Being Better, Living Better: Is Living in the City Affecting Your Mental Health?

Sam is in a rut. She moved from her hometown of Kampar to Kuala Lumpur shortly after graduation, seeking better opportunities. After hitting the five-year mark at her job as an auditor, she feels like she has hit a dead end. Every day, she feels overwhelmed by the increasing amount of work assigned to her. This causes her to experience intense and crippling moments of fear and anxiety, making it hard for her to concentrate on a task.

She used look forward to unwinding in the evening with friends or a session at the gym but no longer finds pleasure in either. More often than not, she can be seen working through her lunch hour with no appetite to eat. Unknown to her, Sam may be experiencing some form of mental distress.

With a growing rural displacement and addition of new urban residents each year, could rapid urbanisation be a cause for the uptick in mental health issues Malaysians are facing?

Back in the 1900s, only 14% of the world’s population lived in urban areas. Since then, almost all of the labour work in agriculture was made obsolete by the invention of machines. New jobs were created along with the rise of the industrial revolution, providing a stable income and economic growth. As a result, more and more places of living were urbanised, nearly equalising the split of the urban and rural population.

There is no doubt that urbanisation has changed the way we work, providing more job opportunities versus a rural area. It changes the way we live and commute, with better and more connected roads and public transportation system. It changes the way we think and deal with life too, whether we know it or not.

Come 2020, it is expected that mental illness will be one of the major health concerns affecting Malaysians. A significant number of Malaysians are under some form of psychological distress, and some perhaps without knowing it. As recently as 2008, almost 400,000 Malaysians sought for help with mental health issues, with perhaps more undetected by undocumented cases. The failure to address the issue when first detected could lead to worsening conditions for the individual and the society.

What was meant to improve the quality of our life could now possibly be damaging it. How do we make sure that we are in control of our urban lives, rather than let urban living rule us?

Studies show that city dwellers are more sensitive to stress than rural residents, and are more likely to experience serious mood disorders. Depression is a common but serious mood disorder that affects the way you think and feel, and may affect the way you approach day-to-day activities like work. Almost half of the people who experience symptoms of depression are not diagnosed and are not receiving treatment for it. It is most commonly exhibited by these symptoms:

• Loss of interest in enjoyable activities
• Overeating or loss of appetite
• Persistent hopelessness or negative emotions
• Restlessness or irritability 

It is normal to experience moments of anxiety on an occasional basis, especially during moments of distress. Among others, anxiety usually manifests itself in feelings of:

• Nervousness
• Restlessness
• A rapid heart rate
• Difficulty to focus
• Digestive discomforts like gas, constipation or diarrhoea

However, when the feelings and reactions become irrational or excessive, it could escalate into an anxiety attack (also known as a panic attack). When anxiety grows from a temporary feeling of fear into a regular occurrence that affects your daily life, it becomes a disorder. An anxiety disorder affects how a person makes decisions, possibly damaging their performance at school, work or personal relationships.

Schizophrenia is a chronic and severe mental illness that affects how a person thinks, feels and behaves. People with schizophrenia may seem like they have lost touch with reality, experiencing hallucinations, delusions and negative symptoms such as emotional flatness or apathy. Although it is not as common as other mental disorders, the symptoms can be very disabling and may lead to unwanted thoughts of self-destruction. It is also on the rise in Malaysia, with one out of 100 Malaysians diagnosed with schizophrenia and 2,000 new cases reported yearly.

Does living in the city increase our risk for mental health issues? Dr. Derek Yach of the Vitality Group answers:

Are we creating opportunities for mental health issues to take root in our lives by living in the city? No, it’s the exact opposite – city living enables us to easily identify and appropriately treat mental health issues.

We should also be promoting mental health in the workplace. Ideally, the workplace should be like an urban safe space to talk about mental health. There are enormous gains in economic and social welfare when this is taken into consideration.

It’s also important to not underestimate the power of mobile in treating and preventing mental health issues. Overseas, tele-help services have been proven to be a low-cost and effective way of managing health issues. After all, mobile technology is already being used to monitor and treat physical health ailments like high blood pressure and diabetes.

Is all the stress we are experiencing bad for us? Dr. Toh Chin Lee, Head of Psychiatry Services at Ministry of Health Malaysia shares his thoughts:

Human beings are very adaptable beings. We’re triggered to stress by external conditions beyond our control, but stress is not necessarily a bad thing. It’s wrong to think of stress as only bad. We only have to learn how to manage it. The solution to managing stress involves many aspects beyond psychiatry – even sociology plays an important part. It’s good to practice healthy lifestyles and have healthy coping mechanisms for stress.

How then do we manage stress and stressors? Consultant Psychiatrist and Addiction Psychiatrist Dr. Philip George of The Mind Faculty answers:

A person’s physical health is connected to their mental health, and vice versa. Hence, the road towards mental wellbeing is ideally a combination of solutions; bio-psycho-social interventions.

Dr. Abdul Kadir Abu Bakar of the Malaysian Psychiatric Association offers some insight on how to have healthy minds in the city.

Malaysia is seeing a changing landscape. Where before 1996, most of the country’s population lived in rural areas, today, almost 60% of Malaysian live in urban areas. The World Health Organization has recognized happiness as a component of health. There are a few things we can do to be happy: Go and pursue happy moments. Do things you enjoy doing, find a meaningful activity to partake in, and nurture good relationships with others.

Hamdan Abdul Majeed of Think City adds:

Living in the city actually provides a framework for human connections. It is an ideal place for an exchange of goods, ideas and relationships. We must do our part to be happy as city residents – by taking ownership of our own cities.

Now that we are made aware of the dark side of the happiness pursuit, it is more important more than ever to find light in the journey and take the first step towards being better. Managing your mental health is not just realignment of your thought process alone, it is a wholesome balance involving body and soul wellness too. Here are 10 simple ways to get started on your journey to #BeBetter.