Mental Health Issue For Ex-Pat

[nakotic]

A friend of mine is suffering from what seems like serious depression. He's 56 years old and has been in a couple of toxic relationships here in the last 2-3 years. He is running short of money now as well.

I met him this morning and he told me that he felt he was going crazy, he's not sleeping well, he thinks he's having some sort of panic attacks every now and again.

Last night and this morning he was in tears about everything and he just doesn't know which way to turn and yes he is getting to the point of being suicidal.

I told him that mental health treatment at Bangkok Pattaya hospital is available but he has basically said that he doesn't trust Thai doctors as they just like to dish out pills without finding the cure.

I suggested heading back to the UK but as he said he has no family there and nothing to go back too. He has also near enough spent all of his money and says he could just about get the air fare back there but after that he'd be homeless.

My question is could the British Embassy help in any way at all by arranging treatment or something in the UK for him ? A long shot I know but I do worry that maybe he's going to get worse.

[Sheryl]

The Embassy is not going to do anything and indeed, cannot as they have no connection with the various departments/ministries that provide social services within the UK. However I believe there are adequate mental health and social services in the UK to help someone like this. NancyL has been involved in reoatriating many a destitute Brit so will ask her to comment.

In the immediate term, there are western counsellors in thailand who can help him get a grip and deal with his depression, panic etc. See the pinned mental health thread.

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[Jingthing]

Yes, sounds like the guy is very depressed but also that there are reasonable fundamental reasons why he is depressed. No mental health counselor can help him with his problem of running out of money. Of course I have no solution. Just pointing out there are limits to what health professionals can do. Similar to calling people paranoid when there actually are people out to get them. 

Edited November 9, 2017 by Jingthing

[superglue]

I have bipolar disorder (type 2). - severe depression which can last for months.

The suicide rate is quite high.

ECT (electro convulsive therapy) seems to do the job.

It is socially misunderstood & thus frowned upon.

You can watch videos on it.

Edited November 9, 2017 by superglue

[nakotic]

Thanks for the replies, when I say he's running out of money he still has an income but not as much as he was used to having.

I've googled western help for him but again his problem is expense as I'm sure they're not cheap.

[nakotic]

3 minutes ago, superglue said:

I have bipolar disorder (type 2). Severe depression which can last for months.

ECT (electro convulsive therapy) seems to do the job.

It is socially misunderstood & thus frowned upon.

You can watch videos on it.

Just read up on this, where do you have it done ? Thailand or your home country ?

 

[superglue]

Both Australia & LOS.

[nakotic]

1 minute ago, superglue said:

Both Australia & LOS.

Is it expensive here ? That's his main concern now, costs.

 

[superglue]

Just now, nakotic said:

Is it expensive here ? That's his main concern now, costs.

 

He really does not have a choice. No action - suicide.

[Sheryl]

Thanks for the replies, when I say he's running out of money he still has an income but not as much as he was used to having.
I've googled western help for him but again his problem is expense as I'm sure they're not cheap.

Chances are he is spending as much on beer/liquor and other things in an effort to dull the pain and feel better as a couple of counselling sessions a month would cost him. And some of these places have sliding scale fees according to income.

Ultimately he has to decide if he wants go feel better and find a way out of this emotional mess or not.

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[superglue]

I have observed that willpower alone does not work. I have been a sober member of AA for 34 years.

When I lived in reasonable proximity I attended 3-4 meetings/week.

It is the unity and not doing it alone which seems to work from my experience.

I have been sponsored & sponsored others for short periods of time.

Finally, 'you have to give it away to keep it.'

[nakotic]

22 minutes ago, Sheryl said:

Chances are he is spending as much on beer/liquor and other things in an effort to dull the pain and feel better as a couple of counselling sessions a month would cost him. And some of these places have sliding scale fees according to income.

Ultimately he has to decide if he wants go feel better and find a way out of this emotional mess or not.

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No, he goes out maybe once or twice a week to a local bar, he's not a big drinker at all, 2-3 beers and he's had enough

[al007]

Does your friend drink too much

 

If this were the case and all his symptoms are often suffered by practising alcoholics, then the answer could, and I repeat could be simple

 

AA

 

Call their helpline and they should take over, in the UK they would

[carlyai]

I have bipolar disorder (type 2). - severe depression which can last for months.
The suicide rate is quite high.
ECT (electro convulsive therapy) seems to do the job.
It is socially misunderstood & thus frowned upon.
You can watch videos on it.

One of my grandaughters tried to commit suicide many many times in her early teens. She is still a bit fragile, but the turning point seemed to be the ECT. She's now going on for 22, so it could have worked for her.

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[carlyai]

Also, while it may not be your friends problem, prescribed Valium, over a long period for me was devastating. Horrible panic attacks, waking up not breathing, the list goes on.
If he is on Valium, this could be a problem.

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[Sheryl]

1 hour ago, nakotic said:

No, he goes out maybe once or twice a week to a local bar, he's not a big drinker at all, 2-3 beers and he's had enough

OK. And has he cut all other expenses to the bone already? Moved to a cheaper apartment etc.?

 

What is not clear is whether he is truly down to living hand to mouth (as in, can barely pay the rent in what is already a cheap apartment and can barely buy enough food) or whether it is a case of his having been previously well off/living the high life and now having trouble accepting his change in circumstances and the death of various associated dreams.

 

If it is the first then there is no rational choice but for him to go back to the UK , get on public assistance for a while and get the mental health help he needs until he is able to start rebuilding his life. It can be done, and many people have done it before him. As for the "have nothing back there", he may indeed be estranged from his family (often the case with expats  who move to Thailand) but it is a little hard to believe he has not even one old friend, even if he may not have kept in touch over the years, surely he made at least a few friends in the past who still live in the UK. Often the issue is as much pride as anything else -  sometimes the person has either "told off" or just neglected all former friends and acquaintances and made a big splash about having found in Thailand a sort of promised land/perfect life, and feel that it would be utter humiliation to now return home, down on their luck, tail between their legs so to speak.

 

But if he is really living so close to the wire that no matter how he economizes, he cannot possibly afford the mental health help he desperately needs (in which case we can also assume he would not be able to afford health care in case of sickness or accident either) then he really has no choice but to go back.  The pride/humiliation thing is all in the head, it is something people inflict on themselves and all that is needed to come out of it is to stop self-inflicting it.  Old friends and acquaintances can prove much nicer and more understanding than one might think in situations like this, or at least some of them will. He is not the first person on earth to make a mess of things and need to start over, and at 56 he is still young enough to do so.

 

If on the other hand his circumstances are reduced from before (which naturally rankles) but he could, with a little belt tightening, afford to get help here then he should do so. Though (unless he is employable in Thailand) I suspect he'll still need to go back to the UK for at least a while, getting counselling here first would help him sort that out in his mind and start to come out of the mental trap he is in so that he can plan appropriately and coem to terms with the internal fears and beleiefs that make him feel it would be better to die than return home.

 

He is feeding himself nonstop negative thoughts and creating for himself an exaggerated sense of how bad his circumstances are. He still has his health, he is not severely disabled, he is young enough to work and start to rebuild his savings -- in fact he is much better of than many people and contrary to what he believes, his life is not over nor is it without future options. The problem is that he is caught in a web of negative thinking and is telling himself endlessly negative stories, and this colors his every perception. It is the opposite of seeing things through rose-tinted glasses - he is seeing the world, and himself, through gloomy grey tints. He needs professional help to stop doing that and start to see things more accurately and realistically.

 

The problem is that that this same negative and distorted thinking causes people to reject every possible solution to their problem out of hand. Mental health professionals are trained to work with that and help people to change their thinking, but the very thing they need help for often prevents them from getting it.

 

Good luck & hope you can persuade him.

 

 

[al007]

Tough task

 

Sheryl talks very good sense

 

The biggest step is maybe acceptance, and without that it will be very difficult

 

Sometimes tough love and stand back and do not enable

 

Good luck you are likely to need it

[chubby]

I wonder if there is a local wat, where the abbot might have some suggestions or even a retreat, that might be   more appropriate than Western talk therapy, 

for severe depression there are medications, that could take 2 months to decide if they help,  though, there is some ironic risks to them ....

 

 

[NancyL]

Sad to say, but the best way for a returning Brit to have immediate access to their social services is to go back as a "criminal", i.e. to be deported for being on overstay.  If someone goes back voluntarily and has been out of the NHS for a time, then there is a waiting period for them, except for extreme emergency care.  Same for assistance in housing, etc.

 

But, if they go on overstay, can get themselves arrested for this, plead down their fine in the Thai court, have the means to pay for their flight back to the U.K., then they are greeted with open arms.  Of course, they will probably be blacklisted from returning to Thailand.

 

A less drastic course would be to consult the psychiatric dept at Bangkok Hospital - Pattaya.  I don't know about Pattaya specifically, but I've been very impressed with the psychiatric dept of Bangkok Hospital - Chiang Mai.  They use a good combination of talk therapy, medication and lifestyle modification (i.e. physical therapy and diet) to treat their patients.  Whether he chooses to follow the recommendations of the doctor is another story.  For example, he probably shouldn't be drinking ANY alcohol, at least now while his mental health isn't good.  He should be going to a fitness center for at least 1.5 hours three or four times a week.  And he should be eating a diet high in fresh fruits and veggies and low in fried foods.  This is the sort of lifestyle the doctors at Bangkok Hospital Chiang Mai encourage in addition to talk therapy and meds.

[carlyai]

I wonder if there is a local wat, where the abbot might have some suggestions or even a retreat, that might be   more appropriate than Western talk therapy, 
for severe depression there are medications, that could take 2 months to decide if they help,  though, there is some ironic risks to them ....
 
 

There is a rehab place outside Pattaya but expensive.

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[Rally123]

On 11/9/2017 at 5:25 PM, superglue said:

I have observed that willpower alone does not work.

It helps and so does the assistance of a good friend/s who have a shoulder there for him to cry on, literally. Those people are important now in helping him not go further down any deeper than he currently is. 
Someone needs to talk and accompany him back to the UK irrespective of him having no one there. If he is genuinely sick he will get help. Been there done that.

Well done the OP for helping.

[Rally123]

13 hours ago, NancyL said:

Sad to say, but the best way for a returning Brit to have immediate access to their social services is to go back as a "criminal", i.e. to be deported for being on overstay.

If he is bad he can get himself sectioned. If not, he will be guided to others that will help him.

Edited November 10, 2017 by Rally123

[superglue]

I stated that willpower alone does not work.

[Rally123]

1 minute ago, superglue said:

I stated that willpower alone does not work.

I never contradicted you.