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Movember: 13 FAQs on Mental Health and More for the Community.

Mental Health Don’t Discriminate.

As part of the Movember series on Mental Health & Suicide Prevention awareness, Dr Tan & Partners (DTAP Clinic) has team-up with the counsellors in Oogachaga to come out with 13 FAQs on Mental health and other health concerns for all the Men in the community!

The Questions are from Counsellors of Oogachaga. The Answers are from Doctors in DTAP Clinic in Singapore & Malaysia.


Q1: What can I do to maintain a good mental health status?

Dr Taufiq: There are many ways one can do this. Let me list a few and elaborate a bit on them.

  • Share your feelings – talking about how you feel is a good form of release and prevents you from bottling up your feelings only for it to affect you negatively later on.
  • Be physically active – Exercising and being active improves blood flow and release endorphins which helps to promote a positive mood.
  • Eat healthy – Clean and healthy food keeps your body healthy. With a healthy body, you can stay mentally healthy too.
  • Ask for help – if you have come to a point where you are not sure of what to do or how to control your emotions, seek help. Oogachaga has professional counsellors that can help you with your issues.

Q2: My anxiety often keeps me awake at night and I find myself irritable and moody the next day. How can I work on my sleeping schedule?

Dr Taufiq: To improve sleeping schedule you need to practice good sleep hygiene. Here are some tips:

  1. Have a regular routine that you do before sleep like brushing your teeth, drinking water etc.
  2. Avoid watching tv in bed. The bedroom should be reserved for sleep and sex only.
  3. Don’t take caffeinated drinks before you go to bed.
  4. Fix a time at which you go to bed.

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Q3: Do I have to come out as bisexual if I don’t have a partner of the same gender?

Dr Taufiq: Try not to be too worried about labels. If you are not partnered right now, it’s a good time to focus on yourself. Pick up a new hobby, learn a new skill, socialize, make new friends. When the right person comes along then it is good, if not you will still be able to live the best life that you can.


Q4: It’s stressful to hear my colleagues say nasty remarks about the queer community. How can I manage to work in a homophobic environment and maintain good relationships with my colleagues?

Dr Taufiq: You need to establish whether your superior and your company is LGBTQ friendly and open to all sexuality. If they are, then speak to your superior to share how you feel about the situation. See if he or she can find a way to make the work environment more comfortable for all. Your superior may also be able to mediate the discussion between you and your colleagues to talk about this issue and clear up misconceptions and unhappiness.

However, if the workplace or your superior is not LGBTQ friendly or open to discussion, then it might not be wise to approach them to talk about this. I suggest speaking to a counsellor from Oogachaga to find out how best to deal with such situations.

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Q5: Is being gay a mental illness or an emotional problem?

Dr Julian Ng: Being gay is NOT a mental illness or an emotional problem. A gay person is simply a male who has a romantic interest in another male, just like heterosexuals who have a romantic interest in the opposite sex.

Just like how someone may like someone with long hair or a great smile or a good sense of humour while another person may prefer other characteristics, being gay is NOT something that one can change or have control. It is simply a difference in interest.


Q6: Why do people attempt suicide when they appear to feel better?

Dr Julian Ng: Some people attempt suicide because they have lost hope while others simply want to stop the pain. Sometimes they hide away their pain so that their loved ones would not worry. We have also heard of cases where someone has already made up their mind but just wants to spend their final hours with their loved ones with the thinking that at least their loved ones will have that final happy memory to remember them by. 

In addition, some may feel better when they are in the company of their loved ones/ friends but when they are alone, the sense of loneliness/ hopefulness comes back.


Q7: I am currently in a heterosexual relationship, can I still identify as bisexual?

Dr Julian Ng: Definitely! Just because you are in a heterosexual relationship, it doesn’t change your sexuality. Sexuality is the emotional, romantic, and/or sexual attractions with whom you build your relationship with.


Q8: How do I know if I am feeling depressed and need to seek help?

Dr Guna: It’s common for one to feel down at times but if you feel hopeless and it just won’t go away, you may have depression. Depression symptoms vary from one to another but in general, you will be able to identify some of them.

Common symptoms of depression are:

  • Loss of interest in daily activities – You have stopped feeling joyful and do not find pleasure in things you used to.
  • Feelings of helplessness and hopelessness – you will start thinking that nothing is going to make anything better, in fact, you might not even try.
  • Anger or irritability – your usual threshold level is no longer high. Anything and everything will make you agitated.
  • Appetite or weight changes. Significant weight loss or weight gain
    Self-loathing. You harshly criticize yourself and blame every mistake on you.
  • Sleep changes. Either insomnia, with frequent early awakenings, or oversleeping.
  • Loss of energy– You would feel you body has been glued to the ground. Too tired even for small activities such as having breakfast or even bathing.
  • Reckless behaviour – You will want to live life dangerously or they would say YOLO!
  • Concentration problems– Trouble focusing, making decisions, or remembering things.
  • Unexplained aches and pains. 

You will need to seek help when you think something is definitely off in your lifestyle. No one will know better about you other than yourself. Despite trying some life modifications, meditations and everything in the book, if you still notice things are not getting better, then it is time to seek professional help. 

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Q9: What can I say to medical professionals who have misgendered me?

Dr Guna: Misgendering is on the rise. Whilst some are on an adventure figuring out themselves, they too have to deal with the public that may unknowingly misgender them. So what should you do? Should you just lash out and scream, ITS MA’AM or just let it slide? Here are some tips for you!

You may consider the following if you would like to correct them:

  • Is it going to be a one-off meeting? If it is, it might be better to save your saliva. Think about it, why waste your time with one person. 
  • How are they going to react? To be honest, there are still some aggro dude bro doctors out there. They might react in the weirdest way possible. So, save yourself some trouble.
  • Your emotional capacity. This is the most important step. If you have reached your BS level for the day, just go with it. If you can rectify the mistake, why not! Make them understand that you have found yourself and you will be pleased if they can stop misgendering you!. 

Despite being in the future, some still go through hard times in the doctor’s office, especially when they are being called with their “dead” names. 

It’s vitally important for trans people to get the healthcare they need while being treated fairly and with respect. Discrimination against trans people in medical offices and hospitals occurs on a daily basis and not many know this. However, many of these people are standing up for themselves and taking action so other trans patients don’t have to suffer through the same ordeal in the future. 

In the end, the choice is always up to you. Some would love to guard their mental health and emotional capacity very carefully. For others, it might be the opposite. It’s really a personal choice and it’ll have to be your decision. Good luck!

For a  better counselling on how to handle such situations, you may look for Oogachaga. This is a community-based, non-profit, professional organisation working with lesbian, gay, bisexual, transgender, questioning and queer (LGBTQ+) individuals, couples and families in Singapore since 1999. 

Oogachaga

Q10: Is it possible for me to get pregnant even though I am on hormone replacement therapy (HRT)?

Dr Guna: HRT generally means taking medications to stimulate certain types of hormones. One of them being testosterone. Testosterone greatly reduces your ability to become pregnant but it does not completely eliminate the risk of pregnancy. Transgender men can become pregnant even while on testosterone. Being said that, if you are sexually active, you do have chances of getting pregnant.  If you think you may have become pregnant, stop your hormone therapy and see a doctor soon as testosterone can endanger the fetus. 

If you do want to have a pregnancy, you’ll have to stop testosterone treatment and wait until your doctor tells you that it’s okay to start trying for a little one.

You should bear in mind that taking testosterone will definitely reduce the chances of one to get pregnant. So, do plan ahead. There are a variety of options from IVF to surrogacy. You also have the option of egg freezing which you can consider prior to starting the hormone therapy. All these options have a high price range, so always plan ahead! 

You can also visit any fertility centres for a better explanation regarding your fertility status. 


Q11: I identify as a transgender man and have not gone for gender-affirming surgery. I find it hard to use male toilets in public and in work for fear of being outed. What can I do?

Dr Guna: This is a very tricky question as many opinions and suggestions are made available out there. To be very honest with you, no one should ever tell what should you do. You first must be comfortable with yourself for you to be comfortable in public. It’s not going to be easy to be out of your comfort zone whilst the public is continuously judging you. 

In Malaysia, back in 2018, Deputy Minister in the Prime Minister’s Department Fuziah Salleh, has urged the transgender community to use the disabled toilets if no unisex toilets are available nearby. This is something to ponder on. Let’s face it, some transgender male, are afraid of using the males toilet as they are worried they might be physically abused, which has happened many times. If they have decided to use the female toilets, the female users might fear for their safety. What much can the transgender community do if they are not given a chance to even breathe properly? 

Another option that I would suggest is, get in touch with your local support group. Discussing matters such as this will help you figure out some better and brilliant ideas as most of them would have pretty much gone through similar things in their life.


Q12: How can I deal with my mental health without the use of medication?

Dr Julian Hong: Top 5 Tips!

  1. Speak to your doctor, get a thorough assessment, sometimes some conditions require medications for treatment and sometimes you can work with your trusted healthcare professional to aim to wean down the medications.
  2. Speak to a counsellor/psychologist.
  3. Get support from your close friends or family, do not be afraid to reach out!
  4. Pick up a new hobby or create an exercise plan – exercise is known to prevent and also help reduce the occurrence of mental health conditions.
  5. Always remember you are not alone and help is but a phone call away!

Q13: Is talking about suicide a bad idea and might be interpreted as an encouragement?

Dr Guna: This question is one of the most famous myths around. People who take their lives don’t want to die, they just want to stop hurting. Most suicidal individuals give ample warning signs or signals of their intentions. Recognizing these warning signs and knowing how to respond when you spot them is the best way of prevention. You can always play a role in suicide prevention by pointing out the alternatives. Showing that you care will help them immensely. If all else fails, getting a doctor or psychologist involved will the best option. 

Suicide warning signs include:

  • Feelings of helplessness, hopelessness, and being trapped. The belief that things will never get better or change
  • Talking about suicide – such as “I wish I hadn’t been born,” “If I see you again…” and “I’d be better off dead.”
  • Seeking access to objects that could be used in a suicide attempt
  • Unusual focus on death, dying, or violence.
  • Feelings of worthlessness, guilt, shame, and self-hatred.
  • Desire to be left alone.
  • Saying goodbye to people as if they won’t be seen again.
  • A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to attempt suicide.
  • Taking unnecessary risks as if they have a “death wish.”

If you are advising a friend that is suicidal, always remember to never say things like: “You have so much to live for,” “Your suicide will hurt your family,” or “Look on the bright side.” Although these are the statements you would want to tell, but there is no point in arguing with them. Always listen to them, and let them speak. Do not interrupt them. Never say suicide is wrong. They know it’s wrong and that’s why they are seeking help. If you think you have no idea how to handle such a situation, help by directing them to a support group. 

Dr Julian Hong: Talking about suicide does not cause suicide. In fact, when it is out in the open, you get to find support and even address the root cause of the suicidal thoughts which more often than not needs a medical evaluation.

Figures from Samaritans of Singapore – In Singapore, Suicide is the leading cause of death for those aged 10-29. There are 2.5 times more deaths from suicide than transport accidents in 2017. 361 lives were lost to suicide in 2017. Males account for more than 66.2% of all suicides in 2017

If you are a loved one who knows of a young person struggling with their mental health, these are some warning signs to look out for (adapted from SOS Singapore)

Talk

  • “My family will be better off without me”
  • “My life is meaningless anyway”
  • “If you don’t love me, I’ll kill myself”

Actions

  • Giving away treasured possessions and saying goodbye
  • Researching suicide methods
  • Writing suicide notes (including emails/diaries/blogs)

Mood

  • Emotional outbursts
    (anger, sadness, irritability, recklessness)
  • Loss of interest
  • Anxiousness or feelings of shame

For immediate help – Call 999 or the Samaritans of Singapore (SOS) at 1800-221-4444 (Both operate 24/7). Stay on the phone with them until someone comes to you. Or, head down to the Accident & Emergency (A&E) Department of the nearest hospital for someone to attend to you.

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Speak To A Professional Counsellor

Speaking to a professional counsellor is helpful as counselling therapy allows the individual to talk about their personal issues and feelings in a confidential, non-judgemental and safe environment.

The counsellor works together with the individual on their issues to help them achieve greater insight into self-understanding, improved relationship with self and others and better control over their life. Counselling provides the individual with different perspectives on their current issues, make sense of past experiences and help them understand how it affects the present, the person they are today.


Oogachaga

Oogachaga is a community-based, non-profit, professional organisation working with lesbian, gay, bisexual, transgender, questioning and queer (LGBTQ+) individuals, couples and families in Singapore since 1999.

They strive forward with a mission to enable lesbian, gay, bisexual, transgender, questioning and queer (LGBTQ+) individuals to make informed decisions that strengthen them and to help them achieve a fulfilling life.

Oogachaga’s team of professional counsellors come from diverse backgrounds, all of whom adopt an LGBTQ-friendly approach that is guided by gay-affirmative practice.

Their services:

  • Hotline, WhatsApp and Email Counselling
  • Professional Counselling
  • Professional Training
  • Corporate Engagement
  • Support Groups

For professional help or counselling, speak to the counsellors at Oogachaga!

For other resources, please see www.congregaytion.com

X.O.X.O