Interview with Shazrina Sabri, clinical psychologist, KPJ Ampang Puteri Specialist Hospital
1. Seeing for yourself the increasing cases of depression recently, is PKP a 100% cause or is it just a "trigger point" for someone to experience more severe depression?
In fact, depression is usually caused by a combination of stress from past life events (past stories), current things (e.g. PKP) and events that occur long and continuously (e.g. loss of source of income, trapped in toxic relationships, stress in the workplace, and isolation or isolation). However, an individual will be more at risk for developing depression if they have a family member who suffers from depression, a neurotic personality (e.g. anxious, low self-confidence), has a chronic illness as well as drug or alcohol abuse. So the short answer is, PKP can be a "triggering" factor or a trigger and a "maintaining" factor to depression for some individuals.
2. Inconsistent food intake, not engaging with any activities at home, seeing the Covid case numbers fluctuate, all of this may seem like a "trigger" that leads to extreme anxiety and depression. As a clinical psychologist, what forms of therapy can we ourselves do to detect and reduce the implications of triggers on our mental health?
Each disorder has its own symptoms, but in general, if you have a mental health problem among the symptoms that can be seen is when there is a change or disruption of basic functions of life such as performing daily chores (eg bathing, wearing clothes), mood swings, drastic, irritable feelings, lack of interest in interacting with others, loss of appetite, disturbed sleep, loss of focus in work as well as loss of sense of enjoyment in life.
As a first step, to maintain mental health throughout the PKPD/PKP period increase virtual interaction with family members and friends, try to understand daily situations with an open and positive mind, practice regular daily routines (eg sleep and wake up at the same time daily), limit the information you receive related to Covid-19, and find time for you to relax or create activities of your choice.
3. What about those who already have mental health problems? What forms of psychotherapy interventions can family members help with during the period of Full Movement Restriction while at home?
Psychotherapy is one of the methods used specifically by therapists because it requires specialized training to be implemented effectively and I discourage family members from doing psychotherapy on their own. Nevertheless, family members play a very important role as a source of emotional support for individuals with mental health problems in addition to therapeutic treatment. Among the steps that can be taken by family members is to listen to the expression of the individual's problems without "judgmental" thinking. Family members are also encouraged to constantly monitor the individual’s condition from time to time and greet them (e.g. are you ok? how are you feeling?). Family members are also encouraged to spend time with the individual, without forcing them. It is also very important to control or ensure that the individual takes their medications as prescribed by a psychiatrist. Finally, family members can also suggest that the individual get help through tele-therapy services, namely online psychotherapy/counselling services and also help through existing hotlines.
4. In such a situation, the subconscious mind is what controls us. Is this a situation we can’t fully identify, or will we realize after something unexpected we have done?
When a person suffers from depressive disorder, most of the time especially in the early stages, the subconscious mind or unconscious mind is more dominant than the conscious mind. The subconscious mind greatly influences our thinking and behaviour. For example, from a thinking point of view, sometimes we don’t notice that we are actually thinking irrationally about things happening around us or we know as negative automatic thoughts. Negative automatic thoughts are of several types; one of which is mind reading. For example, "Abu talks more to Ali than me, Abu must hate me". This way of thinking is very dangerous because over time we will get used to thinking negatively and this will affect the perception of self. If from the point of view of my behaviour, sometimes we do not notice that we are angry with our children but the fact is that we are angry with our boss. Most situations happen without us realizing it. Thus, psychotherapy methods such as Cognitive Behavior Therapy help individuals to be aware of negative thoughts that occur in the subconscious state and to correct those thoughts rationally and positively.
5. What about early detection measures to identify those among us who are experiencing psychological impact as a result of this pandemic situation?
Everyone is experiencing stress or pressure. In general, to know if we are okay or not, we have to ask ourselves "am I okay". Sometimes, we ourselves can know that we are not okay or kind of problematic. For example, such as lack of interest in interacting with others and constant isolation, irritability, drastic mood swings, loss of appetite, disturbed sleep, loss of focus at work as well as loss of sense of enjoyment in life. Maybe before this we didn't feel much of a symptom like this, but we can feel it starting to change. In conclusion, be mindful of how you feel, aware of the change in your feelings, are we okay or not? “It’s okay to not be okay” and “it’s ok to seek for help”.