Workshop : Understanding Depressive illness and suicide prevention Dr. Vincent Wong Choong Wai MBBS(Malaya), M.Med(Psych),CMIA 王忠威心理精神专科医生 Consultant

Workshop : Understanding Depressive illness and suicide prevention

Dr. Vincent Wong Choong WaiMBBS(Malaya), M.Med(Psych),CMIA王忠威心理精神专科医生Consultant Psychiatrist www.brainmindspecialist.com

Dr. Vincent Wong, Consultant Psychiatrist 1

Session 11) What is normal Mental Health ?2) What is abnormal Mental health?3) Causes of Depressive illness.4) The Neurobiology of Depression5) Is Suicide Preventable?

Session 26) How to help those in need?7) How to prevent depression?8) Interview

Contents


“ Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

WHO 1947

PHYSICAL HEALTHFUNCTION ADAPTATION

MENTAL HEALTH

SPIRITUAL HEALTH

WHAT IS

MENTAL HEALTH ?

•How you think/feel about yourself?

•How you think/feel about other people?

•How do you handle the demands of life?

They feel good about themselves and …….

Not overwhelmed by their own emotions –

fears, anger, love, jealousy, guilt or worries

They can accept their own shortcomings Have self-respect and self confidence Neither under-estimate nor over-estimate

their abilities They have tolerant, easy-going attitude

towards themselves as well as others and they can laugh at themselves

They feel comfortable with other people and ……

Have lasting and satisfying personal relationships

Respect the many differences they find in other people

Are able to feel they are part of a community

They feel comfortable with other people and ……

Do not take advantage of others nor allow others to take advantage of them

They are able to give love and to consider the interests of others

They like and trusts others, and feel that others will like and trust them

They are mature, and able to meet the demands of life and they … Set realistic goals for themselves Are able to make their own decisions Accept their responsibilities Plan ahead and look forward to the future Welcome new experiences and ideas

They are able to meet the demands of life and they … They make use of their talents They do something about their problems as

they arise They shape their environment whenever

possible, they adjust to it whenever necessary They are satisfied with putting their best effort

into what they do

Consequences of untreated Depressive

illness.


www.brainmindspecialist.com 12

Suicide is an abnormal death.

For every suicidal death, 20 person will be severely affected.


US data : 1 in 4 has mental disorder

Suicide

Official statistics from the Health Ministry : Malaysia’s suicide rate is 1.3 to every

100,000 people a year, but experts believe actual numbers are far

higher, to between 10 and 13 per 100,000 people.

What are the facts ?


POPULAR MYTH ABOUT MENTAL ILLNESS

A sign of weakness. ( Story of Elyn Saks )

If you can identify the cause of illness (e.g. break-up of relationship) then treatment is not necessary

Christians do not get mental illness


POPULAR MYTH ABOUT MENTAL ILLNESS

Indicates a lack of faith

Indicates unconfessed sin

Mentally ill people tend to be lazy

Healing through medicine is not as good as healing by prayer

Taking medicine indicates a lack of real faith


Rev Rick Warren’s son


They are like the tidal waves.

Most tides are normal. But if it becomes a

Tsunami, it is abnormal! Unusually high or low

moods are abnormal: Low moods or

Depression. High moods or Mania.

Are moodswings normal?


A mood which all of us experience from time to time, usually as a result of some distressing circumstance.

So, it is normal

It can become severe. then it is called: depressive illness

Normal Sadness vs DEPRESSION


Signs and symptoms of Depressive disorder?


Signs and Symptoms

Behavioural Social withdrawal Desire to escape Crying without reason Self harm

Physical Sleep problems Change of appetite Tiredness Painful symptoms ( Masking Effect )

Emotional ( Less among Asians)DepressedLoss of interest / motivationIritable

Thinking Guilt feelingsLoss of self confidenceDecreased concentrationHopelessnessDr. Vincent Wong, Consultant Psychiatrist 22

3 NECESSARY CRITERIA ( 3 D )

DISTRESSING SYMPTOMS DURATION – LASTS LONGER THAN USUAL DYSFUNCTION – i.e. AFFECTS NORMAL

FUNCTIONING IN PERSONAL, SOCIAL OR OCCUPATIONAL AREAS

Normal Sadness VS Depressive illness


Causes of Depressive disorder?


Nature

Nurture

Grace

Not a single cause but multiple complex factors


CAUSES OF MENTAL ILLNESS

STRESS & COPING

COGNITIVE (THINKING)ERRORSBIOCHEMICAL IMBALANCE

DETERIORATION OF BRAIN CELLS

DRUG & ALCOHOL

FAMILY UPBRINGING

PERSONALITY/SPIRITUAL

DEVELOPMENT

GENETIC

Lack of Protective Factors

- Good Parenting/Mentoring

- Spiritual Foundation

- Healthy thinking/coping

- Self Awareness- Social support


Neurobiology of depression


Brain

Activity of the brain

Mind

· memory, 记性· mood and emotion,心情，情绪 · fear and anxiety,恐惧，蕉急 · sensory perception, 感觉· attention, 集中· impulse control, 冲动· pleasure, 榆快，高兴· appetitive drives, · willed actions, · executive functions, · ability to think in

representations, · language, · creativity and imagination, · consciousness, · introspection, · and a host of other mental

activities.

脑

活动

Brain Scan changes ( comparison between Normal vs Depressed

individuals


Suicide : Is it preventable?


Japan : Man who burn himself in the bullet train

( june 2015 )


On average, one person dies by suicide every 40 seconds somewhere in the world.

Over 800,000 people die due to suicide every year and there are many more who attempt suicide.

Hence, many millions of people are affected or experience suicide bereavement every year.

Second leading cause of death among 15-29 year olds globally in 2012.


Suicidal Risk

Mnemonics ( SAD PERSON )

S : SexA : AgeD : Depressive illness

P : Previous attemptsE : Ethanol ( Alcohol )R : Rational thinking lossS : SicknessO : Organized PlanN : No support



Helping people with Depression : General Principles

Dr. Vincent WongMBBS, M.Med(Psych),CMIA王忠威心理精神专科医生Consultant Psychiatristwww.brainmindspecialist.com


Is Healing Human or Divine?


Are Emotional disorders 1)Biological problems?2)Psychological?3)Social?4) Spiritual?

Dr. Vincent Wong, Consultant Psychiatrist

General Principles Biological / Physical treatment

- Medication- Diet- Exercise- Relaxation

Psychological

Social - Family support- Social Support - Overcome the stigma of mental illness.

Educational

Spiritual - Pastoral or Spiritual help

37


My Battle with Depression : by Irene Tan


The LAH technique


Practical Application

How to prevent depression?

www.brainmindspecialist.com 41

Application and Summary

Acronym : ACTIVE

A : Acknowledge our CreatorC : Community living T : Think healthy thoughtsI : Inner peace and joy , good pleasuresV : Value Relationships and FriendshipsE : Eat well, sleep well and Exercise

Depressive illness is a Medical illness. - There is a Biological, Psychological, Social

and Spiritual dimension of the illness

My observations: We need true security, true love, true hope and true self worth. The path to peace is not a highway but a narrow and winding path.

Seek treasures in Heaven ( Mt 6:19 )

Take home message


Documents

Workshop : Understanding Depressive illness and suicide prevention Dr. Vincent Wong Choong Wai MBBS(Malaya), M.Med(Psych),CMIA 王 忠 威 心 理 精 神 专 科 医 生 Consultant

Workshop : Understanding Depressive illness and suicide prevention Dr. Vincent Wong Choong Wai MBBS(Malaya), M.Med(Psych),CMIA 王忠威心理精神专科医生 Consultant