Getting Help for Depression

[Adumbration]

Where can I get help for depression?

 

Is it possible to self medicate?

 

Are antidepressant medications available over the counter here in Thailand?

[CharlieH]

MOVED to Health forum.

 

Samaritans are also available for support

[shadowofacloud]

Quote

Are antidepressant medications available over the counter here in Thailand?

 

I managed to get Trazodone for my dysthymia in _some_ pharmacies. Others would strictly refuse to sell...

 

The prices would also differ dramatically - 20 USD for 3 month supply of a generic in a pharmacy in Udon (been buying from them ever since) - compared to 150 USD for a similar supply in Bangkok Hospital or 70 USD in a pharmacy in Bangkok. So if money is an issue, it's good to search a bit.

Edited October 19, 2021 by shadowofacloud

[Adumbration]

Thanks @shadowofacloud

 

What is the generic brand of Trazodone called and what dosage do you take?

[shadowofacloud]

No brandname, just Trazodone.

 

Dosage is an individual thing, so best talk to a professional.

[bamboozled]

Wellbutrin is available over the counter. If you are not going to go through a professional, I would strongly suggest/insist on doing a lot of research on it and knowing what to expect and the dos and don'ts. There are plenty of personal stories on the web, and doctors stories, too, and I would read through as many as possible to get a picture of the different reactions that you might encounter. Some people have very strong reactions and others feel nothing or mild reactions. Many get a lot of benefit, which is great. A professional can help and evaluate the best course of action, of course, and he/she might feel your particular case is absolutely NOT something that should be tackled with Wellbutrin, that it could be dangerous in some way. All these antidepressant meds have the potential of causing suicidal thoughts and worsening depression. Or feelings of acute discomfort both mental and physical. At the same time, a lot of "professionals" deal them out liberally and with little follow-up. I know from personal experience that this can put some people in life-threatening situations. Just don't jump into anything without informing yourself. A good sense of who you are and mentally how you handle things is important if you have no one guiding you.

I think the major hospitals have psychologists on staff. You could certainly call and ask. There is Suan Prung near the south west corner of the moat which is a mental health hospital but there isn't much English spoken there.

Did you try googling clinics/doctors in Chiang Mai? There are a good number geared toward westerners.

 

I think a great many of us are depressed to different degrees during Covid. It ebbs and flows with me but it seems like there is just a general overall gray cast to everything that is hard to shake off. I think it is important to consider that these are particularly weird and trying times and that everything just feels that much heavier and dire because of it. It will pass, I do think so. One way or another.

 

The book, The Power of Now by Eckhart Tolle really helped me some years ago when I was feeling low. It got me out of my own head and I continue to go back to it. You might have a look.

Edited October 19, 2021 by bamboozled

[rodknock]

i use generic prozac(flouxetine) 1am and 1pm.

 

[Adumbration]

Thank you everyone for your input.

 

I do not have any issue sleeping.

 

However I am suffering from fatigue, brain fog, utter lack of motivation.

 

Some of this I am sure is psychological overlay.  I have a chronic genetic blood disease for which that is no cure no medication.  I also can barely walk due to the development of mortons neuroma in my left foot.

 

Much is due to life problems.  No family support whatsoever.  No income. 

 

So already depressed before Delta came along.  But it was definitely the icing on the cake.

 

We were barricaded into our village for 21 days and were not even allowed out to buy food.

 

Had to live off tinned fish and boiled rice.

 

The travel bans have precluded me from getting to a decent hospital or doctor in Phuket.

 

However the bridge is now open apparently in the last few days.

 

Never taken antidepressants before.  I grew up poor and was told to get on with it.

 

Looking back now with time to reflect I am sure there was clearly defined periods where I was significantly hobbled with depression....but I never sought help...

 

I am at the stage now where I have to write a to do list and a flow chart just to complete the task required each day.

 

My current situation is not sustainable.

[bamboozled]

It sounds like you have a good bit of awareness of the how and why of your current mental health situation. I think that's good, the ability to step back and the wisdom to know that it's time to try for some change. I had similar feelings and lack of motivation which is when I first took Wellbutrin, among doing other things to help myself. I took 150mg/day and did not feel much for two weeks or so and then gradually the glass started to seem half full instead of half empty. What was nice, I think, is that I felt totally myself, not drugged or numb at all. Just, as I said, the glass was suddenly half full instead of half empty. In a way, it's not much change but at the same time, it's huge. Do some research and consider it. Here it's about 1600 baht for 30 pills, I believe, so 30 days if you're taking just one. And again I would suggest the book I mentioned above. You can find lots of info on it online. ...Might not be your thing, might turn you off, who knows. It really helped and helps me. Don't get lost in the author's online presence now or it might make you feel negative about the book or the insight. Also, I think any podcast or books on astrophysics are so mind blowing that you can't help but get out of your own head. I know, sounds weird but when they start talking about time not existing or going back in time or the whole universe being squashed down into a pin head (smaller!) by a black hole, anti-matter, all this insane stuff, well, your problems can seem a lot less like a big deal.

[Sheryl]

It is possible to self medicate but it is not advisable.

 

A combination of counselling and medication is better than either one alone.

 

Please see this thread:  https://aseannow.com/topic/90910-mental-health-resource-list/

 

Where in Thailand are you located?

[jackdd]

While I'm in general somebody who prefers self medication and thinks doctors are a waste of time and money in many cases, I would advise against self medicating mental health issues.

With some normal illness you do obviously notice if your symptoms get better or not, or if you have any side effects and can react accordingly.

But with mental health issues you might not notice it and thus you need a professional to observe you.

[Adumbration]

Sheryl.  I am located in a rural area of Phang Nga province.

 

I am homozygous c282y and have missed a number of my phlebotomies due to lockdowns and travel restrictions.  I requested a letter (by email) from the treating doctor and tried to use it to get through roadblocks but was refused.  The bridge at Phuket has apparently reopened in the last few days so I should be able to catch up.

 

I have not been able to access a lab for ages that could check my serum ferritin and ferritin transferance.  I can now get that done in Anda lab in Phuket town hopefully.

 

A more pressing concern is that I have a morton's neuroma in my left foot.  I have not had access to proper facilities for detailed diagnosis, tried all available facilities and doctors in this area and they were all just twits.

 

I have researched this matter online and am 100% sure this is the problem.  I have flat feet and a morgans toe.  I ordered some arch support inserts for my shoes and had have a marginal improvement.  But still have peripheral numbness in my toes.  From what I have researched online all of my symptoms are an exact fit.  Even the pebble underfoot or scrunched up sock feeling when walking in my shoes.

 

Sheryl do you know of a doctor in phuket that would be able to properly diagnose and treat my foot.  Also I have read lots regarding cortisone injections but apparently this is just short term fix.  I note that surgery to remove the tumor must be guided by MRI.  Would that type of technology even be available here? 

 

 

[Adumbration]

@Sheryl could I also have your opinion on @bamboozledsuggestion of wellbutrin.

 

I gather the generic name is bupropion.

 

I that something I could buy over the counter at a wholesale pharmacist like the one at the big supercheap in Phuket?

[The Hammer2021]

No. You can NOT self medicate for depression in any valid way. That is what junkies, pot heads and alcholics are doing. It's not wrong but don't deceive yourself.

[Adumbration]

11 minutes ago, The Hammer2021 said:

No. You can NOT self medicate for depression in any valid way. That is what junkies, pot heads and alcholics are doing. It's not wrong but don't deceive yourself.

Thanks for your input.  I do not drink and, with the exception of a few times as a student, have never used recreational drugs.  I do not smoke, am not overweight, and despite my health concerns am pretty fit for my age (mid fifties).

Edited October 20, 2021 by Adumbration

[The Hammer2021]

1 minute ago, Adumbration said:

Thanks for your input.  I do not drink and, with the exception of a few times as a student, have never used recreational drugs.  I do not smoke, am not overweight, and despite my health concerns am pretty fit for my age (mid fifties).

That is my point. You are using a different drug. I make no moral judgement. But buying a prescription drug to make you happy is no different than getting high off a street drug. This is precisely the problem in the USA. Once you self medicate you are effectively using drugs for recreational purposes. Valium, Xanax, prescription opiates etc, become recreational when self medicated. You are taking the drugs to make you happy not to address the source of your illness and have no plan to stop taking the drugs  nor receiving counseling, medical support or therapy. In other words: drug abuse.

[Adumbration]

@bamboozled I have reviewed the key principles adumbrated in the Power of Now.

 

Is not the central premise of Tolle's book fraught with paradox?

 

I have a number of significant problems at present that will only be resolved by effective planning and the subsequent implementation of defensible solutions.  If, as Tolle suggests, an individual should hold their mind entirely in the moment, how is it possible to put together a plan for ones future.

[kellyk11]

Can you get help through your home country? The NHS has various online mental health services including this one

 

https://www.silvercloudhealth.com/uk

 

I wouldn't take meds unsupervised. You may be suffering from some other underlying condition that is getting masked. I had really odd hormone profile that turned out to be a tumor.

 

Many of the school shooters who made headlines in America were kids who were coming off anti-depressants.

 

Give a couple of things a go before you try the meds. Firstly, have a look at water therapy. Applying water to our skin in varying temperatures changing our mood. Just splashing cold water on your face can help.

 

Secondly, can you have a go at water fasting? It can clear up brain fog. I do a 36 hour fast once a week with my old dad. You just drink water. If you can do a 72 hour fast that has heaps of benefits. The University of Southern California has done a lot of research on it. They use it for cancer patients.

 

Thirdly, can you lift heavy weights? It promotes testosterone production which can clear brain fog.

 

Good luck.

[Adumbration]

@The Hammer2021 I have put you on ignore. 

 

I find little value in your didacticism.

[Adumbration]

Thanks @kellyk11

 

Every since the diagnosis of my genetic blood disease I have taken my personal fitness very seriously.

 

I am very fit for my age and swim in the open ocean most days.

 

The ocean is a genuine source of joy for me.  It has been a lifelong reference point in the absence of any family I could rely upon.

 

Being barricaded in my home by the army for 21 days had a big effect on my mental health.  Couldn't even get down to the ocean which is literally 5 minutes from my house.

 

 

[bamboozled]

50 minutes ago, Adumbration said:

@bamboozled I have reviewed the key principles adumbrated in the Power of Now.

 

Is not the central premise of Tolle's book fraught with paradox?

 

I have a number of significant problems at present that will only be resolved by effective planning and the subsequent implementation of defensible solutions.  If, as Tolle suggests, an individual should hold their mind entirely in the moment, how is it possible to put together a plan for ones future.

Not a paradox. The main point is not to let your mind live CONSTANTLY in the past or in the future, instead of the moment. It doesn't mean to eschew planning or doing what is needed. It's not that easy, necessarily, to know that you are not in the moment because we spend so little time there. Most of our brain power is devoted to pointless guilt and remorse from the past and worry and fear about the future. Yes, plan for the future but distressing over it brings only suffering. Don't get me wrong, I have not succeeded in "living in the moment" but just understanding the mechanism is powerful. Many if his ideas are not necessarily original but I found his delivery in Power of Now hard-hitting in the best way. If one is looking to disregard it from the get-go, surely it won't be effective. But it might not be your thing, nothing wrong with that.

[Sheryl]

11 hours ago, Adumbration said:

Sheryl.  I am located in a rural area of Phang Nga province.

 

I am homozygous c282y and have missed a number of my phlebotomies due to lockdowns and travel restrictions.  I requested a letter (by email) from the treating doctor and tried to use it to get through roadblocks but was refused.  The bridge at Phuket has apparently reopened in the last few days so I should be able to catch up.

 

I have not been able to access a lab for ages that could check my serum ferritin and ferritin transferance.  I can now get that done in Anda lab in Phuket town hopefully.

 

A more pressing concern is that I have a morton's neuroma in my left foot.  I have not had access to proper facilities for detailed diagnosis, tried all available facilities and doctors in this area and they were all just twits.

 

I have researched this matter online and am 100% sure this is the problem.  I have flat feet and a morgans toe.  I ordered some arch support inserts for my shoes and had have a marginal improvement.  But still have peripheral numbness in my toes.  From what I have researched online all of my symptoms are an exact fit.  Even the pebble underfoot or scrunched up sock feeling when walking in my shoes.

 

Sheryl do you know of a doctor in phuket that would be able to properly diagnose and treat my foot.  Also I have read lots regarding cortisone injections but apparently this is just short term fix.  I note that surgery to remove the tumor must be guided by MRI.  Would that type of technology even be available here? 

 

 

 

As I expect you know - but may be worth reminding yourself of - depression is a common symptom in  hemochromatosis especially when not well controlled. Peripehral neuropathies can also be related, i.e. you may have Morton's neuroma, but you might also be experiencing neuropathic foot pain secondary to your  hemochromatosis .

 

In response to your other question later re Wellbutrin - there are many different antidepressents and the choice of which to use depends on many individual factors including, for example, whether there is also an element of anxiety present. Which is why it is best to be under the care of a good (emphasis on good ) psychiatrist and also to get counselling, good therapists work in tandem with psychiatrists and can give the psychiatrist feedback on the nature of your condition (since therapist spends far more time with you than a psychiatrist can).

 

You have a complicated mix of physical ailments and depression, and the situation is vastly complicated by the fact that you live in an area that is a backwoods when it comes to medical care. I frankly would never advise someone with hereditary hemochromatosis  to live in the Phuket area nor anywhere else except Bangkok or vicinity of one of the major teaching hospitals.

 

As an absolute priority, get your  hemochromatosis under control - updated labs, phlebotomy. This alone will likely lessen the depression.

 

2. Next, the foot issue - you are going to need to come to Bangkok. Should see  Prof. Bavorn

Chuckpaiwong, US trained specialist in foot and ankle. He can be seen at:

 

Siriraj  https://www.siphhospital.com/en/medical-services/doctor-biography?id=202

Bumrungrad (link is currently down)

 

3. Re the depression -  while in Bangkok I suggest you have a consultation with Ben Weinstein, a very good western psychologist who can be seen at PSI. https://www.psiadmin.com/psis-professionals

He can arrange several sessions within a short period to accommodate the fact that you live out in the provinces

 

If medication is necessary, excellent psychiatrist is Dr. Suttiporn Janenawasin at Bumrungrad. US trained (Stanford Univ), very good, very thorough and also a really nice person.  A number of TV members have found it well worth the time and effort to travel to Bangkok fro mthe provinces to see her.

 

Depending on how happy you are with the care you are getting in Phuket for your hemochromatosis, you might also like to consult a western-trained hematologist while in Bangkok (bringing all records with you). If so, let me know and I will suggest one.

 

I really suggest you invest in a few weeks stay in Bangkok, during which time you consult the above doctors and also perhaps look around at housing options and consider relocation - because as you age, problems due to living in a remote area will only multiply.

 

 

 

 

[Bert got kinky]

 

I'm currently winning (just about) my battle, which while being self-medicated, was not all self.

Good support is vital, my wife is my 'June Carter' and helps me to walk my line but I also had to talk to a few of my co-workers about my condition.

I wake up every day now and say to myself "try your best to make today a positive day" and I then carry that out, just trying my best.

At the moment that seems to be working for me.

I don't know whether I am just on a rise and if I will sink again but at the moment I am trying.

 

To all fellow sufferers on here,  I really hope that you get through you dark period.

I found that it helps you to talk with someone who has been there but most important is to talk to your loved ones about it.

 

[mokwit]

12 hours ago, The Hammer2021 said:

That is my point. You are using a different drug. I make no moral judgement. But buying a prescription drug to make you happy is no different than getting high off a street drug. This is precisely the problem in the USA. Once you self medicate you are effectively using drugs for recreational purposes. Valium, Xanax, prescription opiates etc, become recreational when self medicated. You are taking the drugs to make you happy not to address the source of your illness and have no plan to stop taking the drugs  nor receiving counseling, medical support or therapy. In other words: drug abuse.

Antidepressants do not come under the same legal schedule as drugs of abuse because they so not create a "high". Valium, Xanax, prescription opiates are not "antidepressants" and are legally controlled substances in a way that antidepressants are not under the law.

[Adumbration]

@bamboozledThank you for your quality response and genuine interest in trying to help me.

 

Mindset is important in all facets of ones life.  However the triggers for my depression primarily arise out of what might be referred to as structural issues.

 

No amount of mindset will resolve the fact I have a chronic genetic blood disease for which there is no cure.  No amount of mindset will resolve the fact I have no family to rely upon back in my home country. 

 

You get the picture.

 

Thanks again for your input and please continue to provide your comments.

 

[VocalNeal]

5 minutes ago, Adumbration said:

No amount of mindset will resolve the fact I have a chronic genetic blood disease for which there is no cure.

Not wishing to delve too deep but does this affect your day to day activity like walking or...

If it is going to shorten your life then I'm sorry but you should have picked your parents better.????

I don't consider myself clinically depressed but I do get bored sometimes. Or maybe, more, suffer from lack of enthusiasm. My wife says go for a walk but I've been there before.????

Usually cured by meeting a mate(s) somewhere. 

[Adumbration]

@Sheryl Thank you for taking the time to draft a lengthy and detailed response.  Your input and assistance in much appreciated.

 

I live here in the boondocks because my partner worked in the 5 star properties located on a nearby beachfront.  She has not had a single hour of work now for nearly two years.  We have a  tiny house here in a beachside village and before covid life was simple and straightforward. The ocean is a genuine source of joy for me and has helped with my mental and physical health more throughout my life than any practitioner ever can.

 

There are significant risks arising out of where I live, and a stark light was shone upon them by the arrival of the delta strain.  But relocation to Grungthep will never be on the cards.

 

As you would know, when I get my bloods done there is focus upon serum ferritin and ferritin transferance as well as liver function.  Is there any other specific tests you think I should include to shed some light on my neuroma and associated neuropathy?

 

Yes.  Self medication may well be the endeavor of a fool.  But I must offer the Latin phrase "si trabis in naufragio" in my defense.  With that said, do you think Wellbutrin is an acceptable starting point.

 

Could you please let me have some approximate costs for:

1. Consultations with psychiatrist and therapists in Bangkok
2. Consultation with Prof Bavorn
3. Consulation with Ben Weinstein
4. Consultation with Dr Janenawasin

And yes, can you please provide you suggestion for a hematologist.

 

Thank you for your kind support and valuable input.

[Adumbration]

31 minutes ago, VocalNeal said:

If it is going to shorten your life then I'm sorry but you should have picked your parents better.????

The most valuable life advice you can give anyone is to choose their parents wisely.

 

My mother died of cancer when I was 14.  My worthless alcoholic father ran off with the next door neighbour's wife about six months before mum died and left me to fend for myself.

 

I have read extensively on the topic of "father hunger" to properly understand my own condition.

 

My father is about to die in the next few weeks.  Good riddance to him.  But that is another issue feeding into my current mental state.

[Adumbration]

@bert got kinky

 

Thanks very much for sharing your story and your kind words.  I wish you all the best.  I literally have a road map I have drafted hanging on the wall in front of my computer.  There is a work flow of each of the 29 problems I am currently facing in my life.

 

I started this post as a way to reach out and engage with others such as yourself and will keep you updated on my progress success and failures.

 

Please feel free to reach out to me if you think I can offer you any help or support.

[HeijoshinCool]

1 hour ago, Adumbration said:

No amount of mindset will resolve the fact I have no family to rely upon back in my home country. 

.

I do have family back in the States. 

 

I can't count on them for anything other than large doses of judgment.

 

But, I have a friend in the States, and one here in Thailand, that I could count on for anything. 

 

In fact, one of them was about to kill himself several years ago, when we met right here, on Thai Visa, he asking how to get to Thailand (a last ditch effort to prevent suicide) and how to bring his dog (who gave him comfort). I responded to his post. He drove to the airport, left his car in the parking garage, and was here two days later. The rest is history. 

 

If you are in a very rural atmosphere, might it be you are missing out on such a potential friendship? You certainly sound like a very decent guy with a strong mind; I can't imagine any difficulty in your finding friends like mine, though it might take some time.

 

I wish you the best.