Transcript 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 Psychiatrist www.brainmindspecialist.com Dr.

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 Psychiatrist
www.brainmindspecialist.com
Dr. Vincent Wong, Consultant Psychiatrist
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Contents
Session 1
1) What is normal Mental Health ?
2) What is abnormal Mental health?
3) Causes of Depressive illness.
4) The Neurobiology of Depression
5) Is Suicide Preventable?
Session 2
1) How to help those in need?
2) How to prevent depression?
3) Interview
Dr. Vincent Wong, Consultant Psychiatrist
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“ Health is a state of complete physical,
mental and social well-being and not
merely the absence of disease or
infirmity.”
WHO 1947
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 …

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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.
Dr. Vincent Wong, Consultant Psychiatrist
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 Suicide is an abnormal death.
 For every suicidal death, 20 person will be severely
affected.
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What are the facts ?
 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.
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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
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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
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Rev Rick Warren’s son
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Are moodswings normal?
 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.
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Normal Sadness vs DEPRESSION
 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
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Signs and symptoms of Depressive
disorder?
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Signs and Symptoms
Emotional ( Less among Asians)
Depressed
Loss of interest / motivation
Iritable
Behavioural
 Social withdrawal
 Desire to escape
 Crying without reason
 Self harm
Physical
 Sleep problems
 Change of appetite
 Tiredness
 Painful symptoms ( Masking
Effect )
Dr. Vincent Wong, Consultant Psychiatrist
Thinking
Guilt feelings
Loss of self confidence
Decreased concentration
Hopelessness
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Normal Sadness VS Depressive illness
3 NECESSARY CRITERIA ( 3 D )
 DISTRESSING SYMPTOMS
 DURATION – LASTS LONGER THAN USUAL
 DYSFUNCTION – i.e. AFFECTS NORMAL FUNCTIONING
IN PERSONAL, SOCIAL OR OCCUPATIONAL AREAS
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Causes of Depressive disorder?
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Not a single cause but multiple
complex factors
Nature
Nurture
Grace
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CAUSES OF MENTAL ILLNESS
GENETIC
DRUG & ALCOHOL
FAMILY UPBRINGING
PERSONALITY/SPIRITUAL
DEVELOPMENT
DETERIORATION OF
BRAIN CELLS
Lack of Protective
Factors
-Good
Parenting/Mentoring
-Spiritual Foundation
-Healthy thinking/coping
-Self Awareness
-Social
support
Dr. Vincent Wong, Consultant Psychiatrist
STRESS & COPING
COGNITIVE (THINKING)ERRORS
BIOCHEMICAL
IMBALANCE
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Neurobiology of depression
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Brain
活动
脑
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.
Brain Scan changes ( comparison between
Normal vs Depressed individuals
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Suicide : Is it preventable?
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Japan : Man who burn himself in
the bullet train ( june 2015 )
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 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.
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Suicidal Risk
Mnemonics
( SAD PERSON )
P : Previous attempts
E : Ethanol ( Alcohol )
R : Rational thinking loss
S : Sickness
O : Organized Plan
N : No support
S : Sex
A : Age
D : Depressive illness
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Helping people with Depression
: General Principles
Dr. Vincent Wong
MBBS, 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
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Is Healing Human or Divine?
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Are Emotional disorders
1)Biological problems?
2)Psychological?
3)Social?
4) Spiritual?
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General Principles
 Biological / Physical treatment
-
Medication
Diet
Exercise
Relaxation
 Psychological

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Social
Family support
Social Support
Overcome the stigma of mental illness.
 Educational
 Spiritual
- Pastoral or Spiritual help
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My Battle with Depression
: by Irene Tan
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The LAH technique
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Practical Application
How to prevent depression?
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Application and Summary

A
C
T
I
V
E
Acronym : ACTIVE
:
:
:
:
:
:
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Acknowledge our Creator
Community living
Think healthy thoughts
Inner peace and joy , good pleasures
Value Relationships and Friendships
Eat well, sleep well and Exercise
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Take home message
 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 )
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