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How can I get help if I have anxiety issues in Singapore?

Mental Health Singapore Healthcare Psychiatry

I'm 16 years old. I feel like I'm always tense or nervous with no reason to be, and this has been going on for about 6 months. Over the past 2 weeks I realised that I could "feel" my anxiety more acutely. I would like to get help for this, but it feels strange to just walk into a polyclinic and say "hey I think I have anxiety - prove me wrong". Nor do I want to start listing symptoms I found on the internet. Yet at the same time, I know something's wrong, even if it's not necessarily anxiety. What should I do?

DOCTOR’S ANSWER (4)

The symptoms that you describe are commonly experienced by people in many parts of the world. Yes, the symptoms can be attributed to anxiety. There are three possible conditions that come to my mind immediately:

First, is that of thyroid gland abnormalities. Sometimes, persons with excessive thyroid hormone may report feeling anxious and restless. Typically, they may have some hand tremors. The thyroid gland in the neck could be enlarged. Given their increased metabolism, they often report feeling warm and oftentimes prefer to be in air conditioned places. The doctor will usually order a blood test to check the thyroid hormone level.

The second condition that comes to my mind is that of adjustment disorder with anxious mood. This happens in people who experience something stressful in their lives (e.g., school exams, passing of a relative, adjusting to a new job, enlistment for national service, a divorce) and go on to have symptoms of worry and tension. You can seek treatment from a counsellor who can then teach you relaxation techniques and explore with you your previous coping strategies and see how you can deal with the current challenges and life situation. A psychiatrist can also help you in this way.

Third, generalised anxiety disorder (GAD). In such cases, the individual has anxiety symptoms for at least 6 months. Typical symptoms would include poor sleep, constant worrying and tension in the body. The content of the worries may change, depending on the life situation of the person. For GAD, the treatments that are commonly employed in Singapore include cognitive behavioural therapy (CBT, a form of talk therapy and medications (including SSRIs). I notice that you are 16 years old. Some doctors may have reservations about using SSRIs in a teenager as there are reports of increased suicidal ideations in some cases following initiation of SSRIs. So the best treatment in your case if you have GAD may be CBT.

Do go ahead and see your family physician for an evaluation. It is important to take care of your own mental health.

909 views 3 Nov 2018
Dr Paul Ang
Dr Paul Ang
"Family Physician with special interest in Mental Health"
(1 Reviews)

Thank you so much Hana for asking a great question. You have highlighted a lot of problems with our current healthcare system.

When my wife was young like you, that was exactly what she did. She was very sad, and she went to the polyclinic. And guess what the doc there told her? " just snap out of it, you are normal."

It can be extremely frustrating, when someone is trying to seek help and the other party wouldn't even listen.

Not all GPs and doctors are trained in mental health to the same degree, in terms of diagnosis and treatment. And the world of "mental health disease" can be so stigmatizing and confusing for the patients.

For a start, there are GPs, polyclinics, psychiatrists, psychologists, counsellors, family service centres. How does one even make sense of it?

Perhaps some helpful tips before we become lost:

1) Google is your friend. It does put a lot of information on your fingertips, it tells you your possible diagnosis and so on. But I would really take it with a pinch of salt, and see a doctor before you start imagining that you have all the symptoms listed on the DSM-criteria. I find that patients sometimes get stunned when we tell them a different diagnosis, or tell them that they do not have any diagnosis.

2) Go to IMH/NUH, they are big hospitals with well staffed and well trained people. Geylang and Queenstown polyclinic, like what Dr Julian Ng suggested, is a good start as well. They have branches there.

3) Find a GP with a special interest in mental health. 

4) Find a private psychiatrist. 

Take care and hope you find a doctor who will listen to you soon!

1698 views 14 May 2018

Hi,

I'm glad that you are trying to seek help. Anxiety is not an uncommon psychological condition which many people are reluctant to seek help for. In Singapore, there are GPs who have special interests in helping persons with various psychological conditions like anxiety, depression, etc.

IMH would be an excellent place to find out where you can seek help for. Both Geylang and Queenstown Polyclinics also run clinics that provide help and support for those with psychological conditions.

Thank you.

1706 views 11 May 2018

Thank you for your question.

Dr Julian has provided a great answer for where to seek further assessment regarding you anxiety - so I won't repeat this, but have you thought about trying exercise to help with your symptoms

Exercise is well proven to help with symptoms of numerous conditions such as depression, anxiety and stress.

While you are awaiting further help, this might be something to look into.

BW
Dr Dinesh

1655 views 13 May 2018
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