our ability to cope with the daily stressors of our lives. The public broadcasting service (US) has an excellent definition of resilience, while the Huffington Post article “Hope and Survival: The Power of Psychological Resilience” offers illuminating illustrations. And there are many ways to build resilience: Psychology Today describes the 10 traits of emotionally resilient people; this magazine Experience Life! includes self-care as a useful tip; a Harvard Business Review mentions the role of optimism in building resilience; Forbes offers a change in perspective; and Life argues for teachable moments from the difficulties we face in life. We can’t possibly learn to get up when we haven’t had the chance to fall down.

  • How fluid is our cognitive capacity?

    Having good mental wellbeing also means that we’re able to analyze problems, find solutions, make decisions, and do ordinary things like remember, read, and recall things. Research shows that these abilities can be improved with training, and this applies to even school-age children. Lucky for us, other studies have demonstrated that playing video games can enhance our cognitive kills. Playing Starcraft helped young adults with no gaming experience improve their cognitive flexibility, while practice at a divided-attention task (with a car-driving video game interface) helped older adults improve not only their scores for tasks of attention skills but also their performance at working memory tasks (“Put away the knitting”, The Economist, 7 Sept 2013). Of course, it should be remembered that this is only an effective strategy when it’s novel to us. Challenging our brains to learn something cognitively demanding improves not only working memory but episodic memory – our ability to remember new things (Park & Lodi-Smith, Drew et al., 2013). This recent study shows that, in contrast, there are no benefits to staying in our comfort zone (“Mentally challenging activities improve memory as baby boomers age”, UT Dallas,  22 Oct 12). Caffeine is another way to boost our problem-solving and thinking abilities in the short-term (and the short-term can be quite useful!). But of course, too much caffeine has consequences on our ability to make good judgements about our and other people’s emotions, as well as wise decisions in difficult social situations (“Caffeine: The silent killer of emotional intelligence”, Forbes, 21 August 2012). Can’t have too much of a good thing!