Mental Health Conditions – Shan You

Mental Health and Mental Illness

Mental health comprises of our psychological, emotional and social well-being. It influences our thoughts, feelings and actions. It plays a part in how we cope with stress, relate to others and make decisions. Like physical health, mental health is important at every stage of life, from childhood and adolescence through adulthood to old age.

According to the World Health Organisation, to be mentally healthy is to be in a state of well-being, to be functioning, to be productive and contributive and to be able to cope with normal stresses of life.

According to the American Psychiatric Association, mental illnesses are health conditions that can cause changes in thinking, feeling and behaviour which affects a person’s ability to function and carry out daily activities such as work, leisure or relating with loved ones.

Mental Illness: The Myths and Facts

Fact: Such a misconception perpetuates the stigma and shame around mental illness. Many factors contribute to mental health conditions that have nothing to do with one’s mental strength and resilience. In fact, those who struggle with mental health conditions may develop more mental resilience as they grapple with the daily struggles and challenges arising from their conditions.
Fact: Most individuals suffering from mental health conditions are no more likely to be violent than anyone else. Many people with mental health issues are functioning and productive members of our community and do not pose any threat to anyone.
Fact: Mental health conditions are treatable, and people do recover from these conditions. Even when mental health conditions persist for an extended period, individuals can learn to cope with their conditions and lead productive lives just like anyone else.
Fact: Mental health issues are more common than you think and can affect you or your loved ones. For example, about 5.8% of the adult population in Singapore suffer from Major Depressive Disorder at some point in their life. About 100,000 people in Singapore experience anxiety disorders during their lifetime.
Fact: Family and friends can play a very important role in a person’s recovery by encouraging their loved ones to seek professional help, supporting them through the recovery journey and not labelling them by their diagnosis.
Fact: Most people first started struggling with their mental health conditions in their twenties. These conditions can affect children and manifest in behavioural issues that are different from those of adults.

About Depression

Sadness is something we all experience in response to disappointments and setbacks in life. It usually does not persist for weeks and months nor interfere with one’s daily functioning. On the other hand, clinical depression, characterised by prolonged feelings of sadness, can last for weeks, months or even years, and cause significant disruption to one’s daily functioning.

Depression affects the way you think, feel and act and is one of the leading causes of disability worldwide. Major Depressive Disorder (MDD) is the most common mental health condition in Singapore and affects about 5.8% of the adult population at some point of their life (Institute of Mental Health, 2011).

Clinical Depression

Symptoms of Clinical Depression can include:

  • Depressed mood and sadness
  • Loss of interest in activities
  • Lack of energy and fatigue
  • Inability to concentrate
  • Weight loss or gain
  • Changes in sleep pattern
  • Feelings of guilt or worthlessness
  • Suicidal Ideation

Depression can be triggered by a combination of various factors, including:

  • Biological factors (e.g., brain chemistry, genetics)
  • Psychological factors (e.g., negative thinking patterns, psychological inflexibility)
  • Social factors (e.g., stressful events, loss of a loved one)
Left untreated, depression can lead to substance use abuse, relationship conflicts, social withdrawal, impaired ability to study or work, self-harm behaviours and even suicide attempts.

Treatment for Clinical Depression

Clinical depression is treatable. Most people with clinical depression will improve when treated with antidepressant medications, counselling or a combination of both.

Antidepressant medications help improve the neurochemicals that affect stress level and mood. People who take antidepressants usually experience an uplift in their mood and some reduction of their depression symptoms, including improved sleep. Antidepressants are generally safe. Mild side-effects can include nausea and sleepiness. Seeking a doctor or psychiatrist’s advice is recommended when one is considering about taking antidepressant medication.

How Counselling Can Help with Depression

Psychotherapy or counselling is typically recommended for individuals with depression. Counselling provides a safe and validating space for individuals to process their thoughts and feelings and develop understanding about their issues. Counselling helps one to learn and gain practical skills to work with difficult or distressing thoughts and feelings.

Psychotherapies such as Acceptance and Commitment Therapy and Mindfulness-Based Cognitive Therapy have been found to be effective in treating clinical depression.

About Anxiety

Feeling anxious when perceiving danger or uncertainty is part of being human. While fear is how we usually respond to a real or perceived threat by gearing us up to deal with or escape from the threat, anxiety is a state of tension that prepares us for a possible future threat. Although uncomfortable at times, anxiety helps us in some way – to focus on what is important (e.g. examination) and protect us from real dangers (e.g. a speeding car).

A healthy level of anxiety can be helpful and would not impair daily functioning too much. For some, however, prolonged and overwhelming anxiety can leave one feeling helpless and impair daily functioning in school, at work and/or when relating to others.

Anxiety Disorders

Obsessive-Compulsive Disorder (OCD)

is the most common anxiety disorders in Singapore, affecting 1 person in every 33 (Institute of Mental Health, 2011). It can include symptoms like repetitive anxiety provoking thoughts, urges or mental images (known as obsessions) and repetitive behaviours in response to obsessions (known as compulsions). Examples include anxiety and fear relating to germs, untidiness, taboo thoughts of sex or harm to self or others.

Generalised Anxiety Disorder (GAD)

involves excessive and extreme worry about various aspects of life – money, health, relationship, etc. Persons with GAD find it hard to stop worrying, may experience unexplained physical problems, (e.g. muscle aches, stomach pains), difficulty falling and staying asleep and feeling nervous/tense frequently. GAD affects about 0.9% of the adult population in Singapore (Institute of Mental Health, 2011).

Social Anxiety Disorder (SAD)

can develop in someone who is afraid of being judged, shamed or rejected by others. Persons with SAD often feel highly self-conscious about the way they look, sound or act in some or all social situations. When with others and/or having to perform in social situations, they can experience sweating, trembling, rapid heartbeats, nausea and fear of speaking. They may tend to avoid social gatherings and people.

Panic Disorder

A panic attack is an episode of sudden, intense and overwhelming fear that can last for several minutes. Panic Disorder can be diagnosed when someone experiences repeated panic attacks. The person may experience a fear of something bad happening or feel that he/she is losing control of oneself. Physically, panic attacks can include symptoms like pounding heartbeat, shallow breathing, sweating and chills, chest pain and tingling in the limbs.

Post-Traumatic Stress Disorder (PTSD)

may develop in someone who experienced a traumatic, shocking and/or overwhelming event (e.g. witnessing a car accident). Trauma is an experience which can be emotionally distressing and painful. Not everyone who experience trauma develop PTSD subsequently. Persons with PTSD may experience symptoms relating to the event (flashbacks, dreams, worry), have avoidance tendencies (intentionally staying away from reminders of the event), arousal and reactivity (difficulty sleeping, feeling nervous easily) and cognitive and emotional symptoms (trouble recalling the event, thoughts of self-blame, feelings of guilt).

Specific Phobia

is an intense but unfounded fear of something that is usually not dangerous. These fears can be about anything, such as fears of height, small space, spiders and sight of blood. People often find ways to avoid their phobias. However, avoiding can negatively interfere with one’s life, work and/or relationships.

How Counselling Can Help with Anxiety

In counselling, the counsellor would first explore with you the circumstances and factors around the anxiety condition. It is important to know what happened before the onset of the problem, during and after anxiety episodes, and the times when anxiety is less of a problem. Having a better understanding of the anxiety problem would help you to have a clearer picture of what drives the anxiety to the way it is now.

About Bereavement and Grief

Bereavement is a response to the loss of a close relationship, which may include the experience of reacting, grieving, adapting and processing. Grief is the experience of emotional pain after a loss. Although all of us will experience grief in our lifetime, not everyone will have the same emotional experience of grief. After the loss of someone close some symptoms of grieving are normal, which may include:

  • Physical discomfort
  • Feelings of guilt related to the loss
  • Recurrent thoughts and images of the deceased
  • Irritable behaviours
  • Difficulties in carrying out daily tasks

Most people will recover from grief with minimal help and support. However, some don not recover even after an extended period of time and may need professional help and more support. Some may experience complicated grief, which is severe and prolonged grief that affects the person’s ability to carry out daily tasks and functions. Complicated grief affects about 2-3% of the general population.

Bereavement and Grief: The Myths and Facts

Fact: Grief is a cyclical process. Going back into previous stages of grief is normal as it is a process of trial and error.
Fact: Following a loss of a loved one, one may feel isolated and helpless as the loss may have taken away one’s sense of safety and control. However, many people do experience personal growth as a result of this experience.
Fact: The process of grief can begin even before the death of a loved one as people anticipate the impending loss. Grief can also happen when one experiences a loss of any sort, such as a breakup or loss of a job.
Fact: Grieving is a normal reaction to loss and individuals may experience symptoms of depression during the grieving process. However, grief is not the same as depression, which is a mental health condition.
Fact: Most people can recover from grief with minimal help. However, a minority may need more help and support than others.
Fact: Although everyone will experience grief in their lifetime, not everyone has the same emotional experience of grief. People grief differently. For example, while some throw themselves into their work, others choose to confide in people who are close to them.

How Counselling Can Help with Bereavement and Grief


  • Support the understanding and processing of
    bereavement and grief
  • Provide a safe and confidential space to work
    through emotional pain
  • Explore ways to manage grief
  • Facilitate healing and personal growth from the
  • Mindfulness practices can empower individuals
    to face the realities of life and death squarely and without avoidance as well as accept the
    experience of bereavement and grief