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.

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.

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!