March 2022 - Promises Healthcare
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COVID-19, Singapore Easing Measures and Mental Health

COVID-19, Singapore Easing Measures and Mental Health

by | Mar 25, 2022 | Anxiety, Anxiety, Articles, Depression, Jane Low

The COVID-19 pandemic is unprecedented. The ubiquitous influence of the pandemic has been—and continues to be— felt by individuals globally. Many experiences the fear of being infected or infecting others, disruptions in their daily routines, social isolation, the likelihood of unemployment, financial hardship and the looming economic uncertainty (Ministry of Health Singapore, 2020). As such, there is a detrimental impact on the mental health and wellbeing of individuals, including an increased risk of suicidal behaviour.

Globally, the prevalence rates for depression and anxiety in the COVID-19 pandemic were 28.0% and 26.9% respectively (Nochaiwong et al., 2021). Factors contributing to depression and anxiety include suffering, fear or potential death, grief and financial stressors (World Health Organization, WHO 2022).

Young people have been identified as at increased risk for suicidal and self-harming behaviours (WHO, 2022). Women’s mental health, compared to men’s, has been more adversely impacted by the pandemic (WHO, 2022). In addition, people with existing medical conditions such as asthma, cancer and heart diseases, have been found to be at higher risk for developing mental health disorders (WHO, 2022).

In Singapore, a study conducted by the Institute of Mental Health (IMH) (Ministry of Health Singapore, 2020) found that 8.7% of Singapore residents reported having clinical depression, 9.4% reported having clinical anxiety and 9.3% reported mild to severe stress levels.  Older adults were identified as a vulnerable group, particularly, those who lived alone. Similar to the findings from WHO (2022), youths in Singapore were also identified as vulnerable to experiencing poor mental health in response to the pandemic. There is an urgency for countries to boost their mental health and psychosocial support services as part of the pandemic response plan.

According to the COVID-19 mental wellness task force, initiatives in Singapore include providing psychological support via helplines such as the National CARE hotline and a mental health help bot (‘Belle’), incorporating mental health materials in the school curriculum, fostering family resilience and supporting parents with parenting skills.

Here are some recommendations for mental health support during this pandemic:

  • Parents are encouraged to have conversations with their children about their children’s worries and responses to the pandemic. Parents have been found to underestimate such responses (Pfefferbaum & North, 2020). Such “talk time” can also help in trust and bond-building
  • Seniors can be equipped with digital skills and also expand their options for help and support i.e. the provision of telehealth counselling and support services (Brydon et al., 2022). 
  • Health care workers can monitor their stress responses and seek assistance in relation to both their work and personal lives from a mental health professional (Pfefferbaum & North, 2020).  
  • People can be encouraged to limit their consumption of news related to COVID-19 to once a day and to focus solely on credible news sources. 
  • Having social interactions with family and friends and offering to help support one another during this difficult period can also be particularly beneficial.
  • Being outdoors and exercising are good habits for maintaining healthy wellbeing. 

As restrictions are slowly easing around the world, it can also be challenging for most people to adjust back to when restrictions were first introduced (during lockdowns). With new changes and uncertainty, being mindful of one’s mental health and well-being is crucial. For example, larger social gatherings (e.g. group of 10) may seem overwhelming at first, therefore it is important for people to recognise their anxiety levels related to social gatherings. 

Here are some suggestions that might help regulate your emotions as you enter this new season of Singapore opening up amidst the COVID-19 Pandemic (Black Dog Institute, 2022):

  • Gradually, increase your time spent in a larger social gathering at your own pace. 
  • You can also start to focus on things that are within your ability and control. For instance, you can engage in different relaxation techniques such as deep breathing and focusing on being in the present in order to better cope with your stress levels (American Psychological Association, 2021). 
  • it can be useful to discuss reasonable adjustments back to work with your managers such as flexible working arrangements and other training opportunities in order to increase work efficacy 
  • Seek professional help if there are concerns regarding stress levels related to the easing of restrictions.

It is particularly evident that the COVID-19 pandemic has taken a toll on the well-being of Singaporeans and the rest of the world. The pandemic has highlighted the importance of mental health and wellbeing and there is an urgent call for countries worldwide to provide people with mental health and psychosocial support to help them maintain psychological wellness.

Some Local Helplines and support:

Additionally, you could make an appointment to speak with one of our mental health professionals (a psychologist or counsellor) should you require counselling support.

References 

Black Dog Institute (2022). Coping with anxiety about COVID-19 restrictions easing.  https://www.blackdoginstitute.org.au/news/coping-with-anxiety-about-covid-19-restrictions-easing/

Brydon, A., Bhar, S., Doyle, C., Batchelor, F., Lovelock, H., Almond, H., Mitchell, L., Nedeljkovic, M., Savvas, S., & Wuthrich, V. (2022). National Survey on the Impact of COVID-19 on the Mental Health of Australian Residential Aged Care Residents and Staff. Clinical Gerontologist, 45(1), 58-70. https://doi.org/10.1080/07317115.2021.1985671 

Ministry of Health Singapore (2020). COVID-19 Mental Wellness Taskforce Report.  https://www.moh.gov.sg/docs/librariesprovider5/covid-19-report/comwt-report.pdf

Nochaiwong, S., Ruengorn, C., Thavorn, K., Hutton, B., Awiphan, R., Phosuya, C., Ruanta, Y., Wongpakaran, N., & Wongpakaran, T. (2021). Global prevalence of mental health issues among the general population during the coronavirus disease-2019 pandemic: a systematic review and meta-analysis. Scientific Reports, 11(1), 10173. https://doi.org/10.1038/s41598-021-89700-8

Pfefferbaum, B., & North, C.S. (2020). Mental health and the Covid-19 pandemic. The New England Journal of Medicine, 383:510-512, 291-299. https://doi.org/10.1056/NEJMp2008017

World Health Organization (2022, March 12) COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide

Photo by Markus Winkler on Unsplash 

What Are Panic Attacks and How To Manage?

What Are Panic Attacks and How To Manage?

by | Mar 1, 2022 | Adult Psychiatric & Counselling Services, Anxiety, Anxiety, Articles, Dr Elaine Yeo

Written by: Dr Elaine Yeo, Senior Clinical Psychologist

All of us have felt anxiety at some point in our lives, whether before a big test, public speaking, or a job interview. Anxiety is a perfectly normal emotion that serves the purpose of motivating us to prepare for a big event or protect ourselves from potentially dangerous situations. However, too much anxiety may put us at the risk of experiencing panic attacks. In this article, we will discuss the symptoms, causes, and strategies for managing panic attacks. 

 What are panic attacks?

A panic attack is a sudden episode of intense anxiety and fear that triggers strong physiological reactions. These reactions can feel so intense that the individual feels as though they are having a heart attack. Common symptoms of a panic attack include but are not limited to:

  • Heart palpitations
  • Sweating
  • Trembling or shaking
  • Shortness of breath
  • Chest pain or discomfort
  • Feeling dizzy
  • Fear of losing control or going crazy

It is important to note that panic disorder can develop if an individual starts to fear the panic attack itself (i.e., worrying about when the next panic attack may happen or avoiding situations and places when the panic attack occurred). 

What causes panic attacks?

Similar to anxiety, anyone can experience a panic attack. However, some of us may be more prone than others. Several factors play a role in increasing our risk for panic attacks:

  • Family history: Anxiety often runs in families. If you have a family member who has a diagnosed anxiety disorder or, tends to experience anxiety more intensely and frequently than others, you would be at a higher risk for panic attacks. 
  • Mental health issues: Individuals experiencing burnout, intense anxiety, depression, or any form of mental illness are more prone to panic attacks. 
  • Traumatic experiences: A past or recent experience of trauma can result in our bodies remaining in constant “fight-or-flight” mode—the physiological reaction of anxiety and fear—which may then increase the likelihood of panic attacks.
  • Substance abuse: Addiction to substances such as alcohol, drugs, and caffeine can put us at a higher risk for panic attacks. 

How to manage panic attacks? 

If you are experiencing panic attacks at an intensity and frequency that is distressing and debilitating, please seek professional help. Panic attacks can be treated with talk therapy, psychotropic medication, or a combination of both. If not, here are a few ways to manage panic attacks: 

  • Stay calm: It is important to remember that while panic attacks can be scary and extremely uncomfortable, they will not cause you to die. When a panic attack comes, notice and name it as a panic attack, and remind yourself, “It’s just a panic attack, it will pass.” For those of you who are unsure if it may be a medical issue, please see a doctor to rule out such concerns first. 
  • Practice grounding exercises: Grounding is a useful technique that helps us to detach from our anxiety, often with an added calming effect. It works best with regular practice, even when you are not experiencing a panic attack, so that muscle memory can kick in when you most need it. Examples of grounding include:
    • Notice the environment around you with all your five senses, such as what you can see, hear, touch, smell, and taste. Describe this to yourself, either mentally or quietly out loud. 
    • Carry a grounding object (e.g., a rock, gem, ring, small toy) in your pocket. Hold the object and notice its size, shape, texture, and temperature of it. 
    • Engage in slow, deep 4-2-4 breathing – inhale for four counts, hold your breath for two counts, exhale for four counts. You may also focus on your breath and notice the feel of the air entering your nostrils, the movement of your shoulders, chest, and stomach as you breathe, the feel of the air coming out of your mouth. 
  • Avoid caffeine: Caffeine is a stimulant that can activate your body’s “fight-or-flight” response. Adding caffeine to your anxiety-ridden body would be akin to throwing a lit stick of dynamite into a house on fire. 

Overall, please remember that the presence of panic attacks indicates high levels of anxiety. They are our body’s way of telling us that it is at its limit. Should you experience one, it would be helpful for you to reflect on your stress and anxiety levels, identify any triggers and manage them, as well as ensure that you engage in your self-care routine and practice adaptive coping strategies.