"I'm NOT Ok": The Importance of Mental Health Checkups

Its common for people to go for physical checkups where they are put to a few types of stress tests to see how healthy they are physically. Its also common for them to go for medical checkups where blood is drawn to see how healthy their internal organs are functioning. However, very rarely do we hear of someone going for mental health checkups. Why is that?

We often associate mental health with counselling or mental illness. And despite us living in 2020s, there still exists a sense of suspiciousness surrounding this aspect of our lives. This may be due to the fact that the brain is still seen as something of a huge mystery. I mean, even the psychiatrists who treat mental illness does not manhandle the brain unlike other specialists. Dentists examine teeth through direct contact. Same goes for heart surgeons, ENT and orthopaedics, to name a few.

Its a given that many suffer from trust issues and this may be due to many factors. Its all the more daunting to choose a counsellor who you would deem worthy enough for your trust just so you are able to work on issues and challenges which are very close to your heart. But what if you are not ready to trust someone with the skeletons in your closet and yet you are worrying about your mental wellbeing? 

Counselling is an hour long for each session and it involves you discussing difficult topics that are troubling you and your loved ones. However, mental health checkups is just 30 minutes in length and theres no need for you to trust the mental health service provider. Its no different from you going to a general practitioner doctor in your residential area when you are feeling sickly.

According to the WHO, mental health is a state wherein a person understands their potential and has the ability to deal with regular stressors in life. Additionally, the person who has the ability to work in a productive manner and can make a meaningful contribution to his community.

So, if you are wondering why is mental health important, you now know that you need to be mentally healthy to achieve your potential and be productive in the society you live and work in. Without sound mental health, you will find it extra challenging to cope with daily life stresses and this will ultimately affect your ability to remain productive.

If you display any of these five signs, its time for you to seriously consider coming in for a mental health checkup:

Grumpiness: 
If you notice that from a pleasant and happy person, you have turned into snarky person who gets angry over the smallest of things, it is a sign of emotional or mental chaos.

Sleeplessness:
Most people do not get adequate sleep because of demanding work and lifestyle. If you find you are unable to sleep at night, get a doctor to make sure its not a medical condition. If it isn't, then do submit yourself to a mental health checkup where you may figure out the reasons for your sleep disorder.

Avoiding People:
One of the first signs of depression is shunning people. You stop interacting with people and avoid physical and digital contact with them.

Binge Eating:
Long-term stress causes an increase in a hormone called cortisol and this affects your appetite, causing you to eat more. This means you will be craving for high fat and high sugar food which is associated with emotional eating.

Inability to Relax:
Are you always wound up and have a constantly active mind? This is a sign of anxiety, which is often overlooked because it is constantly present. You can live with anxiety for years without realising you are having a mental issue.

Mental health issues can wreak havoc with your life and turn it upside down. Don't let this happen. Instead, get an annual mental checkup done to catch any problem early, before it blows up and turns serious.

Contact MY Confidential at +60172979158 to book an appointment.

Happy Hormones: Food for Thought

Mental states are seldom just a matter of biochemistry, but it's fair to say that a shortage of serotonin can aggravate depression. A shortage of melatonin aggravates sleep problems. But did you know that the shortage of serotonin is what caused the shortage of melatonin, or that this connection explains why so many people who have depression can't sleep? The brain (and the intestines) make serotonin from the amino acid tryptophan, with the help of vitamin B6, creating a chemical known as 5-hydroxytryptophan (5-HTP) as an intermediate step. 

What is Melatonin? 

First identified in 1958, this naturally occurring hormone is manufactured by the pineal gland, a pea-size organ deep within the brain. All humans and most animals secrete melatonin throughout their lives, with the highest levels occurring during childhood. As we age, however, the production of melatonin declines, leading some researchers to theorise that melatonin supplementation might benefit all older people. Interestingly, natural melatonin levels vary widely. about 1% of the population have very low levels, and another 1% have levels 500 times above normal. There's no correlation, however, between these amounts and specific health concerns or sleep patterns. What it does. One of the main functions of melatonin is to regulate cycles of sleep and wakefulness. it does so by helping to set the brain's internal clock, creating what are known as circadian rhythms - the body's daily biorhythms that govern everything from sleeping and waking times to digestive functions and the release of a variety of hormones linked to reproduction and other body processes. In order to produce melatonin, the body responds to light cues, making more when it's dark outside (production begins each evening around dusk and peaks between 2 am and 4 am)and less during the day. this daily cyclical melatonin secretion is what tells the body when to sleep and when to awaken. What is the relationship between serotonin and melatonin? The brain (as well as the retinas, bone marrow, and certain white blood cells) make melatonin from serotonin. Melatonin is also a powerful antioxidant that can slow the progression of Parkinson's disease and ovarian cancer, but once it has quenched a free radical reaction to protect a cell, it is used up, and cannot be recharged. Once serotonin has been transformed into melatonin, there is no further serotonin and melatonin reaction, since there are no serotonin vs melatonin reactions and melatonin is not turned back into serotonin. There are many supplements, such as 5-HTP, that can help your brain make serotonin. 

What is 5-HTP? 

The nutrient 5-HTP, short for 5-hydroxytryptophan, is a derivative of the amino acid, which is found in such high-protein foods as beef, chicken, fish, and dairy products. The body makes 5-HTP from the tryptophan present in our diets. It's also in the seeds of an African plant called Griffonia simplicifolia which is the source of the 5-HTP supplements sold in health-food stores. 

The focus of much recent interest, 5-HTP acts on the brain, helping to elevate mood, promote sleep and weight loss, and relieve migraines, among other uses. Unlike many other supplements, (and drugs) that contain substances with molecules too large to pass from the blood stream into the brain, 5-HTP is small enough to enter the brain. Once there, it is converted into a vital nervous system chemical, or neurotransmitter, called serotonin. Although it affects many parts of the body, serotonin's most important actions take place in the brain, where it influences everything from mood to appetite to sleep.

But if you taking a supplement or a medication for depression, do you also need to take melatonin? 

It all depends on whether or not you have trouble sleeping. If you are already on a selective serotonin reuptake inhibitor (SSRI), ask your doctor if you might not be treated with a drug called agomelatine, which is sold under the trade names Melitor, Thymanax, and Valdoxan. This drug is not a reuptake inhibitor, but it keeps the brain from recycling 5-HTP, keeping serotonin levels higher, while it also helps the brain make more melatonin. Especially if you have obsessive-compulsive disorder with moderate to severe depression, this medication may be better for you than any supplement. Only your doctor will know for sure. 

Deep Sleep 

If you don't need this medication, then you might consider adding melatonin to your supplement program. The thing to remember about melatonin is that it induces sleep-so you want to take it at bedtime, not when you need to be waking up to go to work! Also, start with a smaller dose. Melatonin is non-toxic even in large doses, but you should only take enough to get to sleep. This is usually 1 to 3 mg, taken 1 hour before the desired bedtime. It also helps to sleep in the dark, so your brain can make its own melatonin. The slightest exposure to blue light, even if your eyelids are closed, interrupts the brain's production of melatonin. 

Montmorency tart cherries

Only one food delivers melatonin in a dosage that makes a difference to your health; Montmorency tart cherries. If you like cherries, eat them every day. You may find that they help both depression and insomnia. (More about anxiety and insomnia). 

Hard Truth On Being A Private Practitioner

"Theory is a major element in professional knowledge. Doubts about its value reported by practitioners raise questions at a critical juncture in the careers field about the relevance of prevailing theories and how they are approached. The topic of the relationship between theory and practice is a sensitive one in the debate on competencies and an illuminating one in that on post-modernism. As recent studies demonstrate, problems in integrating theory and practice arise in training and may persist, but experienced practitioners achieve ‘fusion’ between them and become ‘practical theorists’. Practice is improvisatory, and is refined by frameworks provided by theory, critical thinking and ‘reflective practice’. However, theories are often tardy or irrelevant, and practitioners also need to be able to carry out their own research, including action research. This has implications for initial and in-service training, supervision and policy, and for the relationships between researchers, theorists and practitioners." (Audrey Collin (1996) Re-thinking the relationship between theory and practice: Practitioners as map-readers, map-makers—or jazz players?, British Journal of Guidance & Counselling, 24:1, 67-81, DOI: 10.1080/03069889608253709)

Let's get something straight. A registered and licensed counselor in Malaysia has several job options: organizations, education and private practice. Counselors who work in organizations as career counselors earn a monthly income, regardless of how many counseling sessions they clock in a month. Counselors in educational settings would also be receiving monthly salary where the hours spent on counseling is further added with roles of being a substitute teacher. Some might even pursue their doctorate degree that would make them attractive to higher education universities and colleges. They also earn a monthly income which allows them the privilege of providing pro bono counseling as to ensure they do not lose the skills they have acquired through their trainings during practicum and internship. The same cannot be said of those who chose to be their own bosses by taking the huge leap into setting up a private practice.

Many therapists have dreams of one day starting their own private practice. Following through on these aspirations, however, requires taking a number of things into consideration.

There are definite pros and cons. Having worked as a therapist for a number of community organizations prior to having my own private practice, I can attest to the validity of both. Some of the issues to consider include:

BUSINESS CONCERNS

Starting a private practice requires exploring the laws in your city that apply to owning your own business. You will typically need to obtain a business license from the city you live in and renew it on a yearly basis.

WORK SCHEDULE

Owning your own business means having the freedom to limit the number of days and hours worked. However, you also need to be able to accommodate people when they are available to come in, which may require having to work evenings and/or weekends.

MARKETING

Being in private practice requires taking the steps necessary to generate business, which many therapists feel uncomfortable doing. Establishing a web presence is important in order to attract individuals looking for the specific services you offer, the therapeutic approach you use, and any areas of expertise you may have. Effective ways of advertising include creating a practice website, writing a blog, and maintaining one or more professional profiles on online therapist directories such as GoodTherapy.org. All of these efforts take time and some financial investment.

EXPENSES

Going into private practice requires taking into consideration the overhead and other expenses that apply when one owns a business. Some of the expenses to account for include the need to lease office space; the cost of utilities; furnishing the space; marketing efforts; obtaining office supplies and business cards; and the price of medical, dental, and liability insurance. You will also need to decide whether to do your billing yourself, which can be time-consuming, or hire someone to do it for you. If you are just starting out, you may want to consider subletting an office on a part-time basis (for example, on weekends and/or one or two evenings a week) to start building your practice before quitting your full-time job.

FLUCTUATING INCOME

Although a private practice can be profitable, it can also be unpredictable at times. Whereas you are typically guaranteed a certain monthly income when working for an agency or organization, a private practice does not provide the same level of security. The number of individuals seen, as well as the income generated, tends to vary from month to month. It can also take time to build up sufficient business for you to live off of, and you have to set aside money for taxes and/or make quarterly estimated tax payments, as this will not be done for you. You also need to keep in mind you will not get paid for any time off, so you will need to have a cushion set aside in order to account for any vacation or sick time.

Going into private practice can be profitable and rewarding, but it can take a lot of time and energy before you get to that point. The risks associated with any type of business are not for everyone, but the dream of starting your own private practice can become a reality if you are willing to take a leap of faith and put in the work needed in order to succeed.

Source: Good Therapy.

Which brings me to the current pebble in my shoe. People who only know how to teach. They have never been self-employed. They have never been without a boss to make decisions for them. They have never not have a fixed monthly income. They sit on their cushy asses, their noses buried in textbooks they read and vomit to their students. They know theories by hard and accumulate knowledge and yet have no spare time whatsoever to practice the so-called knowledge they had learned. And yet, they have all the time in the world to question the credibility of others who have guts to take risks. They believe that just because they are the academicians, they are the only ones who are ethical. They question other people's decision making styles. Their worldview is confined to the four walls of their classes that it is rendered unrealistic in so many hilarious levels!

The hard truth is private practice can never guarantee you a stable monthly income. There is no EPF or SOCSO unless you are willing to invest in yourself on your own. Without trust, no amount of therapy can ever be effective on the client. However, we can be grateful for technology that we have now that didn't exist when I was first setting out. And I am eternally grateful to western content on the media for making mental health more palatable to the general local public.

So, why choose private practice? Because somehow, when we connect with our clients and see them live up to their fullest potential, something inside us hear words of affirmation: "You did good!" What we do matter to our clients. And that is reason enough.

About MY Confidential

MY Confidential (Association of Private Counselors) was established as an NGO on February 22nd, 2019. We provide private counselling services to the general public as well as service office counselling rooms for licensed practitioners at reasonable fees.

Our humanitarian mission is to provide psychological support to our first responders and rescuers in crises settings. We aim to have our members and volunteers to be trained as caregivers as well as being a support system to those whose jobs are to save lives.

Our members consist of registered and licensed counselors in private practice, counseling interns, counseling students, and those who are trained in Crisis Intervention, First Aid and CPR. Our members have attended extensive Air Emergency Exercises organized by Malaysia Airports.

A Note From Founder

“We’re here to put a dent in the universe. Otherwise why else even be here?”

—Steve Jobs

This quote continuously inspires me. And the very reason I first started out being a pioneer in private practice in Malaysia. Back when the only places anyone can get any counselling services were either in churches or religious governmental department, I saw the gaping void in the need for regular individuals could go to for therapy with the confidence in privacy and confidentiality. The very core to the effectiveness of counselling is none other than TRUST. And with the stigma surrounding mental illness, many were too afraid to even admit they needed help, what more to be seen walking into a public counselling centre. 

Having witnessed how publicly ugly my parents's divorce was back in 1978, I wished there was somewhere they could've gone for some form of help for their marital challenges that was also private and confidential. This spurred me to venture into private practice, although the income was very unstable, at best. Needless to say that I wouldn't have been able to do this without the rock solid support from my husband and the understanding from my daughters.

The challenges that came with the private practice were countless. Aside from the general public phobia of being seen as 'crazy' by their loved ones, finding a private location for an office that was also affordable based on unstable income seemed humungous. 

Fast forward two decades and now I have successfully taught and trained an excellent team of counsellors who have joined me in MY Confidential. I have also established a centre that provides licensed counsellors a place for them to see their clients with flexible hours and very reasonable room rates. All this is a part of the cause that I have been championing: to encourage more and more counsellors to venture into private practice without having to cough out a huge amount of investment to set up an office.

Apart from the private practice, MY Confidential members get to volunteer on crisis missions. Our current focus is on the rescuers and first responders of SMART Malaysia. My personal mission is to have MY Confidential as an NGO that is self-funded by the use of the counselling centre.

My promise to the general public is making your privacy our priority.

My promise to licensed counselors who choose to join us is the affordable room rate for a professional and private setting.

Finally, my promise to Malaysia: MY Confidential is making a dent in the universe; one person at a time. 

Welcome to MY Confidential!

Sincerely,

Johana Dato' Johari