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Straits Times Interviews Juliana Pang about the rise of gaming addiction amid the pandemic

Straits Times Interviews Juliana Pang about the rise of gaming addiction amid the pandemic

The Straits Times interviewed Juliana Pang, Addictions Therapist at Visions by Promises* to weigh in on her thoughts on the rise in Gaming Addiction among children in Singapore.

She shared that gaming addictions often develop in the context of underlying issues, such as struggles with schoolwork, bullying, or tensions at home. Children hence turn to gaming as a coping mechanism, she added.

*Visions by Promises is the addiction treatment arm of Promises Healthcare. This interview was done before its formation.

Follow the link to read the full article: https://www.straitstimes.com/singapore/community/gaming-addiction-on-the-rise-among-children-amid-pandemic-counsellors


Photo by Glenn Carstens-Peters on Unsplash

Youths’ lax mindset, liberal attitudes on drugs pose stiff challenge to S’pore authorities’ zero tolerance stance

Youths’ lax mindset, liberal attitudes on drugs pose stiff challenge to S’pore authorities’ zero tolerance stance

TODAY Online interviewed Dr Sandor Heng of Visions by Promises, the addictions treatment arm of Promises Healthcare, about his views regarding the current methods taken towards those suffering from drug addictions.

Here is his quote:

Dr Sandor Heng of Visions by Promises, the addiction therapeutic arm of Promises Healthcare, cautioned that the “stick” approach may not be a deterrence.

“Negative consequences and fear-based approaches can quell curiosity, but it can also make one even more intrigued,” he said, adding that addictions start with curiosity and accessibility, which then lead to experimentation.

Follow the link to read the whole article:

https://www.todayonline.com/singapore/youth-liberal-attitude-towards-drugs-1933351

How Gen Z is hooked on cryptocurrency and NFTs

How Gen Z is hooked on cryptocurrency and NFTs

Andy Leach,  Principal Addictions Therapist & Director of Visions by Promises was interviewed by BBC online to weigh in on his thoughts regarding Gen Z’s addiction to Cryptocurrency & NFTs.

Here’s his quote:

Andy Leach, from addictions clinic Visions by Promises in Singapore, says he has seen a jump in young – particularly male – clients getting addicted to the thrill of trading crypto and NFTs.

“You have the ability to watch Bitcoin going up and down and basically this process, this rollercoaster ride, the highs, the lows, it’s available on your phone 24/7,” he says.

Follow the link to read the full article: https://www.bbc.com/news/business-60566575

or watch it on BBC’s Twitter: https://twitter.com/BBCMarikoOi/status/1526727052329594880?s=20&t=zggnW2fQY2h_iZS5FN-J2A

or listen to it on BBC digital radio: https://www.bbc.co.uk/programmes/w3ct31bp

Dr Jacob Rajesh Speaks with Expat Living on the misconceptions of psychiatric medication

Dr Jacob Rajesh Speaks with Expat Living on the misconceptions of psychiatric medication

Psychiatry Questions … Answered!

What are some commonly used psychiatric medications?

Depression is a very common disorder, affecting between five to ten percent of people, so we use antidepressants quite often. The medications we’ve been using for the past 25 years are called Selective Serotonin Reuptake Inhibitors (SSRIs). These newer generation drugs have much fewer side effects than those used in the past.

They do have some side effects though, the most common being gastric distress, nausea, headaches and insomnia. Some people also report sexual dysfunction and decreased libido. However, these side effects can be managed once the medication and dose is adjusted. SSRIs are usually more tolerated than older antidepressants.

Another group of drugs is the antipsychotics, which are used to treat schizophrenia and bipolar disorders. The second generation antipsychotics have fewer side effects than older ones, along with fewer cognitive effects and extrapyramidal side effects such as causing tremors or stiffness. However, side effects such as weight gain, increased blood sugar and increased cholesterol can occur with some of these drugs; these side effects need to be screened for on a regular basis

promises healthcare psychiatric medicine and antidepressants

Is psychiatric medication an alternative to therapy? Or do they work hand in hand?

Medication and therapy usually work hand in hand. Being medication-compliant is another important part of the mental health recovery treatment as it helps bring stabilisation to the chemical and biological changes in the sufferer that cause the disorder.

For depression, we prescribe medication for moderate or severe symptoms if it’s causing impairment or distress. We also recommend psychotherapy in its various forms: cognitive behavioural therapy, dialectical behaviour therapy, acceptance and commitment therapy, interpersonal therapy or family therapy, depending on the psychosocial stressors.

For bipolar disorder or psychotic conditions like schizophrenia, medications are the mainstays of treatment. However, psychotherapy methods can also help with regulating emotions and give handles to help regulate distorted thoughts when mild symptoms occur. Psychological therapy also plays a role for Obsessive-Compulsive Disorder (OCD) and eating disorders. Here, psychotherapy has a much more important role.

What are some of the misconceptions people have about psychiatric medication?

The most common misconception is that all psychiatric medications make you feel like a zombie – you can’t function, you can’t go to work, your mental faculties are affected. While some of the older generation antipsychotic medications can cause mental fogginess, there are newer ones with fewer side effects. Some people also believe that if they start taking medication, they might become addicted. It is usually the benzodiazepine class of drugs that are addictive in the long term; antidepressants aren’t addictive in the long term. We also see many patients who’ve been taking medication on a long-term basis, but we work with them to minimise side effects. We do this by adjusting the dosage, changing the class of drugs used and lifestyle modification. It’s also worth mentioning that psychologists cannot prescribe any of these drugs, only psychiatrists can.

Can you tell us more about new techniques like Transcranial Magnetic Stimulation?

Transcranial Magnetic Stimulation (TMS) uses electromagnetic waves to stimulate the brain. Unlike electroconvulsive therapy, which is more for people with severe psychotic depression, TMS doesn’t require any sedation. The patient simply sits in a chair and has a device placed at specific parts of the brain where it sends small electromagnetic waves. It is an outpatient procedure and there aren’t usually any side effects.

TMS is used primarily for people with depression who haven’t responded to antidepressants or have severe side effects from medication. It’s not usually a first-line procedure.

Is it as effective as antidepressants?

It works in combination with them. If that alone isn’t helping, TMS can augment the medication. It can also help by itself, but once the treatment stops the patient can relapse, so it’s better to take medication along with it.

What are some psychiatric issues that people may not realise they have?

Many people don’t realise that depression or anxiety disorders are mental illnesses. They think it’s a weakness in their own personality or the result of external stressors they can’t handle. The stigma of mental disorders also plays a big part. People tend to be quick to seek help for physical issues but still feel uncomfortable seeing a psychiatrist. I think it’s becoming more accepted though. There’s a misconception that psychiatrists just provide medication.

What else do they do?

Psychiatrists work in teams. The team-based approach is very important because we have psychiatrists who are qualified doctors along with psychologists who are trained in psychotherapy. We also have social workers, case managers and occupational therapists.

It’s a misconception that psychiatrists cannot do therapy. There are many psychiatrists who are trained in many forms of therapy, but the psychologists are the professionals who study these critical areas in depth. We refer the patients to them because it is their area of expertise.

What would you tell someone who is unsure about seeking help?

Don’t be ashamed of your symptoms or be self-critical. Many feel their symptoms stem from a weak personality or an inability to handle stress. People need to understand that mental health issues can occur for people who’ve done everything right – people with a good job, a good family life, good support and no financial issues. Depression is a biological response and it can happen without any external stressors so there is no shame in seeking help.

Dr Rajesh is a Senior Consultant Psychiatrist at Promises Healthcare, a provider that offers a wide range of psychiatric and psychological services for patients of all ages. Promises is also the only private centre in Singapore to offer Transcranial Magnetic Stimulation.

For more information on psychiatric medication and treatments offered by Promises Healthcare, click here.
#09-22/23 Novena Medical Center | 6397 7309

This article first appeared in the February 2022 edition of Expat Living and was published on their website. 

 


Dinesh Ajith

Dinesh is a seasoned writer and editor with seven years of experience covering travel, restaurants and bars. His interests include film photography, cheesy 90s monster flicks, and scouring the island for under-the-radar craft beer bars.

Benefits of Family Therapy in the Caregiving Process

Benefits of Family Therapy in the Caregiving Process

When one has to live with debilitating chronic conditions or even degenerative disorders, it is natural that we place emphasis on seeing that the afflicted recover and receive the appropriate management. As our society rapidly ages, the number of elderly living with medical conditions or dementia is also increasing exponentially. However, the care should extend beyond the patients themselves. More often than not, there are other individuals involved, including family members and friends dedicated to supporting their recovery. Is it time we acknowledge their efforts and ensure they are coping well? 

 

Caregiving can be exceptionally draining – both physically and emotionally – when a family member becomes a patient at home. Needless to say, we are unable to predict such unfortunate circumstances, and caregivers are often thrown into their roles without prior knowledge and preparation. This leaves them with no choice but to adapt and pick up new skills in order to commit to their caregiving responsibilities. However, this can take a toll on the primary caregiver as well as family relationships. 

 

With a large part of their time allocated to caring for another person, caregivers are much more susceptible to fatigue and prolonged stress, with little or no time for self-care. It can be a big problem if the caregiver feels that there’s no support – family and social relationships can be compromised, thereby further reducing any support network that a caregiver can receive. This can lead to burnout and immense feelings of helplessness. 

 

A survey by the Singapore Management University (SMU) with the support of Caregivers Alliance Limited (CAL), Enable Asia and the Singapore Association for Mental Health (SAMH), reveals that 3 in 4 caregivers are tired and exhausted caring for a person with mental health issues. Furthermore, the Family Caregiver Alliance estimates that close to 20 percent of family caregivers suffer from some form of depression. In addition, mental health disorders are even more common among dementia caregivers. A study conducted on mental health issues in those caring for Alzheimer’s patients found that the prevalence of depression was an alarming 34 percent, anxiety was 43.6 percent, and the use of psychotropic drugs was 27.2 percent.

 

Some other common problems that caregivers face include (but are not limited to):

 

Mental health concerns Physical health concerns  Secondary Stressors
  • Depression
  • Anxiety
  • High rates of negative affect including guilt, sadness, dread, irritation and worry
  • Ambivalence about care
  • Witnessing the suffering of relatives
  • Feeling isolated or abandoned by others
  • Anticipatory grief
  • Fatigue
  • Sleep problems
  • Risk of illness, injury, mortality
  • Adverse changes in health status
  • Dysregulation of stress hormones

 

 

  • Work/employment (e.g., reduction in work hours, family to work spillover, and work to family spillover)
  • Financial strains
  • Relationship stress
  • Loss of time for self-care
  • Reduced quality of life

 

 

 

This is where family therapy comes in. Families might find therapy useful when they are adapting to a major change in the family such as dealing with a chronic illness or death in the family, or conflicts between family members in the caregiving process. Family therapy is a method to engage family caregivers in active and focused problem-solving approaches related to family caregiving to improve the quality of care, reduce burden and improve family functioning. Family therapy for caregivers, in particular, encompasses six core processes – naming the problem, structuring care, role structuring, role reverberations, caregiver self-care and widening the lens. Therapy is conducted in a way that is tailored to each household. Depending on the needs that caregivers and their families must address, the aspects that are challenging them will become the focus of intervention. Not covering all six areas doesn’t mean that the therapist isn’t taking a comprehensive approach – the core processes simply act as a guideline, and do not imply a rigid prescription of intervention work. 

 

Conflicts and resentment often arise for anyone in the role of family caregiver, and these are exacerbated when trying to share tasks with siblings or other members of the family. Many a time, caregivers tend to bottle up their feelings and put up a positive front so as to avoid passing on any negative feelings to their care recipients. However, this can be extremely detrimental to their own mental and physical health in the long run. The main part of family therapy for caregivers, therefore, involves helping the caregiver and family members sort through challenging emotions and reach resolutions. Speaking about your feelings can help you find comfort, and allows you to gain further insight and through the guidance of the therapists, various emotional-coping strategies. Implementing them will certainly take some weight off your shoulders, and perhaps give you some enlightenment with regards to discovering new problem-solving strategies. 

 

Undeniably, caregivers will benefit tremendously from any assistance in their caregiving responsibilities from family members. Family therapy is extremely beneficial in helping to improve the interactions and support network among family members, especially in providing new perspectives on problems that are seemingly unmanageable (part of which involves building trust, mutual respect and openness). This hence reduces the level of stress within the family and the level of caregiver burden, on top of enhancing communication skills and boosting a positive sense of empowerment. 

 

Family therapy is focused on achieving precisely what is best for the whole family and its cohesiveness, and sorting out obstacles or issues challenging the family dynamics. It is important that you take the important step toward seeking help from professionals in order to achieve a better quality of life for yourself and your family. 

 

While face-to-face consultations are the norm, we understand that as caregivers, you may be faced with time constraints or other concerns. Thankfully, with technological advancement, virtual consultations are also becoming increasingly popular. They are equally effective and allow for more individuals to connect with their family therapists with greater ease. Of course, the decision is entirely yours to make. If you find yourself struggling, or simply feel that you need a trustworthy individual to speak to, feel free to get in contact with us

 


References:

  1. https://news.smu.edu.sg/news/2020/12/09/3-4-caregivers-persons-mental-health-issues-highlight-need-temporary-separation#:~:text=This%20survey%20by%20the%20Singapore,person%20with%20mental%20health%20issues. (Accessed 16/03/2022)
  2. https://au.lifestyle.yahoo.com/caregivers-take-care-of-person-with-mental-health-condition-help-wellness-031845657.html (Accessed 18/03/2022)
  3. https://www.apa.org/pi/about/publications/caregivers/practice-settings/common-problems (Accessed 18/03/2022)
  4. https://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/family-therapy (Accessed 18/03/2022)
  5. https://www.agingcare.com/articles/counseling-for-caregiver-burnout-126208.htm (Accessed 18/03/2022)