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Commentary: We still fail to understand that some people are more prone to mental illness

Why so some people but not others contract mental illness? One Institute of Mental Health expert discusses triggers, stressors, traits and why our responses and recovery may vary.

SINGAPORE: Man is an amazing creature. We have engineered solutions to send us to the moon, explored the deepest depths of the ocean, and split the atom.

We have written music and produced art that stirs the soul. We have produced criminals and masterminds. 

But for all of mankind’s ingenuity to improve an understanding of the world, we retain a tendency to generalise and compartmentalise things.

There is an underlying assumption that we are all created equal. There is the underlying belief that we can deal with our body and mind separately with complete agency. This is not the case.

It is obvious that the mind and body work together. A clear example would be insomnia caused by mental stress. Overtime, sleep deprivation will wreak havoc on the body and lead to serious physical health problems.


The Human Genome Project (HGP) was an international, collaborative research programme created with the goal of complete mapping and understanding of all the genes of human beings.

The HGP has revealed that there are probably about 20,500 human genes, each gene contributing to the human makeup to a different degree. The cumulative effects of these genes result in who each of us are today.

Some of us will be better musicians or artists, some of us will be good at mathematics and some of us might even be able to better understand quantum mechanics. The variations and therefore the possibilities are endless.

ESA astronaut Tim Peake listens to a technician explaining details about the Eutelsat Quantum satellite, billed as the first commercial satellite to be fully configurable in orbit, at an Airbus Space and Defence facility in Portsmouth, southern England. (Photo: AFP/GLYN KIRK) ESA astronaut Tim Peake (L) listens to a technician in the cleanroom explaining details about the Eutelsat Quantum satellite, billed as the first commercial satellite to be fully configurable in orbit, at an Airbus Space and Defence facility in Portsmouth, southern En

This also means that some of us are more vulnerable to developing certain diseases. Examples of diseases with a strong genetic link include cystic fibrosis, haemophilia, sickle cell anaemia and Tay-Sachs disease (which is rare in the general population but relatively common in Ashkenazi Jews).

Other diseases may not have such a strong link, but do show some degree of genetic involvement. Mental illnesses fall within this category.

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Most major mental illnesses such as schizophrenia, bipolar disorder, depression and anxiety disorders have multiple causal factors. While there is a clear hereditary or genetic contribution, childhood factors, personality and environmental factors all play a part in the development of mental illnesses.

Mental illnesses can strike at any age. However, for most of them, there are peak age groups for the onset of the disease.

Schizophrenia, a major mental disorder in which a person would experience hallucinations and abnormal beliefs, commonly appears in early adulthood for males and slightly later for females.

Bipolar disorder, a mood disorder characterised by extreme mood swings, commonly appears in early adulthood to when someone is in their 30s. Both anxiety disorders and depressive disorders also tend to manifest in early adulthood.

Composite picture - bipolar disorder, an illness that has highs and lows.


As we go through life, we will face major events that can cause no small degree of stress. Exams are often cited as a common cause of stress for the young.

In young adults, having to face the final years of education, exploring relationships, dealing with new jobs, getting married, moving to a new home and starting a family are major life events that may have positive connotations but can be causes of stress nonetheless.

In the later years, dealing with family or the lack of, career and eventually retirement can be sources of stress as well. There are also upsetting events that can strike anyone at any time. Illness and the death of a loved one are good examples.

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Most of us will be able to navigate through life and cope with each event as it comes along.

However, when there is an existing genetic vulnerability coupled with other factors such as childhood abuse or trauma, the lack of social and family support or even several events happening at the same time can trigger a mental illness.

Once triggered, a delay in seeking treatment or incomplete treatment can increase difficulties and the risk of the illness relapsing. Unfortunately, it has been shown that with each relapse, the chances of recidivism also increase.

However, the converse can also happen. Despite having a genetic vulnerability or pre-disposition, changes in other factors can help prevent the development of a mental illness.

Having a healthy upbringing with positive childhood experiences, good family and social support, a healthy and balanced lifestyle, and matured ways of coping with stress can help build resilience and prevent the development of mental illnesses.

Indeed, this is why in twin studies, it is never a definitive chance that both identical twins will develop the same mental illness.

Twins born in San Diego, United States. (Photo: AP) Twins Jaelyn, left, and Luis Salgado were born just minutes apart, but in different years, at the San Diego Kaiser Permanente Zion Medical Center in San Diego. (Kaiser Permanente San Diego via AP)

Similarly, once having developed a mental illness, it is not just medication that makes a difference. Repeated studies have shown that early detection and proper treatment improves the long-term prognosis of the illness.

Beyond that, good physical and mental health promotes recovery and helps in prevention of future relapses.


We all go through mixed experiences. We all have different reactions to these experiences.

For some people, mental illness develops due to a combination of influences including genetics, childhood experiences and a host of other factors such as personality, the presence of other disorders, illnesses, drugs or alcohol misuse and the lack of a support structure.

Living well, leading a healthy lifestyle, having a good balance of rest, work, exercise and recreational time, having time for yourself, friends and family, having a faith and contributing to society in terms of helping others − all these, while small tasks in themselves, make a difference.

They help to build resilience and help us cope with the challenges of modern day life, in turn helping with the prevention and recovery of mental illness.

Much like exploring the deepest depths of the ocean, we are only at the tip of the iceberg when it comes to understanding mental illness.

There is much to learn but with increased awareness of what helps to prevent mental illness, we can do our best to support ourselves and others.

Dr Mok Yee Ming is senior consultant and chief, Department of Mood and Anxiety at the Institute of Mental Health.

Source: CNA/sl


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