Anxiety and Depression Bangkok

[natalieee]

A few years ago I struggled with anxiety and my doctor in my home country prescribed Alzam which I took for around a year before moving to Thailand. When I came here I stopped taking the medication and was fine for 5 years. But I've recently been through a few difficult things including a break up of a long term relationship and a death in my family and am now struggling with anxiety and depression. 

Some friends have given me Xanax or Azor, only about 6 tablets but I feel they helped a lot.

I am looking for either a pharmacy that will either sell me this medication or a doctor/hospital that can prescribe exactly what I need. I would really appreciate any advice or recommendations on government hospitals that deal with this as I can't afford private hospital prices for the next month or two. I would rather see a doctor than just go to a pharmacy but unfortunately the costs involved are an issue right now.

[Forkinhades]

im pretty sure you can get sertraline from the pharmacy.

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[Sheryl]

Can, but sertraline is not what OP is asking for. S/he is asking for benzos which are (1) highly addictive (2) strictly controlled in Thailand and not legally available from other than a hospital pharmacy and (3) not an anti-depressive, only anti-anxiety and indeed can actually make depression much worse if taken for more than a few days (sometimes even sooner -- the anxiety will ease and you'll sleep better but then you'll bottom out in depression. Because these drugs are, in fact, depressents. ).

 

Any doctor will use their own judgement in what to prescribe,  and would be doing patients a disservice otherwise. So it is not possible to guarantee that any doctor will prescribe exactly what OP wants and indeed Thai doctors tend to become highly suspicious when a patient seems to want a specific, controlled substance.

 

I in any case strongly urge OP not to self-select medication but rather to get professional advise. Also, would urge not going straight to medication and definitely not relying on medication alone. Counseling, either alone or in combo with meds if needed, is a far better approach. Short-term cognitive-behavioral therapy (CBT)  is often all that is needed to see someone through a reactive depression/anxiety such as described. Plus you will actually gain new insights and learn new coping strategies which will help in the future.  It is not in fact the losses that are causing the anxiety/depression but rather internal thoughts about them, a narrative you are (often unconsciously) telling yourself, and CBT will address this whereas drugs at best just mask it without  changing the underlying dynamic...so the next loss (and life inevitably will bring one, sooner or later) will have the same effect or worse.

 

There are newer drugs which are both non-addictive and much more suitable than benzos for people suffering from a mix of depression and anxiety, e.g. venlaflaxine (Effexor, Valosine). This of course presupposes that OP is correct when s/he says  both anxiety and depression, sometimes lay people  confuse these two things or think of them as virtually the same. In biochemical terms, they are virtual opposite states,   though they can certainly co-exist in the same patient. Figuring out to what extent the problem is depression vs. anxiety vs.a mixed depressive/anxiety state is but one of many reasons why professional advise is advisable.

 

In terms of where to go - OP please indicate where in Thailand you are located.

[Rally123]

Recently, for my depression/anxiety I was prescribed Sertraline for during the day and Lorazapam (Ativan) to be taken one hour before bed. Seems to be working. I did ask the Psychiatrist for Xanax for Anxiety but she said no. 

[Sheryl]

Lorazepam is in same drug famiy as Xanax, would not normally oprescribe 2 different benzos.

[natalieee]

1 hour ago, Sheryl said:

Can, but sertraline is not what OP is asking for. S/he is asking for benzos which are (1) highly addictive (2) strictly controlled in Thailand and not legally available from other than a hospital pharmacy and (3) not an anti-depressive, only anti-anxiety and indeed can actually make depression much worse if taken for more than a few days (sometimes even sooner -- the anxiety will ease and you'll sleep better but then you'll bottom out in depression. Because these drugs are, in fact, depressents. ).

 

Any doctor will use their own judgement in what to prescribe,  and would be doing patients a disservice otherwise. So it is not possible to guarantee that any doctor will prescribe exactly what OP wants and indeed Thai doctors tend to become highly suspicious when a patient seems to want a specific, controlled substance.

 

I in any case strongly urge OP not to self-select medication but rather to get professional advise. Also, would urge not going straight to medication and definitely not relying on medication alone. Counseling, either alone or in combo with meds if needed, is a far better approach. Short-term cognitive-behavioral therapy (CBT)  is often all that is needed to see someone through a reactive depression/anxiety such as described. Plus you will actually gain new insights and learn new coping strategies which will help in the future.  It is not in fact the losses that are causing the anxiety/depression but rather internal thoughts about them, a narrative you are (often unconsciously) telling yourself, and CBT will address this whereas drugs at best just mask it without  changing the underlying dynamic...so the next loss (and life inevitably will bring one, sooner or later) will have the same effect or worse.

 

There are newer drugs which are both non-addictive and much more suitable than benzos for people suffering from a mix of depression and anxiety, e.g. venlaflaxine (Effexor, Valosine). This of course presupposes that OP is correct when s/he says  both anxiety and depression, sometimes lay people  confuse these two things or think of them as virtually the same. In biochemical terms, they are virtual opposite states,   though they can certainly co-exist in the same patient. Figuring out to what extent the problem is depression vs. anxiety vs.a mixed depressive/anxiety state is but one of many reasons why professional advise is advisable.

 

In terms of where to go - OP please indicate where in Thailand you are located.

Thank you very much for your very informative reply. I just want to clarify that I am not after a specific drug, im just saying that I've taken specific things in the past (i actually found Xanax to be the least effective, but Azor and Ativan work well without knocking me out).

 

I would also prefer to see a doctor who could prescribe exactly what is right for me, i feel like 80% is anxiety and 20% stress. I am located in Bangkok and would usually go to Sukhumvit or Bangkok hospitals, but at the moment I can't afford their prices. 

 

Honestly, im looking for the cheapest, legal option. I also just want to mention that i have previously seen a psychologist for almost a year before she decided to put me on medication.

[Rally123]

1 hour ago, Sheryl said:

Lorazepam is in same drug famiy as Xanax, would not normally oprescribe 2 different benzos.

Sorry I didn't explain myself properly. When the doctor said she was going to give me Lorazepam for Anxiety I asked if I could have Xanax instead. It was then that she said 'no'.

Edited January 3, 2018 by Rally123

[Rally123]

35 minutes ago, natalieee said:

but at the moment I can't afford their prices. 

 

Go to your nearest government Psychiatric hospital and register there. Please read my post in 

 

[Sheryl]

Azor is not a psych med, it is for hypertension - do you maybe  mean Zora, which is same thing as ativan?

 

 Your least expensive option would be a government hospital. There is a government psych hospital on the Thonburi side of the river not far from Millenium Hilton Hotel

http://www.somdet.go.th/Eng/contact_us.php

 

BTS to Krong Thonburi Station then bus or taxi

 

 

More expensive than govt but still less than pricey hospitals like Bumrungrad etc would be one of these non-profits:

 

St Louis Hospital on Sathorn  http://www.saintlouis.or.th/index  (doctors names are only in Thaim you'll have ti call to see what pysch drs they have but I'm sure there is at least one, probably more)

Camellian Hopsital  on Thonglor   http://www.camillianhospital.org/en/psychiatic/

Bangkok Chrsitian Hospital on Silom  https://www.bch.in.th/en/doctor-th-4/doctor-en-10/item/632-ent12.html

 

More or less in order of ascending cost. Likely about 600 baht for consultation and there will be some med mark up but not as bad as at the "5 star" places. You can also frankly tell the doctor that you are on a tight budget and ask for a local generic if possible.

 

As you can see these are small places with little or no choice of docs.  IMO well worth the longer trip to go to the psych hospital in Thonburi and will cost about 1/3  as much.

 

For counseling, options here are:

NCS New Community Services
61/1 Soi Intamara 3
Sutisan Road
Phaya Thai (Sapan Kwai Area)
Tel.: 0-2279 8503
Languages Spoken: Dutch, Thai, German, English, and Japanese
BOTH Thai and foreign mental health professionals.
http://ncs-counseling.com/


Psychological Services International
9/2 Sukhumvit Soi 43 (near Phrom Pong/Emporium)
Bangkok 10110,
Tel: 02-2591467
Fax: 02-2620505
Languages Spoken: English, French, Thai, Norwegian, Portuguese
PSI offers services from highly qualified and experienced clinicians. Both expatriate and Thai counselors are available.
http://www.psiadmin.com/

 

I think PSI may have sliding scale fees, anyhow they used to, and of course the cost is per session so if funds are tight you space the sessions farther apart than would be ideal, even once every 1-2 months is still far better than not at all.

 

I am nto sure what you mean by 80% anxiety and 20% "stress" i.e. how is stress different from anxiety? Depression is a very heavy feeling, like there is something heavy in your chest making you just not want to move or do anything at all,  and with it you find you don't enjoy anything/can't imagine enjoying anything, can't think of anything that you would want to do or have everything just seems grey and not worthwhile, and with it there is often a sort of brain fog.  Whereas with anxiety you are tense, jumpy, find it hard to stay still, and generally agitated.

 

It is possible to vary between both. It also can happen that one gives way to the other.  While the psychological causes can be similar, the biochemical states are  very different. 

 

Some psychologists believe anxiety is more likely  when threatening/upsetting thoughts and feelings are very near the surface of your mind whereas depression is more likely when they are deeply repressed (the sheer effort of keeping them buried leaving the person exhausted and depleted).  And of course there can be genetic predispositions to one more than the other.

 

 

 

 

 

[nausea]

Don't know if drugs are the solution. Personally, I have people depending on me, human and furry. Keeps me away from suicide.But then maybe I'm not suffering from real depression. Take the medical advice, but there are other options that can help, if not cure the condition.

Edited January 4, 2018 by nausea