DID YOU KNOW?


Mental Health Perspectives: Culture influences the expression of mental health symptoms. Depression for instance is often expressed by Hispanics in physical ways such as complaining of nerves or headaches, by Chinese in terms of tiredness and imbalances, and in Middle Eastern cultures as problems of the heart (American Psychiatric Association, 1994).


Mental disorders are now among the top leading causes of health burden worldwide, with no evidence of global reduction since 1990. 

The lack of availability of evidence-based services for people exposed to adversity globally has led to the development of psychological interventions with features that will likely make them more scalable. The evidence for the efficacy of e-mental health from high-income countries is compelling, and the use of these interventions could be a way to increase the coverage of evidence-based psychological interventions in low- and middle-income countries.


"Hiding my mental illness from my Asian family almost killed me." The silent shame of having a mental illness in a Chinese family. “Don’t you dare go back to that doctor,” her mother growled into the phone. “He’ll put ‘bipolar’ on your record and then you’ll never be able to get a job.” She never went back. Seven years later, she woke up in a psych ward.

Read more here: https://www.vox.com/first-person/2018/6/18/17464574/asian-chinese-community-mental-health-illness


According to a 2018 study, more than 95% of directors at college counseling centers report that managing students’ mental health is a growing concern. A report released by WHO, urges mental health decision makers and advocates to step up commitment and action to change attitudes, actions and approaches to mental health, its determinants and mental health care. The mental health issues have just exacerbated, especially with COVID-19 pandemic - the most common of these being anxiety and depression.


Even before the COVID-19 pandemic, just a small fraction of people in need had access to effective, affordable and quality mental health care. For example, 71% of those with psychosis worldwide do not receive mental health services. While 70% of people with psychosis are reported to be treated in high-income countries, only 12% of people with psychosis receive mental health care in low-income countries. For depression, the gaps in service coverage are wide across all countries: even in high-income countries, only one third of people with depression receive formal mental health care and minimally-adequate treatment for depression is estimated to range from 23% in high-income countries to 3% in low- and lower-middle-income countries (WHO, 2022). 


‘Just a phase’: the mental health stigma in Asian cultures 


In the United States, mental health issues comparatively don’t have as much stigmatization. Increasingly, there are some resources available almost everywhere for people with mental health illnesses. In most cases, therapy, counseling, support networks, prescriptions and organizations are accessible to help these people heal. Legislation is written to accommodate their needs, and some private organizations also try to adapt to their conditions and compromise.

However, in Asian cultures such as the one I was raised in, the mere mention of “depression” or “anxiety” will get you disapproving looks from people.

It becomes difficult to open up about mental illness when the culture embodies resilience, honor, and filial piety. Filipino culture puts an emphasis on humor amidst pain and personal suffering. Other cultures, especially East Asian, Southeast Asian and South Asian cultures place importance on honor and collectivism. That is to say, each individual in the family has a specific, traditional role to play and is expected to act within that role. This means that any anomaly in the members – for example, a mental illness – brings shame to the family. Thus the tendency of saving face so as to keep up appearances and avoid social disapproval.

There is also an alarming lack of availability of mental health resources in Asia. Despite international emphasis on mental health, mental health is not a high priority in most Asian countries. Generally, most patients resort to either traditional family care alternatives or religious alternatives (both of which may not always be successful) to deal with mental illness rather than seeking professional help. Community care and social security for the mentally ill are usually centered in the urban areas of these countries, which adds even more barriers to those who seek help.

Also, mental health care is highly inaccessible for the simple reason of it being too expensive for most people. Psychiatrists and therapists with post-graduate educations tend to be costly, and prescription drugs take a toll on the daily budget, considering the drug manufacturers are the ones who set the prices. If the cost of mental health care is absurdly enormous in the United States, a country that values mental health, how much more is it in Asian countries whose focus isn’t on mental health care?

Another problem about all this is that the older generation, especially in Asia, are one of the main proponents of the mental health stigma. The general skepticism they have toward the problems of today’s youth don’t make it any easier. They tend to trivialize and discredit mental health issues, chalking it off as a “phase”, a recent fad or a marketing scheme created by doctors to make money. Intergenerational conflict is particularly rampant with this issue, considering the advent and popularization of mental health care came about only very recently.

The worst part of it all is what this stigma does to those who suffer mental illness—students, especially. Academic and parental pressure are extremely prevalent within the Asian youth, and it is painful to see that suicide has become a last resort to some of them because of their low likelihood to seek counseling. 


In Hong Kong, a whopping total of 72 students have committed suicide in the past two years. Each student had various reasons ranging from academic performance to parental pressure and depression. It’s a terrible reality to accept, but it’s a sad truth most Asian students have to live with.

With all this considered, reforms within these cultures would definitely go a long way. It would be extremely difficult to challenge a stigma with cultural, political, economic and social roots, but it wouldn’t be entirely impossible if people started within their own circles. It is true that the government can aid this issue by increasing legislation or providing more accessible mental health resources, but support networks within family and friends would help lessen the general taboo around mental health. After all, if the basic units of society can slowly get rid of its discrimination, then it follows that the society as whole can do it as well.



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Anxiety

In 2019, 301 million people were living with an anxiety disorder including 58 million children and adolescents.  Anxiety disorders are characterised by excessive fear and worry and related behavioural disturbances. Symptoms are severe enough to result in significant distress or significant impairment in functioning. There are several different kinds of anxiety disorders, such as: generalised anxiety disorder (characterised by excessive worry), panic disorder (characterised by panic attacks), social anxiety disorder (characterised by excessive fear and worry in social situations), separation anxiety disorder (characterised by excessive fear or anxiety about separation from those individuals to whom the person has a deep emotional bond), and others. Effective psychological treatment exists, and depending on the age and severity, medication may also be considered. (World, 2022) 

ADHD

ADHD is characterised by a persistent pattern of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning.  Disorders of intellectual development are characterised by significant limitations in intellectual functioning and adaptive behaviour, which refers to difficulties with everyday conceptual, social, and practical skills that are performed in daily life. (World, 2022) 

Depression

In 2019, 280 million people were living with depression, including 23 million children and adolescents. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life.  During a depressive episode, the person experiences depressed mood (feeling sad, irritable, empty) or a loss of pleasure or interest in activities, for most of the day, nearly every day, for at least two weeks. Several other symptoms are also present, which may include poor concentration, feelings of excessive guilt or low self-worth, hopelessness about the future, thoughts about dying or suicide, disrupted sleep, changes in appetite or weight, and feeling especially tired or low in energy. People with depression are at an increased risk of suicide.  (World, 2022) 

Bipolar

In 2019, 40 million people experienced bipolar disorder.  People with bipolar disorder experience alternating depressive episodes with periods of manic symptoms.  During a depressive episode, the person experiences depressed mood (feeling sad, irritable, empty) or a loss of pleasure or interest in activities, for most of the day, nearly every day. Manic symptoms may include euphoria or irritability, increased activity or energy, and other symptoms such as increased talkativeness, racing thoughts, increased self-esteem, decreased need for sleep, distractibility, and impulsive reckless behaviour.  People with bipolar disorder are at an increased risk of suicide. (World, 2022) 

Post-Traumatic Stress Disorder

The prevalence of PTSD and other mental disorders is high in conflict-affected settings. PTSD may develop following exposure to an extremely threatening or horrific event or series of events. It is characterised by all of the following: 1) re-experiencing the traumatic event or events in the present (intrusive memories, flashbacks, or nightmares); 2) avoidance of thoughts and memories of the event(s), or avoidance of activities, situations, or people reminiscent of the event(s); and 3) persistent perceptions of heightened current threat. These symptoms persist for at least several weeks and cause significant impairment in functioning. Effective psychological treatment exists.  (World, 2022) 

Is EMDR right for me?

Eye Movement Desensitization and Reprocessing (EMDR) is a type of psychotherapy proven to be effective in relieving the emotional distress associated with many psychological disorders. EMDR’s use has expanded to treat a variety of disorders beyond PTSD, such as chronic anxiety, depression and acute trauma.

While many forms of therapy, such as CBT for example, focus on resolving a client’s distress by directly accessing and reformulating the thoughts, actions and emotions that resulted from a traumatic experience, EMDR takes a different approach. In EMDR, we focus directly on the traumatic memory and re-process the experience to store the memory in the brain in a way that reduces the symptoms the client is facing.

Is CBT right for me?

In Cognitive Behavioral Therapy, you first learn to identify painful and unpleasant thoughts about problems you have. The objective is to determine if these thoughts are based in reality. If not, you learn ways to change your thinking patterns so they are more accurate. For example, you may struggle with the thought “I’m a terrible father.” This distressing thought may lead to feelings of guilt, sadness, anger, and ultimately contribute to unhelpful behaviors like self-medicating with alcohol, gambling, or staying late at work to avoid your family.

In CBT, your therapist will help you explore how realistic this thought is. Is it really true you’re a “terrible” father? Where is the evidence you’re a “terrible” father? What does “terrible” even mean? Together, you and your therapist will find ways for you to identify when you have these unrealistic and harmful thoughts. You’ll learn how to challenge them. You’ll also learn how to identify which behaviors are hurting you and then create new, more helpful behaviors.


CBT ISN’T FOR EVERYONE


Some clients want a deeper exploration of their memories, behaviors, and early relationships with support and guidance from a therapist. Others may want to attend therapy as a way to seek guidance and support through challenging life transitions like divorce, separation, empty nest syndrome, or the loss of a loved one. Further still, others may just want a deeper exploration of their values and purpose and meaning in their life. Given its direct and practical style, CBT can only go so far in some of these areas.

If you need help with depression, anxiety, grief, or a life transition such as divorce or career change, talk to your therapist (or potential therapist) about their approach and see if it resonates with your goals.

Is ACT right for me?

Acceptance and commitment therapy teaches you new ways to approach and manage your negative and unhelpful thoughts.

Acceptance and commitment therapy is all about taking committed action. Take action where you can and want to take action.

Acceptance and commitment therapy can be used to treat many different issues and mental health concerns. Check out the list below of some of the more common concerns ACT is used to treat.

Is Empty chair therapy right for me?

What is the empty chair technique?

The empty chair technique, also called the “two-chair technique” or simply “chairwork,” is a therapeutic method used in talk therapy. Its objective is to start a “conversation” with parts of oneself or individuals from a person’s past or present.

During an empty chair session, a person may speak to an individual or an aspect of themselves they imagine sitting in the empty chair. Sometimes, the person will then switch places, taking on the role of that aspect or person.

The idea behind the empty chair technique is to resolve conflict, specifically by increasing awareness in the present moment.

Learn how neurons work

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