“Many are having panic attacks because they feel they can’t speak to their bosses about workloads,” says Mahtani. “They can’t speak to their colleagues about delegating work, because they feel like they’ll be judged and they begin to socially isolate themselves.”

Occupational Hazards

Are certain jobs in Hong Kong more stressful than others?

Back in 2004, the government’s Occupational Safety and Health Council conducted a phone survey which revealed that in Hong Kong, those working in the telecoms industry were the most stressed—followed by teaching, finance and property management, transportation and logistics and then construction.

Bonnie Yau, the Council’s executive director, says that “one in five people in Hong Kong may have mental illness,” which she attributes to high and “devastating” levels of work stress.

A survey sponsored by the Council, along with the non-profit Federation of Youth Groups, surveyed 377 workers in June and found that 60 percent suffered from high levels of stress.

Lulls and Lethargy

Mahtani says that those who attend her support group often suffer from high cortisol levels—the fight-or-flight hormone released during stress. Constant and long-term stress causes cortisol to heighten—and high cortisol levels can wreak havoc on the body. One of the most common health risks generated by high cortisol is depression—and in Hong Kong, depression is rampant.

The Mental Health Association of Hong Kong (MHA) is an NGO that has been serving Hong Kong’s mentally ill and handicapped since 1954. MHA data shows that 11.8 percent of the Hong Kong population is depressed. That’s compared to an average of 4 to 5 percent in other developed cities.

“Resistance to stress is like resistance to bacteria and germs—everyone has his or her own resistance to it,” says Dr. Jackie Fu Chi-kin, a psychiatrist with the MHA. “If stress is excessive, it may turn into more serious issues, including mood disorders.”

In January this year, the MHA released the results of a screening of Hong Kong’s adult work force, through all districts of the city. Respondents widely reported loss of energy, insomnia, waning interest in everyday life and even suicidal ideation.

Anxious to Learn

The fight against stress is especially difficult for Hong Kong’s women. “We see in females that the onset of depression is mostly in their mid-30s,” says Dr. Fu, noting that the occurrence of depression is far and away higher in Hong Kong’s women than in Western countries. “When women get married, they have lots of roles—from working a job, to being a mother and also being a daughter of their in-laws.”

But it’s not only Hong Kong’s adults who are susceptible to the dangers of stress; new research shows that a dangerous culture of pressure begins in the city at an early age. A survey taken by the MHA of secondary students in Kwun Tong from April to June this year found that just short of half of respondents reported higher levels of stress than normal.

“If students do not have a healthy way to deal with their problems or release their tension, this will lead to mental health problems,” says Ching Chi-kong, the MHA’s assistant director of service and education.

Last month alone there were three high-profile student suicides. Another survey, conducted by the Federation of Youth Groups of 4,000 students over the last two months, found that 40 percent suffer from symptoms of anxiety. Those findings were released hot on the heels of a government panel report into the causes of unnatural death in the city’s children.

Typically, in developed cities the highest cause of unnatural death is accidents. In Hong Kong, it’s suicide.

Aerobic Therapy

Is there a solution? Exercise, for one.

The Mental Health Association’s screening found that most Hongkongers who reported negative symptoms don’t do regular exercise.

“Normally, Hong Kong people think that they are too busy at work and feel a lack of energy after work,” says Ching. “They say that they have no time or energy to do physical exercise. But we found that if people do more exercise, they have less depressive moods.”

The MHA invited City University of Hong Kong to study the effects of alleviating depression with exercise. The study found that of three types of exercise—aerobic, stretching and weight training—the only one that helped alleviate symptoms of depression was aerobic exercise.

Another interesting find is that Hong Kong’s aging population—a demographic that reports doing more exercise—experiences less stress and depression than others. The research team at the MHA hasn’t found any further links between exercise and stress in this age group, but believe that the age group is more able to pay attention to their physical health because they work less.

Paid in Panic

The MHA has found that family interaction is crucial for mental health and keeping stress at bay.

“People need to help other people deal with stress, and that’s why family communication is so important,” says Ching, who’s also a clinical social worker.

But the demanding and over-competitive nature of work in Asia’s world city—where three in four work overtime without pay, as the government’s Standard Working Hours Committee found in January—is tearing into family time.

Support group organizer Mahtani says that middle-aged men come to her group seeking help because of financial stressors. Unable to keep up with their families’ financial expectations—along with soaring housing prices and retirement planning—they don’t know how to express their perceived failures.

Some have complained to Mahtani of escaping to the office toilets during lunch breaks to have panic attacks.

“Not enough is being done to help those who are struggling,” says Mahtani. “It’s that elephant in the room that no one wants to address—not the government, not employers and sadly not individuals. They don’t know who to turn to.”

—Statistics compiled from the Mental Health Association of Hong Kong, Occupational Safety and Health Council and the Whole Person Education Foundation. Illustrations by Joyce Kwok