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Stress – What It Really Is & How To Manage It.

Stress – What It Really Is & How To Manage It.

Stress is something we can never escape from, be it good (eustress) or bad (distress). From the small, tedious daily hassles to long-term occurrences that weigh on your mind, stress can impact us in different ways, and the experience varies for everyone. Just as how different individuals have differing levels of pain tolerance, the same applies for stress.

Stress comes in many forms, but they can be largely categorised under ‘environmental’ (e.g noise), ‘social’ (e.g family demands, friendship conflicts), ‘physiological’ (e.g sleep disturbance) and ‘cognitive’ stressors (e.g low self-esteem, high expectations of oneself). While a certain level of stress may be necessary to provide motivation and encourage positive growth, excessive and unhealthy levels of stress especially in the long-term may cause undesirable mental and physical health consequences:

Psychological Impacts Physical Impacts
Mood swings Disrupted sleep patterns / insomnia
Undue anxiety or fear Hyperventilating
Difficulty concentrating / forgetfulness High blood pressure
Disorientation Nervous behaviours such as teeth grinding or nail biting
Increased frustration and irritability Nausea
A racing mind / constant worrying Poor eating / digestive upsets
Poor decision-making processes Increased heart rate / rapid breathing
Low self-esteem Sweating / sweaty palms
Sense of helplessness Muscle tension
Apathy Restlessness / fatigue

 

When stress becomes chronic, physical health consequences can definitely worsen, and an individual may also develop depression or anxiety disorders. As such, while there is no one-size-fits-all, this article aims to provide useful tips and suggestions on how you can better manage your stress levels, and to avoid being overwhelmed and giving in to chronic stress.

To guide us along, there are two main types of stress-coping mechanisms – ‘Problem-focused’ and ‘Emotion-focused’ coping. These are possibly the most basic approaches to healthy stress-coping, and aim to reduce or eliminate the causes of stress, apart from merely alleviating its symptoms. 

Problem-focused Coping

Problem-focused coping is where action is taken to clarify and resolve the stressor directly, and hence addresses the demands of a given situation. An example of this method of coping is when a student who is worried over an upcoming examination copes by attending more review sessions and reading up on her course materials diligently. This serves to reduce her anxiety and increase her confidence to excel in her examination. A problem-focused mechanism is primarily used when one appraises a stressor to be within his capacity to change, and hence makes the appropriate adjustments and alterations to cope with the impending demands. As such, it is also important to learn how to identify the root cause of the direct stressor before responding to it accordingly. 

Emotion-focused Coping

Emotion-focused coping may be a concept that you find familiar. Unlike problem-focused coping, emotion-focused coping involves making efforts to regulate your emotional response to a stressor. This means identifying your feelings, focusing and working through them. According to Folkman and Lazarus (1980), such a mechanism can be extremely helpful especially when you need to work through your emotions before you can think clearly enough to act rationally. Emotion-focused coping can be done in various forms such as:

  • Venting or talking to a friend / close oneWhenever you feel stressed or overwhelmed, bottling up may not be the best way around. Talking to others about what’s bothering you could bring great relief, and perhaps they could also provide you with the constructive feedback or encouragement that you need.  Physical affection, such as hand-holding and hugs can help combat stress too. Just as how others may come to you whenever they need support, don’t be afraid to lean into your social circle and find comfort in your friends. Of course, do also remember to be mindful of your friends’ emotions and needs while you’re busy venting!

 

  • Journaling
    In this digital age, perhaps Journaling may come across as a rather old-fashioned way of coping with your emotions. Many a time, people would rather distract themselves and destress by playing mobile games or browsing through social media as and when they are feeling stressed. Although those can be a possible methods of destressing, the beauty of journaling shines through when you give yourself some time to reflect and balance yourself by creating your very own safe space. Writing in a journal can help you clear your mind by releasing any pent-up feelings, to let go of negative thoughts, as well as to enhance your self-awareness as you write about your progress.

 

  • Meditation
    Practising mindful meditation is an effective strategy to combat stress, for it can help you eliminate the stream of jumbled thoughts that are contributing to your heightened stress levels. Studies have shown that training in mindfulness can potentially increase your awareness of your thoughts, emotions, and maladaptive ways of responding to stress, therefore allowing one to cope with stress in a healthier and more effective way (Bishop et al, 2004, in Shapiro et al, 2005). With guided meditations that can easily be found online, all you need to do is to set aside some time for some mental self-care.

 

  • Reframing the situation and finding meaning in it
    When we are stressed, we often only focus on the bad and how much we dread a particular situation. However, it can be helpful to look on the bright side and to find the benefit and meaning in a stressful event. By doing so, we can make these experiences a little more tolerable, as well as to grow and build resilience as we go along.

 

Other Means of Coping with Stress

Last but not least, pay more attention to your diet and nutrition intake. For some of you, caffeine is a must-have on a daily basis, with some people having four to five cups of coffee per day. However, when you combine stress with the artificial boost in stress hormones from caffeine, this creates a significantly compounded effect. While caffeine can be particularly effective in providing you with the short-term energy boost and increased alertness, it can potentially heighten stress levels in the long-term. As such, it is always good to consume it in moderation and to be mindful of your caffeine intake. In addition, you may want to consume foods rich in vitamin B, which can help to reduce stress responses in your body.  

As previously mentioned, everyone experiences life events in their own unique way, and a strategy that works for you may not for others. With that said, we hope this article has helped you to understand the various ways to combat stress better, and that you find the strategy best suited for you. However, if you ever find yourself struggling to cope with stressful life events, do reach out to one of our psychotherapists or counsellors for help.


References:

  1. Zimbardo, P. G., Johnson, R. L., & McCann, V. (2017). Psychology: Core Concepts (8th ed.). Pearson. (Accessed 25/11/2020)
  2. Shapiro, S.L., Astin, J.A., Bishop, S.R., & Cordova, M. (2005). Mindfulness-based stress reduction for health care professionals: results from a randomised trial. International Journal of Stress Management, 12 (2), 164-176. (Accessed 25/11/2020)
  3. https://dictionary.apa.org/problem-focused-coping (Accessed 25/11/2020)
  4. Photo by Tim Gouw on Unsplash
What Are Anxiety Disorders and How Do They Affect Us?

What Are Anxiety Disorders and How Do They Affect Us?

We are no strangers to feelings of anxiety – at certain stages of our lives or in particular situations, we would have experienced anxiousness and worry with relation to our careers, studies, relationships and even our environment. However, anxiety levels may go beyond the healthy norm for some people, and may instead develop into anxiety disorders that may have a debilitating effect on their lives. According to the American Psychology Association (APA), an individual who suffers from an anxiety disorder is described to have “recurring intrusive thoughts or concerns”, where the duration and severity in which the individual experiences anxiety could be blown out of proportion to the original stressor, resulting in undesirable tension and other physical alterations. In this article, we will be exploring a few types of anxiety disorders as well as how they can manifest within us.

 

Generalised Anxiety Disorder (GAD)

Generalised Anxiety Disorder is a psychological issue characterised by persistent and pervasive feelings of anxiety without any known external cause. People who are diagnosed with GAD tend to feel anxious on most days for at least six months, and could be plagued by worry over several factors such as social interactions, personal health and wellbeing, and their everyday routine tasks. For example, an individual with GAD may find himself experiencing headaches, cold sweats, increased irritability and frequent feelings of “free-floating” anxiety. Others may also experience muscle tension, sleep disruptions or having difficulty concentrating. Often, the sense of anxiety may seemingly come from nowhere and last for long periods of time, therefore interfering with daily activities and various life circumstances.  

 

Panic Disorder

In contrast, Panic Disorders are characterised by the random occurrence of panic attacks that have no obvious connection with events that are co-occurring in the person’s present experience. This means that panic attacks could occur at any time, even when someone is casually enjoying a meal. Of course, panic attacks could also be brought on by a particular trigger in the environment, such as a much-feared object or situation. Some individuals have reported that panic attacks feel frighteningly similar to a heart attack, especially with the rapid increase in heart palpitations, and the accompanying shortness of breath. Other symptoms also include trembling, sweating, and feelings of being out of control. With these panic attacks bringing on sudden periods of intense fear and anxiety, it can be exceptionally terrifying when these attacks reach their peak within mere minutes. However, a notable difference between a panic disorder and GAD is that an individual diagnosed with panic disorder is usually free of anxiety in between panic attacks.  

 

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder is a disorder marked by patterns of persistent and unwanted thoughts and behaviours. Obsessions are recurrent thoughts, urges or mental images that cause anxiety. On the other hand, compulsions are the repetitive behaviours that a person feels the urge to do in response to an obsessive thought or image. One common example often exhibited in films is where an individual has an obsessive fear of germs. This person may avoid shaking hands with strangers, avoid using public restrooms or feel the urge to wash their hands way too frequently. However, OCD isn’t purely limited to feelings of anxiety due to germs. OCD can manifest in other ways as well, such as wanting things to be symmetrical or in perfect order, repeatedly checking on things (“Did I leave my stove on?”), or the compulsive counting of objects or possessions. While everyone double-checks their things and has their own habits, people with OCD generally cannot control their thoughts and behaviours, even if they are recognised to be rather excessive. They can spend at least 1 hour a day on these thoughts and behaviours, and will only feel the much-needed brief sense of relief from their anxiety when they perform their rituals. As such, OCD can be exceptionally debilitating to one’s mental health.

 

Social Anxiety Disorder

Persons with Social Anxiety Disorder, or SAD, experience high levels of anxiety and fear under particular or all social situations, depending on the severity of their condition. They are often afraid of being subjected to judgement, humiliation or rejection in public, causing them to feel embarrassed. As such, individuals with SAD may feel extra self-conscious and stressed out, and try to avoid social situations where they might be placed at the centre of attention.

 

Phobic Disorders

A phobia involves a pathological fear of a specific object or a situation. This means that one may experience intense anxiety upon encountering their fears and will take active steps to avoid the feared object. Phobias may centre on heights(acrophobia), birds (ornithophobia), crowds and open spaces(agoraphobia), and many others. People with agoraphobia, in particular, may struggle to be themselves in public spaces, for they think that it would be difficult to leave in the event they have panic-like reactions or other embarrassing symptoms. In severe cases, agoraphobia can cause one to be housebound. 

 

Options for the treatment of anxiety disorders include medication from a psychiatrist and therapy with a psychologist, psychotherapist or counsellor, and anxiety disorders can be treated with either one or both methods. While medication does not cure anxiety completely, it helps to relieve its symptoms, allowing the individual to cope better. Psychotherapy methods such as Cognitive Behavioural Therapy can be particularly effective as well, for it aims to help victims of anxiety disorders change their way of thinking, behaving, and their way of reacting to certain anxiety-causing stimuli. 

 

It is important for us to recognise that seeking treatment for anxiety disorders is crucial, especially if it hinders or interferes with our daily life. While one may choose to adopt the “I can handle it myself” attitude – perhaps due to any pre-existing stigma or societal expectations –  we need to acknowledge that we will ultimately be worse off if we do not seek help early. Don’t struggle alone, talk to us about ways to manage your anxiety and find the support you need.

 


References:

  1. https://www.apa.org/topics/anxiety (Accessed 03/12/2020)
  2. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml (Accessed 03/12/2020)
  3. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml (Accessed 03/12/2020)
Photo by engin akyurt on Unsplash
Understanding Childhood Emotional Neglect 

Understanding Childhood Emotional Neglect 

As a child, how did adults around you react whenever you expressed your feelings? Did you grow up receiving that subtle message to wall up your emotions so they don’t get the better of you, or become anyone else’s burden? Childhood Emotional Neglect (CEN) is a topic often overlooked, and many fail to realise that it can eventually manifest into mood disorders or anxiety disorders if not dealt with appropriately. 

Childhood Emotional Neglect occurs when our caretakers or parental figures fail to respond to our affectional needs suitably during critical stages in our development. An individual who grows up experiencing emotional neglect may experience a pattern of having his or her emotions being disregarded, invalidated or downplayed by others. While many of us may wonder, “What kind of parent doesn’t pay attention to a child’s emotional needs?” In reality, some parents may not actually realise that they have been shutting their child(ren) out emotionally. In Asian societies in particular, some parents are commonly labelled as “authoritarian” or “tiger parents”. These people may in fact perceive themselves to be giving the absolute best to their child, enforcing strict discipline and ensuring that their offsprings are well-equipped with the best skills to succeed in life. However, young children and teenagers may instead be overwhelmed by such demands, and feel as if their feelings were never considered or understood. Whilst we mentioned its prevalence in Asian societies, it is key to note that it is not merely limited to these children – many worldwide experience it too, making it an exceptionally important subject. With emotional neglect being a common feature in the childhood of many, it can become an undesirable shadow that follows us throughout our lives – eventually leading to undermined happiness and the lack of an authentic sense of self.  

Delving into the matter at hand, Childhood Emotional Neglect (CEN) can come in two forms – active and passive CEN. Active CEN is when parents or caregivers actively act in a way that dismisses or denies the child’s emotions. For instance, a boy is sent to his room for crying over the death of his pet fish, and his parents complain of having an overly-dramatic son. When the child is being denied of his sadness and is receiving the message that his behaviour is unreasonable, this forces the child to grow up hiding his feelings, and at times struggling with fear and shame of his own emotions. On the other hand, passive CEN occurs when parents show a lack of care or validation regarding the child’s emotional needs. When parents fail to notice when the child is angry, upset, hurt or anxious, this gives off a subliminal message to the child that his feelings are irrelevant or not worthy of note. In any case, both forms of CEN are clearly detrimental towards one’s mental health. 

Albeit not having a test or questionnaire that can help with a diagnosis for CEN, there are certain “symptoms” of CEN that may surface, be it in the later parts of one’s teenage years or adulthood.\

For one, individuals who have experienced CEN may find it difficult to prioritise their wants and needs, even if it’s something that would bring them great joy. It is innate for us to have desires and to just be aware of what we want and need. However, for someone who grows up having his feelings invalidated and cast aside, it could become a natural thing for him to keep his desires to himself. As such, even if opportunities do come along, these people would often fall through the cracks, most probably due to their inability to request for it upfront, or by allowing others to seize it instead. 

CEN also causes one to start projecting any feelings inward, regardless of whether they are negative or positive ones. People who have experienced CEN are particularly predisposed to turning feelings of anger inwards, as they never learnt how to be comfortable with their emotions, nor how to handle them in a healthy manner. It is often said that nothing good comes from bottled-up feelings, and that is absolutely true. 

Having pent-up feelings also mean that these individuals are not likely to seek help or lean into their support systems whenever things get tough, making them feel all the more isolated and vulnerable. Even at times when they are feeling deeply challenged by certain life events, they find themselves trying to cope all on their own, leading to unhealthy stress levels and anxiety. Unsurprisingly, the constant feelings of shame and inability to get in touch with one’s emotions will eventually lead to one losing sight of his or her strengths as well. As a result, poor self-esteem is sometimes a consequence of CEN.

While many individuals, including adults, fail to recognise the impacts of childhood emotional neglect on their lives due to its subtle nature, it is important that they get themselves back on track – to regain true happiness and greater self-esteem. You might have grown up devoid of your own emotions, but you need to recognise that facing them head-on will ultimately help you to cope with life events and for you to regain your sense of self. 

Learn to start getting in touch with and embracing what you feel – both the good and bad. Identifying what you feel in certain situations will be a good step towards helping yourself cope with your environment and daily life. When challenges seem overwhelming, don’t feel afraid or ashamed of reaching out to your friends and family for help either. Even more so, if you ever feel like you’re losing control of your life and are derailing emotionally, seek professional help as soon as possible. While not everyone who grows up with emotional neglect ends up with mood disorders such as depression or anxiety disorders, there are certainly people who do. Don’t deny yourself of your emotions any longer, therapy might just be the solution to helping you learn the vital life-coping skills you never learnt as a child.  

 


References: 

https://www.straitstimes.com/singapore/how-emotional-neglect-during-childhood-affects-ones-mental-health (Accessed 07/10)

https://blogs.psychcentral.com/childhood-neglect/2018/09/the-2-types-of-childhood-emotional-neglect-active-and-passive/  (Accessed 07/10)

Photo by Isai Ramos on Unsplash

 

Evidence-Based Mental Health Disorder Diagnosis: How It’s Done from a Clinical Perspective

Evidence-Based Mental Health Disorder Diagnosis: How It’s Done from a Clinical Perspective

For individuals that are taking the first step to seek help from mental health professionals, it is natural that they may be concerned with the possibility of a misdiagnosis, or perhaps an overdiagnosis. With the pre-existing stigmatisation of mental health disorders, clients would have needed to pluck up their courage to seek treatment in the first place. A misdiagnosis could not only hinder them from receiving the appropriate treatment for their affliction, but also allows for their distress to grow unchecked as their hope for recovery diminishes. In other words, accuracy in evidence-based mental health diagnosis is crucial, and this article aims to help you better understand how the diagnostic process works.

As the term “Evidence-Based Diagnosis” implies, psychiatrists or clinical psychologists take extra care to ensure that any diagnosis made is accurate, objective, and not subject to any form of personal bias. In some sense, this also means allowing for a safe, non-judgemental and compassionate environment. Primarily, clinicians would have to understand the client’s suffering and situation, before thinking about how that might relate to a possible mental disorder. Perhaps you may be unaware of this – clinicians do not simply jump straight into tying the client down with a specific diagnosis of a mental disorder. Before all else, clinicians have to consider if the client’s symptoms meet the definitions of a mental disorder in the first place. As per the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the definition of a mental disorder considers these five factors:

  1. A behavioral or psychological syndrome or pattern that occurs in an individual
  2. Reflects an underlying psychobiological dysfunction
  3. The consequences of which are clinically significant distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning)
  4. Must not be merely an expected response to common stressors and losses (i.e.. the loss of a loved one) or a culturally sanctioned response to a particular event (i.e. trance states in religious rituals)
  5. Primarily a result of social deviance or conflicts with society

With reference to the definition of a mental disorder, it is particularly important to note that the consequences of a mental disorder is clinically significant, and causes a weighty amount of disruption to one’s lifestyle and day-to-day activities. For example, it is completely natural for one to feel upset over certain situations, and this does not necessarily mean that you have a case of depression. However, you might need to get it checked out if you find yourself unable to cope with prolonged feelings of sadness which start to interfere with your daily activities, or are causing you to have suicidal thoughts.  

Of course, clinicians then assess the syndrome one displays. By “syndrome”, we mean a collection of signs or observable aspects of the client’s suffering (i.e outward expression or behaviour). The main point of this is to identify if the syndrome is clustered in an identifiable pattern that is noted to be severe or pervasive. During the assessment phase, clinicians also try to understand the internal experiences of the client. Besides their outward display of distress, their thoughts and feelings are also important information which counts towards the diagnosis of certain disorders. Upon identifying that the client is indeed suffering from a mental condition, clinicians then try “assigning” the client to a particular category. You can think of it as, “can the syndrome be broadly identified?” There are certain broad categories of disorders, such as anxiety disorders, or psychotic disorders. Needless to say, clinicians have to consider which category the client best fits in.

The last step of the diagnosis process concerns the further narrowing and identification of the specific disorder – branching out from the broader, generalised category and into the specific details. For example, a client could be diagnosed with Obsessive-Compulsive Disorder (OCD), a form of an anxiety disorder. Ideally, a specific disorder is identified during the diagnosis process for various reasons – for the sake of the clients themselves, but also for clearer communication with other mental health professionals (in the case of continuity of care), and even for legal or court matters. Under rare circumstances, some clinicians are able to identify the broad category of the mental disorder, yet are unable to specify the exact condition that the client is suffering from. In cases like these, their disorders will be labelled as “unspecified”, as per the 10th version of the International Classification of Diseases. 

As mentioned, evidence-based mental disorder diagnosis is all about diagnosing clients accurately and objectively. To enhance objectivity, some clinicians go the extra mile, stopping to consider if the diagnosis given was biased, or influenced by his or her own culture and history. “Is the syndrome maladaptive?”, “Did I take cultural variables into account?” An objective diagnosis will certainly go a long way in ensuring that the client receives the most appropriate treatment, which will in turn enhance his or her recovery journey. 

Overall, it is safe to say that it takes two hands to clap in every treatment process. Clients and clinicians should try as much as possible to work together, be it in the assessment or treatment phase. For an effective treatment, clinicians will do their best to assess the severity and pervasiveness of any syndrome using understandable language such that clients are well aware of their condition. However, clients also need to understand that transparency on their side is pivotal and that it will drastically impact the treatment process, for better or for worse, depending on their cooperativity and how much they choose to reveal. 

 


References:

Dr Robert Shwartz, Ph.D., PCC-S, Evidence-Based Mental Disorder Diagnosis: How to Increase Accountability, Efficiency and Objectivity, video recording, Mental Health Academy

<https://www.mentalhealthacademy.co.uk/dashboard/catalogue/evidence-based-mental-disorder-diagnosis-how-to-increase-accountability-efficiency-and-objectivity> (Accessed 11/09/2020)

What is Obsessive-Compulsive Disorder and When Do You Need Treatment?

What is Obsessive-Compulsive Disorder and When Do You Need Treatment?

Written by: Fred Chin, Psychologist

 

What is Obsessive-compulsive Disorder?

Think of the following scenario: you have friends over at your place and you serve them drinks. Before they can place their cups on your beautiful coffee table, you exclaim and dart out coasters underneath the ice-cold glasses before the first drop of dew can drip on that expensive rosewood. Your lightning-fast reflexes have intercepted what would have been a disaster. Your friends are startled at first, then they laugh and tease you. They say you have OCD – obsessive-compulsive disorder.

This, or a similar instance, may have happened at some point in our lives before. We tidy up a mess in the presence of others, or when our belongings are organised ever so neatly, and we end up joking about OCD.

But in truth, OCD is far from such behaviours that could be written off so light-heartedly.

A person with OCD will have compulsions – they feel the need to perform certain repeated behaviours to reduce emotional distress or to prevent undesirable consequences. These compulsions are so intense that they cannot carry out other daily routines without acting on them. Some common ones include:

  • Excessive washing or cleaning – They fear contamination and clean or wash themselves or their surroundings many times within a day.
  • Checking – They repeatedly check things associated with danger, such as ensuring the stove is turned off or the door is locked. They are obsessed with preventing a house fire or someone breaking in.
  • Hoarding or saving things – They fear that something bad will happen if they throw anything away, so they compulsively keep or hoard things, usually old newspapers or scraps of papers which they do not actually need or use.
  • Repeating actions – They repetitively engage in the same action many times, such as turning on and off a light switch or shaking their head a numerous number of times, up 20 to 30 times.
  • Counting and arranging – They are obsessed with order and symmetry, and have superstitions about certain numbers, colours, or arrangements, and seek to put things in a particular pattern, insisting to themselves that the layout must be symmetrical.

When Does OCD Become Chronic and What Should You Do If That Happens?

OCD is a chronic disorder, so it is an illness that one will have to deal with for the rest of his or her life. It is difficult to tell when the disorder becomes chronic, as it presents the individual with long-lasting waxing and waning symptoms. Although most with OCD are usually diagnosed by about age 19, it typically has an earlier age of onset in boys than in girls, but onset after age 35 does occur.

A cognitive model of OCD suggests that obsessions happen when we perceive aspects of our normal thoughts as threatening to ourselves or to others, and we feel responsible to prevent this threat from happening. These misperceptions often develop as a result of early childhood experiences. For example, a child may experience living in a dirty and dusty environment, while being subjected to some form of trauma at the same time. He associates a lack of hygiene with suffering from the trauma. At a later stage in life, he may start to feel threatened upon seeing the unhygienic behaviours of someone he lives with, be it his parents, romantic partner, or flatmates. This leads to the reinforcement of the association and to the development of his beliefs that suffering is inevitable when unhygienic conditions are present, giving him compulsions to improve these unsanitary conditions through washing and cleaning. 

If one is affected by OCD to the extent that he or she is unable to hold down a job and to manage household responsibilities, then there is a need for clinical treatment as the symptoms have become severe. Like in the above-mentioned example, recurrent and persistent thoughts of dirt will give the individual compulsions to neutralise these thoughts, resulting in repetitive washing, and checking behaviours. This causes distress and significantly affects one’s functioning.

When OCD has become a chronic illness, through a formulation of intervention strategies, the psychologist should extrapolate the client’s pattern of behaviour and expect a positive prognosis for functional improvement.

 

How Can OCD Be Treated?

A person diagnosed with OCD may seek treatment through a treatment plan that consists of cognitive strategies. These cognitive strategies involve consciously implementing sets of mental processes in order to control thought processes and content. Through these cognitive strategies, we can examine and restrict the thoughts and interpretations responsible for maintaining OCD symptoms. This is conducted in the initial stages of therapy.

Thereafter, Exposure Response Prevention (ERP) methods are carried out once a client is able to understand and utilise these cognitive strategies. ERP requires the client to list out their obsessive thoughts, identify the triggers that bring about their compulsions and obsessions and rate their levels of distress on each of these. Starting with a situation that causes mild or moderate distress, the client is exposed to their obsessive thoughts and simultaneously tries to resist, engaging in any identified behaviours that they have been using to neutralise these thoughts. The amount of anxiety is tracked each time the process is repeated. When anxiety levels for this particular situation eventually subside, over several repeated processes, and when they no longer feel significant distress over this situation, the same method is repeated for the next obsessive thought with the next level of distress.

A client who is able to demonstrate strength in coping with the symptoms has a better likelihood for sufficient recovery.

 

OCD is Becoming More Prevalent in Singapore: How has it Been Accepted in Society?

In recent years, OCD has topped the list of mental disorders in Singapore, with the greatest number of people experiencing it in 2018, compared with other mental illnesses.

The disorder has been found to be more prevalent among young adults than those aged 50 and above. In terms of socio-economic status, OCD is more likely to occur amongst those with a monthly household income of less than S$2,000 than those who earn above that amount.

It has also been found that the prevalence of people experiencing OCD at least once in their lifetime is higher in Singapore than in South Korea, Australia and New Zealand.

In addition to becoming more prevalent, people who experience OCD are also becoming increasingly reluctant to seek psychiatric help or counselling, making matters worse. There is some acceptance of the condition as normal and trivial by society, because people who do not understand the disorder well enough misconceive OCD as a quality of being clean and tidy, as being clean and tidy is usually seen as a good thing. This misconstrual by society is dangerous for the undiagnosed, and their condition will further deteriorate if they continue to put off addressing their disorder.

The disorder will get worse if treatment is ignored, and there is a need to realise it in its early stages through observing how one’s life is being disrupted. Awareness about its onset of symptoms is important.

Do seek out a psychiatrist,  psychologist, psychotherapist (therapist) or counsellor to get professional help for a better recovery journey. Early intervention is crucial to prevent escalation of the condition.

 


reference(s)

https://www.todayonline.com/singapore/mental-illness-more-prevalent-among-young-adults-ocd-one-of-top-disorders-spore

Photo by Anton on Unsplash

Burnout and How to Heal from It

Burnout and How to Heal from It

It is an undeniable reality that life, in general, is busy. With long work hours and bills to pay, there are so many things going on that we must and are expected to do. With the increase in pressures and demands in daily life, it is very common for people to feel exhausted and burnt out.

Burnout is a state of exhaustion caused by chronic stress. According to the World Health Organisation, it is classified as “chronic workplace stress that has not been successfully managed”. It is characterised by 3 dimensions: Feeling exhausted or devoid of energy, being mentally detached from your job and being less efficient in work. Employee burnout in Singapore is among the highest worldwide, where work is a vital cause of high-stress levels, and where almost one in eight employees cannot cope with their stress. There are many potential causes of chronic stress in the workplace, such as having too many responsibilities, having a negative view of yourself and the world, or a perceived lack of control over your life and work. All of these factors could cause one to burn out easily.

Let us recognise the signs that indicate a burnout. Physical signs include exhaustion, change in sleep habits or diets, frequent illness and headaches; Emotional signs include lack of motivation or enjoyment towards life events and feeling negative emotions such as anger, anxiety or depression; Behavioural signs include adverse coping mechanisms such as overconsumption of alcohol, withdrawal from responsibilities, taking out your frustration on others and reduced work performance. If you are currently experiencing these symptoms, then it is very possible that you may be burning out from work.

Now, you may ask, if busyness in work is inevitable, then how do we overcome this seemingly unmanageable stress? Below are 4 tips that could help you manage stress and prevent burnout:

  1. Turn to other people

It is extremely beneficial to have a social circle or support network, such that there are people that you can rely on for support, encouragement and a listening ear. Friends or family members can recognise maladaptive patterns in your behaviour, identify your burnout signs, and offer you constructive feedback or advice. Through doing that, you can work towards overcoming burnouts. Likewise, if your loved one is going through a burnout, engage her in a conversation and let her open up about what she is going through, while staying patient and understanding. Confiding in and spending time with loved ones would serve to reduce stress and strengthen your relationship with them as well.

If it is possible, try befriending your colleagues. With a similar job scope, your colleagues can better understand your stress at work and everyone can draw support and motivation from one another. Additionally, good relationships with your colleagues enable you to work faster and better while reducing your work’s monotony. Thus, a more positive work environment keeps you energised and productive, countering the effects of burnout.

 

  1. Live a healthy lifestyle

Healthy lifestyle habits such as sleeping, exercising and healthy eating can have a huge impact on your mood and energy, helping to reduce stress and prevent burnouts. Exhaustion or a lack of rest often worsens burnout through causing you to think irrationally, and can take a toll on your energy and emotional balance. Thus, getting a good night’s sleep energises you and improves your mental state, ultimately improving your productivity at work.

What you consume can greatly impact neural circuits in your body that control emotion, mood and motivation. As such, eat food that can elevate your energy and mood such as fruits, vegetables and food that is rich in whole grains; and reduce consumption of food with lots of caffeine, sugar, chemical preservatives and hormones.

Exercising also enables stress relief. While engaging in exercise, you can focus on your body rather than your thoughts, and how your body feels as you move (feeling the sensation of the wind against your cheek can be strangely calming!). However short or simple, any form of rhythmic exercise is beneficial as it can increase your energy while simultaneously relaxing your mind and body. Ultimately, a healthy lifestyle does wonders to your wellbeing.

 

  1. Find ways to relax and unplug from work

We often burnout due to lack of time for ourselves. Thus, give yourself a chance to slow down, rest and heal. Set time aside for activities that are not work-related and do activities that make you happy and relaxed. This includes your personal hobbies, interests or a passion project such as photography, baking or exercising. Doing these activities can make you feel rejuvenated and accomplished, and helps you rediscover joy and meaning in your life outside of work.

Additionally, reserve some time to disconnect from technology. In today’s day and age, smartphones cause us to “carry an office in our pocket”, and make us psychologically connected to our work all the time. Hence, it is a good idea to limit your phone time after work, to prevent yourself from checking your emails or calling your office; such that you can spend quality time with yourself and your loved ones. Through these regular breaks, you are given an opportunity to restock your mental energy and engage in self-care, which can increase your happiness and quality of life.

 

  1. Re-evaluate priorities and set boundaries

Lastly, reflect on the cause of your burn out and consider what makes you feel stressed and anxious. Ask yourself, Is my work making me stressed? Exactly what aspects of work are making me stressed? Do I spend enough time for myself? Through this self-reflection, you can find ways to reduce this burnout. A good solution is to set boundaries for yourself and re-evaluate priorities, such as knowing how much time to allocate to work and relaxation (possibly placing more importance on rest and less importance on work) and learning how to say “no” to tasks. Do not stretch yourself beyond what you can handle or commit to. If you struggle with this, remind yourself that saying “no” enables you to say “yes” to tasks that you find more fulfilling. Through re-prioritising your commitments and tasks, you are able to find balance in your life and focus on parts of life that bring you joy, meaning and satisfaction (even beyond your job).

If possible, you can also identify or consider which aspects of your job you enjoy and find the most fulfilling. After doing so, you could ask your supervisor if you can focus on these tasks as they are more aligned with your responsibilities and strengths. Doing this helps you find value and regain a sense of control in your work, giving you a positive outlook and attitude towards your tasks.

 

Healing from a burnout definitely is not easy, and takes lots of time and commitment to overcome, but it is possible. Take the effort and steps necessary to manage your time and reduce stress, and keep to it. It may be difficult to adjust and keep to these new changes, but ultimately, it will prove effective in preventing burnouts and will improve your physical, emotional and mental well-being.


References:

https://www.helpguide.org/articles/stress/burnout-prevention-and-recovery.htm

https://hbr.org/2015/04/how-to-overcome-burnout-and-stay-motivated

https://www.who.int/mental_health/evidence/burn-out/en/

https://www.pacificprime.sg/blog/employee-burnout-in-singapore/

https://www.fairview.org/patient-education/85169

https://www.helpguide.org/articles/sleep/getting-better-sleep.htm

https://www.inc.com/john-rampton/8-ways-to-get-over-job-burnout-without-leaving.html