Mount Elizabeth Medical Centre
3 Mount Elizabeth #15-05
Singapore 228510

Anxiety disorders

In generalised anxiety disorder, the person has constant worrying, accompanied by muscle tension, palpitations and poor sleep. The worry is repetitive and becomes associated with emotional and physical symptoms, and begins to impact upon his ability to enjoy life. In panic disorder, the individual has episodic attacks of anxiety and has anticipation that the attacks will return. In social anxiety disorder, the person’s anxiety symptoms occur in social situations where he will be observed or scrutinised. The anxiety undermines his confidence and prevents him from doing what he wants to do. Extreme social anxiety and shyness can be crippling. Agoraphobia, fears of leaving the house, being in crowded places or in an open space, is also commonly encountered in the clinical situation. The good news is that It is possible to overcome and break free from the often debilitating effects of anxiety.

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Grief, depression and mood disorders

Grief is a natural reaction to loss, but in some cases it can be devastating, causing a loss of direction, affecting our relationships and our work. Help is available to help the recently bereaved to regain a sense of control and adjust to life without the spouse, friend or family member who has died.

Depression is one of the most serious medical disorders in public health. Approximately 15% of the population will experience an episode of major depressive disorder (MDD) during their lifetime. The World Health Organization has projected that depression will remain the leading cause of disability, second only to cardiovascular disease, in the year 2020. With appropriate treatment, most patients are able to recover promptly from a depressive episode and return to their normal level of function.

In bipolar disorder, which affects up to 5% of the general population, there is an episode of mood elevation, where the person feels high and has increased activity. There has been an explosion of research into the neurobiology and treatment of bipolar disorder over the past 15 years, and effective treatment for the condition is now readily available.

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Insomnia and sleep problems

About 10-25% of the individuals have insomnia at a point in time. It is important to seek treatment for insomnia early as when the problem becomes more protracted, it is harder to nip it in the bud. It is important for clinicians to be able to accurately identify the root cause of sleep dysfunction in individual patients in order to optimise treatment. In many cases, a combination of behavioural and lifestyle interventions can solve the problem. About 10% of cases may rely on hypnotics to sleep well.

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Relationship problems and marital difficulties

Many individuals find themselves trapped in unhappy relationships or marriages (‘entrapment syndrome’). Very often this could be the main source of stress for them. It is important to talk with a professional to discuss how these emotional challenges can be sorted out so that the person can move on in his/her life. Breaking up is much more painful, much harder to manage well, than anyone expects.

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Sexual health concerns and dysfunctions

Common sexual problems seen in the clinical practice include difficulties achieving and or maintaining an erection, loss of sexual desire, fast ejaculation, lack of orgasm, inability to ejaculate inside the partner’s body, pains during intercourse and inability to consummate the marriage. With psychotherapy and use of appropriate medications, it is possible to restore confidence and a mutually fulfilling sex life for both partners.

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Overnight sleep study

An overnight sleep study (polysomnography) is indicated in cases where obstructive sleep apnoea (where individuals have loud snoring, frequent awakenings in response to obstruction to the airway, cessation of breathing and daytime sleepiness). The sleep study is also indicated in individuals where there are abnormal and unusual movements of the limbs which interfere with a person’s ability to sleep well.

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Occupational stress

The problem of occupational stress is being increasingly recognized. Oftentimes, there are factors which can be tied to the individual, to the work setting and to the wider social context. Intervention strategies can be employed by healthcare workers to help individuals suffering from the emotional and physiological stresses engendered in the workplace.

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Obsessive compulsive disorder

There are two parts to this condition. First, the individual has recurring thoughts (for instance, fears of contamination or dirt, thoughts of harm to others) that cause the individual anxiety and distress. Second, there are compulsive acts that the person will engage in repeatedly (for instance, of repeated handwashing and prolonged bathing and washing) in an attempt to decrease the accompanying anxiety. Oftentimes, the symptoms are severe enough to affect the person’s functioning and family relationships. In some cases, family members are made to participate in the rituals, for instance, of washing their feet before entering the house. There is no need to suffer in silence as effective treatments for obsessive compulsive disorder are available.

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Emotional reactions following a traumatic experience

Individuals who encountered a traumatic experience like road traffic accident, robbery or sexual assault, may go on to have recurrent nightmares, fears and re-experiencing episodes. Both acute stress disorder and post-traumatic stress disorder (PTSD) can be effectively managed and the pain can go away. In people suffering from PTSD, their lives are often shattered and they experience significant suffering and extensive disability. Treatment takes the individual through the pain and towards finding meaning in life once more. It is important to gain control of one’s life and one’s feelings, and develop healthy, better relationships.

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Paranoid and suspicious thoughts

Twenty to 30 per cent of people frequently have paranoid or suspicious thoughts about other people and these feelings can make life a living hell. It is possible to seek evaluation and treatment early as such individuals may go on to develop depression and other social and interpersonal problems.

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Adult ADHD

The diagnosis of ADHD (attention deficit hyperactivity disorder) can mean a lifelong struggle against debilitating symptoms as adults with the condition often have problems meeting deadlines, keeping appointments, conquering clutter and keeping track of their most valuable items. Help is available so that the individuals can focus better, overcome procrastination, bring order to their chaotic life and stop ADHD from interfering with their personal relationship.

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Emotional reactions following a diagnosis of heart disease or cancer

In recent years, there has been a growing awareness of the multiple interrelationships between depression and various physical diseases. Many individuals with cardiovascular diseases also experience psychiatric symptoms. Patients with cancer may also go on to have depression and other psychiatric problems. It is important to address the psychological and psychiatric issues and treatment of these comorbid conditions often have a positive impact on the survival of the individual.

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Irritable bowel syndrome

It has been estimated that in patients with irritable bowel (sensitive gut syndrome), about 30 to 50% have concomitant anxiety and depression. By treating the emotional complications, the gut symptoms may improve and consequently, the individuals will have better functioning at the workplace and in their social life.

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Memory problems and dementia

With age, many individuals complain of poor memory. Poor memory could be due to normal aging, depression or dementia. It is important to identify the root problem as some forms of dementia can be due to nutritional deficiencies or endocrine problems and these can be readily treated and are reversible. With effective interventions, many individuals with dementia continue to live in the community under the care of their loved ones.

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LPA stands for Lasting Power of Attorneys, a legal document that empowers an individual to appoint someone to make decisions on his/her behalf when he/she lacks mental capacity in the future. Psychiatrists can be the certificate issuer for the LPAs. Interested individuals are advised to go the website of the Office of Public Guardian (OPG) to look at the relevant documents. It is advisable to download the relevant forms from the OPG website.

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Neuropsychiatry and chronic pains

Many patients with neurological conditions like traumatic head injuries, stroke, Parkinson’s disease, dementia and epilepsy, develop psychological and psychiatric complications. After a mild traumatic brain injury, post- concussion symptoms can include headaches, dizziness, fatigue, irritability, sleep disturbances, memory difficulties, depression, concentration problems, anxiety, reduced thinking stamina or nausea. Chronic pain does not need to dominate a person’s life. By using appropriate strategies and interventions, a person’s experience of pain can be greatly reduced.

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Alcohol use disorder

Alcohol use becomes a problem when there is loss of control in drinking, the person has a compulsive urge to drink and when the person persists in drinking despite adverse consequences like problems in marriage and work. It is possible to use kindness, positive reinforcement, and motivational and behavioural strategies to help our loved ones overcome addiction problems and compulsive behaviours. Recent research has shown addiction is a brain disease and the good news is that effective treatments are available.

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Quitting cigarettes

Many individuals become motivated to quit cigarettes after they are diagnosed with various health problems like cancer, heart diseases and stroke. Help is available and it is never too late to say goodbye to cigarettes. There is a whole spectrum of techniques that may have worked for other quitters and guidance is provided as individuals build their own personalised plan.

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