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You are here: Home / Archives for Depression

When Men Cry: Understanding Common Psychopathology in Men.

March 12, 2023 By Dr Lim Boon Leng

1) What are the most common mental health issues affecting men, and do you have statistics for the percentage of Singaporean men who are affected by these issues? 

Common mental health issues for men include Depression, Generalised Anxiety Disorders (GAD), Obsessive Compulsive Disorders (OCD) and Alcohol Use Disorder. 

Overall about one in 16 men will experience at least one of this condition in his lifetime. 
The lifetime prevalence of depression in men is 4.3%.
The lifetime prevalence of GAD is 1.6%.
That of OCD is 3.6%.
That of alcohol use disorder is 4.1%.

2) What causes these mental health issues? 

The actual causes are not known but these mental health issues are related to genetics, childhood trauma, environmental stress, negative personality resulting in negative outlooks, and use of substances and alcohol. These factors can result in aberrations in the neurotransmitters in our brain resulting in mental illnesses.   

3) What are some signs and symptoms of these issues? 

Depression is characterised by i) depressed mood nearly every day, ii) loss of interest or pleasure in most activities, iii) significant weight loss or weight gain, iv) poor sleep or over sleeping, v) agitation / irritability / restlessness or feeling slowed down vi) feeling tired easily or loss of energy vii) feeling worthless or having excessive guilt, viii) poor concentration, difficulty thinking or forgetfulness and ix) suicidal thoughts, plans or attempts.

GAD is characterised by i) constantly worrying or obsessing about small or large concerns ii) feeling restless, keyed up or on the edge iii)fatigue and easily getting tired iv) difficulty concentrating or mind “going blank” v) irritability and feeling frustrated vi) Muscle tension or muscle aches and vii) trouble sleeping.

OCD is characterized by obsessive thoughts and compulsive behaviours. Obsessive thoughts are experienced by the individual as intrusive and distressing. Common obsessive thoughts include i) fear of contamination by germs or dirt, ii) intrusive thoughts about symmetry and orderliness and iii) obsessive thoughts of checking things.

As a result of the obsessive thoughts, the individual feels that he has to perform a certain act (compulsive behaviours) to undo the obsessions. These include excessive washing and cleaning and/or checking and counting. The compulsions are often performed in a ritualistic manner over a “magical” number of times.

Alcohol use disorders are unhealthy patterns of use of alcohol resulting in harm including binge drinking and addiction to alcohol.

4) Why do so many men avoid seeking professional help for their mental health issues? What is the stigma surrounding this? 

Our society expects a man to be strong and to deal with his own problems himself. As a result, Singaporean men often put up a brave front in the face of adversities. This means that men are less likely to acknowledge their emotional problems and will not seek help if they have psychological difficulties as they are afraid that they may be seen as weak.

Many worry that their employers will come to know that they suffer from psychological illnesses and their careers will be affected. And as men are often expected to be the main breadwinner, they are even more afraid of jeopardizing their job.

5) How can such mental health issues affect men if they’re left untreated or undiagnosed?

Often family members would tell the patient suffering from mental illness to just “get out of it” or to “will it away”.

However, psychiatric illnesses are genuine medical illnesses. One cannot simply will it away and will require help and treatment. If left untreated, mental illness can cause problems in relationships and at work.

When unwell, men can be irritable leading to quarrels with spouse, partner and children. Work can be compromised when they have no motivation. poor concentration or are fixated on the difficulties arising from the symptoms.

To relieve their symptoms, men may turn to alcohol, drugs, pornography and gambling.

Most significantly, we know that men are less likely to express or talk about their symptoms but are very much more likely than women to complete suicide.

6) How can men preserve and protect their mental health on a daily basis? Can you talk about good health habits like stress management, a healthy diet, sleep, exercise, opening up to others, etc?

Start with simple practices like keeping to a good routine. Make sure you have adequate rest, sleep enough, have time for meals and toilet breaks. 

Either have long easy walks daily, or more intense exercising three times a week for at least 30 mins if physically permitting. 

Once you have the basic routines, ensure you look into me time, hobbies and spending time with your spouse.

These and managing your amount of work and hence work stress will help with stress management.

Particularly important for men, be mindful of alcohol use and not be seduced by substance use to numb yourself. 

Don’t be afraid of showing your emotions and in fact crying can be cathartic.  Also, don’t be afraid to talk to your loved ones about your difficulties, be it stress with work or your symptoms. 

7) Many men feel lonely and isolated – how can they overcome these, especially if they are unmarried, have no close family nearby or live alone? 

Being isolated increases the risk of mental illnesses and even suicide. 

Even if you are unmarried and have no close family nearby, maintain good friendships and engage with the community. You can participate in volunteering, join an interest group or play group sports regularly.

With social media and video conferencing, you can also keep close to your family via technology.

Having a pet like a dog has been shown to be protective for isolated individuals.

Life can still be fulfilling without anyone with you if you engage in meaningful activities and hobbies.

Filed Under: Anxiety Disorder, Depression, General, Uncategorized Tagged With: addiction, anxiety, depression, gad, men's mental health, ocd

Depression: Burden of Disease

August 13, 2018 By Dr Lim Boon Leng

Excerpts from a recent interview:

1) It has been projected that depression will be the 2nd leading cause of disease by 2020. Why are we seeing this increase in cases of depression worldwide?

It has been postulated that modernisation is correlated with an increase in the prevalence of depression. This may be related to modern diet and a lack of activity, resulting in obesity and more health problems like diabetes. Chronic health issues are factors in precipitating depression. The decrease in exposure to sunlight as we tend to stay indoors more and decrease in sleeping hours can lead to circadian dysregulation resulting in depression. The ready availability and willingness of people to take illicit drugs and abuse alcohol may also increase the rates of depression. From a social perspective, urbanisation and having to live in crowded quarters, a decrease in faith towards religion and an emphasis on individualism and social isolation can all contribute to this trend of depression

2) In Singapore, are there any groups of people who are more at risk of having depression? (in terms of age/race/gender/socioeconomic background etc)

Generally, women are more at risk of have depression. This may really be related to women being more in touch with their emotions and being more likely to present with depression whilst men turn to alcohol and substance abuse. Teens and the elderly are also more at risk of developing depression.

3) Why is depression a form of disability? How does it manifest as one?

Depression can be debilitating. Even in mild form of depression, the patients can have difficulties concentrating, making decisions, feel lethargic and experience a slowing in their thinking processes, making everyday activities and work hard to accomplish. In severe forms, they may be incapacitated and housebound, losing all energy to go out and having no confidence to face the world.

4) Other than the fear of stigma, what are the difficulties that your patients face when they seek treatment for depression?

The understanding of depression is poor. Many still do not see it as a multi-factorial medical condition and think that there is a root cause that they can get rid of. Sufferers often think that they can snap themselves out of depression just by being positive. Often even when they want to seek treatment, they may meet resistance from family members who urge them not not to have treatment but instead advise them to do the impossible by snapping themselves out of depression. Many also view treatment with suspicion and think of antidepressants as dangerous drugs. They believe erroneously that medication will numb the mind, cause addictions and dependency and cause long time physical problems. For therapy, they assume that it is something didactic and are not willing or motivated to put the hard work and hours necessary to improve.

5) Can patients get an MC (medical leave) when they have depression? If so, are there any criteria they have to meet?

Yes, they can get MC. As long as they are having clinical depression and this is affecting their work or social life, MCs may be warranted. In Singapore, the problem is that even when MCs are offered, patients often decline as they cannot afford to rest from work.

6) Can depression be treated or can it only be suppressed with medicine?

They can be treated effectively with antidepressants and many will recover. Conversely, if depression is not treated, it can become long term and chronic. That is when a person will have to take long term medications and be reliant on treatment.

Filed Under: Depression Tagged With: Burden of disease, chronic illness, depression, stigma

Four Differences Between Depression and Burnout

April 25, 2018 By Dr Lim Boon Leng

Many a times, clinical depression can be triggered by stresses at work. It is no wonder then that people often wonder what the differences between depression and burnout from work are.

1. Depression, A Diagnosis. Burnout, A Description

The biggest difference is that clinical depression or major depressive disorder is a formal psychiatric diagnosis whilst burnout is a description of one’s feelings towards work. To be diagnosed with clinical depression, the sufferer has to have several symptoms of depression and for a duration of at least 2 weeks. You can read this page to find out more about clinical depression.

“Burnout” was coined in the 70s by psychologist, Herbert Freudenberger. To date there is no scientific definition for burnout. It is  general description of  loss of interest and motivation towards work, following a long period of excessive stress. The sufferer complains of tiredness and lethargy. He or she may feel unappreciated and may be cynical about work and colleagues.

2. Pervasiveness

If an individual is just burnt out from work and has not developed clinical depression, the difficult mood and lack of motivation is generally limited to work and work related events. He will feel fine when he is at home, or when he is doing his hobbies. A tell tale sign that this is just burnout and not depression is if the individual feels alright during weekends and starts to worry and brood about work on Sunday night. In depression, not only will the individual have a sense of negativity towards work, the negativity spreads to many other areas of life as well.

3. Severity of Symptoms

Compared to just burnout where physical exhaustion, feeling low about work and poor work performance are typical symptoms, the symptoms of clinical depression can be a lot more serious and include:

i) Hopelessness and Despair
ii) Low Self Esteem and Loss of Confidence
iii) Suicidal Thoughts and Suicidal Attempts

4. Treatment Recommendations

For purely individuals with burnout, removing the source of stress will lead to rapid improvement of symptoms. Quitting or changing one’s job will help to rid one of the feelings of burnout. However, in clinical depression, the sufferer will persist in feeling negative about his new circumstances or new job. In fact, losing one’s job may aggravate the depression! As such, allowing the depressed individual to have some rest from work and to only make a decision AFTER the depression has been adequately treated is important.

When Burnout is Depression and Vice Versa….

The relationship between burnout and depression is a complex one with numerous overlap in symptoms and a bi-directional influence. It is easy to see why a burnout individual who is unhappy at work is at risk of developing depression. Clinical depression can bring about a loss of motivation and lethargy which can worsen work burnout as well. When this happens, the sufferer becomes trapped in a negative vicious cycle.

Regardless of the terminology, there are solutions and treatment for both work burnout and clinical depression. Identifying and delineating the two with careful assessment and investigations will help the clinician / psychiatrist provide the best and optimum treatment for the patient.

Filed Under: Depression Tagged With: Burnout, depression, Treatment

Depression

depression singapore

depression, loss of interest, loss of appetite, poor sleep, forgetfulness, irritability, guilt feelings, suicidal … Read More

ADHD

ADHD Singapore

adult and child: ‎inattentiveness, restlessness, impulsivity, disorganisation, forgetfulness, distractibility, … Read More

Anxiety

Panic Attack

worries, anxious feelings, fears, muscle tension, stress, fatigue, phobias, panic attacks, social anxiety Anxiety … Read More

Obsessive-Compulsive Disorder (ocd)

obsessions, intrusive thoughts, repetitive behaviours, compulsions, handwashing, checking, symmetry, … Read More

Conditions Seen

Depression, low mood and sadness

Child and Adult ADHD / ADD

Anxiety Disorders including:
– Panic Attacks and Panic Disorder
– Phobias / Social Phobia
– Psychological Trauma / Post Traumatic Stress Disorder (PTSD)
– Generalized Anxiety Disorder
– Obsessive Compulsive Disorder

Insomnia

Bipolar Disorder / Mood Swings
Stress & Adjustment Disorders
Psychosis & related conditions

Men’s Mental Health
Women’s Mental Health

Old Age Psychiatry

… Read More

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