See below link for full text:
http://onlinepsychologydegrees.org/10-common-myths-about-clinical-depression/
10 Common Myths About Clinical Depression
1. Depressives are ingrates who lack empathy for real suffering.
2. Depression is not an illness.
3. Depression is nothing more than sustained sadness.
4. Depression can disappear by just thinking happy thoughts.
5. Depression only affects women.
6. Depression is a choice.
7. If a parent or grandparent suffers from depression, their kids will too.
8. Suicide attempts are just a plea for attention.
9. Depression is a psychosis.
10. Depression is a result of personality flaws and weakness.
See below link for full text:
http://onlinepsychologydegrees.org/10-common-myths-about-clinical-depression/
Tuesday, November 10, 2009
Am I Depressed Or Just Deep?
Am I Depressed Or Just Deep?
Therese Borchard
Author of the blog, Beyond Blue, on Beliefnet.com
I spent my adolescence and teenage years obsessing about this question: Am I depressed or just deep?
When I was nine, I figured that I was a young Christian mystic because I related much more to the saints who lived centuries ago than to other nine-year-old girls who had crushes on boys. I couldn't understand how my sisters could waste quarters on a stupid video game when there were starving kids in Cambodia. Hello? Give them to UNICEF!
Now I look back with tenderness to the hurting girl I was and wished somebody had been able to recognize that I was very depressed.
Not that I would have accepted the help. I believed, along with all the other adults in my life, that my melancholy and sensitivity were part of my "special" make-up, that they were gifts to celebrate, not neuroses to treat. And should I take meds that helped me laugh and play and design cool barrettes like the other girls, well, then I would lose my depth.
On the PBS website "This Emotional Life"--a multi-platform project centered on a three-part series documentary to be broadcast in early 2010 hosted by Harvard psychologist and bestselling author Daniel Gilbert--psychologist Paula Bloom discusses the topic of being deep versus being depressed. On her blog post "Am I Depressed or Just Deep?," she writes:
Sometimes, people confuse being depressed with being philosophical. If I had a dollar (well, maybe $2) for every time I hear "I am not depressed, I am just realistic", "Anyone who isn't depressed isn't paying attention", or "Life has no meaning and I am going to die, how can I be happy?" I could likely support a hardcore latte habit. Depression can have such an effect on your worldview.
There are a few basic existential realities we all confront: mortality, aloneness and meaninglessness. Most people are aware of these things. A friend dies suddenly, a coworker commits suicide or some planes fly into tall buildings-these events shake most of us up and remind of us of the basic realities. We deal, we grieve, we hold our kids tighter, remind ourselves that life is short and therefore to be enjoyed, and then we move on. Persistently not being able to put the existential realities aside to live and enjoy life, engage those around us or take care of ourselves just might be a sign of depression.
We all get sad sometimes, struggle to fall asleep, lose our appetite or have a hard time focusing. Does this mean we are depressed? Not necessarily. So how do you know the difference? The answer, as with most psychological diagnoses comes down to one word: functioning. How are you sleeping and eating? Are you isolating yourself from others? Have you stopped enjoying the things you used to enjoy? Difficulty focusing and concentrating? Irritable? Tired? Lack of motivation? Do you feel hopeless? Feel excessively guilty or worthless? Experiencing some of these things may be a sign of depression.
Peter Kramer, clinical professor of psychiatry at Brown University, devotes an entire book to this question. He wrote "Against Depression" in response to his frustration of repeatedly being asked the same question: "What if Prozac had been available in van Gogh's time?"
In a New York Times essay, "There's Nothing Deep About Depression," which was adapted from "Against Depression," Kramer writes:
Depression is not a perspective. It is a disease. Resisting that claim, we may ask: Seeing cruelty, suffering and death -- shouldn't a person be depressed? There are circumstances, like the Holocaust, in which depression might seem justified for every victim or observer. Awareness of the ubiquity of horror is the modern condition, our condition.
But then, depression is not universal, even in terrible times. Though prone to mood disorder, the great Italian writer Primo Levi was not depressed in his months at Auschwitz. I have treated a handful of patients who survived horrors arising from war or political repression. They came to depression years after enduring extreme privation. Typically, such a person will say: ''I don't understand it. I went through -- '' and here he will name one of the shameful events of our time. ''I lived through that, and in all those months, I never felt this.'' This refers to the relentless bleakness of depression, the self as hollow shell. To see the worst things a person can see is one experience; to suffer mood disorder is another. It is depression -- and not resistance to it or recovery from it -- that diminishes the self.
Beset by great evil, a person can be wise, observant and disillusioned and yet not depressed. Resilience confers its own measure of insight. We should have no trouble admiring what we do admire -- depth, complexity, aesthetic brilliance -- and standing foursquare against depression.
Kramer's words are consoling to a depressive who spends 90 percent of her energy a day combating thoughts saying she is depressed because she lacks the stamina to be optimistic. In fact, the first time I read Kramer, I experienced profound relief. However, I still maintain that some of my depth caused by depression is a good thing. Not on the days where I'm in excruciating pain, of course. But should I have been one of those nine-year-olds who got excited about which color ribbon I could use to make my barrettes and wasted her quarters on Pacman ... well, I wouldn't be writing this blog.
***
Originally published on Beyond Blue at Beliefnet.com. To read more of Therese, visit her blog, Beyond Blue at Beliefnet.com, or subscribe here. You may also find her at www.thereseborchard.com.
Therese Borchard
Author of the blog, Beyond Blue, on Beliefnet.com
I spent my adolescence and teenage years obsessing about this question: Am I depressed or just deep?
When I was nine, I figured that I was a young Christian mystic because I related much more to the saints who lived centuries ago than to other nine-year-old girls who had crushes on boys. I couldn't understand how my sisters could waste quarters on a stupid video game when there were starving kids in Cambodia. Hello? Give them to UNICEF!
Now I look back with tenderness to the hurting girl I was and wished somebody had been able to recognize that I was very depressed.
Not that I would have accepted the help. I believed, along with all the other adults in my life, that my melancholy and sensitivity were part of my "special" make-up, that they were gifts to celebrate, not neuroses to treat. And should I take meds that helped me laugh and play and design cool barrettes like the other girls, well, then I would lose my depth.
On the PBS website "This Emotional Life"--a multi-platform project centered on a three-part series documentary to be broadcast in early 2010 hosted by Harvard psychologist and bestselling author Daniel Gilbert--psychologist Paula Bloom discusses the topic of being deep versus being depressed. On her blog post "Am I Depressed or Just Deep?," she writes:
Sometimes, people confuse being depressed with being philosophical. If I had a dollar (well, maybe $2) for every time I hear "I am not depressed, I am just realistic", "Anyone who isn't depressed isn't paying attention", or "Life has no meaning and I am going to die, how can I be happy?" I could likely support a hardcore latte habit. Depression can have such an effect on your worldview.
There are a few basic existential realities we all confront: mortality, aloneness and meaninglessness. Most people are aware of these things. A friend dies suddenly, a coworker commits suicide or some planes fly into tall buildings-these events shake most of us up and remind of us of the basic realities. We deal, we grieve, we hold our kids tighter, remind ourselves that life is short and therefore to be enjoyed, and then we move on. Persistently not being able to put the existential realities aside to live and enjoy life, engage those around us or take care of ourselves just might be a sign of depression.
We all get sad sometimes, struggle to fall asleep, lose our appetite or have a hard time focusing. Does this mean we are depressed? Not necessarily. So how do you know the difference? The answer, as with most psychological diagnoses comes down to one word: functioning. How are you sleeping and eating? Are you isolating yourself from others? Have you stopped enjoying the things you used to enjoy? Difficulty focusing and concentrating? Irritable? Tired? Lack of motivation? Do you feel hopeless? Feel excessively guilty or worthless? Experiencing some of these things may be a sign of depression.
Peter Kramer, clinical professor of psychiatry at Brown University, devotes an entire book to this question. He wrote "Against Depression" in response to his frustration of repeatedly being asked the same question: "What if Prozac had been available in van Gogh's time?"
In a New York Times essay, "There's Nothing Deep About Depression," which was adapted from "Against Depression," Kramer writes:
Depression is not a perspective. It is a disease. Resisting that claim, we may ask: Seeing cruelty, suffering and death -- shouldn't a person be depressed? There are circumstances, like the Holocaust, in which depression might seem justified for every victim or observer. Awareness of the ubiquity of horror is the modern condition, our condition.
But then, depression is not universal, even in terrible times. Though prone to mood disorder, the great Italian writer Primo Levi was not depressed in his months at Auschwitz. I have treated a handful of patients who survived horrors arising from war or political repression. They came to depression years after enduring extreme privation. Typically, such a person will say: ''I don't understand it. I went through -- '' and here he will name one of the shameful events of our time. ''I lived through that, and in all those months, I never felt this.'' This refers to the relentless bleakness of depression, the self as hollow shell. To see the worst things a person can see is one experience; to suffer mood disorder is another. It is depression -- and not resistance to it or recovery from it -- that diminishes the self.
Beset by great evil, a person can be wise, observant and disillusioned and yet not depressed. Resilience confers its own measure of insight. We should have no trouble admiring what we do admire -- depth, complexity, aesthetic brilliance -- and standing foursquare against depression.
Kramer's words are consoling to a depressive who spends 90 percent of her energy a day combating thoughts saying she is depressed because she lacks the stamina to be optimistic. In fact, the first time I read Kramer, I experienced profound relief. However, I still maintain that some of my depth caused by depression is a good thing. Not on the days where I'm in excruciating pain, of course. But should I have been one of those nine-year-olds who got excited about which color ribbon I could use to make my barrettes and wasted her quarters on Pacman ... well, I wouldn't be writing this blog.
***
Originally published on Beyond Blue at Beliefnet.com. To read more of Therese, visit her blog, Beyond Blue at Beliefnet.com, or subscribe here. You may also find her at www.thereseborchard.com.
Psychiatry's Dirty Little Secret
Dear readers,
Here's another article that advocates the holistic treatment of depression.
Psychiatry's Dirty Little Secret
Scott Mendelson, M.D.
When I was in medical school, I learned one of psychiatry's dirty little secrets. That is, that of people prescribed an antidepressant to treat their Major Depression, only about 25% enjoy complete resolution of symptoms, another 50% feel some but not complete relief, and the last unfortunate 25% get no relief at all. This was true 15 years ago and remains true today. As a psychiatrist, I prescribe antidepressants, and I have seen these medications improve and even save lives. There is substantial evidence in the scientific literature that certain individuals are genetically predisposed not only to develop Major Depression, but also to respond to certain types of antidepressants. Thus, there is firm basis to believe that certain individuals have specific deficits in their brain chemistries that can cause Major Depression either "out of the blue" or, more commonly, when stressful situations grow and persist beyond one's capacity to deal with them. It is likely that such people are among those that benefit from antidepressant treatments. But what of those that do not respond to antidepressants? I am happy to say that there is a growing recognition among psychiatrists that mere reduction in symptoms must not be the goal of treatment. Rather, remission of symptoms is what our patients deserve, and this should be what we strive to provide all of our patients.
One approach to bringing full remission of symptoms to patients resistant to antidepressants is augmentation of the antidepressant medication. That is, the addition of another psychoactive medication, with a different mechanism of action, to enhance the effect of the antidepressant and resolve symptoms. Studies have shown that such action can help resolve symptoms in a significant number of patients whose symptoms have resisted the effects of single medication. In fact, I was somewhat startled to see a new commercial on television pitching the use of a drug to add if depression persists while taking an antidepressant. Unfortunately, the costs, side effects, and risks of dangerous drug interactions increase with the addition of a second or even third medication. More importantly, we lack information on the physiological basis and necessity for adding medications.
Prudent psychiatrists look beyond psychoactive medications when a patient presents with Major Depression. Often, despondency is the natural response to adversities of life, and counseling, either alone or in combination with an antidepressant, is the best approach to treating a case of depression. It is also often the case that antidepressants are in order, but inadequacies such as low thyroid hormone, vitamin deficiencies, or substance abuse need to be remedied before the medication can provide all of its benefits.
All psychiatrists in training are exposed to the so-called Bio-Psycho-Social model of mental illness, which states that mental health or illness is the product of complex interactions between the brain, ways of seeing the world, and the way people interact with one another. Unfortunately, there has been a tendency to give short shrift to the role that diet plays in the prevention and treatment of Major depression. A new study in the British Journal of Psychiatry has found that people who eat a diet rich in whole grains, fresh fruit, vegetables and fish, have a 26% less chance of developing Major depression than do those who eat diets loaded with fried food, processed meat, refined grains, sugary desserts and high-fat dairy products. Although the latter diet is likely to be deficient in certain vitamins and minerals, the most concerning effect of a diet loaded with sugar and saturated fat is the development of Metabolic Syndrome.
Metabolic Syndrome is defined by the presence of high levels of fat in the form of triglycerides in the blood; low blood levels of the good cholesterol, HDL; high fasting blood sugar; high blood pressure; and abdominal obesity, which many people refer to as a pot-belly or spare tire. Although Metabolic Syndrome is well known to predispose to heart disease and diabetes, the fact that it also predisposes to Major Depression has been underappreciated. Among the ways that Metabolic Syndrome likely increases the risk of depression is by decreasing the sensitivity of insulin in brain tissue; stimulating liver functions that rob the brain of substrate for important neurotransmitters; increasing levels of the stress hormone, cortisol; and increasing blood levels of potentially detrimental substances called adipocytokines that are released in too high a concentration from abdominal fat cells stretched beyond their capacity to maintain normal function.
The reliance on "comfort foods", substance abuse, unwillingness to exercise, poor sleep, and stress seen in Major Depression is suspected of increasing the risk of metabolic Syndrome. However, there is considerable evidence that having Metabolic Syndrome may significantly increase the risk of developing Major Depression. Insulin resistance, thought to be the underlying basis of Metabolic Syndrome, is four times more likely to be seen in people with Major Depression than in those without this condition. The diagnosis of Major Depression in individuals with Diabetes is roughly three times that seen in the general population. Obesity, particularly the abdominal obesity of metabolic syndrome, is also known to increase the risk of Major Depression.
Although the pathophysiology of Metabolic Syndrome is enormously complicated, the means to treat or prevent the syndrome is astonishingly simple. To minimize the risk of Metabolic Syndrome, we must encourage diets low in sugars and saturated fats, exercise, weight control, stress reduction and adequate sleep. Some individuals are genetically predisposed to Major Depression. However, by reducing the incidence of Metabolic Syndrome, the risk of depression will be substantially reduced and the cases of depression that do arise may be more easily treated. The reliance on expensive and potentially dangerous combinations of psychoactive medications to bring relief to patients with treatment-resistant Major Depression may thus be avoided.
Dr. Mendelson is the author of the new book, Beyond Alzheimer's (http://BeyondAlzheimersBook.com).
Here's another article that advocates the holistic treatment of depression.
Psychiatry's Dirty Little Secret
Scott Mendelson, M.D.
When I was in medical school, I learned one of psychiatry's dirty little secrets. That is, that of people prescribed an antidepressant to treat their Major Depression, only about 25% enjoy complete resolution of symptoms, another 50% feel some but not complete relief, and the last unfortunate 25% get no relief at all. This was true 15 years ago and remains true today. As a psychiatrist, I prescribe antidepressants, and I have seen these medications improve and even save lives. There is substantial evidence in the scientific literature that certain individuals are genetically predisposed not only to develop Major Depression, but also to respond to certain types of antidepressants. Thus, there is firm basis to believe that certain individuals have specific deficits in their brain chemistries that can cause Major Depression either "out of the blue" or, more commonly, when stressful situations grow and persist beyond one's capacity to deal with them. It is likely that such people are among those that benefit from antidepressant treatments. But what of those that do not respond to antidepressants? I am happy to say that there is a growing recognition among psychiatrists that mere reduction in symptoms must not be the goal of treatment. Rather, remission of symptoms is what our patients deserve, and this should be what we strive to provide all of our patients.
One approach to bringing full remission of symptoms to patients resistant to antidepressants is augmentation of the antidepressant medication. That is, the addition of another psychoactive medication, with a different mechanism of action, to enhance the effect of the antidepressant and resolve symptoms. Studies have shown that such action can help resolve symptoms in a significant number of patients whose symptoms have resisted the effects of single medication. In fact, I was somewhat startled to see a new commercial on television pitching the use of a drug to add if depression persists while taking an antidepressant. Unfortunately, the costs, side effects, and risks of dangerous drug interactions increase with the addition of a second or even third medication. More importantly, we lack information on the physiological basis and necessity for adding medications.
Prudent psychiatrists look beyond psychoactive medications when a patient presents with Major Depression. Often, despondency is the natural response to adversities of life, and counseling, either alone or in combination with an antidepressant, is the best approach to treating a case of depression. It is also often the case that antidepressants are in order, but inadequacies such as low thyroid hormone, vitamin deficiencies, or substance abuse need to be remedied before the medication can provide all of its benefits.
All psychiatrists in training are exposed to the so-called Bio-Psycho-Social model of mental illness, which states that mental health or illness is the product of complex interactions between the brain, ways of seeing the world, and the way people interact with one another. Unfortunately, there has been a tendency to give short shrift to the role that diet plays in the prevention and treatment of Major depression. A new study in the British Journal of Psychiatry has found that people who eat a diet rich in whole grains, fresh fruit, vegetables and fish, have a 26% less chance of developing Major depression than do those who eat diets loaded with fried food, processed meat, refined grains, sugary desserts and high-fat dairy products. Although the latter diet is likely to be deficient in certain vitamins and minerals, the most concerning effect of a diet loaded with sugar and saturated fat is the development of Metabolic Syndrome.
Metabolic Syndrome is defined by the presence of high levels of fat in the form of triglycerides in the blood; low blood levels of the good cholesterol, HDL; high fasting blood sugar; high blood pressure; and abdominal obesity, which many people refer to as a pot-belly or spare tire. Although Metabolic Syndrome is well known to predispose to heart disease and diabetes, the fact that it also predisposes to Major Depression has been underappreciated. Among the ways that Metabolic Syndrome likely increases the risk of depression is by decreasing the sensitivity of insulin in brain tissue; stimulating liver functions that rob the brain of substrate for important neurotransmitters; increasing levels of the stress hormone, cortisol; and increasing blood levels of potentially detrimental substances called adipocytokines that are released in too high a concentration from abdominal fat cells stretched beyond their capacity to maintain normal function.
The reliance on "comfort foods", substance abuse, unwillingness to exercise, poor sleep, and stress seen in Major Depression is suspected of increasing the risk of metabolic Syndrome. However, there is considerable evidence that having Metabolic Syndrome may significantly increase the risk of developing Major Depression. Insulin resistance, thought to be the underlying basis of Metabolic Syndrome, is four times more likely to be seen in people with Major Depression than in those without this condition. The diagnosis of Major Depression in individuals with Diabetes is roughly three times that seen in the general population. Obesity, particularly the abdominal obesity of metabolic syndrome, is also known to increase the risk of Major Depression.
Although the pathophysiology of Metabolic Syndrome is enormously complicated, the means to treat or prevent the syndrome is astonishingly simple. To minimize the risk of Metabolic Syndrome, we must encourage diets low in sugars and saturated fats, exercise, weight control, stress reduction and adequate sleep. Some individuals are genetically predisposed to Major Depression. However, by reducing the incidence of Metabolic Syndrome, the risk of depression will be substantially reduced and the cases of depression that do arise may be more easily treated. The reliance on expensive and potentially dangerous combinations of psychoactive medications to bring relief to patients with treatment-resistant Major Depression may thus be avoided.
Dr. Mendelson is the author of the new book, Beyond Alzheimer's (http://BeyondAlzheimersBook.com).
Thursday, November 05, 2009
$35m More For The National Effort To Raise The Mental Wellbeing Of All Singaporeans
$35m More For The National Effort To Raise The Mental Wellbeing Of All Singaporeans
15 Jan 2009
The Government has accepted the recommendations of the National Mental Health Working Group (NMHWG) and is injecting another $35m over the next 3 years to support efforts aimed at raising the mental emotional resilience and wellbeing of Singaporeans. This commitment, on top of the $88m announced earlier, will give further impetus to synergise efforts to improve mental well being in the community. These additional funds will go towards customised education programmes for children, adults and the elderly. Singaporeans can also benefit from more ready access to support and professional help, as community partners will be trained to identify and support potential mental health problems.
Cross-sectoral Partnership for Holistic, Community-based Action
Given that one’s mental wellbeing is shaped by many socio-cultural factors, an inter-agency approach is needed to identify and implement effective measures to support the mental wellbeing of Singaporeans. The National Mental Health Working Group (NMHWG) headed by Permanent Secretary (Health), Miss Yong Ying-I was set up in 2007, with MOE, MOM, MCYS, MHA, MINDEF, NTUC, SNEF and PA as members. The NMHWG built on the existing efforts of various agencies to develop a national strategy for implementation by the public, private and people sectors.
Like physical health, acting early to build mental resilience can prevent the onslaught of mental illness and improve the chances of recovery. The NMHWG’s recommendations therefore focused on 2 strategies:
• Education and Prevention - Increasing public education to help Singaporeans learn how to improve their mental wellbeing and resilience
• Early Identification and Support – Training and building networks with community partners such as schools, social agencies and GPs so that potential mental health problems can be identified early and supported in the community
Guided by these overarching strategies, the NMHWG customised recommendations for Children, Adults and the Elderly to better address the different circumstances and challenges faced by each group. The key recommendations for each group are summarised below.
Customised Support for Each Age Group
Children and Adolescents: Currently, there are individual efforts by several agencies to support the mental development of children in mainstream schools. More recently, MOE also enhanced social emotional learning among students, to help them develop healthy relationships and build up resilience. The NMHWG recommends strengthening partnerships between MOH, MOE, MCYS and community agencies to enhance efforts in mainstream schools, and strengthen outreach efforts to children/adolescents in Post-Secondary Education Institutions (PSEIs), special education and those who are out-of-school.
Education and prevention
• HPB and MOE will enhance the existing MYM mental health education programme for children in primary and secondary schools. New programmes will also be developed for teachers, school counsellors and parents to learn how to support the mental wellbeing of children. Beyond mainstream schools, HPB will work with PSEIs to extend the MYM programme to their students.
Identification and support
• In collaboration with MOE, IMH piloted a new community mental health programme known as REACH in 2007 to train and support school counsellors and GPs in early identification and management of behavioural and emotional problems in children (see Annex A ). Following the pilot, MOE is working with some school clusters to establish Support Teams in schools so that stronger support can be provided to students. These Support Teams comprise existing personnel in the school who have experience and training in providing support for pupils with emotional and behavioural difficulties, such as the Full-Time School Counsellors (FTSCs), Head of Department for Pupil Welfare, Teacher Counsellors and Special Needs Officers. The programme will be rolled out to all primary schools, secondary schools and Junior Colleges/Centralised Institute (JCs/CI) by 2011. IMH will work with NCSS and MCYS to extend the REACH programme to community agencies such as Voluntary Welfare Organisations (VWOs) working with children. To parallel REACH for school students and younger children, the Community Health Assessment Team (“CHAT”) programme will be piloted with PSEIs in 2009 to facilitate outreach to adolescent students.
Adults: Today, efforts among agencies are focused on supporting family-friendly environments and work-life balance. More can be done to help adults cope with more specific risk factors such as poor family or work relationships and stressful events (e.g. bereavement, restructuring). The NMHWG recommends strengthening partnerships between MOH, MOM, employers and unions to introduce initiatives at the workplace. Partnership with People’s Association (PA) will also be stepped up to deliver mental health education to non-working adults in the community.
Education and prevention
• The Treasure Your Mind (“TYM”) workplace mental health education programme was launched by HPB in 2007. As the single largest employer, the public sector will implement TYM or an equivalent programme for employees by 2010. HPB has also started working with PA to conduct Nurture Your Mind (NYM) talks at community centres for non-working adults.
• An employers-led alliance was formed in July 2008 to serve as an industry catalyst to raise employers’ awareness about the importance of supporting the mental wellbeing of employees. The alliance led by Mr Hsieh Fu Hua, CEO of Singapore Exchange (SGX), brings together 10 companies from various sectors and includes representatives from NTUC, MOM and MOH. The alliance has identified a set of good practices to promote employee mental wellbeing. As a next step, they will encourage other employers to adopt these practices. (see Annex B )
Identification and support
• Community Mental Health Teams were started in 2004 by IMH to provide mobile psycho-social rehabilitation for patients. As a next step, IMH will work with CDCs to pilot a “Job Club” initiative to provide employment readiness training and work placement services for stabilised patients.
Elderly: Today, MCYS, HPB, PA and community organisations have started efforts to promote physical health and active ageing of seniors. These also support the mental wellbeing of seniors. Moving forward, the NMHWG recommends strengthening partnerships between MOH, MCYS, NCSS and PA so that efforts to promote active ageing and mental wellbeing are aligned. Targeted efforts are also proposed to educate the public about depression and dementia as these can often be passed off as a natural part of ageing and not addressed.
Education and prevention
• HPB is piloting a mental health public education programme for seniors, named “Nurture Your Mind for Older Persons Programme” (NYMOP). To-date, the NYMOP programme, which focuses on positive relationships, coping, and meaning in life has reached out to about 1,650 seniors. HPB will also scale up public education on the signs and symptoms of dementia and depression; and encourage early help seeking. (see Annex C )
Identification and Support
• The Community Psycho-Geriatric Programme (“CPGP”) was started in 2007 to train and support to staff in eldercare agencies to detect and manage seniors with psycho-geriatric problems in the community. With new committed funds, MOH, NCSS and MCYS are working with CPGP to scale up training of some 420 more staff in eldercare agencies, grassroots leaders, emergency service personnel and frontline staff in CPF Board, HDB and Town Councils. NCSS, MCYS and MOH will also work with WDA to promote the adoption of mental health skills in the Workforce Skills Qualification for the agencies in the Community and Social Services sector by early 2009.
Only the beginning, a long road ahead
As our demographic profile changes and socio-economic structures change, Singapore must look forward and prepare for the possible strains on the mental wellbeing of Singaporeans. These increasing strains affect not only the individual but also impose indirect costs on families, the society and the economy. While the prevalence of mental illnesses today is not alarming and is not expected to rise too significantly, we should be comprehensive in upgrading the capabilities of our healthcare delivery system and our residents to improve their individual wellbeing and effectiveness.
The promotion of mental wellbeing will require the joint and sustained effort of the public, people and private sectors. To ensure that inter-agency efforts are well-coordinated, the NMHWG will reconstitute itself into a standing committee and oversee the implementation of the recommendations.
MINISTRY OF HEALTH
15 JAN 2009
15 Jan 2009
The Government has accepted the recommendations of the National Mental Health Working Group (NMHWG) and is injecting another $35m over the next 3 years to support efforts aimed at raising the mental emotional resilience and wellbeing of Singaporeans. This commitment, on top of the $88m announced earlier, will give further impetus to synergise efforts to improve mental well being in the community. These additional funds will go towards customised education programmes for children, adults and the elderly. Singaporeans can also benefit from more ready access to support and professional help, as community partners will be trained to identify and support potential mental health problems.
Cross-sectoral Partnership for Holistic, Community-based Action
Given that one’s mental wellbeing is shaped by many socio-cultural factors, an inter-agency approach is needed to identify and implement effective measures to support the mental wellbeing of Singaporeans. The National Mental Health Working Group (NMHWG) headed by Permanent Secretary (Health), Miss Yong Ying-I was set up in 2007, with MOE, MOM, MCYS, MHA, MINDEF, NTUC, SNEF and PA as members. The NMHWG built on the existing efforts of various agencies to develop a national strategy for implementation by the public, private and people sectors.
Like physical health, acting early to build mental resilience can prevent the onslaught of mental illness and improve the chances of recovery. The NMHWG’s recommendations therefore focused on 2 strategies:
• Education and Prevention - Increasing public education to help Singaporeans learn how to improve their mental wellbeing and resilience
• Early Identification and Support – Training and building networks with community partners such as schools, social agencies and GPs so that potential mental health problems can be identified early and supported in the community
Guided by these overarching strategies, the NMHWG customised recommendations for Children, Adults and the Elderly to better address the different circumstances and challenges faced by each group. The key recommendations for each group are summarised below.
Customised Support for Each Age Group
Children and Adolescents: Currently, there are individual efforts by several agencies to support the mental development of children in mainstream schools. More recently, MOE also enhanced social emotional learning among students, to help them develop healthy relationships and build up resilience. The NMHWG recommends strengthening partnerships between MOH, MOE, MCYS and community agencies to enhance efforts in mainstream schools, and strengthen outreach efforts to children/adolescents in Post-Secondary Education Institutions (PSEIs), special education and those who are out-of-school.
Education and prevention
• HPB and MOE will enhance the existing MYM mental health education programme for children in primary and secondary schools. New programmes will also be developed for teachers, school counsellors and parents to learn how to support the mental wellbeing of children. Beyond mainstream schools, HPB will work with PSEIs to extend the MYM programme to their students.
Identification and support
• In collaboration with MOE, IMH piloted a new community mental health programme known as REACH in 2007 to train and support school counsellors and GPs in early identification and management of behavioural and emotional problems in children (see Annex A ). Following the pilot, MOE is working with some school clusters to establish Support Teams in schools so that stronger support can be provided to students. These Support Teams comprise existing personnel in the school who have experience and training in providing support for pupils with emotional and behavioural difficulties, such as the Full-Time School Counsellors (FTSCs), Head of Department for Pupil Welfare, Teacher Counsellors and Special Needs Officers. The programme will be rolled out to all primary schools, secondary schools and Junior Colleges/Centralised Institute (JCs/CI) by 2011. IMH will work with NCSS and MCYS to extend the REACH programme to community agencies such as Voluntary Welfare Organisations (VWOs) working with children. To parallel REACH for school students and younger children, the Community Health Assessment Team (“CHAT”) programme will be piloted with PSEIs in 2009 to facilitate outreach to adolescent students.
Adults: Today, efforts among agencies are focused on supporting family-friendly environments and work-life balance. More can be done to help adults cope with more specific risk factors such as poor family or work relationships and stressful events (e.g. bereavement, restructuring). The NMHWG recommends strengthening partnerships between MOH, MOM, employers and unions to introduce initiatives at the workplace. Partnership with People’s Association (PA) will also be stepped up to deliver mental health education to non-working adults in the community.
Education and prevention
• The Treasure Your Mind (“TYM”) workplace mental health education programme was launched by HPB in 2007. As the single largest employer, the public sector will implement TYM or an equivalent programme for employees by 2010. HPB has also started working with PA to conduct Nurture Your Mind (NYM) talks at community centres for non-working adults.
• An employers-led alliance was formed in July 2008 to serve as an industry catalyst to raise employers’ awareness about the importance of supporting the mental wellbeing of employees. The alliance led by Mr Hsieh Fu Hua, CEO of Singapore Exchange (SGX), brings together 10 companies from various sectors and includes representatives from NTUC, MOM and MOH. The alliance has identified a set of good practices to promote employee mental wellbeing. As a next step, they will encourage other employers to adopt these practices. (see Annex B )
Identification and support
• Community Mental Health Teams were started in 2004 by IMH to provide mobile psycho-social rehabilitation for patients. As a next step, IMH will work with CDCs to pilot a “Job Club” initiative to provide employment readiness training and work placement services for stabilised patients.
Elderly: Today, MCYS, HPB, PA and community organisations have started efforts to promote physical health and active ageing of seniors. These also support the mental wellbeing of seniors. Moving forward, the NMHWG recommends strengthening partnerships between MOH, MCYS, NCSS and PA so that efforts to promote active ageing and mental wellbeing are aligned. Targeted efforts are also proposed to educate the public about depression and dementia as these can often be passed off as a natural part of ageing and not addressed.
Education and prevention
• HPB is piloting a mental health public education programme for seniors, named “Nurture Your Mind for Older Persons Programme” (NYMOP). To-date, the NYMOP programme, which focuses on positive relationships, coping, and meaning in life has reached out to about 1,650 seniors. HPB will also scale up public education on the signs and symptoms of dementia and depression; and encourage early help seeking. (see Annex C )
Identification and Support
• The Community Psycho-Geriatric Programme (“CPGP”) was started in 2007 to train and support to staff in eldercare agencies to detect and manage seniors with psycho-geriatric problems in the community. With new committed funds, MOH, NCSS and MCYS are working with CPGP to scale up training of some 420 more staff in eldercare agencies, grassroots leaders, emergency service personnel and frontline staff in CPF Board, HDB and Town Councils. NCSS, MCYS and MOH will also work with WDA to promote the adoption of mental health skills in the Workforce Skills Qualification for the agencies in the Community and Social Services sector by early 2009.
Only the beginning, a long road ahead
As our demographic profile changes and socio-economic structures change, Singapore must look forward and prepare for the possible strains on the mental wellbeing of Singaporeans. These increasing strains affect not only the individual but also impose indirect costs on families, the society and the economy. While the prevalence of mental illnesses today is not alarming and is not expected to rise too significantly, we should be comprehensive in upgrading the capabilities of our healthcare delivery system and our residents to improve their individual wellbeing and effectiveness.
The promotion of mental wellbeing will require the joint and sustained effort of the public, people and private sectors. To ensure that inter-agency efforts are well-coordinated, the NMHWG will reconstitute itself into a standing committee and oversee the implementation of the recommendations.
MINISTRY OF HEALTH
15 JAN 2009
New resource centre to help recovering mental patients find jobs
SINGAPORE: There is now a new vocational rehabilitation centre that aims to help those with mental illness to select, secure and keep a job. The centre, known as Job Club, is spearheaded by the Institute of Mental Health (IMH).
IMH has been providing job training and placement services to its patients since 1972. But the Job Club aims to provide a more holistic approach – it will equip patients with critical job-seeking skills such as resume-writing and personal grooming.
Jobseekers will also get to learn skills for work through vocational training programmes offered at IMH.
The centre has successfully matched patients to nearly 400 jobs since its soft launch in April last year. These include jobs in the F&B, retail and hospitality sectors.
There are currently 59 employers registered with Job Club.
Lilian Mark Fong Eng, head of Department of Medical Social Work, IMH, said: "We have a multi-disciplinary team who conduct many field visits to both the patients' work environment, as well as home environment, to work with their employers, their caregivers and family members to ensure that they have all the support they need to sustain their efforts in keeping the job."
- CNA/so
(http://www.channelnewsasia.com/stories/singaporelocalnews/view/1015936/1/.html)
IMH has been providing job training and placement services to its patients since 1972. But the Job Club aims to provide a more holistic approach – it will equip patients with critical job-seeking skills such as resume-writing and personal grooming.
Jobseekers will also get to learn skills for work through vocational training programmes offered at IMH.
The centre has successfully matched patients to nearly 400 jobs since its soft launch in April last year. These include jobs in the F&B, retail and hospitality sectors.
There are currently 59 employers registered with Job Club.
Lilian Mark Fong Eng, head of Department of Medical Social Work, IMH, said: "We have a multi-disciplinary team who conduct many field visits to both the patients' work environment, as well as home environment, to work with their employers, their caregivers and family members to ensure that they have all the support they need to sustain their efforts in keeping the job."
- CNA/so
(http://www.channelnewsasia.com/stories/singaporelocalnews/view/1015936/1/.html)
Monday, November 02, 2009
The meaning of life after retirement
The meaning of life after retirement
05:55 AM Oct 10, 2009
by Eveline Gan
WORN out by his former stressful and hectic work life in the stockbroking industry, Mr See Chak Wah had initially looked forward to his retirement. But the novelty of being able to relax and take catnaps at whim wore off a few months after he retired at 55.
“After a while, I just started to feel that life was so meaningless. Because I was so used to being an ‘economic unit’, I felt so useless when I wasn’t out there making money,” the 60-year-old said candidly. At times, Mr See felt so depressed and disconnected with the rest of the world that he would “hide at home” and mope.
Getting the post-retirement blues, such as that experienced by Mr See, isn’t uncommon among seniors.
For some people, retirement may sometimes invoke a sense of “loss” – not just a loss of income, but also of self-esteem, said Dr Seng Kok Han, an associate consultant at the Institute of Mental Health’s department of geriatric psychiatry. Although people may financially plan for their retirement, many tend to neglect the social aspects of retirement, he added.
Ms Peh Kim Choo, assistant director of counselling and social work practice at Tsao Foundation, added: “Some people are driven by the need to be useful, and one of the main issues an older adult may face post retirement is the feeling of uselessness. This could result in negative feelings such as frustration, anger, disappointment, confusion and uncertainty.”
People at risk include those who have no recreational activities during his or her career or no friends other then colleagues in the office, and do not plan for their retirement, said Dr Seng. Those who do not have close relationships with their family may also be at risk.
Maintaining a meaningful life after retirement is important for successful ageing, said Ms Peh.
“The average lifespan of a Singaporean is 80.9 years, so we are talking about 19 years of life after retirement at age 62, so there is every reason for us to lead meaningful lives after retirement,” she said.
“A meaningful life is a mentally- and physically-healthier life.”
After moping around for about half a year, Mr See decided to pick himself up. These days, he finds fulfilment and keeps himself engaged by doing volunteer work. He currently volunteers at Tsao Foundation, giving talks and conducting workshops for seniors.
To find an outlet for his “competitive spirit”, he has also started taking table-tennis lessons. “It is important for seniors to challenge themselves, and remain useful and engaged with the community so as to keep their spirits alive. Otherwise, the more isolated you become, the more you’ll ’sink’,” he said.
To maintain a healthy mind, Dr Seng offered a few tips:
- Have a positive attitudeBe realistic, flexible and learn to accept what you cannot change.
- Build harmonious relationshipsKeep in touch with family and friends.
- Take up a hobbyTry cognitive-stimulating activities such as playing card games, chess, mahjong and reading, and keep up with current events through television, radio or newspapers.
- Take an educational courseLifelong learning provides for lifelong growth and development.
- Help othersVolunteering is a way of sharing skills or learning new ones while interacting with people and providing community service.
- Consider a new careerFull-time or part-time, it’ll keep you active. The income helps, too.
- Keep the faith Religion provides support, and a sense of life’s meaning.
Watch the warning signs
While there is no evidence that retirement increases the risk of psychiatric disorders, Dr Seng Kok Han, an associate consultant at IMH’s department of geriatric psychiatry, said those who do not plan for their retirement, or have no other interests or friends outside of their work, may be at risk of depression.
Symptoms of depression may include:
- Prolonged period of low mood, lasting more than two weeks
- Problems with sleep such as difficulty falling asleep or sleeping excessively
- A decrease or increase in appetite
- Difficulty concentrating
- Loss of interest in activities that were enjoyed in the past, and lethargy
- Feelings of worthlessness, excessive guilt and suicidal thoughts
Other warning signs of elderly depression include:
- Prominent somatic complaints, for instance preoccupation with bowel function.
- Unexplained health worries
- Heightened pain experience
- Social withdrawal
- Cognitive complaints such as problems with concentration and memory.
- Functional decline in daily activities
URL http://www.todayonline.com/Silver/EDC091010-0000045/The-meaning-of-life-after-retirement
Copyright 2009 MediaCorp Pte Ltd | All Rights Reserved
05:55 AM Oct 10, 2009
by Eveline Gan
WORN out by his former stressful and hectic work life in the stockbroking industry, Mr See Chak Wah had initially looked forward to his retirement. But the novelty of being able to relax and take catnaps at whim wore off a few months after he retired at 55.
“After a while, I just started to feel that life was so meaningless. Because I was so used to being an ‘economic unit’, I felt so useless when I wasn’t out there making money,” the 60-year-old said candidly. At times, Mr See felt so depressed and disconnected with the rest of the world that he would “hide at home” and mope.
Getting the post-retirement blues, such as that experienced by Mr See, isn’t uncommon among seniors.
For some people, retirement may sometimes invoke a sense of “loss” – not just a loss of income, but also of self-esteem, said Dr Seng Kok Han, an associate consultant at the Institute of Mental Health’s department of geriatric psychiatry. Although people may financially plan for their retirement, many tend to neglect the social aspects of retirement, he added.
Ms Peh Kim Choo, assistant director of counselling and social work practice at Tsao Foundation, added: “Some people are driven by the need to be useful, and one of the main issues an older adult may face post retirement is the feeling of uselessness. This could result in negative feelings such as frustration, anger, disappointment, confusion and uncertainty.”
People at risk include those who have no recreational activities during his or her career or no friends other then colleagues in the office, and do not plan for their retirement, said Dr Seng. Those who do not have close relationships with their family may also be at risk.
Maintaining a meaningful life after retirement is important for successful ageing, said Ms Peh.
“The average lifespan of a Singaporean is 80.9 years, so we are talking about 19 years of life after retirement at age 62, so there is every reason for us to lead meaningful lives after retirement,” she said.
“A meaningful life is a mentally- and physically-healthier life.”
After moping around for about half a year, Mr See decided to pick himself up. These days, he finds fulfilment and keeps himself engaged by doing volunteer work. He currently volunteers at Tsao Foundation, giving talks and conducting workshops for seniors.
To find an outlet for his “competitive spirit”, he has also started taking table-tennis lessons. “It is important for seniors to challenge themselves, and remain useful and engaged with the community so as to keep their spirits alive. Otherwise, the more isolated you become, the more you’ll ’sink’,” he said.
To maintain a healthy mind, Dr Seng offered a few tips:
- Have a positive attitudeBe realistic, flexible and learn to accept what you cannot change.
- Build harmonious relationshipsKeep in touch with family and friends.
- Take up a hobbyTry cognitive-stimulating activities such as playing card games, chess, mahjong and reading, and keep up with current events through television, radio or newspapers.
- Take an educational courseLifelong learning provides for lifelong growth and development.
- Help othersVolunteering is a way of sharing skills or learning new ones while interacting with people and providing community service.
- Consider a new careerFull-time or part-time, it’ll keep you active. The income helps, too.
- Keep the faith Religion provides support, and a sense of life’s meaning.
Watch the warning signs
While there is no evidence that retirement increases the risk of psychiatric disorders, Dr Seng Kok Han, an associate consultant at IMH’s department of geriatric psychiatry, said those who do not plan for their retirement, or have no other interests or friends outside of their work, may be at risk of depression.
Symptoms of depression may include:
- Prolonged period of low mood, lasting more than two weeks
- Problems with sleep such as difficulty falling asleep or sleeping excessively
- A decrease or increase in appetite
- Difficulty concentrating
- Loss of interest in activities that were enjoyed in the past, and lethargy
- Feelings of worthlessness, excessive guilt and suicidal thoughts
Other warning signs of elderly depression include:
- Prominent somatic complaints, for instance preoccupation with bowel function.
- Unexplained health worries
- Heightened pain experience
- Social withdrawal
- Cognitive complaints such as problems with concentration and memory.
- Functional decline in daily activities
URL http://www.todayonline.com/Silver/EDC091010-0000045/The-meaning-of-life-after-retirement
Copyright 2009 MediaCorp Pte Ltd | All Rights Reserved
Sunday, November 01, 2009
Interview with Greysteppenwolf
1. When did schizophrenia strike you?
I don't know. I do know that I was troubled as a teenager, I punched an electric socket, it got repaired and I punched it again (though I must emphasise I was not violent towards anyone), and I went to the top of my flat to contemplate suicide. I do know that I was nearly bedridden from stress during my A levels, and I threw up before my paper. I do know that in my second year of university I suddenly find I cannot concentrate on my studies and had flight of ideas. I also know that in 2005 I was warded in IMH because of my agitated state of mind and because I caused a scene in my family.
2. How did you know that you might have contracted schizophrenia?
I was told by my two pdocs that I had schizophrenia. I was also involved in a few research studies concerning schizophrenia and was terminated from my MOE bond without repaying it so it could not be a set-up. :-) Personally, I know I do have unrealistic out-of-the world ideas some of which got me into trouble but I don't hear voices. So yeah, I may not have schizophrenia, in the same way I have two eyes, a nose and a mouth, but it is a fact that I had gone through periods of extreme mental anguish.
3. In what ways did schizophrenia affect your lifestyle?
At first, in the throes of illness, I can lie on my bed all day, feeling utterly miserable, sometimes not able to sleep and not able to get up. Or I might so agitated that I go from temple to temple trying in vain to find peace from mental anguish.
Then there is when I am relatively well. Firstly, I have to take medications regularly, medications that have unpleasant side-effects like weight gain. I gained 10-20 kg from my medications which also caused high cholesterol. Some medications I have taken even cause palpitations. Secondly, I need to monitor my state of mind and mood and remedy any down-spiral. Thirdly, I know I can't get a high-stress or even a regular job at least now knowing from experience I may need lots of downtime, even 1 week of rest at times. I need a holistic approach to mental health with exercise, qigong, Traditional Chinese Medicine, vegetarianism, hobbies etc. That's for lifestyle. As for my life, I have trouble knowing the illness has stolen 10 years of the prime of my life when my peers have built their careers and families and convincing myself I may never fulfill my previous ambitions
4. How did you deal with your condition then?
With lots of patience, and heartache.
5. What inspired you to write a blog about mental health issues?
I started initially just to rant about life . Then one day I sat at my computer and decided I wanted my blog to be about something in particular. That's when I decided my blog should be a mental health blog. I wanted it to give hope to the mentally ill in Singapore, although I haven't succeeded.
6. Were there people who became judgmental towards you because of your condition?
There are people who believe there is no mental illness and it is a weakness of mind; you're just a weakling. There are people who tell you to think positive damned and that's it. There are people who think you're a second class citizen. There are people who say oh, it's no big deal everyone's a bit crazy. Then there was a particular principal in my stint at NIE practicum who think I'll go berserk.
It's worst when they are the ones who have control over your life. Some of these people may even be your mother or staff at IMH.
7. Do you think social stigma associated with mental disorders is a problem in Singapore?
I once used the email on this blog to apply for jobs. I was totally unsuccessful. So I think we have some way to go concerning social stigma.
8. Do you think the majority of Singaporeans are still ignorant about mental health issues?
Singaporeans are a harried lot. We don't even care about the auntie that sells tissues in the coffee shop, saying "She's got hands and legs what. Can get work." Much less someone whose disability cannot be measured and cannot be seen.
.
9. Besides getting medical treatment, what else can one do to help the patient get up on his way towards recovery?
Supportive family and friends are crucial. So is education about one's condition. Even then patience and wisdom is necessary.
10. If given the chance, what message would you want to convey to the public about mental disorders?
""A nation's greatness is measured by how it treats its weakest members." ~ Mahatma Ghandi.
I don't know. I do know that I was troubled as a teenager, I punched an electric socket, it got repaired and I punched it again (though I must emphasise I was not violent towards anyone), and I went to the top of my flat to contemplate suicide. I do know that I was nearly bedridden from stress during my A levels, and I threw up before my paper. I do know that in my second year of university I suddenly find I cannot concentrate on my studies and had flight of ideas. I also know that in 2005 I was warded in IMH because of my agitated state of mind and because I caused a scene in my family.
2. How did you know that you might have contracted schizophrenia?
I was told by my two pdocs that I had schizophrenia. I was also involved in a few research studies concerning schizophrenia and was terminated from my MOE bond without repaying it so it could not be a set-up. :-) Personally, I know I do have unrealistic out-of-the world ideas some of which got me into trouble but I don't hear voices. So yeah, I may not have schizophrenia, in the same way I have two eyes, a nose and a mouth, but it is a fact that I had gone through periods of extreme mental anguish.
3. In what ways did schizophrenia affect your lifestyle?
At first, in the throes of illness, I can lie on my bed all day, feeling utterly miserable, sometimes not able to sleep and not able to get up. Or I might so agitated that I go from temple to temple trying in vain to find peace from mental anguish.
Then there is when I am relatively well. Firstly, I have to take medications regularly, medications that have unpleasant side-effects like weight gain. I gained 10-20 kg from my medications which also caused high cholesterol. Some medications I have taken even cause palpitations. Secondly, I need to monitor my state of mind and mood and remedy any down-spiral. Thirdly, I know I can't get a high-stress or even a regular job at least now knowing from experience I may need lots of downtime, even 1 week of rest at times. I need a holistic approach to mental health with exercise, qigong, Traditional Chinese Medicine, vegetarianism, hobbies etc. That's for lifestyle. As for my life, I have trouble knowing the illness has stolen 10 years of the prime of my life when my peers have built their careers and families and convincing myself I may never fulfill my previous ambitions
4. How did you deal with your condition then?
With lots of patience, and heartache.
5. What inspired you to write a blog about mental health issues?
I started initially just to rant about life . Then one day I sat at my computer and decided I wanted my blog to be about something in particular. That's when I decided my blog should be a mental health blog. I wanted it to give hope to the mentally ill in Singapore, although I haven't succeeded.
6. Were there people who became judgmental towards you because of your condition?
There are people who believe there is no mental illness and it is a weakness of mind; you're just a weakling. There are people who tell you to think positive damned and that's it. There are people who think you're a second class citizen. There are people who say oh, it's no big deal everyone's a bit crazy. Then there was a particular principal in my stint at NIE practicum who think I'll go berserk.
It's worst when they are the ones who have control over your life. Some of these people may even be your mother or staff at IMH.
7. Do you think social stigma associated with mental disorders is a problem in Singapore?
I once used the email on this blog to apply for jobs. I was totally unsuccessful. So I think we have some way to go concerning social stigma.
8. Do you think the majority of Singaporeans are still ignorant about mental health issues?
Singaporeans are a harried lot. We don't even care about the auntie that sells tissues in the coffee shop, saying "She's got hands and legs what. Can get work." Much less someone whose disability cannot be measured and cannot be seen.
.
9. Besides getting medical treatment, what else can one do to help the patient get up on his way towards recovery?
Supportive family and friends are crucial. So is education about one's condition. Even then patience and wisdom is necessary.
10. If given the chance, what message would you want to convey to the public about mental disorders?
""A nation's greatness is measured by how it treats its weakest members." ~ Mahatma Ghandi.
Saturday, October 31, 2009
Antidepressants 'work instantly'
Antidepressants 'work instantly'
By Michelle Roberts
Health reporter, BBC News
Antidepressants get to work immediately to lift mood, contrary to current belief, UK researchers say.
Although patients may not notice the effects until months into the therapy, the team say they work subconsciously.
The action is rapid, beginning within hours of taking the drugs, and changes negative thoughts, according to the Oxford University researchers.
These subtle, positive cues may add up over time to lift the depression, the American Journal of Psychiatry reports.
It may also explain why talking therapies designed to break negative thought cycles can also help.
Psychiatrist Dr Catherine Harmer and her team at Oxford University closely studied the reactions of 33 depressed patients and 31 healthy controls given either an antidepressant or a dummy drug.
The depressed patients who took the active drug showed positive improvements in three specific measures within three hours of taking them.
These patients were more likely to think about themselves in a positive light, rather than dwelling on their bad points, the researchers said.
They were also more likely to see the positive in others.
For example, if they saw a grumpy person they no longer internalised this to think that they must have done something wrong to upset the person.
New drugs
This was despite feeling no improvement in mood or anxiety.
Dr Harmer said: "We found the antidepressants target the negative thoughts before the patient is aware of any change in feeling subjectively.
"Over time, this will affect our mood and how we feel because we are receiving more positive information."
She said the findings could help scientists looking for new drugs to treat depression.
Dr Michael Thase, a psychiatrist from the University of Pennsylvania, said the findings challenged conventional wisdoms and were potentially "paradigm-changing".
But he said much more research was needed.
"The highest research priority is to confirm that the rapid effects observed in this study are predictive of eventual clinical benefit."
He said it was possible that switching off the negative thoughts was a crucial part of the therapy.
Alternatively, it might merely be a sign that the drug was beginning to work at the cell level in the brain.
Paul Farmer, chief executive of Mind, said: "This research may contribute to our understanding of how our bodies respond to antidepressants, but the changes recorded can't always be felt by patients and it can be some weeks before they begin to feel the symptoms of depression easing.
"We must also remember that the side-effects of medication can often be felt straight away long before the benefits really kick in, and this will always affect people's experiences in the initial stages of treatment."
(http://news.bbc.co.uk/2/hi/health/8304782.stm)
By Michelle Roberts
Health reporter, BBC News
Antidepressants get to work immediately to lift mood, contrary to current belief, UK researchers say.
Although patients may not notice the effects until months into the therapy, the team say they work subconsciously.
The action is rapid, beginning within hours of taking the drugs, and changes negative thoughts, according to the Oxford University researchers.
These subtle, positive cues may add up over time to lift the depression, the American Journal of Psychiatry reports.
It may also explain why talking therapies designed to break negative thought cycles can also help.
Psychiatrist Dr Catherine Harmer and her team at Oxford University closely studied the reactions of 33 depressed patients and 31 healthy controls given either an antidepressant or a dummy drug.
The depressed patients who took the active drug showed positive improvements in three specific measures within three hours of taking them.
These patients were more likely to think about themselves in a positive light, rather than dwelling on their bad points, the researchers said.
They were also more likely to see the positive in others.
For example, if they saw a grumpy person they no longer internalised this to think that they must have done something wrong to upset the person.
New drugs
This was despite feeling no improvement in mood or anxiety.
Dr Harmer said: "We found the antidepressants target the negative thoughts before the patient is aware of any change in feeling subjectively.
"Over time, this will affect our mood and how we feel because we are receiving more positive information."
She said the findings could help scientists looking for new drugs to treat depression.
Dr Michael Thase, a psychiatrist from the University of Pennsylvania, said the findings challenged conventional wisdoms and were potentially "paradigm-changing".
But he said much more research was needed.
"The highest research priority is to confirm that the rapid effects observed in this study are predictive of eventual clinical benefit."
He said it was possible that switching off the negative thoughts was a crucial part of the therapy.
Alternatively, it might merely be a sign that the drug was beginning to work at the cell level in the brain.
Paul Farmer, chief executive of Mind, said: "This research may contribute to our understanding of how our bodies respond to antidepressants, but the changes recorded can't always be felt by patients and it can be some weeks before they begin to feel the symptoms of depression easing.
"We must also remember that the side-effects of medication can often be felt straight away long before the benefits really kick in, and this will always affect people's experiences in the initial stages of treatment."
(http://news.bbc.co.uk/2/hi/health/8304782.stm)
Tuesday, October 27, 2009
Deadly serious for Japan and S. Korea
Deadly serious for Japan and S. Korea
Both countries grappling with the rising number of suicides in recent times
By Kwan Weng Kin, Japan Correspondent
The Straits Times
(http://www.straitstimes.com/Asia/Asia/Story/STIStory_445968.html)
TOKYO: When well-known Japanese musician Kazuhiko Kato hanged himself at a hotel recently, his death sent shock waves throughout Japan's entertainment industry.
The 62-year-old was the founder of the once internationally successful Sadistic Mika Band and even better known in Japan as a member of the popular Folk Crusaders pop group in the 1960s.
However, no one batted an eyelid at the news that depression was probably the main factor behind Kato's death.
While illness of all kinds was the main reason that drove people to take their own lives, in the past few years, depression has emerged as the main reason.
Police said that last year, almost half of the suicide cases were due to depression.
Last year, people between the ages of 50 and 69 made up nearly 40 per cent of the suicide cases in Japan.
The depression was in many instances caused by factors such as retrenchment and family problems. Many who took their own lives were said to be unaware that they were suffering from depression.
Experts said that many people experience shock when diagnosed with depression. They suffer a second shock when confronted with the idea of having to go for psychiatric analysis.
The serious-minded and methodical - a description that fits many middle-aged Japanese - are said to be more prone to depression than others.
But it is not only the old who suffer.
Japan has one of the highest suicide rates in the world, particularly among developed nations.
Its annual number of suicide cases has topped 30,000 people for 10 years running, and increasingly, these days, people below the age of 40 are also taking their own lives. For most, it is depression brought on by the economic crisis.
Drastic cost-cutting by employers has come to mean less well-paying permanent jobs for young people in recent years.
A 39-year-old man, who was out of work for half a year, took an overdose of drugs when he failed to find a job after 50 interviews.
The last interviewer told him that the job offered would pay only one-fifth of what he used to earn, with no salary increments, bonuses, health benefits and of course, no career path. Doctors managed to save the man's life.
For the first half of this year, the number of suicides has already climbed to 17,076, or 768 more than for the same period last year. Of the dead, 71 per cent were male. With the Japanese economy showing little sign of an early upturn, the total for this year could well exceed the existing record of 34,427 deaths in 2003.
Among Japanese children, bullying by peers is often cited as the cause of suicide.
But one 11-year-old pupil in a public school took his own life after his teacher shook him violently by his coat lapels and demanded that he apologise to a fellow pupil for a prank.
The court decided that the teacher's action constituted corporal punishment and awarded damages to the dead boy's parents, who had sued the local authorities.
Suicides by company presidents caught up in financial scandals, or politicians implicated in major corruption cases are, however, largely a thing of the past in Japan.
The shame from losing one's parliamentary seat seems to be greater.
Former parliamentarian Hisayasu Nagata jumped from the 10th floor of a building in January this year after suffering from mental illness. He was forced to give up his Lower House seat in 2006 after he tried to frame a ruling politician using an e-mail that turned out to be fake.
In neighbouring South Korea, where suicides have climbed rapidly in recent years, the many deaths of well-known people have focused national attention on the growing problem.
In May, thousands of Koreans mourned the death of former president Roh Moo Hyun, who ended his life by jumping off a cliff. He was under suspicions of corruption, which he had denied.
Severe bouts of depression were cited as the cause of death of Korean actress- turned-singer U Nee (also known as Lee Hye Ryeon) in January 2007 and another actress, Lee Eun Joo, in 2005.
Korean attitudes towards depression as a treatable illness remain undeveloped.
Suicides are said to have doubled in South Korea in the past decade. A total of 12,858 people took their own lives last year.
Suicide is the main cause of death among young Korean adults. About 60 per cent of deaths in the South Korean military in the past four years were by suicide. A majority of the dead were young conscripts.
Saturation coverage of high-profile suicides by the Korean media is also said to have induced many copycat suicides among young people. The rise in suicides in South Korea has been attributed not only to the tough economic times, but also to factors such as the high divorce rate and the rise in credit card debt.
The state's response has been to use television commercials to urge people not to kill themselves, to set up more suicide hotlines and to train more suicide counsellors.
The Japanese have not found answers as to how to bring down their own suicide rate, though the government has been urged to provide more financial help for the retrenched or the destitute.
Meanwhile, the Japanese retain a morbid fascination with well-known people such as writers who take their own lives.
This year has seen a number of movies, books and television programmes celebrating the 100th anniversary of the birth of Osamu Dazai, regarded as one of Japan's greatest fiction writers.
Dazai, known for his gloomy wit and obsession with suicide, finally took his own life in 1948 at the age of 38 by jumping with his lover into a river swollen with rainwater, after several unsuccessful attempts in the past to kill himself. One of his best-known works is No Longer Human, about a character plunging down the road to self-destruction, which he finished a month before he killed himself.
wengkin@sph.com.sg
Both countries grappling with the rising number of suicides in recent times
By Kwan Weng Kin, Japan Correspondent
The Straits Times
(http://www.straitstimes.com/Asia/Asia/Story/STIStory_445968.html)
TOKYO: When well-known Japanese musician Kazuhiko Kato hanged himself at a hotel recently, his death sent shock waves throughout Japan's entertainment industry.
The 62-year-old was the founder of the once internationally successful Sadistic Mika Band and even better known in Japan as a member of the popular Folk Crusaders pop group in the 1960s.
However, no one batted an eyelid at the news that depression was probably the main factor behind Kato's death.
While illness of all kinds was the main reason that drove people to take their own lives, in the past few years, depression has emerged as the main reason.
Police said that last year, almost half of the suicide cases were due to depression.
Last year, people between the ages of 50 and 69 made up nearly 40 per cent of the suicide cases in Japan.
The depression was in many instances caused by factors such as retrenchment and family problems. Many who took their own lives were said to be unaware that they were suffering from depression.
Experts said that many people experience shock when diagnosed with depression. They suffer a second shock when confronted with the idea of having to go for psychiatric analysis.
The serious-minded and methodical - a description that fits many middle-aged Japanese - are said to be more prone to depression than others.
But it is not only the old who suffer.
Japan has one of the highest suicide rates in the world, particularly among developed nations.
Its annual number of suicide cases has topped 30,000 people for 10 years running, and increasingly, these days, people below the age of 40 are also taking their own lives. For most, it is depression brought on by the economic crisis.
Drastic cost-cutting by employers has come to mean less well-paying permanent jobs for young people in recent years.
A 39-year-old man, who was out of work for half a year, took an overdose of drugs when he failed to find a job after 50 interviews.
The last interviewer told him that the job offered would pay only one-fifth of what he used to earn, with no salary increments, bonuses, health benefits and of course, no career path. Doctors managed to save the man's life.
For the first half of this year, the number of suicides has already climbed to 17,076, or 768 more than for the same period last year. Of the dead, 71 per cent were male. With the Japanese economy showing little sign of an early upturn, the total for this year could well exceed the existing record of 34,427 deaths in 2003.
Among Japanese children, bullying by peers is often cited as the cause of suicide.
But one 11-year-old pupil in a public school took his own life after his teacher shook him violently by his coat lapels and demanded that he apologise to a fellow pupil for a prank.
The court decided that the teacher's action constituted corporal punishment and awarded damages to the dead boy's parents, who had sued the local authorities.
Suicides by company presidents caught up in financial scandals, or politicians implicated in major corruption cases are, however, largely a thing of the past in Japan.
The shame from losing one's parliamentary seat seems to be greater.
Former parliamentarian Hisayasu Nagata jumped from the 10th floor of a building in January this year after suffering from mental illness. He was forced to give up his Lower House seat in 2006 after he tried to frame a ruling politician using an e-mail that turned out to be fake.
In neighbouring South Korea, where suicides have climbed rapidly in recent years, the many deaths of well-known people have focused national attention on the growing problem.
In May, thousands of Koreans mourned the death of former president Roh Moo Hyun, who ended his life by jumping off a cliff. He was under suspicions of corruption, which he had denied.
Severe bouts of depression were cited as the cause of death of Korean actress- turned-singer U Nee (also known as Lee Hye Ryeon) in January 2007 and another actress, Lee Eun Joo, in 2005.
Korean attitudes towards depression as a treatable illness remain undeveloped.
Suicides are said to have doubled in South Korea in the past decade. A total of 12,858 people took their own lives last year.
Suicide is the main cause of death among young Korean adults. About 60 per cent of deaths in the South Korean military in the past four years were by suicide. A majority of the dead were young conscripts.
Saturation coverage of high-profile suicides by the Korean media is also said to have induced many copycat suicides among young people. The rise in suicides in South Korea has been attributed not only to the tough economic times, but also to factors such as the high divorce rate and the rise in credit card debt.
The state's response has been to use television commercials to urge people not to kill themselves, to set up more suicide hotlines and to train more suicide counsellors.
The Japanese have not found answers as to how to bring down their own suicide rate, though the government has been urged to provide more financial help for the retrenched or the destitute.
Meanwhile, the Japanese retain a morbid fascination with well-known people such as writers who take their own lives.
This year has seen a number of movies, books and television programmes celebrating the 100th anniversary of the birth of Osamu Dazai, regarded as one of Japan's greatest fiction writers.
Dazai, known for his gloomy wit and obsession with suicide, finally took his own life in 1948 at the age of 38 by jumping with his lover into a river swollen with rainwater, after several unsuccessful attempts in the past to kill himself. One of his best-known works is No Longer Human, about a character plunging down the road to self-destruction, which he finished a month before he killed himself.
wengkin@sph.com.sg
Monday, October 19, 2009
Hired guns? Not us, say private psychiatrists
Hired guns? Not us, say private psychiatrists
By Kimberly Spykerman
PSYCHIATRISTS in private practice have taken issue with allegations that they are simply 'hired guns' for defence lawyers, as Principal Senior State Counsel Bala Reddy described them at a recent conference.
Mr Reddy said there had been no fewer than 10 instances over the last six months in which the prosecution challenged the findings of private psychiatrists in court hearings. There was none over the same period last year.
He also suggested that defence lawyers turn to psychiatrists from the Institute of Mental Health (IMH) as the hospital was known to be both 'objective and impartial'.
But psychiatrists told The Straits Times that it is inevitable that members of their profession have different opinions as psychiatry is not an exact science.
Those in private practice say they are hardly 'hired guns' and are subject to the same level of scrutiny as those at IMH.
Dr Ang Yong Guan, a former psychiatrist for the Singapore Armed Forces who is now running his own clinic, said: 'The quality of the psychiatrist should be measured by how objective and how thorough he is.'
Last year, he penned a 34-page report on Australian journalist Peter Lloyd, who was jailed for drug offences, after extensive interviews with Lloyd, his family, friends and colleagues.
He even had the journalist warded and videotaped him to observe his behaviour. He then had him assessed by an IMH psychiatrist, whose findings matched his.
The time private psychiatrists spend assessing their patients is one reason why lawyers turn to them instead of IMH psychiatrists.
Lawyers such as Mr Amolat Singh said IMH psychiatrists may not have as much time to spend on a patient because of their heavy caseloads.
And in some cases, said lawyer Sunil Sudheesan, IMH reports take months to produce, compared with those from private psychiatrists, which can be ready within weeks, or even days.
But Dr Stephen Phang, a senior consultant at IMH, said it usually takes up to three weeks to prepare a report. He said it takes longer only if the case is complicated and there is a need for extensive clinical interviews and other medical procedures such as CT scans.
Private psychiatrists such as Dr Ang and Dr R. Nagulendran also say they are all too aware that offenders may feign conditions for the sake of getting lighter sentences.
But Dr Ang said 'good training, experience and clinical wisdom' help them weed out offenders who try to trick psychiatrists.
Dr Nagulendran, a former IMH psychiatrist who has been in private practice since 1981, said: 'We don't go in for the sake of being defence psychiatrists. We go in to assess whether there really is a problem.'
The psychiatrist, who examined child murderer Took Leng How in the Huang Na case and Kallang body-parts killer Leong Siew Chor, said he has no qualms telling lawyers if he finds nothing wrong with the offender.
Fellow psychiatrist Calvin Fones said Mr Reddy's suggestion to send all offenders to IMH is impractical. 'There are inadequate resources to meet such a need. Moreover, the sub-speciality expertise and experience required for some cases may be better found in other hospitals,' he said.
But Mr Reddy points out that it will not do the reputation of forensic psychiatrists any good if their conclusions are constantly challenged.
He said in the paper which he presented at a forensics conference here earlier this month: 'Perhaps this paper will serve as a wake-up call for forensic psychiatrists to... perhaps consider introducing ethical guidelines to help them navigate the potential pitfalls when it comes to providing expert testimony in criminal trials.'
kimspyke@sph.com.sg
By Kimberly Spykerman
PSYCHIATRISTS in private practice have taken issue with allegations that they are simply 'hired guns' for defence lawyers, as Principal Senior State Counsel Bala Reddy described them at a recent conference.
Mr Reddy said there had been no fewer than 10 instances over the last six months in which the prosecution challenged the findings of private psychiatrists in court hearings. There was none over the same period last year.
He also suggested that defence lawyers turn to psychiatrists from the Institute of Mental Health (IMH) as the hospital was known to be both 'objective and impartial'.
But psychiatrists told The Straits Times that it is inevitable that members of their profession have different opinions as psychiatry is not an exact science.
Those in private practice say they are hardly 'hired guns' and are subject to the same level of scrutiny as those at IMH.
Dr Ang Yong Guan, a former psychiatrist for the Singapore Armed Forces who is now running his own clinic, said: 'The quality of the psychiatrist should be measured by how objective and how thorough he is.'
Last year, he penned a 34-page report on Australian journalist Peter Lloyd, who was jailed for drug offences, after extensive interviews with Lloyd, his family, friends and colleagues.
He even had the journalist warded and videotaped him to observe his behaviour. He then had him assessed by an IMH psychiatrist, whose findings matched his.
The time private psychiatrists spend assessing their patients is one reason why lawyers turn to them instead of IMH psychiatrists.
Lawyers such as Mr Amolat Singh said IMH psychiatrists may not have as much time to spend on a patient because of their heavy caseloads.
And in some cases, said lawyer Sunil Sudheesan, IMH reports take months to produce, compared with those from private psychiatrists, which can be ready within weeks, or even days.
But Dr Stephen Phang, a senior consultant at IMH, said it usually takes up to three weeks to prepare a report. He said it takes longer only if the case is complicated and there is a need for extensive clinical interviews and other medical procedures such as CT scans.
Private psychiatrists such as Dr Ang and Dr R. Nagulendran also say they are all too aware that offenders may feign conditions for the sake of getting lighter sentences.
But Dr Ang said 'good training, experience and clinical wisdom' help them weed out offenders who try to trick psychiatrists.
Dr Nagulendran, a former IMH psychiatrist who has been in private practice since 1981, said: 'We don't go in for the sake of being defence psychiatrists. We go in to assess whether there really is a problem.'
The psychiatrist, who examined child murderer Took Leng How in the Huang Na case and Kallang body-parts killer Leong Siew Chor, said he has no qualms telling lawyers if he finds nothing wrong with the offender.
Fellow psychiatrist Calvin Fones said Mr Reddy's suggestion to send all offenders to IMH is impractical. 'There are inadequate resources to meet such a need. Moreover, the sub-speciality expertise and experience required for some cases may be better found in other hospitals,' he said.
But Mr Reddy points out that it will not do the reputation of forensic psychiatrists any good if their conclusions are constantly challenged.
He said in the paper which he presented at a forensics conference here earlier this month: 'Perhaps this paper will serve as a wake-up call for forensic psychiatrists to... perhaps consider introducing ethical guidelines to help them navigate the potential pitfalls when it comes to providing expert testimony in criminal trials.'
kimspyke@sph.com.sg
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