There is no denying that with all the extra time we had in hand these past two years, we naturally had time to engage in some soul-searching. Living in the age of information, it was not that difficult for many of us to pick which outlet or platform to help us with that journey.
While I was scrolling incessantly through my social media platforms, I began to notice many self-care apps and programmes filling the ad space. The digital universe seems to have started to hint at the importance of maintaining spiritual well-being.
In a traditional sense, people would reach out to astrologers, go on meditation retreats, go on pilgrimages, or reach out to those who practice alternative medicine to enrich their spirit. Thanks to the introduction of mobile apps, streaming platforms, and social media platforms, we can now practice these in the comforts of our own homes. Therefore, it is no surprise to come across such practitioners offering one-on-one sessions of daily meditation guides, sharing daily affirmations, offering tarot readings, and sharing their experiences of their spiritual awakenings.
What is Spiritual Self-Care?
Spiritual self-care goes hand in hand with the practice of soul-searching. Therefore, we can say that the steps we take towards improving our connection to a higher self are in essence, spiritual self-care. It can start with the simplest of actions, such as practising gratitude, spending time in nature, reading a daily affirmation, taking part in group prayers or meditation classes.
Enriching your spiritual well-being
If we were to look at the simple actions we take towards enriching our spiritual well-being, you would notice that these actions could also help us to decompress, relieve stress, find inner peace and achieve some balance in our minds. Studies have revealed that practising living a spiritual/ religious life could assist with battling depression, responding to setbacks in life in a more empathetic manner, and finding a support system that will be there for us during our life’s highs and lows.
Lately, the spiritual self-care topic has amassed millions of users on TikTok to follow accounts such as @MysticTarot and @babyreckless as they rally around the content that is released for their followers. The app’s informal format has allowed such influencers to post bite-sized videos multiple times a day under tags like #Spiritualtok, #spiritualmeaning, #Spiritual and #wellness that reaches millions and billions of views.
Given the ongoing crises around our world, there has not been a better time to look at nurturing our spiritual well-being. Even if it means that some of us are not religiously inclined, there are still practical methods that are in place to practice spiritual well-being.
Here are some apps that would help you in your journey to improve your spiritual well-being:
- Co-star – Founded by Banu Guler, this app provides daily astrology readings and zodiac-sign inspired tips.
- Breathwrk – Founded by Max Gomez, the platform provides its users with breathing exercises backed by science and research that would help them fall asleep, relieve stress and anxiety, improve endurance and energise themselves.
- LOA – Law of Attraction Toolbox brings you the best teachings of Abraham-Hicks, the app provides you tools, exercises and games to help focus, visualise and improve your mood any time of the day.
Although the skin is our largest organ, when it comes to products or procedures that are available to care for our skin, majority of it is focused on facial skincare. Given that the skin on our faces is thinner and more sensitive, we naturally reach out to grabbing products to protect them from harsh elements.
However, topical skincare alone will not help us achieve the glowing, radiant skin that we require, meaning that we need to look at other areas of well-being that contribute towards achieving better skin. While our skin becomes a reflection of how well we manage our sleep cycles, nutrition, mental health, and physical activity, in recent times practitioners of traditional medicine are consulted for bodywork to achieve glowing facial skin.
According to Board-Certified Doctor of Chinese Medicine Dr Debbi Kung, most often when her clients come for facial rejuvenation consultations through acupuncture, she recommends them to attend several body constitutional acupuncture sessions.
“Rejuvenating your face is a bonus of being healthy already because your face reflects your entire body. However, if there’s a lot of other stuff happening in the body that hasn’t been addressed, facial rejuvenation acupuncture won’t be as effective. Your chi can’t get to the face if it’s more needed in the hips, back, or for mental health,” Dr Kung explains.
How does your facial skin benefit from bodywork?
Bodywork is done to relax or relieve pain in your body using body manipulation therapies that allow natural, graceful movement. It is often used on persons who have limited mobility, or those who have unnatural ways of moving or locking their posture following injuries.
Traditional medicine practitioners can often suggest the internal issues that we are undergoing by looking at our faces and skin. For instance, when our lymph and circulation is stagnant can make our faces puffy. The facial asymmetries indicate that the body is out of alignment. These indications should be taken as cues from our bodies to address the issues at their root cause.
While the ongoing trend for anti-aging has been the use of injectables, Dr Kung says that all these treatments are about freezing your muscles causing stagnation. However, should a person look at acupuncture as a treatment option, it could help them improve the circulation of chi and blood providing proper nourishment to tissues.
Storing issues in tissues
The pandemic somewhat affected our overall well-being, many of us have fallen out of our routines, and as we continue to live in uncertain times, we are involuntarily placing ourselves under physical and mental tension. This is why bodywork requires several sessions that would assist to undo these tensions.
Dr Kung says that the face tends to hold tension and trauma, which is why, most often, it is the worry lines or frown lines that start to show up on your face first; “We store our issues in our tissues, so when we continue with our bodywork and move towards the facial acupuncture work it can make people emotional. It could be a challenging experience for those who repress things and are not ready to share it with anyone, thus creating a healing crisis.”
Some of Dr Kung’s clients have confided in her that after the bodywork sessions, they went home and cried, that is after not having cried for years.
In conclusion, Dr Kung notes that superficial signs of pain, stress, and trauma surface in the form of wrinkles, dullness and sallowness of the facial skin. However, treating these superficial signs will not address the root cause which is often physical and emotional imbalances that people experience.
When the first lockdown was announced and I was told that I could work from home, I thought it was the best thing that could happen to me. I wanted to make full use of the time that I had at hand and workout, cook healthy meals, do other household chores, whilst trying to meet deadlines at work.
Little did I know that soon, all these tasks were going to overwhelm me and affect the quality of my work. I seem to have set up unrealistic expectations by trying to cram in these household tasks during my work hours, and later on realised that my work was trickling into the after-work hours that I would spend with my loved ones at home.
I was struggling to switch off work mode even during my off-days, which I did not realise until my partner pointed it out. What I was experiencing was toxic productivity – I was extremely obsessed with productivity, yet at the end of the day, had not achieved anything qualitative be it at work or in my personal life.
Although toxic productivity is something that has been under discussion for years, the past two years of the pandemic seems to have popularised the term. Toxic productivity goes hand-in-hand with hustle culture and workaholism, and tends to trap a person in a never-ending cycle of work, which leaves you with a feeling that you are not doing enough.
It stems from a culture that praises and rewards productivity, which is a good thing, but does not always tell us where to draw the line. You get obsessed with work – where you are trying to do more, not taking into account the quality of work that you are delivering, leading you to burnout.
Dangers of Toxic Productivity
While toxic productivity can indeed negatively affect your relationships and leave you with feelings of guilt, it can also lead to workplace burnout and fatigue. In 2019, the World Health Organization (WHO) classification of diseases included burn-out as an occupational phenomenon in its 11th Revision of the International Classification of Diseases (ICD-11).
According to WHO, “burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed”. It is characterized by feelings of energy depletion or exhaustion, increased negativity or cynicism in relation to one’s job, and reduced professional efficacy.
If you feel like you may be suffering from toxic productivity right now, you are not alone. A 2020 study conducted by global staffing firm Robert Half found that nearly 7 in 10 professionals (68%) who transitioned to a remote setup as a result of the pandemic said they work on the weekend. In addition, 45% of remote employees reported regularly putting in more than 8 hours a day. The good news is that you can take simple steps to break the cycle.
Signs of Toxic Productivity
- Working so much that it harms your health and personal relationships – If you are ignoring basic human requirements like eating, sleeping, meeting friends and family and forgetting your other obligations and responsibilities, then you are falling into the trap of toxic productivity.
- Having unrealistic expectations from yourself – You expect the same output every day, irrespective of the external factors and stressful situations that may disrupt your normalcy, which is unreasonable.
- Difficulty staying still or constant restlessness – If you feel guilty taking a break or time off, and feel your self-worth reducing, you may be suffering from toxic productivity.
- Overwhelmed by feelings and unable to work – Many of us attach our self-worth to how productive we are or how many hours in a day we have worked. That is unhealthy. It is important to work hard, but equally as important to not work yourself to the point of burnout.
Avoiding toxic productivity
Mood and stress expert Erika Katherine Ferszt, who is also the founder of Moodally – a purpose built-app that provides access to mood management tools to enhance a person’s mood, says that the key to avoiding toxic productivity is finding balance. Ferszt suggests that it is important to read the signals when one notices that they are spiralling and recommends that we take steps to balance them out. The first step towards finding the balance between work and rest is to remember to take breaks in between our work hours – like walking away from our work desk for a 10-minute break.
She points out that most often people do not relax because they do not know what to do. She suggests making a list of the things we would like to do, if time / money / distance / COVID-related travel restrictions were not an issue, such as going on vacation to an island resort in Asia, or travelling across Europe to improve our culinary skills. Ferszt explains that we can start relaxing by watching YouTube videos relating to the experiences, and gradually plan our trip or discover alternatives, such as finding a recipe to make at home that will turn out to be an enjoyable experience.
Ferszt further notes that; “Toxically productive people are so focused on what they have to do that they’ve completely forgotten what they like to do. Investing energy in that discovery will start to awaken an internal voice that reminds us ‘Hey, you remember me?’”.
Ending toxic productivity
Set realistic goals – The pandemic had a drastic impact on many of us as we had to adjust to working from home. This might have blurred the timelines between your work and attending to your household work. It is better to understand these obstacles and work around them by reducing the goals that you set to accomplish within the day.
Take breaks – Taking breaks is necessary and can help you avoid falling into the toxic productivity trap. Studies have revealed that people who take breaks are more productive than people who do not. Schedule breaks throughout your day at regular intervals, rather than taking a break when you are on the verge of collapse. The Pomodoro Method is a great strategy to stay on task while also taking frequent breaks – where you work for 25 minutes and then take a 5-10 minute break.
Get some accountability – Have a circle of friends or family members who will remind you of your harmful behaviours (setting unrealistic goals, attempting to take on too many work-related tasks, forgetting to eat and take breaks). Listen to them when they remind you that you are falling out of line.
Define clearer work-life boundaries – Do not take on too much work that it trickles into your personal life, and takes up your relaxation time or the time you dedicate to spending with your family, loved ones or friends. You can always say ‘no’ if your work is taking up your free time. Make sure you communicate your boundaries to everyone in your life. Set a schedule to turn off your work phone / email or set aside your phone when spending time with your loved ones.
Practice mindfulness – Mindfulness is a way to help us connect to the present moment and ourselves. Mindfulness invites us to observe and accept what is happening around us and within us without judgement. We learn to be more aware of our bodies and needs. Mindfulness helps us disconnect from our “fight or flight” survival instincts, allowing us to connect with more mature, healthy ways of relating to the world.
Seek mental health help – Finally, if you continue to feel the signs of toxic productivity even after introducing these tactics to your work and home life, seek help from a mental health professional to ensure you do not find yourself burned out in the future.
How do you respond to stress and adversity – are you able to carry yourself well and interact with others or do you get overwhelmed by negative thoughts and emotions?
According popular Instagram Holistic Life Coach and Certified Trauma Support Specialist, Amy Fielder, how a person copes, soothes and regulates their emotions during times of adversity can determine one’s emotional health.
Amy explains that; “Someone who is emotionally healthy would witness their thoughts, feel their feelings but then regulate and soothe them and find clarity in an effort to determine if they need to take any action or speak up about something or not. They hold themselves accountable for how they feel”.
What Is Emotional Health?
Emotional health is a person’s ability to identify, process, and act upon feelings in specific circumstances over a course of time. It includes both emotional intelligence and emotional resilience. When the subjective experience of emotions is appropriate over a sustained period, emotional health is thought to be present.
How To Improve Your Emotional Health
Emotional health is built upon five pillars: your psychology, relationships, nutrition, sleep and exercise.
Your psychology – Which is made up of your established patterns and beliefs in how you talk to yourself, your history of trauma, the stories about the fact of life you grow up around that contributes towards your personal development; and your willingness to step out of your comfort zone and discover what patterns have been running your life. This is your ability to create and live the vision of the person you wish to be.
Your relationships – As you’ve heard, we are the average of the five people we spend the most time with. Because it is so monumentally important, if our relationships with those people turn sour, our emotional health will suffer significantly. Working on your relationships means addressing the pain points with your significant other and those close to you. It means having conversations with your boss and co-workers to create an environment that is most conducive to your emotional intelligence and emotional resilience. It also includes releasing who you should be and embracing who you are, so you can attract the right people into your life.
Your nutrition – If our brain and nerve functions are not operating at a proper capacity, we are not going to feel well. When we do not feel well, our emotional resilience will suffer. What we may not be aware of is that 90% of our neurotransmitters are located in our gut. An estimated 100 trillion bacteria in our gut are responsible for neurotransmitter production and other functions. Diets high in refined sugar, fried fats, processed food, and animal products tend to produce a sub-optimal gut microbiome, but diets that are high in whole plant foods and insoluble fibre are essential for a gut microbiome and can, in return, give us optimum emotional health.
Your sleep – We’ve all sacrificed sleep to get more work done (or watch more Netflix). However, these missed sleep hours can catch up with you later on, causing adrenal fatigue – which can take a toll on your emotional resilience. Sleep is important as the brain uses that time to process our day’s events. We place the day’s events into long-term memory and form connections in our brain, detoxify our bodies and shed waste. Therefore, if you want to improve your emotional health, you need to prioritise getting adequate hours of sleep.
Your exercise – Good emotional health requires good physical health. We should all workout to train our bodies to operate at their highest level. If you want to feel good and perform at your best, move your body. Adapt a healthy workout routine to suit your daily activities.
By working on improving the above five pillars, you will be able to improve your emotional health significantly.
Self-Reflection Questions For Your Emotional Health
You can ask yourself the following questions to help self-reflect and keep your emotional health in check:
- Am I taking responsibility for my words and actions?
- Am I speaking up for myself after I’ve regulated my emotions – to assure that I’m not attacking, projecting or deflecting onto anybody?
- Am I holding myself accountable for soothing my own thoughts and feelings, and once I’ve done so, do I still need more support?
- Am I allowing myself to ask for help from those I trust and confide in?
- Am I matching my words to my actions?
- Am I being honest about how I feel with myself and others in my life?
- Am I engaging in behaviours or thoughts that are unproductive, harmful, or infringing on my peace?
- Am I turning to the coping tools I have learned and know what works for me?
Many of us have started preparing for the festive season, marking our calendars for the upcoming dinners filled with holiday foods and drinks. It’s the season of overindulgence, so we’re raising awareness about a commonly occurring reflux disease known as GERD, which tends to present symptoms when under stress.
In 1999 the International Foundation for Gastrointestinal Disorders (IFFGD) added the GERD Awareness week to the US national health observances calendar. Since then, every year during Thanksgiving week, the IFFGD raises awareness about chronic gastrointestinal disorders like GERD to help educate the public and support those who are suffering from such conditions.
What is GERD?
Gastroesophageal reflux disease, or GERD, is a common disorder. The IFFGD notes that 1 in 5 people suffer from GERD in the United States, with each year closer to 5 million Americans admitted to the hospital due to chest pains caused by GERD.
Commonly referred to as acid reflux disease, GERD occurs when acidic or non-acidic stomach contents back-flows into the oesophagus accompanied by heartburn and regurgitation of acid symptoms. At times one might only find out that they are suffering from GERD when complications become evident.
Symptoms result from constant exposure of the oesophagus lining to acidic or non-acidic contents from the stomach, which leads to GERD with tissue damage known as oesophagitis or erosive GERD, and GERD without tissue damage causes non-erosive GERD.
There is no known single cause of the disease. However, medical professionals know that the reflux aspect happens when the muscle barrier between the oesophagus and the stomach malfunctions or is otherwise overwhelmed. Although chronic heartburn is the most common symptom, there are several other less common symptoms associated with GERD:
- Difficulty or pain when swallowing
- Sudden excess of saliva
- A sensation of food sticking in the oesophagus
- Chronic sore throat
- Inflammation of the gums
- Erosion of the enamel of the teeth
- Chronic irritation in the throat
- Hoarseness in the morning
- A sour taste
- Bad breath
The link between GERD and anxiety
A study conducted in 2015 revealed that anxiety and depression might play a role in the occurrence of GERD and especially that of non-erosive GERD. Having severe GERD symptoms can be a stressful experience and may thereby increase anxiety.
If someone has GERD and anxiety, they will have to look at a treatment plan to treat symptoms for both of these conditions. Common medications used to treat anxiety could worsen GERD symptoms.
How stress makes GERD worse
Researchers have proposed that psychological conditions, including anxiety, might have physiological effects that lead to GERD, suggesting that there are several possible physical reasons for this:
- Anxiety may reduce pressure in the lower oesophageal sphincter, which is the band of muscle that keeps the stomach closed and prevents acid from leaking into the oesophagus.
- Stress responses and anxiety may cause long-lasting muscle tension around the stomach, causing an increase in pressure and pushing the acid up.
- High anxiety levels may increase stomach acid production.
Despite all these studies, there is still no proof that people that undergo stress produce more stomach acid or experience GERD symptoms. However, many who responded to the studies reported that they noticed an increase in GERD symptoms when they were under a lot of stress.
Knowing why stress aggravates acid reflux is less important than knowing how to reduce stress and manage your symptoms. Other treatment options and lifestyle changes appropriate for both anxiety and GERD include:
- Psychotherapy or counselling
- Eating a well-balanced meal
- Avoiding trigger foods such as heavily spiced cuisine, greasy or fatty fried foods, citrus fruits, peppermint or spearmint, chocolate, carbonated beverages, alcohol, caffeinated beverages
- Reducing stress
- Progressive relaxation
- Sleep hygiene
If you are experiencing GERD due to stress, seek medical attention to get advice and guidance on lifestyle changes to reduce stress and get the necessary medication and treatment to ease symptoms of GERD
During the prolonged lockdowns, I was eager to meet up with friends and family. Although Zoom and FaceTime calls were essential to maintain social connections, they weren’t able to subtitle real human contact. We made plans to meet up as soon as the lockdown lifted, but now that restrictions have eased and opportunities to socialise have grown, I find myself feeling exhausted and looking forward to some quiet time.
Before the pandemic, I always felt inspired and energised whenever I was with my friends. That seems to have changed after our first few post-lockdown hangouts – I struggled to follow through with the conversations. Why was I feeling this way? I knew I couldn’t be the only one, so I did some searching online and discovered that I was experiencing a social hangover.
What is a social hangover?
A social hangover is not a clinical term, but it’s a term that has existed in the vocabulary of introverts. Now, post-lockdown, it’s a term that many of us can relate to, regardless of whether we are introverts or extroverts. Similar to an alcohol hangover, a social hangover is the feeling of utter depletion after socialising. There may not be a headache or sick bucket involved, but after too much socialising, one can feel physically and emotionally exhausted.
Why do we experience social hangovers?
According to Australian psychotherapist Amber Rules, when we spend time with people in large crowds or noisy places, the social part of our brain gets stimulated, making us hyper-aroused. Since we have not socialised in a while, this can become an exhausting experience, prompting us to rest and recover. She added that it is normal to feel overloaded or overwhelmed even after very little social engagement.
How to get over a social hangover
After experiencing social hangovers during my recent meet-ups, I thought that I could share some tips with you on how to avoid experiencing it further:
- Ease into social interactions – Before meeting up in larger groups, start with meeting a few people at a time. Choose people from your closest social circle that you would feel more comfortable interacting with.
- Set time boundaries – The more time you spend in a social setting, the more exhausted you would feel. If possible, set a time limit for your social interactions, between one to three hours, and inform your friends or family before you meet them.
- Leave time to recover – You do not have to attend all the social events you get invited to; allow yourself to rest and recover after a social interaction. Indulge in some self-care, such as having a soak in the tub mid-afternoon, going for a 10-minute walk, meditating, or reading a book.
- Acknowledge your emotions – While we are all adjusting and re-adjusting to socialising, we should all accept that we may experience a social hangover. Most of us will get over this sensation, but if you think you need help from a mental health professional, please don’t be afraid to seek it.
Malaysia’s Health Authorities have fully vaccinated 90% of its adult population against Covid-19 and has relaxed movement control orders for fully vaccinated people – giving them the opportunity for outbound international and interstate travel. This allows us to look forward to returning to some semblance of normalcy.
While people are optimistic about returning to normalcy, this seems to make us feel more anxious. We have begun to question what would happen next. Would the movement control orders be imposed again? Would a more virulent variant of Covid-19 get introduced to the country? Would I feel overwhelmed when I start socialising?
Many had been very optimistic when the vaccination rollout for Covid-19 reached a record number of persons in the population, presuming that the world could return to some form of normalcy soon after most were vaccinated. Yet when the world faced the impact of the Delta variant, this sentiment soon changed. Many reported experiencing a spike in anxiety and depression that triggered their yearning to change something about their lives.
According to Social Psychologist, author and faculty member of Harvard Business School executive education program, Amy Cuddy and author JillEllyn Riley, people are experiencing what they refer to as ‘pandemic flux syndrome’.
With the fluctuating status of the pandemic and having no sight of a timeframe that the pandemic would end; the emotions that people are cycling through, need to be closely examined. Centre for Human Development Director and Clinician Katelyn Merz said that when examining these emotions, many factors were to be considered and renewing the sense of hope and motivation among people was important.
Adding that, although many of us feel as if we are getting back to some form of normalcy, it is not going to feel that way. When the public healthcare guidelines keep changing to adapt preventive measures as the pandemic fluctuates, that uncertainty and instability can drive anxiety and depression in a person.
Merz suggest the following tips to navigate pandemic flux syndrome:
Set boundaries – As your life and comfort zones shift, it is important to have a good understanding of your boundaries as well. Do not overcomplicate or overwhelm yourself over what situations you are getting exposed to. Do what makes you feel comfortable.
Take control of your wellness – With adapting to working from home or virtual learning, we often tend to overlook our physical and mental well-being. To maintain the overall personal well-being, one has to make sure to get an adequate amount of sleep and maintain a balanced diet.
Refrain from making impulsive decisions – Pandemic flux can push you to make drastic changes in your life. While change is considered to be positive, it is also better to take a step back and reconsider your decisions.
Seek support – You are not the only person who is feeling this way. Reach out to your support system; friends and family. Discuss with them what you are going through. You must realise others feel the same.
In recent times, we have been witnessing an increase in severe weather events such as floods and droughts, wildfires, intense storms, heat waves, and rising sea levels. According to the Center for Climate and Energy Solutions, the intensity and frequency of these incidents are about to increase. These severe weather events can have lasting disruptions in the weather patterns, which are causing climate change.
While these events cause an immediate impact on the environment, agriculture, economy and physical health, they can also impact a person’s mental health. This is called climate change anxiety.
A recent landmark survey found that climate change has caused distress, anger and other negative emotions in children and young people, who felt let down by their government’s inaction towards reducing the impact on the environment.
Weather events such as extreme storms or heat waves can lead to depression, anger, and even violence. The American Public Health Association recorded, 25 to 50 per cent of people exposed to an extreme weather disaster were at risk of an adverse mental health effect, with 54% of adults and 45% of children recorded to have experienced depression after a natural disaster.
Following natural disasters, psychologists have seen a rise in what they call distress reactions, which include things like: insomnia, irritability, increased substance use, and depression. These reactions are supposed to subside gradually, yet it is not always easy for vulnerable groups directly affected by the incident. They may, later on, show signs of PTSD and anxiety disorders.
Rather than feeling anxious about what is taking place around us, we can look at the following methods to cope with climate change anxiety:
- Acceptance – Accept that you do not know what will happen or what the future holds, and that you can only change your actions.
- Get a new view – Rather than focusing on post-apocalyptic scenarios, try to imagine a world running on renewable energy sources, have gardens that produce organic food and a sustainable environment.
- Find a support system – Find an eco-friendly community around you, so you can share your thoughts on how you feel about climate change.
- Get to work – Take control and ownership over your actions by reducing waste, switching to eco-friendly, recyclable and reusable product packaging. Urge policymakers to take action on declaring climate emergencies and work towards establishing carbon-neutral states/cities.
- Focus on the positive news – There are various initiatives that countries are currently taking to combat climate change, such as banning single-use plastic, reforestation initiatives, governments’ setting up carbon-neutral policy goals.
The Covid-19 pandemic has exposed the widening disparities and inequities, especially when it comes to access to mental healthcare services. Many countries underwent longer periods of lockdown and are at present, facing an economic crisis that has negatively affected the mental well-being of the people.
This year as we prepare to mark yet another World Mental Health Day on 10 October, the World Federation for Mental Health (WFMH) has set the theme ‘Mental Health in an Unequal World: Together we can make a difference’ to highlight that mental health care, and the inclusion of persons with mental disorders in all spheres of life, remain unequal.
According to WFMH President Dr. Ingrid Daniels, “Growing inequalities due to race and ethnicity, sexual orientation and gender identity, lack of respect for human rights and, stigma and discrimination against people with mental health conditions have created visible societal divide and injustices”.
She further pointed out that health inequities are grossly unfair and unjust, often violating human rights and failing to protect of the most vulnerable. While inequalities in mental health care can no longer be ignored; regional, country and individual commitment is required to address the harm caused by the layers of systemic and historical inequalities and injustices, which impacts the mental health of all.
The cost of neglecting mental health is significant. Studies have estimated that poor mental health accounted for $2.5 trillion of the global economic burden in 2010 and is projected to rise to $6 trillion by 2030.
Scaling up quality mental health services
WHO Director for Mental Health and Substance Use World, Dévora Kestel, sharing her observations, noted that; “Across the world, far too few people have access to quality mental health services. In high-income countries, nearly 75% of people with depression report not receiving adequate care. In low- and middle-income countries, more than 75% of people with mental health conditions receive no treatment at all for their condition”.
According to Kestel, despite these inequalities, governments spend, on average, just over 2% of their health budgets on mental health, and international development assistance for mental health has never exceeded 1% of development assistance for health. Adding that; “Yet, in the face of these grim realities, there remains reason for hope. Momentum is growing internationally to advance the mental health agenda and governments around the world have recognised that access to these services must be scaled up at all levels”.
A survey conducted by the WHO in mid-2020 indicated that services for mental, neurological and substance use disorders had been significantly disrupted during the pandemic. However, during the World Health Assembly in May 2021, the UN member states had recognised the need to scale up quality mental health services at all levels and endorsed the updated Comprehensive Mental Health Action Plan 2013-2030, including the Plan’s updated implementation options and indicators for measuring progress.
The action plan relies on six cross-cutting principles and approaches:
- Universal health coverage – Regardless of age, sex, socioeconomic status, race, ethnicity or sexual orientation, and following the principle of equity, persons with mental disorders should be able to access, without the risk of impoverishing themselves, essential health and social services that enable them to achieve recovery and the highest attainable standard of health.
- Human rights – Mental health strategies, actions and interventions for treatment, prevention and promotion must be compliant with the Convention on the Rights of Persons with Disabilities and other international and regional human rights instruments.
- Evidence-based practice – Mental health strategies and interventions for treatment, prevention and promotion need to be based on scientific evidence and/or best practice, taking cultural considerations into account.
- Life-course approach – Policies, plans and services for mental health need to take account of health and social needs at all stages of the life-course, including infancy, childhood, adolescence, adulthood and older age.
- Multisectoral approach – A comprehensive and coordinated response for mental health requires partnership with multiple public sectors such as health, education, employment, judicial, housing, social and other relevant sectors as well as the private sector, as appropriate to the country situation.
- Empowerment of persons with mental disorders and psychosocial disabilities – Persons with mental disorders and psychosocial disabilities should be empowered and involved in mental health advocacy, policy, planning, legislation, service provision, monitoring, research and evaluation.
In endorsing this updated Action Plan, Member States have agreed to targets relating to expansion of service coverage, increasing the number of community-based mental health facilities and integrating mental health into primary care.
In addition, they have agreed to develop and strengthen mental health services and psychosocial support as part of universal health coverage, and in preparedness and response to emergencies, with a particular focus on improving the understanding and acceptance of mental health conditions, vulnerable populations and use of innovative technologies. This represents one of many powerful calls to action during the pandemic, that have been made to bring about equal and universal access to mental health services for those in need.
Continued access to support services
It is critical that people living with mental health conditions have continued access to treatment. Changes in approaches to provision of mental health care and psychosocial support are showing signs of success in some countries.
Given the nature of the Covid-19 pandemic, local policy-makers have identified emergency psychiatry as an essential service to enable mental health-care workers to continue outpatient services over the phone. Home visits are therefore organized for the most serious cases. Egypt, Kenya, Nepal, Malaysia and New Zealand, among others, have reported creating increased capacity of emergency telephone lines for mental health to reach people in need.
While the support for community actions that strengthen social cohesion and reduce loneliness, particularly for the most vulnerable, such as older people, must continue. Governments, local authorities, the private sector and members of the general public, should also support with initiatives such as provision of food parcels, regular phone check-ins with people living alone, and organization of online activities for intellectual and cognitive stimulation.
Most of us are very routine-oriented and those routines are always planned around the 24-hour clock, where we have separated our time for rest, play, sustenance, and work. But as menstruating persons, there are days that we struggle to find the necessary energy or motivation to get on with our routines, especially around the days before we start our period or while we are menstruating.
We often forget to keep track of what is going on inside our bodies, and at times, get overwhelmed by what we are expected to do and our actual capacity to fulfil such tasks. What if we told you that there was a healthier way to adjust our lifestyles and optimise our productivity?
A study has revealed that hormone fluctuations play a key role in how a menstruating person’s body responds to the changes that are taking place within the 28-day hormonal cycle. According to the study, the changes in the hormone flow affects the physiological, neurological and psychological development and function; impacting the thought process, eating habits, emotional status, energy levels and more.
What is Cycle Syncing?
In recent years, cycle synching has become a buzzword and the hashtag returns a considerable amount of content across social media platforms, such as TikTok and Instagram, sharing tips on the how’s, what’s and why’s.
Alisa Vitti, who is a Functional Nutritionist (HHC, AADP), hormonal expert and the founder of Flo Living, popularised her now trademarked term Cycle Syncing after taking into consideration her years of study, and her personal experience in understanding the female reproductive-system and wanting to assist.
According to Vitti, the 28-day hormonal cycle has four phases, and based on which phase of the cycle a person is, they should adjust their lifestyle (i.e. food intake, physical activity and work schedules) to improve productivity, as well as their overall physical and mental well-being.
Cycle syncing can also benefit groups that have polycystic ovarian syndrome (PCOS), struggle with weight fluctuation, looking to improve fertility, and improve their libido.
The Infradian Rhythm
For persons who menstruate, it is quite beneficial to take note of their infradian rhythm, which takes place through four phases during their 28-day hormonal cycle. The infradian rhythm affects a person’s mood, health, as well as energy levels as it cycles through the four phases; that is follicular, ovulatory, luteal and menstrual.
It is important to understand how your hormone levels fluctuate, and the changes that are taking place within these four phases, so you can adjust your lifestyle around it.
Phase 1: Follicular Phase
- Duration – Day 6 to 14 of your hormonal cycle.
- What happens – The pre-egg release stage, where estrogen and progesterone levels start to rise.
- What exercises to do – Light cardio, hiking, jogging, flow-based yoga to work up a sweat.
- Foods – Try to add foods that will process estorgen to your diet, such as sprouted or fermented foods; flax seeds, tofu, tempeh, soybeans, edamame, kimchi, broccoli sprouts, cauliflower, sauerkraut, dates, prunes, dried apricots, strawberries, cranberries, and raspberries.
- Activities – With estrogen levels gradually rising, this is the best time to use your sense of curiosity and inspiration to brainstorm, create vision boards, explore new ideas, plan your next carer move or even plan a road trip.
Phase 2: Ovulatory Phase
- Duration – Day 15 to 17 of your hormonal cycle.
- What happens – The egg is released, estrogen levels are at its peak, testosterone and progesterone rise.
- What exercises to do – Circuit and high-intensity exercises, high-intensity interval workouts, or spin class.
- Foods – Add foods that are good for your liver as well as anti-inflammatory foods; coffee, tea, grapefruit, beet juice, leafy greens (spinach, kale, collards), fatty fish (salmon, mackerel, tuna, sardines), olive oil, blueberries, cranberries, grapes, prickly pear, oranges, nuts (walnuts and almonds), and tomatoes.
- Activities – During this phase you should look at networking, problem solving, following up on projects, initiating important conversations and negotiating work terms.
Phase 3: Luteal Phase
- Duration – Day 18 to 28 of your hormonal cycle.
- What happens – Post-egg release stage, where estrogen and progesterone levels are high. If the egg isn’t fertilized, hormone levels decrease and the menstrual cycle starts again. You may also experience cramps, bloating, or acne due to Pre-Menstrual Syndrome (PMS).
- What exercises to do – Light-to-moderate exercise, such as strength training, pilates, and more intense versions of yoga.
- Foods to add – Magnesium-rich foods and serotonin processing foods, such as dark chocolate, avocado, bananas, pineapple, nuts (almonds, cashew, brazil nuts), Legumes (lentils, beans, chickpeas, peas, soybeans), seeds (flax, chia, pumpkin), whole grains (wheat, oats, barley, buckwheat, quinoa), fatty fish (salmon, mackerel, halibut), and leafy greens (kale, spinach, collard greens, turnip greens and mustard greens)
- Foods to avoid – Alcohol, carbonated drinks and artificial sweeteners, red meat, dairy, foods with added salt.
- Activities – As your hormone levels start to equalise, this is a good time to engage in activities that require a lot of focus, such as following through on projects, compiling and reviewing reports, and other such administrative work.
Phase 4: Menstrual Phase
- Duration – Day 1 to 5 of your period.
- What happens – Estrogen and progesterone continue to decrease, the endometrium (lining of the uterus) is shed, causing bleeding and fatigue.
- What exercises to do – Workouts that engage mindfulness, such as yoga or restorative stretching, or opt for meditative walks through nature.
- Foods to add – Warm and nourishing foods, such as soups and red meat, iron-rich foods such as dried apricot fruit, spinach, podded peas, asparagus, white button mushrooms, acorn squash, leeks, dried coconut, green beans, raspberries, passionfruit, lentil sprouts, and olives. To combat cramps, you can also drink camomile tea.
- Foods to avoid – Fatty foods, alcohol, caffeine, and salty foods.
- Activities – Cut back on work tasks and avoid the pressure of inflexible deadlines, schedule rest and prioritise sleep, allow yourself to work at a slower pace. This is also a good time to reflect, evaluate yourself, and make informed decisions.
My Flo – A period-tracking app that helps you to achieve hormonal balance; recommending what foods, exercises and activities are best suited for each phase of your cycle. It also keeps track of any symptoms and provides necessary food-based tips to resolve them.
Clue – An app that uses gender-neutral language to help you track your cycle and health. The app predicts your period, PMS, fertile window, and provides additional information on birth control, cramps, emotions, skin, hair, sleep, sex, pain, moods, cervical fluid, and more.
The recent revelation made by the Royal Malaysian Police (PDRM) on the cases of suicides recorded between January to May 2021, which amounted to 468, has turned the spotlight on the rising number of suicides amid the pandemic. In comparison to the annual total of 631 cases in 2020 and 609 cases in 2019, which averaged about two cases per day, this year, the average cases per day have almost doubled.
According to PDRM, the main reasons behind these incidents had been financial difficulties caused by debt, emotional pressure, and troubled family relationships.
The Ministry of Health meanwhile stated that in 2020, a total of 1,080 cases of persons who attempted suicide received treatment at government hospitals.
Director General of Health, Tan Sri Dr. Noor Hisham Abdullah, issuing a statement noted that the pandemic has severely impacted the mental health of people. He had further noted that certain individuals are more susceptible to mental health problems when they are disconnected from their support networks, such as friends and family, due to the ongoing movement control orders, and would experience episodes of depression that could even lead to suicide.
Suicide Is Criminalised In Malaysia
Malaysia being a country with a Muslim majority considers it a sin to take any life including one’s own. Moreover, as an attempt to deter persons from taking their lives, the government has criminalised suicide under Section 309 of the Penal Code, where anyone who attempts to commit suicide and fails would be imprisoned for a term extending up to a year or imposed a fine or will be subjected to imprisonment and imposed a fine.
The law enacted in 1936 originated from the Indian Penal Code that was based on the British Common Law. While many other countries in the region that adopted the Colonial common law has by now repealed or has modified the section, we have yet to follow suite.
The country’s Psychiatric and Mental Health Services Operational Policy, while recognising suicide attempts as a mental health issue that needs treatment, indicates that when an individual who attempted suicide is referred for medical care, they should be placed under strict supervision until they are considered to be in a stable condition and would not harm themselves.
However, Section 309 does not indicate that the individual should be referred to medical or psychological care after or during sentencing. Which calls for its immediate repeal or appropriate modification by concerned citizens.
Since suicide is criminalised by law, it may also discourage individuals from reaching out to counselling services or suicide prevention helplines, fearing that their situation would be compromised and they would have to face legal action.
Decriminalising Suicide Is Suicide Prevention
For many years, the civil society, mental health specialists and various other non-governmental agencies have been pushing for the decriminalisation of suicide in Malaysia. Highlighting the importance of decriminalising suicide, and the progress that the authorities have made so far towards achieving it, Bar Council Law Reform & Special Areas Committee Co-Chairman and National Coalition of Mental Wellbeing member, Datuk Seri M. Ramachelvam, noted that; “The World Health Organisation has called upon the countries around the world to decriminalise suicide, therefore the moment is now, and we should not delay anymore”.
Adding that, in 2012 the government’s Law Reform Committee conducted a study on reviewing the penal code section 309, and in the same year the then Minister of Health had stated that suicide should be decriminalised.
Ramachelvam also stated that, in 2019, the Minister of Law had said that a bill would be presented in Parliament to repeal Section 309 of the Penal Code, which was supposed to have happened in 2020. While in 2020 the federal government had said that the Attorney General’s chamber was studying various jurisdictions on the issue of decriminalising suicide.
Ramachelvam further noted that; “People who are contemplating suicide or who have attempted suicide never gets reported to relevant mental health authorities through the doctors or family members. Because if the incident gets reported there will be a potential criminal charge over the person who attempted suicide and survived. The stigma caused by the criminalisation of the act itself can deter the individual from seeking and receiving mental health related care, counselling or rehabilitative care”.
According to Associate Professor of Psychiatry & Consultant Psychiatrist at the National University of Malaysia, Dr. Lai Fong Chan, criminalising suicide does not act as a deterrent to prevent somebody from attempting suicide, and can actually have a negative effect, as it marginalises people who are in distress, from accessing help from mental health services.
Adding that; “When someone is in acute suicidal crisis, somebody who is crying out for help in that distress, it’s unthinkable that you would dangle this punishment as a deterrent saying ‘you are going to prison’. Emotional distress is not best dealt with a prison sentence”.
Dr. Chan pointed out that there are already laws in place in the Mental Health Act that if someone is suspected to have mental health issues that puts the individual at risk of their own safety, PDRM and the registered social workers have the mandate to bring such persons to a mental health service provider or to a health service provider for assessment and care.
If you or anyone you know is having suicidal thoughts, please contact the Befrienders at 03-76272929.
Sign and share this petition to decriminalise suicide in Malaysia.
A birth of a child is often considered to be a blissful moment; yet, it can also trigger a sense of overwhelming emotions in new parents. According to the Royal College of Obstetricians and Gynaecologists, what is commonly referred to as the ‘baby blues’ is normal and would pass within the first two weeks postpartum. However, this condition could progress into an episode of major depression known as postpartum depression (PPD), which can in return affect the mother’s ability to care for the newborn.
Although an estimated 1 in 7 women globally is said to experience PPD, a review revealed that the incidents of maternal PPD in Malaysia was at 6.8%-27.3%. Even with the recent increase in prevalence of PPD, the number of women seeking help in Malaysia for PPD is said to be far less.
The stigma of mental health issues is universal, but it is particularly prevalent in Asian countries. This causes PPD to be even more taboo and prevents women from seeking help for their struggles with depression. Mothers are pressured to be perfect, even new mothers, so the shame and embarrassment of admitting to what society sees as “weakness” forces them to suffer in silence. On top of that, mothers may feel guilty for experiencing negative feelings during what should be a joyous occasion, and downplay their own emotions.
What is Postpartum Depression?
PPD is a depressive illness that presents symptoms similar to depression in new mothers, including a low mood that lasts for more than two weeks. Based on the severity, the mother will struggle to look after herself and her baby. At times the person experiencing PPD will even find it difficult to manage simple tasks.
According to experts, symptoms of PPD generally develop after the first two weeks of childbirth and can last up to six months or even a year, while in some cases symptoms could also develop in the weeks prior to childbirth. PPD symptoms may differ from person to person, and the common symptoms can surface as a combination of emotions: anger and irritability, fatigue, excessive crying, finding it difficult to bond with the new-born, and being anxious.
While the heightened emotions of the mother can be attributed to the sudden shift in hormonal levels, experts also attribute that sleep deprivation plays a large role in causing PPD. As the mother adjusts with her new responsibilities to care for the baby, they tend to not get enough sleep, which impacts the way they function, how they feel and how mentally stable they could be.
Types of Postpartum Depression
Depending on the severity of symptoms, there are several types of PPD:
- Postpartum Blues: Affecting approximately 30%-80% of new mothers, this condition will only have a milder or short-term form of the disorder, where the symptoms displayed would range from sadness, crying, tiredness, insomnia and anxiety.
- Postpartum Anxiety: The mother would show symptoms of intense and chronic anxiety, where they would feel nervous and constantly worry that something bad would happen to the baby. These symptoms could last from weeks to months.
- Postpartum Obsessive-Compulsive Disorder (OCD): Can occur during the prenatal period of the second trimester or one month after postpartum, where the mother would experience disturbing thoughts, imagine that the baby is in danger or would be extremely afraid to be left alone with the baby.
- Postpartum Panic Disorder: Postpartum anxiety that includes physical symptoms, such as a racing heart, tightening chest, hyperventilation, dizziness, weakness, and other extreme symptoms.
- Postpartum Post-Traumatic Stress Disorder (PTSD): This disorder can be triggered due to a traumatic incident the mother faced during childbirth or afterwards. The incident could range from emergency C-section, the baby being sent to the Neonatal Intensive Care Unit (NICU), complications experienced during childbirth or lack of support during delivery.
- Postpartum Psychosis: Although a rare and severe disorder, the symptoms of the person could drastically change from agitation to anxiety, which could lead to memory loss and confusion, causing hallucinations and the mother showing disinterest about the baby.
PPD left untreated could interfere with the mother and child bonding, and can also lead to family problems. It could also place a strain on the relationship with the baby and the partner. Moreover, PPD can also impact the development and behaviour of the child, which can have a long-term effect.
While any new mother could experience PPD, it is imperative to know who is more vulnerable to develop symptoms. It is advisable to seek assistance from a psychological counsellor if the mother has: a history of depression during or prior to pregnancy or is receiving treatment for depression; experienced PPD during a previous pregnancy; baby has health issues or other special needs; experienced strenuous events during the past year such as pregnancy complications, illness or job loss; have family members who had depression or mental disorders; experiencing problems in their relationships with the spouse or partner; experiencing financial difficulties; or the pregnancy was unplanned or unwanted.
The doctor could thereafter monitor the mother closely for signs and symptoms of depression and get the mother to respond to a depression-screening questionnaire during the pregnancy and after the delivery. The doctor might refer the parents to support groups, counselling sessions/ therapies, and if required, prescribe suitable antidepressants.
PPD is a serious mental health condition, but the lack of education, prevention and treatment has caused it be unrecognisable. According to a recent study, suicide is among the leading causes of deaths among new mothers, making it crucial for them to voice their concerns and seek help, as well as share their experiences and normalise the conversation. If you or anyone you know is having suicidal thoughts, please contact the Befrienders at 03-76272929.