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HomesingaporeThe Big Read: Mental health no longer dirty words as awareness grows...

The Big Read: Mental health no longer dirty words as awareness grows – but are some youths adopting labels too loosely?

SINGAPORE: When then-19-year-old Ashley Poo told friends that she was diagnosed with clinical depression and anxiety, the young woman who had always come across as confident and assured was greeted with a mixture of shock and confusion.

Remarks like “why are you depressed”, “your issues are not that severe”, and “how can you be struggling when you have such a good family?” were thrown at her. 

Such reactions aggravated the poor mental state that the Republic Polytechnic student, now 22, found herself in, resulting in multiple emergency admissions to the hospital over the years.

Contrarily, when former radio deejay Kim Anne Tan shared with others that she had been diagnosed with dysthymia – also known as persistent depressive disorder – the responses she received were nothing but supportive.

“I’ve never met a single person who was like, weirded out by it. Everyone, even if they didn’t understand what the condition was or they weren’t sure, nobody was negative,” the 28-year-old said.

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From TODAY’s recent interviews with Ms Poo, Ms Tan and five other youths who had struggled with their mental health, one common thread that emerged with regard to how loved ones responded to their battle against mental illness was how extreme those reactions could be – from denial and dismissive to showing care and concern.

One interviewee who did not wish to be named said that her parents had hinted that she was part of a “soft” generation of youths.

“My mother would say in Mandarin, ‘I’ve eaten more salt than you’ve had grains of rice’,” she said, implying that people “back in the day” had more challenges to deal with. 

Another interviewee spoke of how her parents neither accepted nor validated her struggles, and started to “push her away” after she began showing signs of reclusiveness due to trauma – in stark contrast to how they treated her brother who had been diagnosed with another mental health disorder.

As the world marks Mental Health Day on Oct 10 amid global concerns that today’s youths are more mentally unwell than previous generations due to a myriad of uncertainties, TODAY spoke to mental health experts, advocates and survivors for some insights into how Singapore is dealing with the issue, and how youths can be better supported in their struggles. 

FLIP SIDE TO GREATER AWARENESS – SELF-DIAGNOSIS

For one, the increase in therapy-speak in social discourse could lead to the trivialisation of those who suffer from mental health issues, said some of TODAY’s interviewees.

Using the word “trauma” callously, for instance, could trigger “a real trauma” in another person, said Ms Ong. 

“And if that person who was listening in feels trivialised without the right support system, it’s possible that person could go into a very unsafe place without any help available.”

There is also the concern that youths might be too quick to diagnose themselves with mental illnesses based on symptoms found online, even though these may not be accurate.

Indeed, some mental health practitioners who offer counselling and therapy services said that they have observed more youths entering consultations with a preconceived idea of the mental illness they have before being officially diagnosed.

Dr Charmaine Tang, chief of the department of psychosis at IMH, said that her initial reaction to such patients was the worry that normal experiences in people’s daily lives might be “over-medicalised”. 

For people who face everyday emotions like stress, anxiety or low mood, “we don’t want to equate that straightaway to – ‘oh, you’ve got depressive disorder’, or ‘you’ve got a diagnosis’,” she said.

A misdiagnosis or overdiagnosis of mental health conditions can also potentially lead to a “diversion of already-scarce mental health resources away from those who need them”, said Dr Adrian Loh, a senior consultant psychiatrist at Promises Healthcare, a psychiatry and psychology clinic.

“It can lead to more people thinking that an underlying condition will limit their own chances of flourishing in life. It can also paradoxically cause more stigma if people come to doubt the legitimacy of those seeking help,” he added.

Mr Asher Low, founder of the mental health non-profit organisation Limitless, said that such misuse of words tends to stem from an unintentional misunderstanding of their original meanings, and can result in “unhelpful” perspectives on dealing with personal problems.

He cited the example of the word “boundaries” – which refers to one protecting one’s own free time, personal space and even money from being taken away by others – but may be interpreted as cutting “everyone off”.

Sally (not her real name), a 25-year-old working in the healthcare industry who has been seeing a therapist for the past three months for her own mental health struggles, feels that workplace initiatives aimed at improving mental wellness might have started off as well-intentioned, but has “gotten to the point where it feels performative”. 

She cited the example of how, in her search for companies who were accepting of employees with mental illnesses, firms tended to trot out mental health benefits that were largely inadequate, like “one wellness off-day”, or a minimal amount of reimbursement for a single therapy session.

Her view was echoed by Mr Loo of Resilience Collective, who said that it is important for institutions to “operationalise” its mental wellness initiatives in a mindful manner – focusing on both the needs of its employees and the need for results.

“It should not be productivity at the expense of mental health, but productivity as a result of attending to mental health,” he said.

“While initiatives like monthly staff fitness programmes are well-meaning, it needs to go beyond that into something integrated into your policies and routine practices, so that it becomes something that we constantly are attuned to, something that we are mindful about.”

HOW TO HELP THOSE WITH PROBLEMS

At the core of mental health literacy is the understanding of mental health conditions, and by extension, the ability to distinguish between a temporary mental setback from certain circumstances and a protracted mental health challenge that might need clinical support.

According to Dr Loh of Promises Healthcare, the symptoms of many mental disorders are often a common feature of a person’s life experience, and knowing when to seek professional help is important.

He said that the symptoms which may warrant concern can be broken down using a framework of three “D”s and two “P”s:

Distress: The level of discomfort and suffering related to the symptomsDysfunction: The resulting impact of the symptoms on one’s roles and responsibilitiesDeviation: The degree of divergence from accepted social norms like personal space and physical touch between peoplePervasiveness: The breadth across settings in which the symptoms manifest – like at home, in school, or in social situationsPersistence: The duration across time the symptoms are present

Mr Roberts of Olive Branch also suggested various coping strategies to deal with the stresses of daily life.

This includes dedicating time to self-care activities or hobbies that one enjoys, attempting guided, mindfulness meditation via apps or videos to help reduce one’s anxiety, and making an effort to connect with friends who can provide the person with emotional support.

However, Mr Low of Limitless said that people should seek professional help when they notice three key things: Their usual coping mechanisms do not work; the symptoms have persisted for an extended period of time; and it severely affects their quality of life. 

For those who hope to be of better help to friends and loved ones who may be struggling with their mental health, the youths whom TODAY spoke to shared about the kind of support they would have liked when they were grappling with the problem.

Ms Poo, who shared that she had previously lost a few friends to suicide over the years, said that it is important for people not to be too “quick to judge or offer solutions”, and instead simply lend a sympathetic ear. 

While she still struggles with her mental health from time to time, Ms Poo believes that she has a clearer awareness of her condition today and has made it her mission to spread better mental health awareness, not wanting “the next generation to experience what I went through”. 

The integrated events management student is now a mental health advocate and youth fellow with the digital stress management platform mindline.sg. 

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