What’s the difference between mental health and mental illness?

target

There are many local news stories which implicate mental health issues. But rarely an explanation about the mental health issue involved.

We use the term “mental illness” to refer to medical conditions including schizophrenia, depression, and bipolar disorder. Other times, we use the term “mental health” to refer to the same things.

But there are conceptual differences. WHO defines mental health as “a state of complete physical, mental and social well-being, and not merely the absence of disease“. That means that mental health is also about our immune system, physical health indices, life satisfaction, and psychological wellbeing, as well as our capacity to regulate mood and manage emotions, ability to manage daily stress, resilience, and coping mechanisms for dealing with stressful events.

The collaboration between mental health professionals and the police service (e.g., a UK pilot scheme) is a step in the right direction. Education is of course a reliable way to address mental health awareness issues at the workplace.

But what information is available about mental health in Singapore? A speedy search on google for local information about individual mental health issues and concerns yields at least one relevant website. Here’s a cheat sheet:

1. Stress
HPB lists the impact of stress on our physical and mental health: SAMH has useful tips for managing stress levels.

2. Depression
HPB lists symptoms to look out for: Insights into myths and misconceptions here.

3. Eating disorders
AWARE offers an FAQ on eating disorders here.

4. Anxiety
HPB offers an overview of anxiety, including symptoms and treatment options.

5. Obsessive Compulsive Disorder
HPB lists the symptoms of OCD.

6. Alcohol Dependence
NAMS lists the warning signs.

7. Gambling Problems
NAMS lists the signs to watch out for and offers a tool for self-assessment.

8. An Addiction to Gaming
Among the signs is the use of gaming as a means of escaping problems and the act of concealing game playing from family and friends. Read this NAMS overview.

9. Substance Dependence
Watch out for these behaviours in your co-workers (NAMS).

10. Schizophrenia
Schizophrenia is defined by IMH as “a disorder of fragmented mental processes”. Click here for more information.

11. Dementia
Working adults are increasingly faced with the challenges of juggling work and caregiving roles: Alzheimer’s Disease Association and HPB have fact sheets.

12. Learning Difficulties
Employees are also often parents who may have children with learning difficulties at school. Attention deficit (hyperactivity) disorder or ADHD information is available on Spark, while dyslexia assessments are available through the Dyslexia Association of Singapore. Autism resources are abundant at the Autism Resource Centre.

The International OCD Foundation has a useful fact sheet on hoarding. Finally, Singapore Focus on the Family offers advice for families faced with bullying at school, while the Media Literacy Council has information for individuals experiencing cyberbullying and AWARE has advice for personal protection orders and family violence.

Information is power. Don’t be afraid to use it.

Unsuitable behaviour

It’s the story of “the suitor who won’t take no for an answer” (Straits Times, 11 March 2014).

Boy meets girl. They go on a couple of dates. On date #3, they discuss marriage and children. Jealous, possessive, and manipulative behaviours surface. She stops answering his calls. But he continues the incessant phone and text campaign. She closes her facebook account and opens a new one—twenty times. He calls her at the office, turns up at her workplace, verbally abuses her family on the phone and online, sends her flowers at her home to let her know that he knows where she lives. She makes numerous formal complaints. But the damage is done.

At what point should we do something about it? Let’s rewind.

Boy meets girl. They go on a couple of dates. On date #3, they discuss marriage and children. Sharing one’s views about marriage and children. Yes, one expects to have that discussion at some point. But talking about getting married at date #3? Jealous, possessive, and manipulative behaviours surface. Alarm bells start to ring. One would think about not having any more to do with this person. That’s exactly what happens. She stops answering his calls. But he continues the incessant phone and text campaign. She closes her facebook account and opens a new one. Wait. Doesn’t this sound a lot like bullying?

The official definition of bullying is “a situation where a powerful bully intentionally harms a vulnerable and isolated victim through repeated hurtful behaviours that can result in damaging consequences” (Singapore Children’s Society). Said another way, it’s when someone does something with the intention of hurting someone else, more than once. In fact, online bullying is up for discussion today—”Let’s start an open conversation about bullying” (Today Online, 11 March 2014). So it’s not a story about a “suitor”, but about a “bully”.

Legal protection is one thing. But the real issue is the mental health and emotional wellbeing of the person who has been bullied and/or been the subject of harrassment.

There is much consensus that bullying has negative consequences in terms of poor physical and mental health: Bullied children are at risk for depression and have poor self-worth (CNN, 17 Feb 2014), while harrassment puts adults at risk for depression and post-traumatic stress disorder (www.livescience.com).

So what can we do about it?

Writing a letter to the bully to communicate that the behaviour is unwelcome, is an important first step. Writing down all encounters factually (supported by audio-video documentation and copies of any written correspondence) with dates, times, witnesses, and location details, in chronological order, is equally important.

In the meantime, we can reduce the negative effects of bullying and harrassment by taking some extra steps:

1. Change your mobile phone number and give it out to your close friends and family. They have your interests at heart. So they will understand that you need to do this.

2. Carry a second mobile for work and activate caller ID. You could redirect your direct dial office phone to your new mobile number and use voicemail to screen your calls.

3. Request that your telco block your telephone numbers from being displayed on the called party’s phone (e.g., the Caller Number Non-Display option).

4. Ask everyone to email you rather than call you (you can call them back).

5. Set up a new alias email address at work with your initials instead of your full name.

6. Set up a new personal email account. Give it out sparingly, as least initially.

7. Open a new facebook account, choosing the privacy settings which allow only friends of friends to search for you and only friends to message you and access your newsfeed, pictures, and posts. Choosing a profile picture and profile name which conceals your identity, declaring fewer pieces of information about yourself (e.g., contact details, your social networks, the city you live in, the schools you’ve attended), and adding friends judiciously are all key to playing a successful cat and mouse game. 

8. Allow only trusted friends and family to access your contact details and online status on messenger platforms such as  whatsapp.

9. Change your routines by choosing a different route to work or by leaving home or the office at different times.

10. Ask your extended family to call before coming to visit. Make arrangements so that you’re not the first to arrive when you meet your friends on social occasions.