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.

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

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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.

“Let’s find out more about mental illness”

Mental health resources

Yes, let’s. The article “Let’s find out more about mental illness” published in Straits Times, 16 Nov 2013, talks about childhood mental health disorders, and specifically, depression, anxiety, and schizophrenia.

It’s timely, given that understanding about mood and anxiety disorders involving adults tends to be poor, let alone mental health disorders involving children and adolescents. And it’s a good time as any to talk about mental health disorders, especially in the light of recent news reports involving individuals with depression.

But what is it that we understand about mental health disorders? From the resources made available to various organizations dealing with mental health issues, quite a lot actually.

But first, maybe we should know at least a few things worth knowing:

1. Stigma is everywhere, not just in Singapore.

That there is local stigma about seeking help for mental health disorders is not surprising.

But these are ubiquitous issues, relevant to other communities such as those in UK (“Understanding anxiety and mental health stigma”, The Guardian, 27 Sep 2013), Australia (“Mental health stigma still affecting Australian workers, with research showing 4 in 10 hide depression from their employers”, ABC, 12 Nov 2013), Canada (“Montrealers demonstrate to end mental health stigma”, CBC, 20 Oct 2013), Hong Kong (“First mental health web radio in Hong Kong raises the community’s awareness on mental illness and mental health”, UHK, 15 Nov 2013), and Taiwan (“Society must confront mental health stigma, redefine success”, The China Post, 3 June 2013).

We may not have progressed very far (“S’poreans fear mental patients, study finds”, Straits Times, 29 Oct 2007), but at least we’re increasingly cognizant of the issues and are adding to facts not fiction.

This Huffington Post article provides 3 helpful suggestions for how you and I can make a difference. The UK campaign which started in 2009 to end mental health discrimination at their www.time-to-change.org.uk offers useful tips on how to talk about mental health issues.

2. There are resources out there for the public.

3. There’s information about mental health disorders in children and adolescents.

4. Other resources include information about developmental disorders.

5. We can always do more.

A 2012 report in the Singapore Annals Academy of Medicine did not investigate whether their stratified sample of 6616 respondents, among whom 12% met the criteria for mood, anxiety, or alcohol use disorders but less than a third had sought professional help, used the internet to find out more about mental health disorders. Given that the same report acknowledges 80% or more of the local population aged 49 years and below (and 40% of those aged 50 to 59 years) has internet access, there’s much scope for accurate information about mental health to be provided on an online platform. This BBC Wales health report presents possibilities, while the UK Child and Maternal Health Intelligence Network offers ideas via a Tackling Stigma Toolkit. There are always more things that can be done. Something we can work towards perhaps?