I had no idea my mental health had been rearing its ugly head. For every morning of October, I’d wait by the MRT platform to board the train to my office, like any other. Usually, while waiting, I have a knack for mentally Nazi-ing the copies written on ads plastered across the MRT doors. It’s a writer’s thing, I suppose.

The flavour of the month was something called ‘Beyond The Label’, a campaign initiated by National Council of Social Service to raise awareness on mental health issues in Singapore. There was no Grammar Nazi-ing this time, just an inexplicable fixation on a statistic printed on it: 1 in 8 Singaporeans suffer from mental health conditions. In a population of 5.6 million, that’s 700,000 people who, at some point in their lives, have to deal with conditions such as anxiety disorders, panic attacks, schizophrenia and clinical depression.

And you know what the frightening part is? Some are not even aware that they’re suffering from it. It’s almost like a silent killer.

. . .

In the MRT campaign posters, four ambassadors stared back at me, each one of them having survived their respective mental health condition. I noticed there were more women than men – rightfully so if we’re talking about the symbolism, since women are more at risk. Or perhaps that was pure coincidence. Either way, I had a revelation.

Two, actually.

The first? I have reasons to believe men are at higher risk when it comes to self-awareness. For the longest time, archaic guidelines on masculinity, societal pressures, pop culture and their own egos have discouraged men from discussing their emotions openly, for fear of being ridiculed as ‘feminine’. They’d be told to suck it up in the face of adversity.

That sounds familiar, doesn’t it? You’ve probably heard that everyday for two years back in the army. I believe the exact words are ‘suck thumb’.

This is stupidity at its best because even when repeated trauma from environmental and societal stressors start giving way to serious mental health problems, guys consciously and subconsciously choose to mind the labels, shove their problems under a rug, and sacrifice their happiness.    

Ha, don’t I know a thing or two about that.

After all, I am a guy who decided to take up the mantle of The Guy behind this publication – all the more I cannot and should not falter under any kind of scrutiny, no matter how public or private. Any cracks in the armour of masculinity that I show, even if it’s that quiver in speech that hits me whenever I panic under social settings (of any degree of familiarity), I’d automatically assume it robs me of my ‘cred’.

I’d assume things are destined to go downhill and I won’t ever make a meaningful impression on people.

So as time went by, I chose the easy way out. I kept up a stone cold façade and said as little as possible. Somedays, it’d pass without me uttering a word. I isolated myself from such environments if I could help it, and avoided people like a plague. My anxiety had developed into irrational levels such that anyone who engages me in small talk, or as much as cast a glance in my direction, I’d think they want something out of me.

Which leads me to my second revelation: this probably isn’t just a bad case of INFJ. The mental health statistic on the MRT ad? It resonated with me because I might have been part of it the whole time.

. . .

Once I got to the office, I did what any respectable journalist would do: interview Dr. Google to scope out the top symptoms. I ran down the list.

…excessively self-conscious in everyday social situations. Check.

… go through the day filled with exaggerated worry and tension. Check.

…fatigue, stomach upset, forgetfulness, chilly hands. Check.

…losing interest in hobbies. Check.

And over at the sources of work stress-induced anxiety, I found these:-

Negative self talk. Check.

Perfectionism. Check.

Unrealistic expectations. Check.

Being too busy. Check.

It didn’t take long for the dots to connect. On top of my side hustle as The Guy, I sell my words at an agency by day, a line notorious for its lack of work-life balance. Both gigs demand nothing short of a writing factory out of me.

Now, surely you’ve heard of the writer’s block. That’s nothing, really. The real psychological spook is the writer’s curse, in which the more you write, the more your inner voice convinces you that whatever you’ve written will never be good enough.

You’ll never be good enough.  

As you might have guessed, the pleasure I used to derive from writing is long gone. These days, it’s a chore I have to force myself through. My pernicious OCD-ness with words has made every story I produce feel like I’ve just conceived at the end of it. Through my asshole. And I’m just tired of living up to punishing expectations of myself.

There’s been more than just a few occasions when I pace about in the deafening silence of solitude, asking myself existential questions and contemplating giving up writing – the very thing that has gotten me most of my successes like accolades for this publication, along with rave reviews on my wordsmanship

I’m supposed to feel great about myselfYet, I still find myself regressing into a cycle of self-doubt, paranoia and unhappiness in the chase for writing perfection and financial rewards.

What gives?

I don’t have concrete answers yet, but I’m sure of one thing. Mental health conditions can happen to the best of men and I don’t believe they’re permanent. Getting well, finding your footing, and overcoming foolish labels is not just a distinct possibility. It can be your new reality – if you suspect you’re falling through a mental health trapdoor. 

How do I know that? Because as a respectable journalist, I consulted Denise Lim, clinical psychologist at Institute of Mental Health (IMH), to shed some professional light on mental health issues among men.

First things first, what’s mental health and how do we define it?

Whenever we talk about mental health, we look at a person’s social, mental and emotional well being. We also look at his ability to cope with everyday commitments at work, relationships, as well as how he engages in hobbies. Anything that can impact an individual’s well being in these areas, it can be considered as part of the mental health conversation.

What are some misconceptions about people dealing with mental health issues?

Like you mentioned, it is very common. 1 in 8 Singaporeans are diagnosed with a mental health condition, the most common one being depression. Some people turn to alcohol abuse, while some others exhibit oppressive compulsive disorder – (OCD).

One of the misconceptions is how people think that those who have to see a psychiatrist to get treated are weak, and they have a lack of control over themselves. But some things that bring about mental health conditions may not be within control, such as one’s life circumstances, for instance, childhood abuse, financial factors and difficult relationships. In some cases, there is a genetic vulnerability.

Despite what some might think, it is also possible for resilient people to develop a mental health condition, if the situational factors exceed their ability to cope.

Does depression fall under mental health? Is there a difference?

Mental health is a broad umbrella term, and depression is a specific condition under it. The word ‘depression’ tends to get loosely thrown around, and people sometimes trivialise it as a normal bout of sadness. They would simply ask you to snap out of it and get over it.

But it’s not that simple. Clinical depression involves prolonged period of sadness and difficulty in functioning on a day to day basis.

Do you see a trend of younger men seeking help?

There’s a wide spectrum of men that we see. There are younger ones, and there are those higher up in the age range. But I do see a difference in the problems that men initially present for, compared to the ladies.

While the emotional distress of females are generally apparent when they present for help, the emotional distress of guys tend to present more subtly, and can sometimes be masked by behavioural or social difficulties (such as excessive drinking, irritability, or interpersonal difficulties).

They sometimes find it hard to identify the underlying emotional issues, as they are not accustomed to talking about their emotions.

What are some of the top symptoms of mental health deterioration?

Some of the common symptoms include sadness, anxiety – some people also experience hallucinations. He may see or hear something that’s not there. We could also be looking at changes in appetite. Eating very little.

Conversely, he could be eating a lot to make himself happier. Same for sleep patterns too, which can get affected. He could be sleeping as less than usual, or he could be oversleeping a lot.

He may lose interest in something that he used to find enjoyable. Like soccer. He could still be playing it but he no longer finds pleasure in the activity.

Is anxiety normal? How bad is bad?

There’s a spectrum for anxiety. For example, it is normal to experience some anxiety the night before a big presentation. But like depression, it is considered clinical if it is prolonged, or if you find that it is becoming a long-lasting bother and it stops you from doing things that you used to enjoy.

For those who are aware that their mental health is being compromised, what should be the first step?

You may go to your neighbourhood GP or a polyclinic doctor to get an initial diagnosis. He will be able to determine if you have to go see a psychiatrist. It’s like someone with diabetes. You see a GP first, and then you get a referral to a specialist if the condition requires specialised attention.

What are some DIY coping techniques one can practise on his own to overcome irrational anxiety and worry?

One can attempt to change stressors present the environment that you’re exposed to daily (it could be your work environment). But of course, in some circumstances, it is hard to change these external factors, for instance, the kind of household you’re living in or your financial situation. For things that you can’t change, it is still best for you to learn to manage or accept them.

And I believe it is hard for someone to feel emotionally well without physical wellness, so engage in regular exercise and look after your body. Some others find comfort in their religion, by speaking to their religious leaders. If not, confide in a friend.

How much can breathing exercises help in DIY recovery?

Of course, breathing exercises and mindfulness can help in terms of reducing one’s experience of stress. In addition, you’ll have to try to avoid being too harsh on yourself. Manage the inner critique that could be triggering unfavourable thought patterns. Always be compassionate towards yourself.