MAy, 2019 | The Health
issue: mental health
15
The manageable
can turn to severe
Prof Dr Amer Siddiq breaks down mental health issues which
can take a nosedive for the worse if left untreated
I
t has been shown that as of now, the number of
Malaysians found to face mental health issues
are on the rise. The three mental health issues
found to be the most common among us is stress,
anxiety, and depression.
Compared to the more severe mental illnesses
such as schizophrenia or bipolar disorder, the three are
considered to be more manageable. Yet, as awareness
and stigma surrounding mental health issues in general
still leaves a lot to be desired, these milder conditions
can evolve into more severe ones.
The harsh realities
of mental illness
Failing to cope with stress
Prof Dr Amer Siddiq Amer Nordin, Associate Profes-
sor with the Department of Psychological Medicine in
University of Malaya and a Consultant Psychiatrist at
University of Malaya Medical Centre tells about how
work-related stress, anxiety, and depression can indeed
evolve into severe psychological disorders. Especially
when the person experiencing it are not getting the
help they need.
“The most common symptoms of mental health
issues are often stress and sleep disturbances, and these
can be pre-cursors for someone to develop more severe
issues such as anxiety disorders and depression,” says
Dr Amer.
The problem nowadays he says, is how we are not
being taught proper stress management techniques.
“People need a certain level of stress to function
normally, however when these people are exposed to
chronic stress, it can lead to distress. And people who
are in distress would normally have problems coping
because they don’t have the skills to cater to their
mental well-being,” he explains.
“We don’t normally teach people to manage stress,
be it in school or university. Therefore as we are exposed
to new technology and information, the levels of coping
becomes lesser.”
Dr Amer says that the demand to have our stress
managed has increased, while the mechanism to help
us actually managing it is insufficient.
Continuous degrading of mental
health can happen
Individuals who are under a lot of stress and failed to
manage it will then experience burnout. Burnout is a
situation that mimics depression, in a sense that the
individual will lose the appetite or interest to do things.
Burnout however, differs to depression in one way.
When the individual experiencing burnout are given
time off from the activity, or are given a different task,
they can fully recover from it.
“But if you do not give these individuals the chance
Dr Amer explains that stress can lead to depression,
and depression can lead to a more severe mental
health issue.
to cope with their burnout, then it can evolve into
mental illnesses such as depression and anxiety,” Dr
Amer tells.
As depression and anxiety sets in, it can then spiral
further as the mental health worsens. “Depression,
when left untreated, will foster the individual to start
having suicidal thoughts. And could also develop into
chronic mental state of psychosis,” he adds.
The urgent need to get help
Dr Amer stresses the need for individuals who are
experiencing stress, anxiety, or depression to seek
help quickly. Stress from overworking can be managed
through time off and a change of task, while clinical
therapy and consultation can effectively help individu-
als with anxiety and depression to cope and recover.
“It is the responsibility for doctors to ask their
patients questions regarding their mental health, how-
ever we as part of the general public should also make
it easier for affected individuals to open up to their
doctors about it. Identifying anxiety and depression at
an earlier stage significantly magnify the effectiveness
of treatment.”
If you are feeling stressed out from work or studies,
having anxiety attacks, and are feeling depressed – do
seek help from your doctor. Psychology and psychiatry
services has been made available in most public and
private hospitals nowadays, therefore help is always
available. — The Health
What is depression?
D
epression in its clinical context refers to an
individual experiencing depressed mood and
are unable to enjoy day-to-day activities for a
prolonged and sustained period of time. It often lasts
for around two weeks or longer.
At the same time, the individual will also have
physical symptoms such as difficulty in sleeping,
decrease or increase of appetite, having concentra-
tion difficulties, psychomotor retardation in which
they feel everything they are doing slows down
and the body doesn’t seem to want to do what it
should.
They might also develop psychological symptoms as
well. This is when they would have a pervasive feelings
of doom and gloom. They feel hopeless, worthless,
and guilty. This feeling is consistent and wouldn’t just
go away in the period that the individual is in clinical
depression.
Prolonged untreated depression can lead to psycho-
sis and suicidal thoughts.
Depression can be visualised by the stages of a tree
going through summer, autumn and winter. Summer
is when the trees have leaves aplenty, similar to how a
normal person feels. However when depression hits,
our feel-good feelings waivers and dissolves just like
the leaves leaving the tree in autumn. Chronic depres-
sion is when the tree is in winter, totally without its
leaves.
Nowadays, thanks to research into exercise
and efforts to highlight why it’s good for us, we
tend to take our physical health and nutrition
more seriously. However, the same cannot
be said for our mental health. Sadly, there
still exists the misconception that our mental
health is inconsequential.
We spoke to Anushia Subramaniam (pix),
the Head Business Operations of the Malaysian
Institute of Human Resource Management
(MIHRM) to discuss whether companies in
Malaysia are embracing patient with mental
health issues.
Do patients with mental health issues face
discrimination when it comes to employment in
Malaysia?
“Yes there are plenty of discriminations.
Unlike countries like the US, UK and Australia,
there are no existing anti-discriminatory laws
in Malaysia to protect the rights of people
with mental health illnesses. In most cases,
employers may ask the potential employees to
disclose pre-existing conditions which may have
implications on their job performance. Hence
if the said individual declares, then he/she is
unlikely to secure a job,” explains Anushia.
“Yes, the employers do take care of their
employees but only in terms of medical and
insurance benefits which are enough to cover
the physical illnesses. They may come across
mental health as a character weakness. There
is also the issue of the employer finding out that
the employee is seeing a psychiatrist. When this
happens, usually an outbreak of gossip in the
workplace often begins. A possible promotion
or termination may occur, hence many
employees opt not to take MC from a registered
psychiatrist but rather take their annual leave
instead.”
Malaysia has a long way to go when it comes
to a mentally supportive workplace.
“Employers should take the in initiative to
organise workshops on mental health issues
for its employees conducted by registered
Counsellors,” states Anushia.
What are the existing financial support for
people with mental health issues in Malaysia?
“Currently, Jabatan Kementerian Malaysia
issues an OKU Mental card for serious mental
disorders. Examples would be schizophrenia,
bipolar and organic mental disorders. Patients
with this card are allocated:
• RM150/month – for non-working
individuals
• RM300/month – working individuals
The above OKU patients, are entitled to
receive their parents’ pension (for those in the
government sector) upon their demise.
There is provision from PERKESO named
Pencen Ilat for those with severe mental illness
and are unable to work. However this scheme is
only applicable if the said patient had previously
contributed to PERKESO. Only individuals with
certified letter from a registered Psychiatrist,
are able to receive the benefits from the above
mentioned.” — The Health