Depression: Back Again

[RickBlaine]

Hi guys.

Hope this isn't too long-winded;

I live in Thailand with my wife, been here about 8 years.

I've had chronic, sometimes life-threatening depression since early teens (I'm 60 now), and thought I'd got used to coping with it.

But recently things have got worse again, to the extent that when I first thought about writing this a few weeks ago I was having a major dip, and was seriously thinking about giving up.

As so often, by the time I'd finished denying and prevaricating the worst had eased and I'm feeling 'not too bad' this week.

So, I'm thinking about options and have been reading about the Thai system here on ThaiVisa and the internet generally.

In the UK only a doctor can give prescriptions for mental health medicine (not a psychologist or counsellor). If I decided to go back on meds (I had a short spell of anti-depressants in my 40's, and they helped a lot), do I need to find an English-speaking doctor/psychiatrist first?

I'm told that Zoloft, and others, are available over the counter here, but I don't want to do that without an up to date diagnosis.

Actually, the most help I've ever had came from face-to-face counselling in my 20's and again in my 40's. That would be my first choice, but I've checked and there's nothing around here in the north east (near Sakon Nakhon), so it would probably have to be via phone.

Has anyone found a service, based in Thailand, that does phone counselling?

I saw online the mental health retreats in Thailand, and the specialist hospitals around Bangkok and Chiang Mai. They look great but are either out of my price range or the distances make it impractical.

Any thoughts or advice?

Many thanks.

[Sheryl]

You can buy most anti-depressents over the counter here without a prescription. However, there is definite benefit to seeing a good psychiatrist to help you obtain the right drug for your situation.

 

There is a psych hospital in Khon Kaen (and usually a psychiatrist or two on staff at most large general hospitals) but I cannot guarantee the English fluency nor cultural fluency of the doctors there.  If you can swing a trip to Bangkok it would be well worth it to see this US trained psychiatrist, she specializes in mood disorders and is very sincere, thorough and caring with a lovely personality:

 

https://www.bumrungrad.com/doctors/Suttiporn-Janenawasin

 

I have referred other TV members to her who also live far upcountry and they have found it well worth the trip. You would not need to go often.

 

The consultation will cost you around 1500 - 2000 baht. Find out the name of the med and dose she recommends and politely decline it at the cashier, saying you already have it, then buy at a pharmacy -- hospital mark ups are huge.

 

Re counseling, that is indeed very helpful. There are 2 options that might work for you:

 

1. http://www.benweinstein.com/therapyserv.htm

 

 Ben is a US trained/licensed therapist who, after  initial in person session(s) , will offer sessions online via Skype for people living far upcountry. A number of TV members have been treated by him and feedback is positive.

 

2. This place offers online counseling for those unable to come in (though I would urge at least one initial in person session) https://www.bangkokcounsellingservice.com/

I have no specific feedback on them. Most of the therapist are Thai; there is one Brit.

 

Lastly as you mentioned almost "giving up" during a low point please keep the Samaritan English language hotline number on hand:

 

http://www.samaritansthai.com/news/samaritans-of-thailand-english-hotline/

http://www.samaritansthai.com/contactus/

 

 

[RickBlaine]

19 hours ago, Sheryl said:

You can buy most anti-depressents over the counter here without a prescription. However, there is definite benefit to seeing a good psychiatrist to help you obtain the right drug for your situation.

...

 

Thanks Sheryl for your reply.

I think you're right. I'm going to have to splash some cash and visit Bangkok, if only for the initial consultation.

I get what you are saying about regional psychiatric hospitals - my nearest is Nakhon Panom, but I'm told there isn't a fluent English speaking doctor there.

The two counselling services look interesting and I will email them and get details. Also, from your resources list, Tim Armstrong in Nakhon Sawan looks to be my closest, although there's no mention of online counselling, again I'll email for details.

As to 'giving up', I'm not sure what I feel. Generally, my depression has mellowed over the years into steady rises and falls, but recently I've had 'micro bursts' of short, severe, episodes. They only last a few days - never more than a week - and can be triggered by anything. It's driving me (and the wife) nuts, and I need to talk it through with someone.

Anyway, thanks again.

[Sheryl]

At some future time, when you feel up to it, you may find a course of Vipassana meditation very helpful.  It won't so much alter your mood states as it will help you better deal with them and achieve some distance/perspective over them, not let them control you and not "listen" to them so much..

 

many centers in Thailand, courses are fee. You have to spend a full 10 days at them to learn the technique

 

www.dhamma.org for more info and location of courses

[RickBlaine]

On 10/25/2018 at 7:20 PM, Sheryl said:

At some future time, when you feel up to it, you may find a course of Vipassana meditation very helpful.  It won't so much alter your mood states as it will help you better deal with them and achieve some distance/perspective over them, not let them control you and not "listen" to them so much..

 

many centers in Thailand, courses are fee. You have to spend a full 10 days at them to learn the technique

 

www.dhamma.ord for more info and location of courses

Thanks for that. I had a look at their website - as you say, not a cure for depression, but one to think about later, after counselling.

[Sheryl]

The best doctors in Thailand hold teaching supervisory positions in government hospitals - major, tertiary level ones. (These same doctors also often have hours at private hospitals).

 

I very much suspect the "local" hospital you refer to was not  a tertiary level hospital.

 

See https://www.thaivisa.com/forum/topic/615461-the-thai-public-health-system/

 

Going to a "top" end private hospital is absolutely no assurrance of a good doctor. There are some, but there are also some truly awful ones. In my many years on this board, the most egregious malpractice I have seen has been at private hospitals.