You are Not Alone: The Role of Social Support in Mental Health Recovery

The road to mental health recovery is not an easy one. However, having the right support around you can help ease the burden.  

Social support refers to the network of people including your family, friends and community members who you can rely on during challenging times. Humans are social creatures, and we need to feel a sense of safety and belonging to live a fulfilling life. In fact, social support is strongly linked to our happiness levels and can even increase our life expectancy by 45%. This reflects how powerful social support is in our mental health journey.  

So, what is Social Support? 

Social support can come in many shapes and forms but at its core, it is the idea of “community”. You may choose to rely on your friends and family, or even support groups in the community you live in. Social support encompasses various forms:  

1. Emotional Support – Offering understanding, validation and reassurance to alleviate feelings of isolation and loneliness (e.g. hugs, active listening) 

2. Instrumental Support – Being physically available to help them with practical tasks and responsibilities (e.g. doing housework, delivering meals, running errands) 

3. Informational Support – Providing guidance in the form of advice or insights to help the individual make informed decisions when navigating challenges (e.g. legal, medical, financial advice) 

4. Appraisal Support – Building up the individual's self-esteem or confidence through encouragements and positive framing (e.g. pointing out the individual's strengths) 

Each type of social support enhances mental health recovery and acts as a protective factor, preventing further declines in your mental well-being. In the 2016 Singapore Mental Health Study, individuals with a strong social support system had better mental health outcomes. Being surrounded by people who love and care for you can build your mental resilience, drastically improving your mental well-being.  

Challenges in Accessing Social Support 

Despite the growing awareness of mental health, many individuals in Singapore still lack adequate social support. This is partially because symptoms of anxiety and depression can cause people to withdraw from social circles, making it harder for them to engage with social support. Furthermore, many do not seek support due to fear of judgment, rejection or simply a lack of awareness about available resources. These barriers, fueled by the persistent stigma around mental health, prevents individuals from receiving the support they need. Addressing these challenges is essential to building a more mentally resilient and supportive society.  

Take a moment to reflect on your social support system. Ask yourself: 

• Who is trustable that I can turn to for emotional support? Do I feel comfortable opening up to them? 

• Are there any relationships in my life that make me feel drained or unsupported? 

• How can I be a better source of support for others in my life? When others share their troubles with me, do I make a conscious effort to create a meaningful connection with them? 

Social support is a fundamental stepping stone to recovering from a mental health challenge. It fosters a sense of belonging, safety and validation, empowering the individual on their journey of mental health recovery. While social support has profound benefits, it is often insufficient in dealing with mental health challenges. When dealing with a mental health disorder, it is crucial to seek advice from a mental health professional. With social support alongside professional help, you can be empowered to manage mental health challenges in a healthy and effective way. 

Women’s Emotional Concerns

This is an overgeneralisation to say the least. How emotional “should” we really be?  

In the 19th century, doctors removed uteruses to treat “hysteria”, a so-called “female-problem.” But, surprise! Here in the 21st century, we have found out that men are just as emotional as women: in fact, men and women experience similar emotional fluctuations.  

Society tends to be more accepting of women expressing emotions compared to men. As a result of these gender norms, women may have more opportunities to develop emotional awareness through lived experiences.  

With multiple roles and identities in our daily lives, women are often weighed against the expectations of culture and society. As a result, we experience a whole range of emotions, which sometimes become too much to manage. When we feel like we’re losing control, we may start to experience emotional distress.  

What emotional challenges are commonly experienced by women?  

Ψ Biological 

There are many biological reasons we feel heightened emotions. Most of them relate to hormonal changes that occur in different stages of our lives. Since puberty, we experience the menstrual cycle. It prepares our bodies for pregnancy, and eventually ends with menopause. 

The key “female hormones”, oestrogen and progesterone, ebb and flow according to these processes. Associated with other hormones like cortisol and adrenaline (the stress hormones), they cause us to feel changes in energy and mood. 

In addition to mood changes, we often endure pain and discomfort from these biological processes. Balancing these with our roles and responsibilities can make coping challenging. 

Ψ Psychosocial 

You are a woman: a daughter, a mother, a wife, an employee, a caregiver...  

Women often find ourselves juggling multiple roles.  

Juggling these roles can become a major source of stress for women, since it involves managing relationships. How do we meet both society’s expectations and our own for every role we play?  

How we cope with these challenges depend on our personality traits and experiences, which influences our emotional responses. When we struggle to cope, we could experience burnout or overwhelm. This puts us at an increased risk of mental health conditions depression and anxiety. 

Here are some examples of psychosocial stressors women face: 

• Reproductive and sexual health 

• Work-life balance 

• Gender discrimination 

• Body image and self-esteem issues 

• Relationship issues (parenting, partners and family dynamics) 

• Mental health conditions 

Coping with women’s emotional concerns 

There are many ways we can explore our emotions and the concerns that come along with them. Consider giving some of these strategies a try! 

• Build self-esteem through Positive Self-Talk 

• Try Stress Management Strategies 

• Practice self-care through Mindfulness  

Feeling lost? Let us assure you: you’re not alone. The empathy we women can provide each other with can create a safe and supportive community for us to lean on. By showing our compassion and harnessing our unique strengths, we can navigate challenging emotional concerns. 

For specialised help, contact our experienced Women’s Health Psychologists. We are ready to support you through the exciting journey of womanhood.  

Disordered Eating

An “eating disorder” is a clinical diagnosis, with specific criteria for conditions like anorexia or bulimia. On the other hand, “disordered eating” refers to unhealthy eating behaviours or patterns that don’t meet the full criteria for an eating disorder. 

Someone with disordered eating may not have an eating disorder, but people with eating disorders often exhibit disordered eating behaviours. Disordered eating is quite common and can often go unnoticed, as it may show up in small actions you might do daily without realising.  

How do I know if I have a disordered eating and not an eating disorder? 

Disordered eating can fly under the radar because its signs are usually more subtle. In contrast, eating disorders are generally more severe and easier to spot. For more information, read more about eating disorders here. 

But when it comes to disordered eating, here are a few behaviours to take note of: 

• Eating when stressed or for comfort 

• Eating when not hungry or not for nourishment 

• Following restrictive diets 

• Fasting for extended periods (more than 24 hours) 

• Regularly skipping meals 

• Episodes of binge eating 

• Using diet pills to control weight 

• Misusing diuretics, laxatives, or enemas 

• Feeling guilty after eating or for eating certain foods 

If any of these sound familiar, it may be time to reflect on our relationship with food.  

Disordered Eating vs Eating Disorder: A Summary 

Here’s a short summary of the differences between disordered eating and eating disorders: 

There is no single, perfect guideline on what constitutes “normal eating”. Each of our bodies is different, and healthy eating is about nourishing our body in a balanced and flexible way. Not overly restrictive, preoccupied, or obsessed (binging, excessive calorie counting). Eat when hungry and stop when satiated. Whether it’s 3 regular meals a day, or smaller portions but more frequent, our food intake should have all the necessary nutrients our body needs. 

Disordered Eating and Mental Health: The Connection 

While disordered eating might seem less severe than an eating disorder, it can still impact both physical and mental health over time. Disordered eating often stems from emotional reasons, particularly to cope with distress. This distress may come from feeling heightened stress in our lives, or anxiety about our weight, health or appearance. 

For example, finding ourselves rummaging through the office pantry right after lunch because we’re feeling stressed or skipping dinner because we’re already full from snacks, telling ourselves, "I need to lose weight.”  

Soon after, feelings of regret and guilt may arise, whether from eating or restricting food. This can lead to anxiety, low self-esteem, or feeling unsatiated, prompting behaviours like skipping meals or overeating. This cycle of stress, eating, guilt, and restriction can create a pattern that’s hard to break. 

If you notice these signs, it might be time to check in on your emotional needs.  

Okay, I think... I might have it. So, what should I do now to stop it? 

The key is to start from within. Addressing disordered eating isn't just about changing eating habits – it's also about understanding the emotional and mental factors that drive these behaviours. Here are some steps you can take: 

1. Gather knowledge and check in with yourself often  

Start by learning the signs of disordered eating and eating disorders, just like you’re doing now! Recognising these patterns early can help you catch them before they become more ingrained.   

Mindfulness plays a big role here. Stay grounded and present and be aware of your emotions and physical cues. Eat when you’re hungry and try to differentiate between physical hunger and emotional hunger.   

2. Try alternative coping mechanisms 

If you’re using food to deal with emotions like stress or sadness, or even binge eating when you’re feeling happy, try adopting healthier ways to manage your emotions and eating, such as: 

• Exercise: Physical activity can help relieve stress and improve mood. 

• Creative hobbies: Engage in activities like painting, writing, or crafting to channel your emotions in a productive way. 

• Heathy snacks: Opt for nutritious options like fruits.  

3. Avoid fad diets 

Fad diets often promise quick results but can harm your body and disrupt healthy eating habits. Focused on balanced, long-term changes (choosing healthier options, or preparing your own meals) instead of drastic restrictions that can lead to disordered eating behaviours. 

4. Self-positive encouragement 

Celebrate small victories! Even the tiniest steps toward healthier behaviours deserve recognition. Use positive self-talk to motivate yourself. You could say things like: 

• “Good job to me! I didn’t overeat, even though I loved the food!” 

• “I made it! I didn’t skip any meals this week!” 

Sometimes, enjoying a good meal can be a form of celebration – just remember to enjoy it in the right portion and be aware of when you feel satiated.  

What is the right portion? 

There’s a Chinese saying, “qi (7) fen bao, gang gang hao,” which means “eat until you’re 70% full.” This could be the balanced portion your body needs.

5. Set realistic goals 

Don’t expect to change everything overnight. Set achievable, small goals that focus on improving your relationship with food and your body. This could be as simple as: 

• Eating 3 regular meals per day 

• Reducing emotional eating from 5 times a week to 3 times 

Lastly, if you’re struggling to manage disordered eating on your own, reaching out for professional support is a great next step. Therapists, dietitians, or counsellors specialising in eating behaviours can guide you toward healthier coping strategies and a balanced relationship with food. 

Highly Sensitive Persons (HSPs): Understanding and Thriving with Sensitivity

In today’s modern society, we recognise that being highly sensitive is not a weakness but a unique strength. If you’ve ever been told you’re "too sensitive" or find yourself overwhelmed in certain situations, you might identify as a Highly Sensitive Person (HSP). In this article, we’ll explore the traits, challenges, and strengths of HSPs, along with practical strategies and how therapy can help. 

If you’re looking to understand high sensitivity and how it relates to mental health, emotional well-being, and stress management, you’re in the right place.  

What Is a Highly Sensitive Person (HSP)?

A Highly Sensitive Person is someone who experiences heightened sensitivity to physical, emotional, and social stimuli. It’s not classified as a mental disorder but a personality trait that shapes how individuals process their experiences.

This personality trait, known as Sensory Processing Sensitivity (SPS), was first described by Dr. Elaine Aron. It is thought that around 15-20% of the population are HSPs.

Traits of Highly Sensitive Persons (HSPs)

HSPs have unique qualities that distinguish them:

• Deep Emotional Processing: HSPs think and feel deeply about their life experiences.

• Heightened Empathy: They often pick up on the emotions of others with great accuracy.

• Awareness of Subtleties: HSPs notice small details in their surroundings.

• Overstimulation: They can feel overwhelmed in loud, crowded, or chaotic environments.

These traits often overlap with topics like emotional sensitivity in relationships, managing overwhelm, and mental health coping strategies. 

Strengths of Being Highly Sensitive

Sensitivity can be a powerful asset. HSPs often excel in: 

• Creative Expression: Many HSPs are highly artistic and innovative. 

• Emotional Intelligence: Their empathy helps them build meaningful relationships. 

• Attention to Detail: Their awareness of subtleties makes them exceptional problem-solvers. 

• Connection with Nature: HSPs often find peace and inspiration in natural settings. 

What Challenges do Highly Sensitive Persons Face?

Highly Sensitive Persons face unique challenges due to their heightened sensitivity to a combination of emotional, physical, and social stimuli. They often experience overstimulation in chaotic or noisy environments, emotional exhaustion from deeply processing their own and others’ feelings, and sensitivity to criticism, which can impact self-esteem. HSPs may struggle with setting boundaries, avoiding conflict, and balancing their need for rest with social obligations, leaving them prone to stress, burnout, or anxiety. They are also more likely to feel misunderstood or invalidated in a world that often prioritises resilience over sensitivity.

• Overstimulation and Burnout: Crowded spaces or busy environments can be draining.

• Difficulty Setting Boundaries: Many HSPs struggle to say no, leading to exhaustion.

• Sensitivity to Criticism: HSPs can feel deeply hurt by negative feedback.

• Stress and Anxiety: Their heightened emotional reactivity makes them more vulnerable to stress.

Misconceptions About HSPs

Sensitivity is often misunderstood, and it’s important to address some of the common misconceptions surrounding Highly Sensitive Persons (HSPs). First, sensitivity does not equate to weakness; it is a natural personality trait that can be a source of great strength when understood and embraced. Additionally, not all HSPs are shy. In fact, research suggests that approximately 30% of HSPs are extroverted.

Lastly, high sensitivity is not a mental health disorder but rather a distinct personality trait that shapes how individuals process the world around them. Recognising these distinctions is essential for promoting mental health education and fostering greater self-awareness, empowering HSPs to embrace their unique characteristics.

How Highly Sensitive Persons Can Thrive

With the right strategies, HSPs can live fulfilling and enriching lives. Consider:

• Self-Care Practices: Create downtime for recharging, practice mindfulness, and design a sensory-friendly space.

• Healthy Boundaries: Learn to say no without guilt and prioritise your needs.

• Stress Reduction Techniques: Engage in calming activities like yoga, meditation, or time in nature.

• Supportive Relationships: Surround yourself with people who respect your sensitivity.

How Therapy Supports Highly Sensitive Persons

If you feel that you have traits of sensitivity that are affecting your daily life, you may want to consider seeking professional help. Psychologists can help HSPs explore their sensitivities and build resilience. Our services include:

• Cognitive Behavioral Therapy (CBT): Manage overwhelming thoughts and emotions effectively.

• Emotion Regulation Therapy: Develop tools to handle intense feelings.

• Assertiveness Training: Build confidence in setting boundaries.

• Psychoeducation: Understand your sensitivity and how to leverage it as a strength.

Supporting Highly Sensitive Children

Children can also be highly sensitive.

As parents, it is important to understand our child’s unique temperament and how to nurture them. Highly sensitive children thrive in environments that are safe, structured and predictable. Encouraging verbal and emotional expressions is another powerful way to support their development, as it allows them to communicate their needs in a meaningful and non-destructive or oppositional manner. Equally important is ensuring that we provide ample opportunity for rest and quiet time to recover from overstimulation.

These strategies form the foundation for effective parenting approaches for sensitive children and can be complemented by child therapy to enhance emotional regulation and resilience.

Celebrating Sensitivity 

At Annabelle Psychology, we believe sensitivity is a gift that enhances your ability to connect, create, and contribute meaningfully to the world. By embracing your sensitivity, you can unlock your full potential. Whether you’re navigating the challenges of high sensitivity or seeking guidance to thrive, our team is here to help. 

Self-Regulation for Different Attachment Styles

It's common to hear people attributing their struggles with relationships to attachment styles developed in childhood. However, despite its influence on relationship formation in adulthood, attachment style is not a fixed trait. This means that someone who developed attachment style A in early childhood could possibly grow up to have style B in adulthood. 

Type of Attachment Styles

Researchers in this area generally agree that they are 4 attachment styles in the adult context.

Secure Attachment 

• Individuals with a secure attachment style are able to form stable and close relationships with others. They are also able to maintain a good balance between being independent and showing dependency on another person. 

Avoidant Attachment 

• Individuals with this attachment style may seem detached or uninterested in forming close relationships. They display a strong sense of independence.  

Anxious Attachment 

• In contrast to individuals with an avoidant attachment style, those with an anxious attachment style often display a strong sense of dependency in a relationship. They usually crave intimacy and might appear demanding. 

Disorganised Attachment 

• This is a combination of both avoidant and anxious attachment styles. Individuals with a disorganised attachment style often experience a conflict between the desire for intimacy and the fear of intimacy. They might appear to be unstable and unpredictable in a relationship. 

How to Self-Regulate for Each Attachment Style 

Secure Attachment 

• Individuals with a secure attachment style usually find it easy to regulate themselves, but during times of vulnerability, kindly refer to the tips suggested for other attachment styles and give them a try.  

Avoidant Attachment 

Ψ Challenging Your Thoughts 

• "I shouldn't get too close to him; he will soon leave me" might be an example of a thought that people with an avoidant attachment style usually encounter. Whenever this happens, identify the thought, acknowledge it, and then try to challenge it. Look for evidence that suggests otherwise. For example, find instances where someone actually stayed with you and supported you when you needed them. If you find it challenging to do this virtually in your mind, you can try writing them down in your journal and keep track of how accurate or inaccurate those thoughts are. 

Ψ Gradual Exposure 

• Repression of emotions is one common reaction for individuals with an avoidant attachment style. They often find it uncomfortable to open up to others. One way to manage this is by taking one small step at a time. For instance, start by sharing something that is less emotionally intense or something you are relatively more comfortable sharing. 

• Apart from the emotional intensity, who you are sharing with is important as well. Reach out to someone you are more comfortable talking to, and consider sharing with them what you are expecting (e.g., just a listening ear or looking for suggestions) from the conversation. 

Ψ Communicate Openly 

• When you feel the need to take a break and have your personal space, communicate that openly. Let others know that you need to take a breather, and you will come back and talk about it when you are feeling better.  

Anxious Attachment 

Ψ Mindfulness Practice 

• The first step in self-regulation is recognising and identifying one's anxious thoughts. Mindfulness practice could be useful in this case, as constant mindfulness practice has been found to increase one's awareness of the self, the surroundings, and the present moment. 

• There are various mindfulness techniques available, and one simple technique that we are sharing here today is the “hand exercise”.  

  • Keep your palm at a comfortable distance from your face. In the next few minutes, try observing your hand as if you were an astronaut that just landed on a new planet.  

  • Notice the outline of the hand, the creases in your skin, your fingerprints, the lines that cut across your palm. 

  • Now, flip your hand over. Notice any scars or calluses. Notice how your knuckle turns white when you make a fist.  

  • Notice any judgements or thoughts you’re having. Simply acknowledge them as you bring your attention back to what’s physically in front of you. 

Ψ Reframing Your Thoughts 

• This is similar to challenging thoughts mentioned above, with one additional element, which is to “reframe” your thinking. For instance, when you notice the thought, “She’s not replying to my message; she must hate me”, how can it be reframed? 

  • “She’s not replying to my message; she might be in the middle of a meeting”. 

  • “She’s not replying to my message; she might be driving”. 

  • “She’s not replying to my message; she might be resting and taking a break from her phone”.  

  • “She’s not replying to my message; it’s okay, she will reply when she wants to”.  

    These are some possible alternatives, and you can always come up with your own ones. The idea is to redirect or reframe our negative automatic thoughts, telling our minds that we don't know for sure that what's in our minds is absolutely right; we would like to consider other possible alternatives as well. 

Disorganised Attachment 

Individuals with a disorganised attachment style experience both avoidant and anxious thoughts. Practising a combination of different mentioned above could be helpful.  

Understanding your attachment style is the first step towards building healthier relationships and improving your emotional well-being. While these patterns may have been shaped during childhood, they are not set in stone. With self-awareness and consistent effort, we can shift towards a more secure attachment style and develop stronger, more fulfilling connections with others. 

Why Someone Rubs You the Wrong Way

This person could be a colleague, a friend, a neighbour, or even a family member. There is always something about them, whether it's the way they speak, behave, or simply their mere presence, that makes you feel irritable.

But why is this the case? 

Different Values 

Values drive our actions, perceptions, and essentially every aspect of our lives. When two people with different values, or even opposing values, come together, clashes and conflicts can become inevitable. We must invest extra effort in regulating our emotions and managing our expectations in such situations. However, as time passes, it may become increasingly challenging to tolerate these differences. For example, consider someone who highly values punctuality meeting with someone who has a more relaxed approach to time. Being late once might be tolerable, but a consistent pattern of lateness can gradually wear down the person who values punctuality, making them increasingly irritable over time. 

Different Personality 

Apart from values, personality is another factor that might play a role here. Introverts and extroverts are probably two of the most common personalities known. Introverts are those who prefer solitary and low-stimulation environments, while extroverts are those who prefer social interaction and enjoy external stimuli. When people with these two different personalities meet, clashes could potentially happen. On one hand, introverts may feel overwhelmed by extroverts' social demands, and on the other hand, extroverts may feel that introverts are aloof or uninterested. 

Past Experiences 

Our life experiences shape our perceptions. If we've had a bad experience with an insurance agent, it's possible that when we encounter another insurance agent in the future, we might already have a negative impression of them before knowing much about them. When we meet someone who shares similar characteristics with those whom we had unpleasant experiences with in the past, they can easily rub us the wrong way even without doing anything. 

Conflicting Goals 

One simple example to illustrate this is by looking at football fans. I believe most of us have come across news where rival football fans were fighting or involved in violent clashes. Two different groups of individuals with different goals. When this occurs, or in cases where someone obstructs us from achieving our goals, it is natural for us to view them as enemies. 

There are various reasons that could contribute to why someone rubs us the wrong way, but there is probably one simple antidote to it, which is by being mindful. Being mindful of how our behaviours or perceptions are affected by our values, personalities, experiences, and goals allows us to be aware of our thinking and behaviour and gain better control of our actions.  

I've been called manipulative, what should i do?

We may even have heard that people with borderline personality disorder (BPD) are manipulative and worry if we may have the same disorder too. So, what should we do to check? 

Reflect 

Firstly, let us take a moment to reflect on these questions: 

Have others called me “manipulative”? 

What constitutes an acceptable behaviour can vary between individuals and cultures. If only one person labelled us as such, perhaps our personalities simply do not match. However, when many people think of us as manipulative, it may be beneficial to consider the next few questions. 

What did I feel while carrying out the acts? 

“Manipulation” may draw to mind a calm and collected con artist. If we enjoy lording over others, we may even feel exhilaration! On the other hand, individuals with BPD experience feelings of desperation! They engage in such behaviours as they are terrified of being abandoned and need the consistent reassurance or validation. 

What was I hoping to achieve through my actions? 

Unlike notions of manipulation where we are trying to gain something at the expense of someone else, individuals with BPD have different aims! Granted, individuals with BPD may sound manipulative with requests like “If you love me, help me do…” or “Do …, otherwise I will hurt myself”. However, their intention isn’t to inflict harm or dominate the other person. Instead, it is usually done to seek emotional comfort and reassurance that they are cherished and not about to be abandoned. 

After having pondered these questions and if it seems that we are similar to a person with BPD, let us move on to the next step to further explore if we may have BPD. 

Consult the family 

BPD runs in the family, with studies estimating that having a parent, sibling or child with BPD puts us at a 5 times greater risk of developing it ourselves. Checking in with our loved ones to see if there are any relatives within the family with BPD may help confirm or allay our worries. 

Seek professional opinion 

Lastly, the sure-fire way to check if we may have BPD would be to seek out a mental health professional. With their expertise and more in-depth assessment tools, they are more likely to provide you with an accurate assessment. 

Written by Yi Ling and our Associate Psychologist