CONVERSATIONS WITH… A Mental Health Expert

A medical practitioner who works with children and adults opens up about his vocation and offers insights on mental illness.

Kids-CONVERSATIONS-WITH...-A-Psychiatrist-1
Not only can mental illness be deadly, this condition affects people of different ages — even kids.

Here’s a sobering fact: As many as one in 15 people will be affected by mental illness in their lifetime, says Dr Lim Boon Leng, 42, a psychiatrist at Dr BL Lim Centre for Psychological Wellness, His patients range from children to the elderly.

A psychiatrist in private practice at Gleneagles Medical Centre, a third of Dr Lim’s patients are kids aged 6 to 18. Conditions he treats in youths range from Attention Deficit Hyperactivity Disorder (ADHD) and anxiety disorders to depression and more.

Noting that his young patients visit him for many issues — from a fear of ghosts to a teen lost in love, he explains, “As I may be their first point of contact, my duty is first to determine if they are suffering from a psychiatric disorder and to make a diagnosis”. He hastens to add, however, that what his youthful patients often actually need is to see a counsellor.

All parents want the best for their children, but it can be difficult to cotton on that your offspring is struggling and needs professional help, especially if they don’t share all of their emotions with you. Dr Lim, who has been practising for 16 years, says that it is important for you to check on your child’s well-being from time to time.

Be vigilant, he advises, to signs that your child is behaving strangely. For instance, if your mini-me’s temperament, behaviour or personality changes, this is a sign that something may be wrong. He adds, “Dangerous behaviour like self-harm, expressions of [wanting to commit] suicide, alcohol and drug abuse, and irrational aggression are all strong red flags.”

Dangerous behaviour like self-harm, expressions of [wanting to commit] suicide, alcohol and drug abuse, and irrational aggression are all strong red flags.”

Acknowledging that the number of patients he is treating has risen over the years, Dr Lim notes that this is due in part to better awareness of mental health illness. He stresses, “Early treatment may prevent chronic mental illness and lead to better outcomes, but many people still refuse to seek treatment as they are worried about the stigma of mental illness… Decreasing the fear of stigma is crucial to decreasing the fear of seeking treatment.”

However, if you’re unsure if you or your child needs treatment, he has this advice, “If your ability to function at work or in school and in a social situation is adversely affected, you should seek professional help.”

We also asked Dr Lim how he refrains from taking his problems home to his two children, age 9 and 13. He explains that many years of training has helped him to compartmentalise his personal life from his professional one. Peer support is important, too, to “keep our own emotions in check”.

He adds, “I see it also as wearing different hats and having very different distinct roles in different situations. When I am at home, I’m a father, husband and son, and I leave my hat as a psychiatrist in the clinic.”

SmartParents sits down with Dr Lim for a heart-to-heart about his experiences as a psychiatrist, as well as the issues affecting kids in this (digital) day and age.

Dr Lim, why did you decide to become a psychiatrist?
The human psyche and human mind have always been of interest to me. I wanted to become a psychiatrist during junior college... More importantly, I discovered after graduating from medical school that hanging the stethoscope around my neck the whole day gave me a bad neck ache and, as a psychiatrist, I did not have to do that [chuckles]!

What misconceptions do people have about mental illness?
Many. People believe that patients with mental illness are dangerous. Many think that having a mental illness means that they are crazy. They think that once they have been started on medication, they will get addicted and have to be on them forever.


Kids-CONVERSATIONS-WITH...-A-Psychiatrist-2

Is there a condition you’re treating a lot of young patients for currently?
Yes, ADHD.

Any reason for this?
I think mainly due to the increase in recognition of the condition. Also, it’s hard for parents to ignore it, given that the child's results are adversely affected, and we are an extremely kiasu, competitive and academically-focused society.

Recently, the World Health Organization classified gaming addiction as a mental health condition — are you treating kids for this?
Parents do complain that their children are addicted to gaming. Many are not truly addicted but may have some difficulties with their over-usage. However, there are patients with very severe gaming addiction, to the point where they do not leave their room, refuse to go to school and are gaming all the time.

Why do more males get addicted to gaming?
At present, most are males ― I have yet to see a female gaming addict. Gaming historically has been more male dominated. I suppose the earliest game developers were males and games they created were therefore male-orientated. Also, the more a game provides random positive reinforcements and rewards, the more addictive it becomes. At present, these games still mostly male-themed (that is, tower defence-type and first person shooter games) and attracts mostly male players.

This may change with time with more females going into serious gaming and also working in the gaming industry.

“We may not be able to cure mental illnesses, but we can often bring about comfort and relief.”

What is the saddest story you’ve encountered?
I saw a lady who was suffering from schizophrenia and had made a few home visits to see her. She had a son in Primary school I came to know during these visits who was a hardworking and bright child. Her husband was really proud of the boy.

Many years later, after having left the hospital, I bumped into her husband. He told me that his son, the cheerful and bright boy I knew, had also developed schizophrenia and could no longer go on with his studies.

And the most memorable patient?
Many years ago, I saw a patient with a severe mental illness who had not worked for decades since leaving school and relied almost completely on his brother. One time, we made a minor change to his medication and somehow after this, things seemed to click together! He started having much more motivation, started rehabilitation and is able now to make a living and to live independently!

Can you elaborate on your biggest success story?
My biggest success is in seeing one patient recover after many years of treatment. After having seen very little improvement in the first year, the patient was ready to give up but the decision to plough on with treatment did eventually pay off. The lesson learnt is to never give up and to persist!

What is your advice to those who fear getting professional help as it might affect their ability to get a job?

Patient confidentiality is of paramount importance to us. Also, if left untreated, the mental illness itself may cause the individual not to be able to work, or to behave strangely at the workplace, resulting in worse stigmatisation.

Any pet peeves about your patients?
I do get annoyed when loved ones and friends, sometimes frivolously, discourage patients from seeking or to continue with their treatment. While I can understand that they are well meaning, it can sometimes lead to the worsening of symptoms and even severe consequences, like suicide.

The most rewarding part of your job?
Seeing patients feel better, of course! We may not be able to cure mental illnesses, but we can often bring about comfort and relief.


Kids-CONVERSATIONS-WITH...-A-Psychiatrist-3
Can parents protect their offspring in a world where digital devices and social media rule?

This is a real headache and there are no universal answers. I’m afraid we have reached the tipping point where most kids of this generation are too entrenched in digital devices and social media. Parents have to grapple with the balance between having digitally savvy children versus preventing them from developing pathological use.

Many people say this “strawberry generation” of kids are very spoilt. Any advice for parents on raising strong and resilient kids?
Parents can help by managing their own anxiety towards their children. Allow them to have minor failures or falls in their life. Give them freedom (as appropriate to their age) to explore the world around them. Teach them delayed gratification and to persevere in their endeavours. Teach by first being a good role model.

What do you think is the leading cause of the many cases of depression, self-harm and suicide among teenagers?
There really isn’t a single cause that can explain depression, self-harm and suicide. For suicide, I see it as a Swiss cheese model where the random holes — factors for depression align, resulting in a tragic outcome.

“We should also not romanticise mental illness… I wish that society… understands that mental illnesses are no different from medical illnesses. Get treatment, get well, and move on with life.”

It’s said that “We’re all crazy, some of us are just better at hiding it than others”. Anything changes you hope to see in our society?
We can afford to be more tolerant as a society. This pertains not only to mental illness but also all other issues regarding prejudice and discrimination like racism and ageism.

On the other hand, we should also not romanticise mental illness. I wish that society is pragmatic and understands that mental illnesses are no different from medical illnesses. Get treatment, get well, and move on with life.

How do you unwind in your downtime?
I have always been a couch potato! While I nag at my patients all the time to exercise, I don’t do so as much as I really should — exercising is a great way to unwind! #puttingonmypsychiatristhat

Please fill in the blanks:

* Mental health is… As important as physical health.

* A motto I live by is… Worry about tomorrow, tomorrow.

* A superpower I’d love to have is… To stop time — there is never enough to go around.

* Something I always want to tell all my patients is… Please don’t ask for “lunch time” appointments — psychiatrists eat lunch, too.

* My go-to comfort food is… Bak chor mee.

* My last holiday was… In June in Bangkok.

* If I weren’t a psychiatrist, I would be a… A shopkeeper ― sitting and observing people and time go by seems quite appealing to me!

Photos: Dr Lim Boon Leng & iStock

Like us on Facebook and check SmartParents regularly for the latest reads!

Check out these stories, too…

9 qualities of a “mean” mum

At what age should junior get a mobile phone?

Celeb kids Chen Yi Xi and Yi Xin: We used to hide the cane from our mum!