Listen to #Hashtag Hong Kong every Sunday morning at 8.15
Focusing on issues affecting civil society, we'll hear from representatives of NGOs, associations, statutory bodies, and non-profit groups.
(Sundays 8.15am - 8.25am)
Good morning, welcome to #Hashtag Hong Kong. As a clinical psychologist at the Mental Health Association of Hong Kong - which is a non-profit association dedicated to mental health awareness and services - I would like to shine a spotlight on a condition that affects many but is often misunderstood: psychosis.
Let me start with a brief introduction about this condition. Psychosis is a mental health condition characterized by a disconnection from reality. People experiencing psychosis may have difficulty differentiating what is real from what is not real. This can manifest through symptoms such as hallucinations. For example, you are seeing things or hearing things that aren’t there, and delusions – you are having strong beliefs that are not based in reality.
According to global estimates, approximately 3 in 100 people will experience psychosis at some point in their lives. It can occur at any age but is most commonly diagnosed in late adolescence to early adulthood. While it’s less common than other mental health conditions such as depression and anxiety, psychoeducation about psychosis and early intervention are crucial.
In general, symptoms can be categorized into positive symptoms and negative symptoms. Positive symptoms happen when a person is experiencing additional things that are originally not there. For example like delusional thoughts like somebody is spying on me or you are the president of a country, or having different types of hallucinations that pertain to our senses like auditory, visual and tactile. Or you may have disorganized speech and abnormal motor behaviors such as agitated movements or repetitive actions. On the other hand, negative symptoms refer to the absence or reduction of normal behaviors. For example like having flat affect, limited facial expressions, limited speech, changes in mood, lack of motivation, or lack of desire to engage in social activities.
Treatment typically involves a combination of antipsychotic medications, psychotherapy, and also psychosocial support groups. Early intervention is key—it can significantly improve outcomes. Psychotherapy such as Cognitive-behavioral therapy or we call CBT tailored for psychosis can help individuals to manage symptoms and to develop coping strategies. Support groups and community resources also play a vital role in recovery. There are a lot support groups tailored for individuals struggling with psychosis to target social skills improvement, self-care skills and independent living skills. The goal is to help them in skills building to decrease the functional impairments caused by psychosis, and hence resume a normal life and integrate back to the society.
On a personal level, I’ll say it’s crucial for individuals to maintain a structured daily routine, and to stay connected with supportive friends and family, and also follow with your treatment plans including medications and psychotherapy. It’s also important to explore interests and activities that bring you joy and purpose and to stay engaged with people around you.
I once had a client who’s been struggling with psychosis for over 10 years that he would cover his left ear whenever he hears voices. With proper treatment and skills building, he’s able to differentiate reality with his auditory hallucinations, so that he’s not being responsive or reactive to the voices, even if the voices are still there with him. Once he has become more stable with his symptoms, we started taking him to do volunteer work in the community where he would help dispatching lunch boxes to the homeless population. That volunteer work gave him opportunities to reconnect to people, to the community and also built a sense of accomplishment in him. Ultimately he’s able to live a fulfilling life despite his diagnosis.
I want to emphasize that psychosis is a treatable condition. If you or someone you know is experiencing symptoms, seeking help early can make a significant difference. Recovery is a journey, increasing awareness and reducing stigma are important steps to make sure everybody gets the right support they need. Last but not least, remember your mental health is just as important as your physical health, and no one should face these challenges alone.
Thank you so much for tuning in today and hope together we can build a more informed and supportive community.
Hi everyone, my name is Steph, and I am the founder of Body Banter, a local charity that empowers young people to spark conversations about body image.
Weight loss advertisements lining the walls of our MTR stations, beauty pageants on prime-time television, and social media influencers promoting supposedly ‘painless’ dieting techniques. These messages teaching us to link our sense of self-worth to our physical appearance surround us at every turn in Hong Kong society. Yet, eating disorders and body image struggles remain taboo topics rarely discussed openly.
In my work at Body Banter, I am all too familiar with this silence. While there are no population-level studies on the prevalence of eating disorders and body image concerns among Hong Kong youth, evidence from smaller studies indicates significant food and body-related distress in our community. For instance, a study of 424 university students in 2021 demonstrated that 15% of women and 4.5% of men exhibited negative emotional eating, which refers to maladaptive eating behaviours in response to negative emotions.1 Another study conducted in 2022 of 316 Hong Kong adults revealed that over a quarter of sample participants showed signs of disordered eating, partly due to stressors from the COVID-19 pandemic.2 These smaller samples only capture a fraction of the broader situation, and the actual prevalence of eating disorders is likely underreported due to a lack of research on how these issues manifest in our cultural context. Consequently, eating disorders are often misdiagnosed or overlooked entirely.
While social media often takes significant blame for food and body-related struggles that youth face, I like to say that social media is often only a “loudspeaker” for deeper, underlying insecurities. I don’t think any of us are strangers to the fact that the teenage years are extremely turbulent times filled with changes in our physical, psychological, and social lives. For many young people, controlling their body image becomes a means of finding stability during these tumultuous times. By focusing mainly on seemingly controllable aspects of their lives, such as how much they are eating and exercising, they feel like they can shield themselves from more complex stressors, including academic pressures and family expectations. Research also tells us that in cultures like Hong Kong, where food plays a vital role in social relationships, changing eating behaviors can become a form of rebellion against parental authority.3 In sum, the factors contributing to eating disorders are like cooking a soup – it’s the chemistry between all kinds of ingredients, and not just a single ingredient, that cumulatively creates the flavor you taste.
So, what can we do about it? Just as the reasons for the development of eating disorders are complex, so too are the potential solutions. I’d like to share three steps that I consider crucial to take going forward, from the perspective of a researcher and educator in Hong Kong’s mental health space:
· First, we must commit to sharing and hearing stories about eating disorders and body image struggles more openly. This will help remove the stigma surrounding these issues and encourage individuals to seek help without shame. It also fosters empathy among those who have not experienced such struggles. Campaigns like local charity Mind HK’s “More than a Label” are great places to start reading about stories of recovery from various kinds of mental health problems.
· Second, schools can integrate curricula on body image and eating disorders into their programs. Most students spend over half their waking hours at school, where they learn not just academic subjects but also how to relate to themselves and others. This makes schools an ideal setting for instilling healthier perspectives on body image.
· Third, we need to conduct more research on how eating disorders manifest in Hong Kong's cultural context. Existing research indicates that eating disorders can present differently based on age, gender, ethnicity, and culture. Understanding these nuances is essential for identifying origins and solutions for eating disorders in our community.
Breaking the silence surrounding eating disorders and body image struggles in Hong Kong is a mission we can all contribute to. Even if we don’t personally struggle with these issues, it’s likely that a friend, family member or colleague does. In both big and small ways, we can all play a part in learning more about these topics, listening to others’ stories with open hearts and minds, and ultimately making our communities more welcoming places.
Now I’d like to dedicate this song “Robot” to everyone listening to Hashtag HK. Enjoy! This song is one of my favourite singer-songwriters lewloh, it talks about the cultural pressure that Asian youth often face.
