Psychiatric medicine for depression & anxiety

[Peterw42]

12 hours ago, aussienam said:

Thanks.  I am from Australia. Psychiatric services are not free, but are part subsidized under Medicare. However, psychiatrists charge way over the rebate amount meaning it still costs a fortune there.  Psychologist fees the same.  Medicines are subsidized under the Pharmaceutical Benefits Scheme there which helps a lot, albeit different rates for different meds.  

I don't qualify for a pension so lose out there as well. And would be homeless in Oz due to cost of living.  Everything is pointing towards me choosing one particular inevitable outcome.  Not blaming anyone. It is what it is. Thanks for all the input.  Maybe time to end this post as not going to solve anything. 

OP, everyone can get some level of welfare in Australia, you will get better diagnosis, treatment, access to drugs in Australia and most of it is free. The system may be a little hard to navigate initially but there is a system for people like yourself.

I think you are living in some sort of false economy thinking Thailand is cheaper. Its not if you don't have welfare, free medical,  correct diagnosis/treatment, affordable drug treatment etc.

You appear to have some sort of income/savings otherwise how are you living in Thailand.

There is noting about life in Thailand that benefits your condition.

[Sheryl]

12 hours ago, IvorBiggun2 said:

No, there is a good availability of psychiatrist at the government psychiatric hospital in Korat. Highly recommended. Only problem that appears to be is that there are no children's psychiatrists available in Korat other than private ones. St Mary's private hospital has a good clinic.

Obviously there are plenty of psychiatrists at psych hospitals. I was referring to general hospitals such as the government hospitals closest to Pattaya. 

 

Korat is hardly convenient  for OP. The govt psych hospital in Bangkok is closer and also much larger with more English speaking.

 

 

 

 

 

 

 

 

[ivor bigun]

2 hours ago, tonray said:

Depression is a disease, one which is poorly understood, especially to the causes. You don't necessarily need to be depressed about anything. It may be a chemical imbalance, or some other underlying organic cause. Learn a bit about it.

It really must be terrible to be depressed ,i know i was really bad many many years ago when my first wife asked if we should try again .

sorry just trying to lighten it  up ,it must be really bad especially if you have no family here or back home .

i do hope you find some relief,

[ChrisKC]

1 hour ago, ivor bigun said:

It really must be terrible to be depressed ,i know i was really bad many many years ago when my first wife asked if we should try again .

sorry just trying to lighten it  up ,it must be really bad especially if you have no family here or back home .

i do hope you find some relief,

Depression in itself is not a disease. Diagnosed 'clinical depression' is a mental disorder and requires medical attention.

[tonray]

2 hours ago, ivor bigun said:

It really must be terrible to be depressed ,i know i was really bad many many years ago when my first wife asked if we should try again .

sorry just trying to lighten it  up ,it must be really bad especially if you have no family here or back home .

i do hope you find some relief,

Thanks..but I'm not depressed. I was just trying to point out to some less informed members that might not understand how devastating the condition can be.

[from the home of CC]

On 4/11/2021 at 7:08 PM, aussienam said:

Thanks but I do not abuse Valium and understand the addictive nature etc.  I have been on a strict medication dosage on a PRN basis via qualified psychiatrists in Australia.  It is not only for my chronic PTSD and depression as I have other comorbid issues.  

I understand valium abuse and what you are saying but I would rather go by my few specialists in Oz said for my treatment plans.  Not sure if you are a qualified medical professional or not.  

 

Easier said than done to just suggest I go home to Oz.  I have no home there. Would be on the street as rent too much. Think suicide the way to go if I have to return. Looks like the end of the road is nigh. 

Thanks anyway. 

I'm not talking about addiction, more to the fact that valium is a depressant.   https://www.mentalhelp.net/substance-abuse/valium/effects-of-abuse/#:~:text=Some of the other short,Depression and loss of motivation.

 

Your 'qualified' psychiatrist should know this. Do you drink also? Bottom line is that if you get worse here in Thailand your outcome imo will be a lot worse than in your own country - whether you have a home there or not.

[Bruno123]

Also natural things like learning to relax, floating in a swimming pool, being nice to people. Change your view of the world from being a harsh environment to one where everyone cares and wants to help. Be a part of it. Will help to produce the chemicals that make you feel better.

[IvorBiggun2]

34 minutes ago, Bruno123 said:

Also natural things like learning to relax, floating in a swimming pool, being nice to people. Change your view of the world from being a harsh environment to one where everyone cares and wants to help. Be a part of it. Will help to produce the chemicals that make you feel better.

 If only. I think you are referring to being depressed which is totally different to clinical depression.

[pseudorabies]

On 4/12/2021 at 12:36 PM, ChrisKC said:

Depression in itself is not a disease. Diagnosed 'clinical depression' is a mental disorder and requires medical attention.

I would definitely classify Major Depressive DIsorder  (MDD) or what you are calling "clinical depression" as a disease in the same way that cancer, parkinson's, Alzheimers, Type 2 Diabetes and heart failure are diseases.  It's a pathological breakdown of normal physiological processes with distinct changes in the organs involved.  In MDD significant changes are usually seen in the brains of those affected, notably in the hippocampus in the form of dendritic pruning and overall shrinkage. Also overactivity of pathways originating from the amygdala (along with underactivity from the hippocampus) is usually noted.  It's a really nasty disease that those who haven't had it have trouble relating to.

 

I agree about the GABA-A agonists like valium.  And alcohol.  With alcohol you would feel good for about 15 minutes and then it's a trip to hell.  It might be that the OP's MD was more concerned about the anxiety aspects than the depressed mood.

 

OP - I'd use this opportunity to look into low-dose ketamine and new drugs with the same mechanism of action.  It's reported to work very well and immediately in depression.  Maybe others can chime in on whether ketamine is authorized for any use in Thailand or if similar drugs are available.  Best of luck and never forget that life will get better.

[Patong2021]

On 4/11/2021 at 5:59 AM, IvorBiggun2 said:

No you are wrong. To see a psychiatrist at a government hospital will cost you EXACTLY 50 Baht once you register. Free to register.

A person must be able to qualify to register. There is a  need for a referral. How many months do you expect the person to wait because it will be a long waiting time to see a psychiatrist. There are 882 Thai psychiatrists including medical student residents for a country of 70 million. Due to the enormous workload, many of the psychiatrists are off sick or burnt out.  The psychiatrists are triaging now, doing emergencies first with little time for follow up and treatment program.      https://pubmed.ncbi.nlm.nih.gov/32315309/

 

 

 

 

[IvorBiggun2]

2 minutes ago, Patong2021 said:

A person must be able to qualify to register. There is a  need for a referral. How many months do you expect the person to wait because it will be a long waiting time to see a psychiatrist. There are 882 Thai psychiatrists including medical student residents for a country of 70 million. Due to the enormous workload, many of the psychiatrists are off sick or burnt out.  The psychiatrists are triaging now, doing emergencies first with little time for follow up and treatment program.      https://pubmed.ncbi.nlm.nih.gov/32315309/

 

 

 

 

Total tosh. I never had to qualify to register, or be referred, to get treatment at Rajanagarindra Psychiatric Hospital in Korat. It was a case of turning up unannounced, registering, and being assessed prior to having my first contact with a psychiatrist here. All vetting and registering, first time, took less than 3 hours including getting meds.

Outpatients clinics are carried out on Mondays on a first come basis. The clinic finishes around lunchtime. They also have a 24 hour emergency outpatients clinic. No overworked doctors observed on my visits.

Could 'Patong2021' please state what qualifications one has to show to register please.

[ChrisKC]

2 hours ago, pseudorabies said:

I would definitely classify Major Depressive DIsorder  (MDD) or what you are calling "clinical depression" as a disease in the same way that cancer, parkinson's, Alzheimers, Type 2 Diabetes and heart failure are diseases.  It's a pathological breakdown of normal physiological processes with distinct changes in the organs involved.  In MDD significant changes are usually seen in the brains of those affected, notably in the hippocampus in the form of dendritic pruning and overall shrinkage. Also overactivity of pathways originating from the amygdala (along with underactivity from the hippocampus) is usually noted.  It's a really nasty disease that those who haven't had it have trouble relating to.

 

I agree about the GABA-A agonists like valium.  And alcohol.  With alcohol you would feel good for about 15 minutes and then it's a trip to hell.  It might be that the OP's MD was more concerned about the anxiety aspects than the depressed mood.

 

OP - I'd use this opportunity to look into low-dose ketamine and new drugs with the same mechanism of action.  It's reported to work very well and immediately in depression.  Maybe others can chime in on whether ketamine is authorized for any use in Thailand or if similar drugs are available.  Best of luck and never forget that life will get better.

Thank you for the details.

 

My first sentence about "depression" is intended to point out that being depressed (in a depressed mood) can, and often is, a state of mind due to personal circumstances and is not remotely a medical or "clinical" condition. Feeling depressed about 'something' can be overcome with time, the circumstances improving and support from others, therefore not requiring medical intervention.

 

The term "clinical depression" is a collective definition that simply excludes situations mentioned above.

 

When I studied this in College, many patients were in Mental Hospitals and even Asylums (that don't exist in England anymore) that I actually visited and saw patients whose cases were exacerbated by possible wrong diagnosis and were effectively given up on by the mainstream medical profession.

 

And yes, though not from personal experience, I can vouch that for a permanent-type depression, the world is a bad place for those so afflicted.

Edited April 15, 2021 by ChrisKC
double word deleted

[Sheryl]

1 hour ago, IvorBiggun2 said:

Total tosh. I never had to qualify to register, or be referred, to get treatment at Rajanagarindra Psychiatric Hospital in Korat. It was a case of turning up unannounced, registering, and being assessed prior to having my first contact with a psychiatrist here. All vetting and registering, first time, took less than 3 hours including getting meds.

Outpatients clinics are carried out on Mondays on a first come basis. The clinic finishes around lunchtime. They also have a 24 hour emergency outpatients clinic. No overworked doctors observed on my visits.

Could 'Patong2021' please state what qualifications one has to show to register please.

 

What he was describing is true in general hospitals where there is often just one or two psychiatrists available and usually nto every day (no psychiatrists at all in the case of lower level hospitals). Also I think he is thinking of what Thais need to go through to get treatment free of charge.

 

Not in the least true of government psych hospitals for patients paying out of pocket.

[WhiteBuffaloATM]

Consider throwing all those drugs and healing yourself with your very powerful human body / mind.

How many depressed people are actually cured by drugs ? Zero, I venture, just relieve but prolong the symptoms never solve root causes ( mainly forms of loss ?)

 

You Tube Dr. Eric  Berg. Get your body and mind back in shape by proper diet, exercise, stress relief.

Will be hard at first in your condition but any worthwhile results in this life require discipline /hardship.

You Can Do It !

 

 

[Neeranam]

On 4/6/2021 at 2:40 PM, aussienam said:

Thanks. I have considered it. High cost of living and respite were main reasons to come to Thailand.   Rent in Australia is too much.  I know what you are saying and it makes sense. I'm just trying to find a solution as things are all coming to a head.  

Why do you live in a large tourist city? Have you thought of moving to a little seaside town like Pranburi? 

[aussienam]

On 4/27/2021 at 10:37 AM, Neeranam said:

Why do you live in a large tourist city? Have you thought of moving to a little seaside town like Pranburi? 

I chose here as I wanted to have things to do and not feel so isolated. 

Also, I haven't learnt Thai and wanted to be around other expat areas so I didn't feel lonely and could have someone to chat with.  Plus hospitals nearby and mixed foreign/Thai foods.  

But the longer staying here I realise why expats move into quieter places.  Plus cost of living cheaper.  Good advice thanks.  

[aussienam]

On 4/26/2021 at 12:54 PM, WhiteBuffaloATM said:

Consider throwing all those drugs and healing yourself with your very powerful human body / mind.

How many depressed people are actually cured by drugs ? Zero, I venture, just relieve but prolong the symptoms never solve root causes ( mainly forms of loss ?)

 

You Tube Dr. Eric  Berg. Get your body and mind back in shape by proper diet, exercise, stress relief.

Will be hard at first in your condition but any worthwhile results in this life require discipline /hardship.

You Can Do It !

 

 

You have a point.  I've cut back significantly on meds I used to take over the years.  I would prefer to go drug free.  But was told I needed ADs as clinically depressed.  Because of current situation here in Thailand I am not taking antidepressants now and hardly any valiums too.  I exercise like a maniac and it does help for moderate anxiety for a few hours after.  Cheers.  I will check out Dr Berg. 

[BenDeCosta]

I hate to say this, but in general, mental health issues are really not understood, recognized or accepted in Thailand as they are in the West. If you are suffering, the best thing that you can possibly do is to go home and get some good quality treatment before coming back.

 

Although many Thai doctors obtained their qualifications overseas, there is definitely still a stigma attached to mental health issues in Thailand. Daily exercise, a good diet, and maybe taking up a new hobby helped me a lot.

 

Get your body healthy first, find something healthy that you enjoy doing, and try and focus on that, eventually you should get back to normal. And stop blaming yourself for the things that have happened to you.

Edited April 29, 2021 by BenDeCosta

[cyril sneer]

4 minutes ago, aussienam said:

You have a point.  I've cut back significantly on meds I used to take over the years.  I would prefer to go drug free.  But was told I needed ADs as clinically depressed.  Because of current situation here in Thailand I am not taking antidepressants now and hardly any valiums too.  I exercise like a maniac and it does help for moderate anxiety for a few hours after.  Cheers.  I will check out Dr Berg. 

Valiums are very cheap if obtained from a government hospital, or even some private hospitals. it's a nasty <deleted> of drug but you'll know that already

 

 

[aussienam]

46 minutes ago, cyril sneer said:

Valiums are very cheap if obtained from a government hospital, or even some private hospitals. it's a nasty <deleted> of drug but you'll know that already

 

 

thanks.  Yeah I had been going to a clinic.  I will check out the hospital next time.  Thanks.  Yeah it's a drug to use with great caution.  I don't like using them unless absolutely necessary.  But they can help immensely if used sparingly as they are still effective.  Cheers.  

[aussienam]

54 minutes ago, BenDeCosta said:

I hate to say this, but in general, mental health issues are really not understood, recognized or accepted in Thailand as they are in the West. If you are suffering, the best thing that you can possibly do is to go home and get some good quality treatment before coming back.

 

Although many Thai doctors obtained their qualifications overseas, there is definitely still a stigma attached to mental health issues in Thailand. Daily exercise, a good diet, and maybe taking up a new hobby helped me a lot.

 

Get your body healthy first, find something healthy that you enjoy doing, and try and focus on that, eventually you should get back to normal. And stop blaming yourself for the things that have happened to you.

Thanks mate.  Appreciate the candid comments.  Getting back to Australia right now is not easy and expensive too.  Pre-COVID I'd have been on a plane back there and getting treatment if needed.  Now it's a logistical and costly exercise with 28 days quarantine each way.  

Yeah been working on exercise and cognitive work as an attempt to circumvent the drug route as much as I can.  Self blame and regret are a big cause of manifesting and perpetuating depression.  So you are definitely are beating ourselves up for things that cannot be changed.  Sage advice thanks.  

[WhiteBuffaloATM]

STOIC Mental Approach ; HIIT Exercise (Intense Gym Bike, Fast Fin Pool Swims); Plant Diet;

Intermittent Fasting; Good Sleep; No Drugs / No Sugars / No Alcohol/ No Snacks / No Processed Foods; all helps promotes HGH, Low Insulin, Liver / Kidney Function, Max. Immune System etc......

Found Sustained Weight Loss / High Energy/ Positive Even Moods / Mental Sharpness. Get at it !

 

Do take Medical Advice....... at least an annual 3,000 baht Blood/ Urine / XRay test with Doctor Analysis.

Immediate / Biannual CAT Heart Scan with Brain MRI also recommended.

Essential to know your Heart Attack & Stroke condition / risk before intense exercise or diet change.......