Here are some questions you’ve always wanted to ask a mental health expert

“Hey cheer up, don’t be so sad”, or “look on the bright side, there are others worse off than you” — you may have heard phrases like this from well-meaning friends or relatives that were intended as words of comfort.

However, they may in fact do more harm than good and come off as being dismissive, especially to someone who is facing a mental health crisis.

Instead of telling someone who is living with a mental health condition like depression what they should or should not do, or how they should be feeling, one should show concern by expressing empathy and validating their feelings, says Dr James Cheong.

Cheong is a general practitioner partner with the Agency for Integrated Care (AIC) under the Mental Health GP Partnership programme, which supports persons living with mental health conditions and dementia.

At work, he not only treats people with physical health symptoms, but also helps in identifying those with mental health needs.

“Using caring words, being an assuring presence, encouraging seeking treatment and offering help in practical ways will support them in their treatment and recovery,” he adds.

Growing focus on mental wellness

With less stigma surrounding the topic of mental health and more awareness about the issue, many of us may wonder how we can support someone who’s struggling.

In January, we asked some of you on Instagram to share questions you’ve always wanted to ask regarding mental health.

Many of you responded with issues that went beyond topics about depression or anxiety.

Losing a loved one, for example, is highlighted as one of life’s most stressful events which can cause an emotional crisis.

Cheong shares with us his perspective on some of your most-asked questions.

The pandemic has made me feel withdrawn and alone. How do I cope?

Loneliness is a perceived experience of isolation, says Cheong, and can occur even when surrounded by company or crowds.

In this pandemic environment, loneliness can be exacerbated by prolonged periods of solitude due to altered work, study, or social arrangements.

He adds: “While staying connected virtually may be sufficient for some, many of us still enjoy and find fulfilment through physical face-to-face interactions.”

Cheong offers several coping mechanisms to help us feel less alone:

• Recognise your feelings and that you are not alone in this
• Reduce boredom by learning something new
• Develop a schedule and hobby to spend your time meaningfully
• Try new ways to connect with others, for example through social media, video calls
• Create or join an online community to stay connected

I just lost a loved one, how can I walk out of grief?

Losing someone can be a very intense and distressing experience and grief doesn’t look or feel the same for everyone.

But there are ways to cope with your grief and learn how to heal, says Cheong.

It may take a long time to come to terms with the loss of a loved one, however, “we will eventually be able to adapt, integrate the loss and move forward”.

Some suggestions that may help us better cope with grief include:

• Recognise and acknowledge the emotions and distress
• Share our thoughts and feelings arising from the loss with our loved ones (Social support is a powerful tool that can help us adapt well to grief)
• Express our grief in a positive way, such as pursuing a new passion, or helping others. This not only enables us to cope with the emotional distress, but also helps us understand our loss, and recalibrate for the future
• Make plans, no matter how simple it is, for the future. This sets the stage for us to adapt, reconnect and reintegrate

How do I break up with someone who has mental health issues? I’m afraid of what might happen.

Ending a relationship with anyone is emotionally difficult and never easy, Cheong remarks.

The reasons for terminating a bond with someone should be carefully considered, as the consequences can be far-reaching and permanent for both parties.

Here’s how one can approach the prickly subject:

• Have an early and candid conversation about the difficulties in the relationship, so that both parties have an opportunity to reflect and respond
• To cope with the expected distress, both parties should seek to support and build alternative interpersonal networks for each other, even as both parties pull away. It is important to recognise that difficult emotions, thoughts, and behaviour will arise during a break-up and both parties should acknowledge them

Cheong explains that the approach should be no different with someone who has mental health issues, “although one may wish to consider the mental and emotional state of the person at the time and consider how to best support them”.

He also suggests speaking to the person’s loved ones or close friends who may be able to reach out to the person to provide assistance, or to consider speaking to the psychiatrist, psychologist or counsellor who is caring for the person, so that they can provide professional aid to the person during the journey.

How do l tell if someone is not in a good mental or emotional state or is depressed?

A person with depression is usually quiet, downcast, and withdrawn, says Cheong.

“They often avoid eye contact and speak with a soft tone and volume. They may be emotionally volatile and irritable. They often appear unkempt, disinterested, and tired looking.”

However, depression is an invisible condition that can afflict even those who appear “normal” on the outside.

Signs that are often overlooked include changes in eating or sleeping patterns (either excessive or deficient), losing interest in activities that they used to enjoy, or having a negative or hopeless outlook on life.

To help equip the public and caregivers with knowledge and skills to identify the signs and symptoms of mental and emotional distress, the Agency for Integrated Care (AIC) has developed e-learning modules on the various mental health conditions.

According to AIC, “It is important for the community to come together and be aware of the various mental health conditions as well as the signs and symptoms, in order to better support persons who are not in a good mental state or living with a mental health condition”.

Conversely, if you are the one who’s feeling like you’re not in a good mental state and find it hard to verbalise that you need help, Cheong suggests letting someone know through clear, concise and honest statement, such as “I am not feeling well” or “I am facing emotional difficulties”.

How do I help someone struggling with depression or their mental health while taking care of my own emotional well-being?

Acknowledging and understanding your own reactions, emotions, fears, and worries will place you in a better position to support someone with depression, says Cheong.

Often, a listening ear and assuring presence would already help a person with depression cope better.

He adds that “one should avoid trying to diagnose the situation or provide solutions.”

According to AIC, mental health support is also available for caregivers of persons living with mental health conditions.

Caregiver community outreach teams set up by social service agencies in partnership with the Ministry of Health and AIC provide emotional support to caregivers who have or are at risk of developing mental health issues.

Find out how the community mental health integrated network can support you and your loved ones here.

What should you say to someone who just lost a loved one?

Words can often feel like cold comfort to someone who has just suffered a loss.

“But simply being present and offering your listening ear are ways you can support them,” says Cheong.

“Avoid telling the person what he or she should or should not do, and refrain from explaining the loss. Express your support and concern through simple words such as ‘I am very sorry for your loss’.”

How can I encourage my loved ones to seek help if I suspect they need mental health support, especially for loved ones who stigmatise mental health?

“We should convey our concerns in an honest manner to our loved ones and seek their views respectfully,” Cheong states.

He explains that stating our observations of their emotions, thoughts, or behaviour in a factual manner, conveying our genuine concerns and understanding our loved ones’ perspectives may be a good way to start the difficult conversation.

“We should avoid being accusatory and judgemental,” he cautions.

How do I tell my parents that I want to see a mental health professional?

Just as how we seek medical advice when our physical bodies experience unpleasant symptoms, similarly, our mind can experience unpleasant sensations and we need to seek medical advice to understand their significance.

There may not be an underlying illness or disease, but getting evaluated by a mental health professional can help us better understand what the sensations mean, says Cheong.

This is one way that the younger generation can explain their need for a mental health assessment to their parents.

To support youths, the Ministry of Health and AIC work with social service agencies such as Care Corner, Singapore Association for Mental Health (SAMH), Limitless, SHINE Children and Youth Services and TOUCH Community Services to provide community outreach and intervention for the youth and their families.

These teams help to promote recognition of early signs and symptoms of mental health conditions, as well as involve parents and peers in the recovery journey of the youth.

Other concerns around mental health

Once I see a GP for my mental health condition, will it be in my records when I apply for a job, etc?

Cheong maintains that patients have nothing to worry about when it comes to seeing a doctor for their mental health issues, as absolute confidentiality is kept.

“Your medical information is held in confidence by the GP who saw you and cannot be shared without your permission unless ordered by the court of law or under very extenuating circumstances,” says Cheong. These include preventing harm done to oneself or others, or in the interest of public safety.

How should one talk about mental health issues at the workplace without being judged?

“A physically and emotionally well person will be able to contribute his or her best at the workplace,” is Cheong’s advice for employers.

He has three suggestions for companies to lessen the stigma at work. These include:

• Having an anonymous feedback channel for raising mental health issues at work,
• Creating a strong culture for mental and emotional well-being at the workplace, and
• Addressing the issue rather than the person when talking about mental health issues.

Support for mental health is available in the community. Look out for services around you such as GPs and polyclinics, via the Mind Matters Resource Directory. You can also visit www.aic.buzz/mh-resources to access resources to support you in your journey. Remember, you are not alone. Email [email protected] if you need any information, links or resources.

This article is sponsored by AIC.

Top image adapted from Mothership’s photo.