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.

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.

Getting your facts straight

Recent media attention on substance abuse, problem gambling, and other addictions has put the thorny issue on the spotlight yet again. Although acupuncture is a new addition to the current multidisciplinary treatment approach comprising medication and counselling (“IMH takes a stab at helping addicts”, Straits Times, 6 Sept 2013), there are a number of existing resources available to address the problem of addictions:

1. Local resources

  • National hotline for all addictions: 6-RECOVER (Mon to Fri, 8.30am to 10pm)
  • National hotline for Problem Gambling: 1800-6-668-668 (24h hotline)
  • Resources and services | National Addictions Management Service (NAMS)

2. Problems with substance use

Drug addiction is a complex disease (NIH). It’s important to have the facts:

3.  Problems with alcohol use

When does drinking become a problem? Find out from this NAMS fact sheet.

4. Problem gambling

Activation of brain reward areas of people with problem gambling is similar to those of people with alcohol use disorders. It’s important to know the signs: