Getting Help for Depression

[ivor bigun]

when i read posts like these although i have had heart problems for 40 yrs ,i realize what a lucky ,lucky <deleted> i am ,having all my life so many loving relatives and wives and now my wonderful one (the only time i was depressed was when my first wife who left me said she wanted to come back)

I hope you find some relief, and get better ,all the best from another poster

[Adumbration]

@HeijoshinCoolI have been here for more than a decade now.  In that time I have encountered very few expats that are worth spending time with.  I had several a few years back working in education but they were gradually squeezed out by visa restrictions.  I also had some friends who had businesses but they are all now broke and had to head back home.

 

Prior to starting this thread I contacted a number of old friends that I respect and trust.  They are located in various countries around the world.  I outlined my current problems and asked them if I could schedule a regular time with them each fortnight to chat on whatsapp. Two accepted my proposal and we have scheduled appointed times.  The other 4 declined saying they are flat out dealing with their own stuff.

 

Please note that I am not that old.  I am just mid fifties so most of my peers are up to their necks in businesses, mortgages and raising kids.

[HeijoshinCool]

4 minutes ago, Adumbration said:

@HeijoshinCoolI have been here for more than a decade now.  In that time I have encountered very few expats that are worth spending time with.  I had several a few years back working in education but they were gradually squeezed out by visa restrictions.  I also had some friends who had businesses but they are all now broke and had to head back home.

 

Prior to starting this thread I contacted a number of old friends that I respect and trust.  They are located in various countries around the world.  I outlined my current problems and asked them if I could schedule a regular time with them each fortnight to chat on whatsapp. Two accepted my proposal and we have scheduled appointed times.  The other 4 declined saying they are flat out dealing with their own stuff.

 

Please note that I am not that old.  I am just mid fifties so most of my peers are up to their necks in businesses, mortgages and raising kids.

.

 

Understood. And I agree many expats deserve a wide berth. 

 

But...

 

My local (ex-suicidal) friend is now in his 40s and works online, married with three kids. He and I talk numerous times every week. 

 

The married couple who are in the States are approaching fifty, with two wild boys. He works 50 hours a week as a plumber.

 

Both are enormously generous with their time. The guys stateside are now actively spending lots of time trying to sell my truck.

 

It is not easy finding friends like these, but rest assured, they are out there.....

 

On the other hand, have you ever noticed it is often easier opening up to strangers than acquaintances? A study was actually done confirming this.

 

Some one earlier suggested calling Good Samaritans.....

 

 

[Adumbration]

@ivor bigunThanks for your kind words and support

 

[VocalNeal]

1 hour ago, Adumbration said:

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.

Sounds as if he had problems all of his own? Just remember be kind. for everyone you meet is fighting a battle you know nothing about. Maybe going home and telling your father you forgive him would be beneficial to both of you.

[Adumbration]

33 minutes ago, HeijoshinCool said:

 

My local (ex-suicidal) friend is now in his 40s and works online, married with three kids. He and I talk numerous times every week. 

 

I have the skill set to work online to try and solve my zero income problem.  Chasing online work is one of tasks listed on the roadmap I have drafted.

 

Can I enquire what your friend does online and is there any opportunity to contact him via email to discuss if there are any opportunities to also work with his employer.

 

While on that point, if there is any other member reading this thread who has a genuine opportunity to offer some online work I would welcome a private message with the details.

 

I hope my posts are sufficient to demonstrate that English is my first language and that I have the ability  to communicate effectively.

Edited October 21, 2021 by Adumbration

[Bruno123]

40 minutes ago, Adumbration said:

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.

 

As Funkadelic once wrote: "Free your mind and your a*s will follow". ????

 

Your mind is creating your world. Change your mind. Clear your mind. Twenty nine things? Really?

I decided long ago, that I would not allow life to change me into a 'worse' person. 

Forgive your father; don't allow such negative thoughts to appear in your mind. That negativity is affecting you. I do not allow such things in my life.

The ocean is a good place to help you to relax. Learning how to relax and fix your problems is key. Your foot issue is one such thing. You can likely fix it yourself; but you have to allow yourself to fix it. You cannot do that if your brain is cluttered with unnecessary nonsense. 

The more you clear your mind and relax mind and body, the more able you will be to look inside yourself figure out and fix minor health issues. Our bodies are amazing. It's only our limited thinking that holds it back. We think things should be a certain way; so we force it to be that way. You have to unlearn that behaviour and allow yourself to traverse a different path.

I fixed a shoulder issue and a leg/foot/ankle issue just this way. By allowing my mind and body to relax and move in the ways necessary to free the twists and blockages. 

 

Whereas in your mind things some things appear set. Life isn't like that. Start allowing yourself to feel better. 

 

[HeijoshinCool]

7 minutes ago, Adumbration said:

I have the skill set to work online to try and solve my zero income problem.  Chasing online work is one of tasks listed on the roadmap I have drafted.

 

Can I enquire what your friend does online and is there any opportunity to contact him via email to discuss if there are any opportunities to also work with his employer.

 

While on that point, if there is any other member reading this thread who has a genuine opportunity to offer my online work would welcome a private message with the details.

 

I hope my posts are sufficient to demonstrate the English is my first language and I have the ability  to communicate effectively.

.

 

I'll PM you....

[Adumbration]

3 minutes ago, VocalNeal said:

Sounds as if he had problems all of his own? Just remember be kind. for everyone you meet is fighting a battle you know nothing about. Maybe going home and telling your father you forgive him would be beneficial to both of you.

Yeah.  That is how it happens in the Hollywood version.

 

In my early 30's I spent hours reading over child of violent alcohol father, and father hunger literature.  I bought a house for my father to stay in near to me and tried to get to know him.  He started showing up to my work office each day drunk and carrying a small cooler bag full of beers. Abusing my clients and my staff. He moved out the house and back to a town where his favorite bar and slot machines where located.

 

Sorry, but no tearful hug and all is forgiven in this scenario.

 

 

[Adumbration]

@Bruno123Thanks for your input

[Adumbration]

13 minutes ago, HeijoshinCool said:

.

 

I'll PM you....

@HeijoshinCoolThanks. I look forward to hearing from you

[Bruno123]

Just now, Adumbration said:

Yeah.  That is how it happens in the Hollywood version.

 

In my early 30's I spent hours reading over child of violent alcohol father, and father hunger literature.  I bought a house for my father to stay in near to me and tried to get to know him.  He started showing up to my work office each day drunk and carrying a small cooler bag full of beers. Abusing my clients and my staff. He moved out the house and back to a town where his favorite bar and slot machines where located.

 

Sorry, but no tearful hug and all is forgiven in this scenario.

 

 

 

Forgiving is for yourself; not him. Forgiving makes you a better person. That's the point. He had a chance to be better; but couldn't do it. Don't make the same mistake. Don't allow someone's behaviour to make you into a more unpleasant person. Stay kind, stay loving and if you cannot; work on it. You'll feel better for it....and that's the point. Feeling better.

 

 

[Adumbration]

8 minutes ago, Bruno123 said:

 

Forgiving is for yourself; not him. Forgiving makes you a better person. That's the point. He had a chance to be better; but couldn't do it. Don't make the same mistake. Don't allow someone's behaviour to make you into a more unpleasant person. Stay kind, stay loving and if you cannot; work on it. You'll feel better for it....and that's the point. Feeling better.

 

 

I would like to think of myself as a loving and kind person. 

 

I tried as a young man to open my heart again to my father and get to know him better.  Despite as a kid having watched him bash my mother to the ground with an ash tray.  Or having an irate husband showing up at our door to inform my mother that my father was sleeping with his wife.....or....my god the list is endless....and better not shared here.

 

My father is off my Christmas card list for eternity.  Nothing will ever change that...and it is best for me to avoid that emotional black hole entirely moving forward.

Edited October 21, 2021 by Adumbration

[allanos]

There is a saying in the legal profession that a lawyer who represents himself has a fool for a client.

 

Clearly, the OP is an educated man, but all of the online research and self-help activity is causing analysis paralysis; a road to nowhere.

 

There is no question that the physical impairments are genuine; the psychological ones perhaps not so much. Whilst "father hunger" may indeed be a recognised mental condition, and the OP has a history of child-neglect and abuse, it may well not be true that, in his particular, individual case, that the one has fed the other!

 

I would urge professional psychiatric counselling, by a true professional, at the soonest possible time. 

 

Then the OP can use it as a sound, realistic basis to create all of the road maps and flow charts in the world, which seem to be important in providing some degree of comfort to him.

 

In other words, and simplistically, put the cart in the correct place with respect to the horse, and not the other way around!

 

 

[jts-khorat]

5 hours ago, mokwit said:

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.

As the OP is close to Phuket; in case he has already made up his mind, which exact medication is best for him, it was no problem whatsoever to get both Valium and Xanax prescribed in Vachira Hospital, on my specific insistence with the doctor; however it is of note that he would have never suggested them himself, he told me so. Also I was asked to keep the schedule of repeat visits fairly tight, as he would not prescribe much of a stock.

 

I expect more modern and therefore much less problematic medicines to be less of a difficulty.

 

I think, it is indeed a very good idea to get specialist help in Bangkok, as @Sheryl advised, but if then a permanent move there is not possible or your overall symptoms do not make it a necessity right now, get a referral back to Phuket to guarantee access to the needed medicines.

[VocalNeal]

40 minutes ago, Adumbration said:

Yeah.  That is how it happens in the Hollywood version.

 

In my early 30's I spent hours reading over child of violent alcohol father, and father hunger literature.  I bought a house for my father to stay in near to me and tried to get to know him.  He started showing up to my work office each day drunk and carrying a small cooler bag full of beers. Abusing my clients and my staff. He moved out the house and back to a town where his favorite bar and slot machines where located.

 

Sorry, but no tearful hug and all is forgiven in this scenario.

 

 

OK then.

[malt25]

17 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.

You have absolutely NO idea what you're rambling on about. There's a vast amount of scientific evidence that a lack of certain body chemicals "serotonin" for one, can cause severe depression. I wasted some 40 years of my life being undiagnosed. Not much was available on the subject way back when. I've been taking prescribed medication for the past 22 years, and will continue till the day I drop off the perch. Had I been diagnosed in my youth my life would have been extremely different.. I purchase my meds via the local govt hospital at a "reasonable" price. They are available over the counter at some pharmacies, however at an inflated  cost.

[pseudorabies]

I'll second bupropion/Wellbutrin.  I had taken SNRI's and SSRI's with little to no benefit.  Wellbutrin was the only med that had any effect.  It works by increasing levels of norepinephrine and perhaps most importantly dopamine in the brain.  There is minimal therapeutic delay as is often the case with SNRI's and SSRI's.  If taken as directed it's relatively safe.  You will probably know if it is working for you after a day or two.  It is expensive and might be difficult to find outside of tourist areas.  

I'd also take Sheryl's advice and consult a psychiatrist.  I'd also ask her or him about newer therapeutics targeting NMDA receptor signaling including ketamine.  It's being used in the West but I haven't heard anything about its use in Thailand. It's benefit is its efficacy rate and rapid response.

 

Looking for the status of NMDA receptor pathway antagonists I came across a paper describing the use of dextromethorphan and bupropion combination therapy.  Again, I wouldn't recommend self-medicating but mention it so you can make sure that the doctor is considering all options, especially those that are newer.  Some in the depression field are stuck on the Monoamine Hypothesis and prescribe only around that.  The data for ketamine and similar, more tailor-made drugs is compelling and IMO should be considered.

 

Hang in there.  Try to accept and remember that things for you will get better.

[Adumbration]

Thank you for recent and helpful posts.

 

[Bruno123]

1 hour ago, Adumbration said:

I would like to think of myself as a loving and kind person. 

 

I tried as a young man to open my heart again to my father and get to know him better.  Despite as a kid having watched him bash my mother to the ground with an ash tray.  Or having an irate husband showing up at our door to inform my mother that my father was sleeping with his wife.....or....my god the list is endless....and better not shared here.

 

My father is off my Christmas card list for eternity.  Nothing will ever change that...and it is best for me to avoid that emotional black hole entirely moving forward.

 

As I stated, it's not about him; it's about you. Avoiding it isn't the same as forgiving it. He may have been a product of his upbringing.

Happily you have broken the chain; but perhaps it still has a profound effect. 

You sound a bit overwhelmed.

Who knows what is really 'normal'? You just don't feel good within yourself right now. It's something on which you need to work. Remedies; natural or otherwise, need to work in conjunction with you working on yourself.

Learning to be more relaxed in certain situation if not every situation. Dealing with your fears in so they don't affect your life in a negative way. 

So if you take something to help you relax; then explore the relaxation. Example: Dislocated shoulder; perhaps too painful to move without a painkiller; though once a painkiller is administered you can explore comfortable positions and more easily manipulate the arm into place. Something you could not do beforehand. Once fixed, no need for more painkillers and you have better knowledge of how to manipulate your body to fix things.

Depression is like a perception. I talk to friends who were depressed and realise that their reasons for depression can be solved easily; but they just cannot see it because they are bogged down with their negative thinking; failing to see that someone else standing in their exact same shoes would think they are in paradise.

That negative thinking affects your health and well being.

The water is good for you as it takes the weight off. Fitness isn't just about swimming long distances. When was the last time you did some mad spins and twists in the water; rather than controlled and repetitive movement?

Reprogram your brain for fun, laughter and happiness until most of your time is spent in feeling good or just relaxed with minimal stress and worry.

The 'no income' thing may be a stress; but how can you minimise that stress? This is your life; you need to be enjoying it.

 

Edited October 21, 2021 by Bruno123

[Tropposurfer]

Please don't listen to all these self-qualified 'doctors' here. Never take any medication especially a psychotropic without careful consultation, and ongoing monitoring of the effects of the drug you are prescribed by a qualified health professional, preferably a Dr of clinical psychology or a psychiatrist.

As a retired psychotherapist of many decades practice I actually know, the spectrum of possible ramifications of what I am saying to you.

While GP's can prescribe, and do prescribe anti-depressant medication their understanding of same is not to the levels of the above two other medical professionals noted.

If taking a psychotropic medication, and that medication has an adverse effect on you it could cost you your very life.

[Adumbration]

I stated earlier in this thread that I am currently dealing with 29 separate issues.  Someone commented "really" with the inference that I was having a laugh.

 

Here is a link to another thread that I have just started seeking help with just one of the issues:

 

 

[fittobethaied]

21 hours ago, jackdd said:

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.

I can certainly relate. A few years after moving to Thailand in 2010, I was dreadfully depressed and having trouble adapting to this culture and its people, so I went to see a psychiatrist at one of the private hospitals here in Udon Thai. After I shared my story with him, he responded by saying " don't worry....be happy...just change your attitude"! That was certainly a waste of good money. 

Whatever you do, don't get talked into taking any benzodiazepines like Alprazolam (Xanax), Diazepam (Valium) or Lorazepam (Ativan). You can easily become addicted after only 10 days, and the withdrawal symptoms from trying to wean yourself from them are horrendous. It took me 6 months before I was anywhere near normal again. 

[1FinickyOne]

4 hours ago, Adumbration said:

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.

This I am sure is correct and you seem to have a good grasp on your conditions. I have not read all of the comments above but I think someone talked of living mindfully and in the moment.. it does not have to be every moment, but some structured 'down time' or meditation or just time to take your mind off things and relax might be helpful. 

 

You have a lot on your plate to deal with - try and find some time and some way to take a break from it every day, if you can. 

 

Sorry for your problems. And not to minimize, I am finding so many of us have problems these days... it is as if the world is off kilter. 

[Sheryl]

3 hours ago, Adumbration said:

@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.

Specialist consultation at hospital will usually be between 1200 - 1800 baht doctor fee plus a few hundred baht hospital add on so figure about 2000. Do not buy medications at the hospital, if any are prescribed get at an outside pharmacy.

 

For therapist at PSI I don't know, best to call or email them.

 

Wellbutrin is an atypical antidepressent and would not usually be the first line of appriach. It is also hard to source in Thailand. For simple depression I think most doctors would start with an SSRI like sertraline. If there is also anxiety then might opt differently. Patients often are not aware of underlying anxiety.

 

One thing you might consider trying first are amino acid supplements that are precursors to serotonin and dopamine: 5-HTP (serotonin precurser) and L- tyrosine (dopamine precursor). These are milder in effect than antidepressents but also much safer and can be gotten on Lazada. 5-HTP dose usually 50- 100 mg at bedtime and L-tyrosine usually 500mg early morning but can experiment a bit to find best balance. While milder than antidepressents,  they do help and you will likely feel at least some lift especially if you also take steps to manage your hemochromotosis and get counseling. I would certainly try this first before resorting to self medication with antidepressents.

 

The problem with self medicating with antidepressents is, among other things, that the wrong choice of drug can set off other pysch problems e.g. acute anxiety, even mania in some people. Also suicidal ideation can occur. In addition there are potential physical side effects including cardiovascular and liver effects. I have no idea if your hematochromatosis would cause any special problems but that should certainly be explored. This really is not a good idea  for DIY.

 

I will post some hematologist recommendations later as I need to research it a bit.

 

I can appreciate your need to be near the ocean but perhaps you could consider a less isolated  location for it such as futher up the coast or along the eastern seaboard? With a signific chronic cobdition you need to be accessible to appropriate medical care.

 

[Adumbration]

Hello @fittobethaied

 

Am I correct in reading your past posts that you are a Australian chap currently living off disability pension with your Thai wife and bouncing back between gold coast and Thailand?  If so please let me know if it is ok to pm you and ask a few questions.

[Speedhump]

I am heartened by the amount of great advice you have received here. I can't add anything other than to agree that self-medication is fraught with problems as quite aside from which drug and dosage you need (which can even need to change) you will not know how/when to wean yourself off the medication, or may not even feel inclined to at all. I hope you can get help online from medical professionals if you can't visit a major city regularly. Bless you and I wish a long and happy life for you. ????????

Edited October 21, 2021 by Speedhump
Speeling

[DogNo1]

Eckhart Tolle now has short videos on YouTube.  His approach to easing mental problems is very eclectic and does not depend on the spiritual teaching of any particular guru.

[Fairynuff]

On 10/19/2021 at 11:12 PM, shadowofacloud said:

 

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.

I always pay in Thai baht

[Stevemercer]

A problem with anti-depressant medications is that you have to start with a low dose (in case there are unexpected side effects) and build up to a full dose over a period of several months. Similarly, you must gradually reduce the dose over a month or two if the drug does not work for you and the doctor wants to try another medication.

 

You cannot just start taking a full dose or stop taking the medication because there will be bad physical and mental side effects.

 

All this means it is a bit hit and miss and will take time to find the best medication that works for you. All major public hospitals in Thailand have mental health doctors and should be able to help for a very modest cost.

 

I use Sertraline (generic brand in Thailand is Zotaline) under the supervision of a doctor at our local public hospital. I am lucky because my wife is an ex-government officers so the visits and medication is free.

 

I started off at 50 mg per day and worked up to 200 mg per day over 2 months. The drug worked for me because I regained my motivation/drive and zest for life. Looking back, I could clearly appreciate that being in a depressed state was not normal and that there was no need to live like that. 

 

I am steady at 100 mg per day now which seems the minimum to be effective. I've tried going off it a few times, but the depression always returns. It is a terrible feeling. I expect I will be on it for life. I've tried a few other medications (under supervision), but none seemed to work for me or had side effects.

 

For some reason, the drug also got rid of my crippling social anxieties. For example, public speaking, meetings and conferences etc. used to terrify me. But all those phobias went away and I was able to better realise my potential at work. I certainly no longer had a problem speaking my mind!

 

Sertraline also does away with premature ejaculation. I don't know why. But a lot of players take it just for this reason. But like all psychotic drugs it can be dangerous if taken with alcohol and/or other drugs. Michael Hutchense (former lead singer of INXS) did himself in in this way.