Time to talk about mental health

Time to talk about mental health

'A smile is worth a thousand words," the old saying goes. This simple but powerful act can light up a room and create bonds with people without the need to converse.

Most of us associate smiling with joy, contentment and kindness, but smiles can signal many things. Some people smile to signal attraction and flirtation, while some use it to cover up uncertainty, embarrassment or annoyance, even depression.

The true feeling behind a smile can therefore be puzzling, making it a perfect shield for those who prefer to live in their own secret hideaway.

In Asian culture, relationships are deeply valued and highly ritualised. We learn from childhood the proper etiquette required when one is with certain people, especially elders to whom respect and courtesy is ingrained.

The culture of "face" guides daily life. Junior employees "give face" to their seniors, shifting the spotlight from themselves and letting the senior person receive the credit. They also tend to suppress discontent or contradictory viewpoints to avoid losing face.

The nature of society is such that there are not many culturally acceptable ways for Asians to express frustration, anger or "inappropriate" feelings, whether in public, at work or among family members.

Something as innocent as a smile then becomes an escape from an uncomfortable situation. But this can cause emotional distress to accumulate, even to the point of mental illness: mild to severe disturbances in thoughts and behaviours that render a person unable to cope with life's routine needs.

There are more than 200 classified forms of mental illness and the symptoms vary. Some people turn violent, others become obsessive, paranoid, depressed or socially withdrawn, to name a few. However, sufferers may go for months or years without admitting they have a problem, which causes the illness to intensify.

Talking about mental illness, let alone seeking help, is especially difficult in Asia. Seeking treatment or other intervention is seen as a stigma on the person and his or her family.

In Japan, millions of young people suffers from hikikomori or social withdrawal, retreating to their rooms for months, years or decades. However, parents sometimes refuse or delay seeking professional help as they fear damage to family social standing.

Many suffer in the dark alone and see death as an escape. The figures are shocking: last year 250 Japanese students in elementary, middle and high schools took their lives for reasons including bullying, family issues and stress, government data revealed. This was the highest in three decades.

Japan has Asia's second-highest suicide rate at 18.5 deaths per 100,000 people, according to the World Health Organization (WHO). Only South Korea (26.9) ranks higher.

The WHO estimates that close to 800,000 people die due to suicide every year -- that is one person every 40 seconds. However, experts say effective and evidence-based interventions can help prevent suicide and suicide attempts.

In Japan, for example, though the youth suicide rate was up, the total number of suicides in the country fell from its peak in 2003, thanks to a government programme to hire counsellors for schools and the launch of a 24-hour call centre.

But because of the stigma attached to treatment, the mental health care system in many parts of Asia is underdeveloped and ineffective. There is an acute shortage of psychiatrists and clinical psychologists, who in any case tend to work in silos, unlike in the West where they collaborate on care.

I had a direct experience in seeking intervention in Thailand. It took us several months to set up the first meeting as the waiting list was long. For those who are already suffering, a lot can happen in a month or even a day.

Technology has also made this worse with less face-to-face communication and physical contact and more isolation, which is the number one precursor of depression and suicide.

It took a close family member years to disclose to us the issues that were troubling her. We were astounded and perplexed, as it seemed she had been living the life she's always wanted, always with a smile on her face.

If you have ever had troubling thoughts and wondered about your mental health, I hope this small article can inspire you to start to talk to people around you that you trust. Don't accept that this is a taboo subject or something you must fight alone. The path to recovery is not easy, but having the support of loved ones along the way will make the journey much easier.

Tanyatorn Tongwaranan

Asia Focus Writer

Asia Focus Writer

Email : tanyatornt@bangkokpost.co.th

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