With society advancing at increasingly rapid speeds, mental disorders now have more places to grow, as well as hide.
by Emily Mary Chin, Carrybeans
The World Health Organisation (WHO) believes that mental illnesses affect one in four people at some point in their lives. And as grim as that statistic is, the situation in our country may be even more so. The prevalence of mental health issues among adults in Malaysia has spiked from 11.2% in 2006 to 29.2% in 2015, as per the National Health and Morbidity Survey 2015.
Artistic interpretation of depression // Credit: Federico Babina
However, this does not take into account cases that presumably go unreported. Practitioners in the mental health field believe the number should be closer to 40%. And with nearly half our population suffering from some form of mental illness, it becomes ever more necessary that we are aware and informed on the differences between them.
Bipolar disorder, also commonly known as manic depression, is a mood disorder that is characterised by extreme mood swings. A person living with bipolar disorder would undergo intense shifts not just in mood, but also energy, productivity, and motivation. They cycle through episodes of mania and depression. A person going through a manic episode would experience ‘high’ periods of unreserved euphoria and energy. ‘Low’ periods of depression and hopelessness would, then, follow.
Borderline personality disorder (BPD) is a personality disorder that is fairly new to the field of psychology and can be tricky to pin down. BPD expresses itself differently in different people. However, it is generally characterised by an in ability to regulate one’s own emotions. People living with BPD have difficulty balancing their mood, self-image, interpersonal relationships, and behaviour. This, then, seeps into their lives at home and work, creating toxic relationships and disrupting any form of routine or long-term planning.
Schizophrenia is a mental disorder that affects thinking, feeling and behaviour. It is characterised by an inability to comprehend reality and properly distinguish it from imagination. People living with schizophrenia tend to exhibit abnormal social behaviour, through paranoia, agitated body movements and an inability to think in logical terms. They are intensely detached from reality, making it hard for them to find motivation or pleasure in their daily lives. Because of this, they usually have trouble focusing and making plans.
A mood disorder relates to a person’s mood or emotional state when it does not align with their circumstances. People living with a mood disorder would experience the normal ups and downs of human emotion, but much more intensely and for much longer periods of time. Experiences of sadness, agitation, and fatigue are all common symptoms of a mood disorder, as is troubles in concentration and shifts in appetite. Some common mood disorders include depression and bipolar disorder.
A personality disorder relates to dysfunctional and limiting thought patterns and behaviour. While personalities are influenced by genetics, environment and experience, a personality disorder makes a person behave and think in a way that does not align with their experiences. A person living with a personality disorder would find it hard to relate to their environment and the people around them. It affects their relationships and behaviour, making them unstable and uninhibited. It also affects their self-image, causing them to swing between low and high self esteem. Examples of personality disorders are narcissistic personality disorder (NPD) and BPD.
Mental disorders comprise of a wide range of issues, relating to all mental illnesses. The terms, ‘mental disorder’ and ‘mental illness’ are interchangeable. A person living with a mental disorder would typically exhibit a combination of abnormal behaviour, perception, relationships, thought processes, and/or expression of emotions. Some common mental disorders—other than the ones already mentioned above—include schizophrenia, dementia, anxiety disorders, eating disorders, obsessive-compulsive personality disorder (OCD), and attention deficit hyperactivity disorder (ADHD).
Because mood and personality disorders can share some similar characteristics, it is easy to confuse the two. BPD, for instance, is very commonly misdiagnosed as bipolar disorder. A study published in the Journal of Psychiatric Research found that as many as 40% of people with BPD have been previously misdiagnosed as bipolar.
This is largely due to the number of symptoms they share in common. A person with BPD and another person with bipolar disorder would both share symptoms of impulsive behaviour, mood swings, suicidal thoughts, and episodes of rage.
Artistic interpretation of bipolar disorder // Credit: Shawn Coss
However, mood and personality disorders affect the mind in different ways. While mood disorders largely impact a person’s mood and emotional state, personality disorders affect thought patterns and behaviour. In this way, a mood disorder would affect a person when they are battling strong bouts of emotion, whether extremely sad or happy. Outside these extreme swings, they would still be very capable of having healthy social interactions.
A person suffering from a personality disorder, however, would find that their overall behaviour, beliefs, values, and fundamental character does not align with society around them. This person would, then, find normal social interactions a lot more challenging.
For example, a person suffering from a mood disorder like depression may find themselves unfocused in their intimate relationship and unable to engage with their significant other. But in periods where their symptoms are under control or alleviated, interaction within that relationship can return to normal. A person suffering from a personality disorder like NPD, however, would find it a challenge maintaining healthy relationships and interaction with people.
One of the most significant distinctions between these two types of mental disorders is the method of treatment. Medication is very effective in the treatment of mood disorders, able to help adjust chemical imbalances in the brain and bring emotions to a more stable and less reactive baseline.
Personality disorders, however, don’t benefit as much from medication and instead, gain the most from psychotherapy. Talking things out is a very important factor in recovery for people living with personality disorders. Therapy sessions help them to identify their symptoms so that they can, then, modify their behaviour and responses from there.
Studies show that about 75% of people with BPD will suffer from a mood disorder at some point in their lives, the most common ones being depression and bipolar disorder, also known as manic depression. Being such a prominent factor in so many mental disorders, it’s clear that we can no longer ignore depression.
More than 18,000 Malaysians were diagnosed with depression last year and experts believe that number should actually be a lot bigger. But there is still a lot of stigma that surrounds the topic of mental illness in Malaysia. Most cases go unreported, sometimes as many as 90% of them.
But stigma only serves to stifle the conversation. And the conversation is ever more necessary for understanding. With more understanding, we will be more informed and thereby more able to distinguish and detect symptoms within our loved ones and ourselves. This, in turn, will prevent future cases of misdiagnosis as well as encourage more people to put a name to the demons they are fighting.
Let’s face it. We can’t run away from our mental health anymore. It’s time to face it head on.
Mental health issues still carry a lot of stigma here in our country. Click here to read what the current Malaysian landscape of mental health is like.
Featured Image Credit: Wikimedia Commons