Monthly Archives: July 2017

Introducing “Recovered Grace: Schizophrenia”

by Harris Ng Yoke Meng

This book was bought from MPH at RM38 many years ago. It is now no longer available in most of the major bookstores in Malaysia, but I believe it’s possible to order it at MPH or Kinokuniya.

The book serves as an inspirational story to sufferers of mental illness and their caregivers, and for me, more importantly and personally as a mental health professional, it helps us to care for the mentally ill more sensitively and effectively.

I remember Harris talked about revealing his illness to his then 3 month girl friend Violet, on a Valentine’s day, how she was shocked and then willingly going to see his psychiatrist together. This reminds me a lot about the patients in our clinic, who sometimes bring their new partner to see us, wanting their partner to understand their illness better and sometimes planning their future based on that. You might guess that experience like this would scare them off, but no, quite often, those partners are just like Violet in the book, having deep love and attachment for the patient that they can also accept this part of them.

Towards the end of the book there was also some discussions on the media’s portrayals of the mentally ill committing crimes, which often end in homicide, murder or suicide.

Such bizarre stories, though real, often stigmatise the sickness. Although there are hundreds of thousands of mental health cases, perhaps only one in a thousand end up in such a mess. The press much provide follow-up reports. What happened after that? … Should society continue to view mental illness with deadly fear?

What to do when one who suffers from mental illness committed crimes due to his mental states?

Sleep and Dreams

  • All people dream when they sleep, including people who think they don’t (more…).
  • According to sleep and dream expert Rubin Naiman, good dreaming contributes to our psychological well-being by
    • supporting healthy memory
    • consolidating memories
    • retaining information
    • warding off depression
    • expanding our ordinary limited consciousness into broader, spiritual real
  • Sleep generally occurs in 90-minute phases repeated throughout the night. Each phase moves from non-REM sleep to REM sleep. At the beginning of the sleep cycle, the REM phase lasts only a few minutes, but in the last phase before awakening, the REM phase can last  up to 40 minutes, and these late-stage dreams often stay in our memories as we awaken.
  • Dreams are largely confined to the REM, or rapid eye movement, phase of sleep.  In REM sleep, we are also in a type of paralysis, and if this paralysis doesn’t occur for whatever reason, a deadly acting out of our dreams can take place.
  • The longer your REM cycle, the more intense your dreams (more…)
  • When someone is sleep deprived we see greater sleep intensity, meaning greater brain activity during sleep; dreaming is definitely increased and likely more vivid (Mark Mahowald, director of the Minnesota Regional Sleep Disorders Center in Minneapolis.)
  • It has been observed that dream deprivation causes effects such as:
    • waking dreams (visual and auditory hallucinations)
    • interference with memory and learning
    • a loosening of associations
    • impaired waking ability to do tasks requiring focused attention
    • difficulty maintaining a straight line of thought
    • creating irritability and suspiciousness.
  • High dream recallers are more reactive to environmental stimuli [during sleep], awaken more during sleep, and thus better encode dreams in memory than low dream recallers. (more…)
  • Whatever people are exposed to during the daytime will have an impact on their dreaming at night.
  • You can have a negative impact on your dreams if you’re surrounded or getting exposed to negative things throughout the day. But, on the flip side, you can also have a positive impact on your dreams if the last things that you’re thinking about are positive things. (Dr. Shalini Paruthi)
  • How to have better dreams: While we can’t have 100 percent control over our dreams, there are things we can do to influence them in a positive direction, experts say. Among them:
    • exposure to pleasant smells and sounds while we’re sleeping
    • avoiding spicy foods
    • not smoking
    • eating healthy and exercising regularly
    • improving our daytime thought patterns
    • In simplistic terms, if you want good dreams, sleep well and think happy thoughts. (Dr. Shalini Paruthi)
  • In Dr. Naiman’s view, your complaint of feeling tired the day after dreams disturb your sleep is not usually the result of dreaming, per se, but of attempting to deny, resist or fight the dreams. It is this struggle that can leave you exhausted. He notes that occasional bad dreams and even nightmares are a normal part of one’s dream life, also to keep in mind that even a negative dream can have a positive effect on one’s life.

 


About SLEEP

  • According to Antrobus, factors that can lead to poor sleep include:
    • consuming alcohol before bed
    • experiencing stress and having a disturbing day
    • keeping electronics like cell phones, televisions or computers in the bedroom
    • eating, exercising or consuming caffeine too late
    • having an uncomfortable bed or sleeping environment
    • keeping an inconsistent sleep schedule.
  • Dr Shalini Paruthi’s advice on getting a good sleep:
    • sleeping in a room that’s dark, quiet and cool (18 to 22 celcius degree)
    • taking a bath and reading a book before bed
    • practicing relaxation exercises
    • avoiding stressful or stimulating activities before sleep
    • napping early in the day (or not at all)
    • exercising earlier in the day
    • avoiding alcohol, sugar and large meals before sleep
    • maintaining a regular sleep schedule
    • going to bed when we’re tired.

 

Seeking mental health help leaving permanent record?

This thing has been ongoing from day one I started my job, it is usually with parents who are a bit concerned taking their children to get professional mental health care services, whether it is psychiatric, psychology, counselling services.

Their main concern is that this will leave permanent record/impact on the patient, affecting his/her future education and career opportunities and developments. So I have met parents who wouldn’t take their child to see us, or parents who argue over it, or parents who wouldn’t register their child’s name in our system and want us to use and call their (parents’) name instead.

I’m not sure what happens in government hospitals. But as far as I’m aware, all of the information we hold here in our systems is private and confidential. Unless we have the consent of the patient (or of the guardian for children or those that are less capable), or it is required by laws, we can never disclose anything to anyone, no matter if it’s their spouse, parent, supervisor from workplace or faculty head from college. I’d always add that if the patient has a very high risk of harming the self or others, we might need to do something about it (it’s often contacting the next of kin, which is a contact provided by the patient, who is already aware of patient’s condition and aware that s/he is seeing us).

So I can’t emphasise enough that seeking professional mental health care and help will not leave you with any permanent damage and record. If you allow the condition and symptoms to worsen, things can be a lot worse than what it is now.

However, with the patient’s consent, we do write medical reports, stating the patient’s mental condition and functionality. A medical report usually serve a specific purpose, like when one’s trying to apply for insurance (written to insurance company), trying to take a gap year from studies or work (written to his/her college or workplace), trying to change teaching location (written to ministry of health) etc. This is the part we can never guarantee. For insurance company, I would just hope that they deal with those reports professionally. And for a college, a company or a government department that holds one’s medical report, it does seem possible to leave a permanent record and affect one’s future. I remember there was a student requested to have a letter written to her favour, and few years later contacted us again to ask if it is possible to write another letter to waive off the previous letter… Surely it is not possible. Even if you’re now healthy and fit (even with 0.0001% chances of relapse), your previous record becomes your mental history, it doesn’t disappear and can never be removed that way. So, do take a deep consideration, before you request for any report submitted to anyone anywhere.