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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

Psychiatrist vs Psychologist

March 14, 2018 By Dr Lim Boon Leng

In Singapore, many people do not know the differences between psychiatrist vs psychologist. What do Singapore psychiatrist do? How are they different from psychologist? Even healthcare professionals sometimes get confused between psychiatrist and psychologist. Let me start by explaining what Psychiatry is as that was where it all started from……

What is Psychiatry? A Historical Perspective.

Psychiatrist vs Psychologist Pic

Sigmund Freud, Father of Psychiatry

Psychiatry is a medical specialisation focusing on mental illnesses and disorders. Before Psychiatry, mental disorders were thought of as demonic possessions or character flaws. Sufferers were often locked up and kept away from society. In the 20th century, psychological treatments were discovered for these illnesses. In the early 1800s, mood disorders started to be recognised as a psychiatric disorder. Doctors and scientist started to classify these disorders and to study them scientifically. In the 1880s, Sigmund Freud, started his career as a neurologist. He went on to help patients who suffered from hysteria with hypnosis but quickly abandoned hypnosis as a clinical technique, both because of its inconsistency and ineffectiveness and because patients were able to retrieve crucial memories and process them while conscious.  This lead to him devising the technique of psychoanalysis or talk therapy. Subsequently the discipline of psychiatry branched into psychology when non-medically trained individuals became proficient in these talk therapy to become experts in their own rights. These experts came to be known as psychologists and they help further evolve talk therapy to its current modern versions like Cognitive Behavioural Therapy.

Following talk therapy, the first medication for psychiatric disorders were discovered in the 1950s. First tranquilisers were discovered and were found to in fact help with the symptoms of Schizophrenia like delusions and hallucinations. Subsequently sleeping aids and antidepressants were discovered bringing about relief to hundreds of millions of sufferers.

Who are Psychiatrists? The Practice of Modern Psychiatry.

Today, Psychiatrists are medical doctors who are trained and specialises in the field of psychiatry and psychology. As medical doctors, we are trained to identify and diagnose psychiatric and mental disorders. At times, there may be need for physical examinations, blood tests, brain imaging and pharmacogenomic testing to exclude other physical conditions or to help with further treatment. We can then prescribed the necessary treatment for our patients and these can be therapy, medications and even simple lifestyle changes.

When it comes to talk therapy, the role of psychiatrists, psychologists and counsellors often overlap. Depending on his training, the psychiatrist may decide to perform the talk therapy with the patients himself. Often, he will work with the psychologist or counsellor in his team to implement the therapy.

Psychiatrist vs Psychologist. Who to see?

This is where it may sometimes get confusing. If you suspect you or your loved one has a psychiatric illness or condition, it will be best for you to seek help from a medical doctor. A good staring point may be your family physician or a psychiatrist. Many a times, medical conditions (eg. Hyperthyroidism) can masquerade as low mood, anxiety or poor sleep. You should see someone medically trained to make sure that the psychiatric condition is not due to a medical or physical problem.

For this reason, in most Singapore public hospitals, you will need to consult a psychiatrist before you can be referred to a psychologist or a counsellor for therapy. The psychiatrist plays the role of a case manager, is responsible for making the diagnosis and to decide on the treatment plans for you. Only a medically trained doctor can order blood tests, brain imaging or prescribe medications. He will bear the medical and legal responsibility of your well being.

However, if you are looking for help to talk about difficult issues in your life, or a specific problem, like relationship issues with your partner, and you are sure you are not looking into a medical model of treatment, a counsellor or a psychologist can be a good starting point. In particular, clinical psychologists are trained to provide therapy to help with emotional and psychological issues.

For the best outcomes in treatment, a multi-pronged biological-psychological and social approach is recommended. Hence, when considering private care treatment, it is important to remember that a psychiatrist is in the unique position to provide and recommend holistic and comprehensive care:

  • Exclude other medical problems
  • Diagnose your condition
  • Prescribe the appropriate medication /  biological therapy
  • Address psychological issues and perform or refer you for further psychological therapy
  • Advise on lifestyle changes
  • Address social issues

Filed Under: General

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

Call for an appointment with our doctor today and embark on the road to psychological well-being and mental wellness.

Resources for Professionals

Mental health resources for General Practitioners, Family Doctors and other professionals: Click Here
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