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Mental Health Handbook English
Mental Health Handbook English
3
MENTAL
HEALTH
HANDBOOK
Foreword
Most Malaysians today are still not well- Most of these disorders can be
informed about mental health and successfully treated if the signs and
mental disorders.1 Misconception, stigma symptoms associated with each
and discrimination remain pervasive. disease are detected early. The most
According to The National Health common mental disorders include
Morbidity Survey (2015), the prevalence depression, anxiety, bipolar disorder and
of mental health problems among adults schizophrenia, but there are many others.
and children were 29.2% and 12.1%, ‘Mental Health Handbook’ is written for
respectively.2 The Malaysian Psychiatric easy-reading supplemented with rich
Association believes the statistics could info-graphics and illustrations that make
just be the tip of the iceberg as most cases the subject matter less ‘clinical’. It also
includes a directory listing of mental
individuals do not receive any attention or healthcare specialists and facilities which
treatment. will greatly help those who need to seek
It is important to know that mental illness expert advice and treatment.
is treatable. One of the key highlights of he Malaysian Psychiatric
the handbook is how to recognize signs Association would like to acknowledge
or symptoms of mental illness and when the contribution from sponsors and
to seek professional help. Mental disorders
encompasses a broad range of problems, in researching and collating information
to deliver a handbook that will help every
are generally characterized by some Malaysian gain a better understanding
combination of abnormal thoughts, about their mental health.
emotions, behaviours and relationships
with others.
References
1. Yeap R and Low WY. Mental health knowledge, attitude and help-seeking tendency: a Malaysian context. Singapore Med J. 2009;50(12):1169-1176.
2. Institute for Public Health (IPH) 2015. National Health and Morbidity Survey 2015 (NHMS 2015). Vol II: Non-Communicable Diseases, Risk Factors &
Other Health Problems; 2015.
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MENTAL
HEALTH
HANDBOOK
Foreword
By 2020, mental illness is expected to be the those within government to change the
way we think about it.
Malaysians after heart disease.1 According Individuals experiencing episodes of
to The National Health Morbidity Survey mental illness and the people who care
(2015), every 1 in 3 adults aged 16 years for them need quick access to reliable
health information. If you or your loved
form of mental health issues.2
Mental illness does not discriminate.
information or what to do next.
gender, race, social status or income. ‘Mental Health Handbook’ aims to
provide a credible reference resource
are usually perceived to be restless, guide to enable Malaysians to acquire
violent and unpredictable. Such stigma some basic knowledge about mental
and discrimination will only prevent such health and recognize the early warning
individuals from seeking professional help signs and symptoms of the various
and treatment early. mental disorders.
Learning to cope with mental health
Malaysians towards mental disorders will it can be done. We hope this handbook
improve. Education is the most important
step to understanding mental health individuals with mental illness through
problems. Like physical illness, mental better understanding, acceptance and
illness is nothing to be ashamed of. For respect.
that reason, it is important to educate
our communities, employers, schools and
References
1. Hassan MF, et al. Issues and challenges of mental health in Malaysia. IJ-ARBSS. 2018;8(12):1685-1696.
2. Institute for Public Health (IPH) 2015. National Health and Morbidity Survey 2015 (NHMS 2015). Vol II: Non-Communicable Diseases, Risk Factors &
Other Health Problems; 2015.
5
CHAPTER 1: CHAPTER 4:
Overview: What is Mental Taking Active Steps to
Illness? Manage Your Mental Health
• How do I know if I need to
CHAPTER 2: seek professional help?
Understanding Common • Psychologist or psychiatrist?
Mental Disorders •
• Depression • Treatment for mental illness
• Anxiety • 10 tips to stay mentally well
• Bipolar disorder Appendix:
• Schizophrenia • Standard self-assessment
forms
CHAPTER 3: • Directory of mental health
Family & Social Support: services
• Reach out to someone with
mental health issues
• How to start a conversation
about mental health?
• Patients’ quotes of
encouragement
MENTAL
HEALTH
HANDBOOK
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MENTAL
HEALTH
HANDBOOK
References
1. CDC. Learn About Mental Health - Mental Health. https://www.cdc.gov/mentalhealth/learn/index.htm. Accessed on 1st October 2018.
2. World Health Organization. Mental health: strengthening our response. https://www.who.int/en/news-room/fact-sheet/detail/mental-health-
strengthening-our-response. Accessed on 1st October 2018.
3. American Psychiatric Association. What is mental Illness. August 2018. https://www.psychiatry.org/patients-families/what-is-mental-illness.
Accessed on 22nd July 2019.
4. Institute for Public Health. National Health and Morbidity Survery 2015.
5. American Psychiatric Association. What is depression. https://www.psychiatry.org/patients-families/what-is-depression. Accessed on 22nd July 2019.
6. Browne D. What to know about anxiety. https://www.medicalnewstoday.com/articles/323454.php. Accessed on 23rd July 2019.
7. National Institute of Mental Health. Bipolar Disorder. April 2016. https://www.nimh.nih.gov/health/topics/bipolar-disorder/index/shtml. Accessed
on 23rd July 2019.
8. National Institute of Mental Health. Schizophrenia. https://www.nimh.nih.gov/publications/schizophrenia/19-mh-8082-schizophrenia_155669.pdf.
Accessed 24th July 2019.
9. World Health Organization. Mental disorders affect one in four people. https://www.who.int/whr/2001/media_centre/press_release/en/. Accessed
on 1st October 2018.
10. World Health Organization. Child and adolescent mental health. https://www.who.int/mental_health/maternal-child/child_adolescent/en/.
Accessed on 1st October 2018.
11. World Health Organization. 10 facts on mental health. https://www.who.int/mental_health/mental_health_facts/en/index4.html. Accessed on 1st
October 2018.
12. WebMD. Causes of Mental Illness. May 2018. https://www.webmd.com/mental-health/mental-health-causes-mental-illness. Accessed on 1st
October 2018.
13. Mayo Clinic. Mental illness. https://www.mayoclinic.org/diseases-conditions/mental-illness/symptoms-causes/syc-20374968. Accessed on 22
October 2019.
14. National Institute of Mental Health. 5 Things You Should Know About Stress. https://www.nimh.nih.gov/health/publications/
stress/5thingsshldknowaboutstress-508-03132017_142898.pdf. Accessed on 24th July 2019.
15. Mayo Clinic. Depression in women: Understanding the gender gap. https://mayoclinic.org/diseases-conditions/depression/in-depth/depression/
art-20047725. Accessed on 1st October 2018.
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MENTAL
HEALTH
HANDBOOK
anxiety usually displays the helping someone feel less alone and more
supported in recovering from anxiety.
following: Don’t underestimate the importance of
just being there. It is important to know
1. Excessive worry
loved one has. When someone is having
5. Chronic indigestion
Breathing Techniques
for Anxiety27
6. Possessing stage fright
Breathing exercises are an excellent,
quick and easy solution for stress
and anxiety relief. Proper breathing
7. Becoming self-conscious
techniques work on a physiological
level by slowing your heart rate.
Breathing techniques don’t need to
8. Having panic attacks be complicated. The only instruction
is to breathe out slowly. The key is to
focus on your out-breath and ignore
9. your in-breath. Your in-breath will
naturally lengthen when your out-
breath is longer. Try to make your
10. Obsessive perfectionism breath out slow, steady, and gentle.
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MENTAL
HEALTH
HANDBOOK
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MENTAL
HEALTH
HANDBOOK
• Feel very “up,” “high,” or elated • Feel very sad, down, empty, or
• Have a lot of energy hopeless
• Have increased activity levels • Have very little energy
• Feel “jumpy” or “wired” • Have decreased activity levels
• Have trouble sleeping • Have trouble sleeping, they may sleep
• Become more active than usual too little or too much
• • Feel like they can’t enjoy anything
things • Feel worried and empty
• Be agitated, irritable, or “touchy” • Have trouble concentrating
• Feel like their thoughts are going very • Forget things a lot
fast • Eat too much or too little
• Think they can do a lot of things at once • Feel tired or “slowed down”
• Do risky things, like spend a lot of • Think about death or suicide
money
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MENTAL
HEALTH
HANDBOOK
Based on the results of the evaluation, a person may be diagnosed with one of the
following categories of Bipolar Disorder:
bipolar disorder symptoms that do not match the three categories listed above.28
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MENTAL
HEALTH
HANDBOOK
How Can I Help Someone People with bipolar disorder are more likely
to seek help when they are depressed than
Who Suffers From Bipolar when experiencing mania or hypomania.
Disorder? Unless a medical history is taken, bipolar
Bipolar disorder is a lifelong illness. disorder can sometimes be mistakenly
Episodes of mania and depression typically diagnosed as major depression.28 Unlike
come back over time. Between episodes, people with bipolar disorder, people who
many people with bipolar disorder are have depression only (also called unipolar
free of mood changes, but some people depression) do not experience mania.28
may have lingering symptoms. Long-term, Keeping A Life Chart
continuous treatment helps to control
these symptoms.28 The combination of
patient and doctor work closely together
medication, therapy, healthy lifestyle, and
and talk openly about concerns and
support helps the vast majority of people
36 choices. Keeping a life chart that records
daily mood symptoms, treatments, sleep
Having a loved one with bipolar disorder patterns, and life events can help one
can put a strain on relationships and track and treat bipolar disorder most
disrupt all aspects of family life. However, 28
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MENTAL
HEALTH
HANDBOOK
Schizophrenia
Schizophrenia is a severe mental disorder, characterized by profound disruptions in
experiences, such as hearing voices or delusions.31 People with schizophrenia may seem
like they have lost touch with reality. There is no single attributable cause linked to
schizophrenia, rather, there are multiple factors that combined to lead to certain mental
illness.38 Schizophrenia typically begins in late adolescence or early adulthood.31
Prevalence Of Schizophrenia
million people worldwide but is not as common as
other mental disorders. It is more common among males than females.31,38
41
39
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MENTAL
HEALTH
HANDBOOK
What Are The Common imbalance between the two may be the
basis of the problem. Others have found
Causes Of Schizophrenia? a change in the body’s sensitivity to the
The exact causes of schizophrenia are neurotransmitters as part of the cause of
still unknown. Research suggests that schizophrenia.
a combination of physical, genetic, Pregnancy and birth complications:
psychological and environmental factors Research evidence suggests that
can make a person more likely to develop infants who experience birth trauma
this mental illness.42 or complications while in the womb
There are several risk factors that are at greater risk for schizophrenia.43
contribute to the risk of developing Research has shown people who develop
schizophrenia: schizophrenia are more likely to have
Genetics:42 experienced complications before and
during their birth, such as low birth
may increase the risk of schizophrenia, but weight, premature labour and a lack of
that no single gene causes the disorder by oxygen (hypoxia) during birth.42,44
itself. It is not yet possible to use genetic
information to predict who will develop
schizophrenia.
Abnormal Brain Structure:
Many individuals with schizophrenia
have structural or functional anomalies
in their brain.42 These include things such
as reduced ventricular enlargement, Schizophrenia runs in
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MENTAL
HEALTH
HANDBOOK
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MENTAL
HEALTH
HANDBOOK
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MENTAL
HEALTH
HANDBOOK
I have been
worried about
you. Can we Do you know of It seems like you
are going through
talk more about others who have
what you are experienced these
types of problems time. How can I help
experiencing?
who you can talk
If not, who are with?
you comfor table
talking to?
What can I do to help
you to talk about these
issues with your parents How can I help
or perhaps someone else
Who or has anyone who is responsible and
helped you deal cares about you? information about
with similar issues mental health
in the past? problems?
31
Patients’ Quotes of Encouragement
We don’t develop
courage by being
happy every day.
We develop it by Do not go where the path may
surviving difficult lead, go instead where there is
times and challenging no path and leave a trail
adversity – Ralph Waldo Emerson
– Barbara De Angelis
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MENTAL
HEALTH
HANDBOOK
ANXIETY14
The type of treatment will depend on
the type of anxiety one is experiencing.
For mild symptoms, lifestyle changes,
such as regular physical exercise that
reduces stress levels is encouraged. Where
symptoms of anxiety are moderate to
severe, Cognitive Behavioral Therapy
MYTH
Once you feel better you can
(CBT), psychological and/or medical stop taking your psychiatric
treatments are likely to be required. medications.
BIPOLAR DISORDER15
Treatment for bipolar disorder typically
aims to reduce the severity and number
of episodes to allow the person to live a
normal life as much as possible. Bipolar
disorder can be treated by medication.
Psychological treatment such as FACT
psychoeducation, Cognitive Behavioral Almost all patients with
Therapy (CBT) and family therapy can be
ongoing treatment for a period of
well. time and sometimes for the rest
of their lives to prevent relapses
SCHIZOPHRENIA16 and recurrences.17
Schizophrenia can be treated with a
tailored combination of therapy and
medication. Antipsychotics can be
prescribed to reduce acute schizophrenic
episodes. In addition, psychological
treatments such as Cognitive Behavioral
Therapy (CBT), family therapy and arts
therapy can also be applied to treat
schizophrenia.
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MENTAL
HEALTH
HANDBOOK
References
1. Sane. Treatments for mental illness. https://www.sane.org/mental-health- 10. National Institute of Mental Health. Depression. https://www.nimh.nih.gov/
andillness/facts-and-guides/treatments-for-mental-illness. Accessed on 22 health/topics/depression/index.shtml. Accessed on 22 October 2018.
October 2018.
11. Al-Harbi KS. Treatment-resistant depression therapeutic trends, challenges, and
2. Lackey S. How to Prepare for Your First Visit to a Psychologist. Health Works future directions. Patient Prefer Adherence. 2012;6:369–388.
psychologist/. Accessed on 22nd October 2018. 12. British Psychoanalytic Council. What is psychoanalytic psychotherapy? https://
www.bpc.org.uk/about-psychotherapy/what-psychotherapy. Accessed on 22
3. Health Direct. Diagnosis of mental illness. https://www.healthdirect.gov.au/ October 2018.
diagnosis-of-mental-illness. Accessed on 22 October 2018.
13. Beyond Blue. Medical treatments for depression. https://www.beyondblue.
4. Psychologist License. Clinical Psychologists: What do they do? And how to org.au/the-facts/depression/treatments-for-depression/medical-treatments-
become one. http://www.psychologist-license.com/types-of-psychologists/ fordepression. Accessed on 22 October 2018.
41
Standard Self-Assessment Form (PHQ9)1
Patient Health Questionnaire (PHQ-9):
The PHQ-9 is a multipurpose instrument designed for screening, diagnosing, monitoring
and measuring the severity of depression.
Completed by a patient and scored by a clinician, the PHQ-9 incorporates DSM-IV
depression diagnostic criteria with other leading major depressive symptoms into a brief
self-report tool that can be administered repeatedly.
Disclaimer:
This handbook is intended to provide general information on mental health and not to be used wholly or partially as medical
advice, diagnosis or treatment. You should seek the advice of a qualified healthcare professional before making decisions about
your own circumstances.
PP-CNS-MYS-0152-3FEB2021