Self Medication For Severe Depression, Anxiety And Fatigue

[philo]

Thanks again for all suggestions, especially the link in post #29. That thread was very interesting, but it broke down (please read it to the end).

I am not CM based, but have been considering CM for a long time because there is a detox facility in a hospital where you have some foreign MDs and AA meetings every day. Now I have learned that there might a western psychiatrist also. Thanks.

But places like this and this (that some of you suggest) is not my style (I have called one of them a few months ago: we are talking about 10k+ USD and no resident MD). I would rather hire a GF or go to PYA.

The temple Wat Thamkrabok (see several threads on the 'I drink too much' forum) is for highly motivated people and has no resident MD. I have been there to take a look, and I think it is very good for younger people who wants a future. But they allow no medication (only herbs), so I would probably end up in an ambulance heading for a hospital in Lopburi after the first day there.

Also there is a drug addict rehabilitation centre in KK. Been there too, jail like facilty with a lot of Thai youngsters going off yaa baa. Not for me.

It should by now be clear to everybody that I have checked many possibilities for quitting alcohol already. Accordingly I will ignore all posts concerning this theme.

Anyway, If you like to post about stopping drinking, please go to the I drink too much Forum

(Edit: Post # 29 for the CM link)

Edited September 7, 2009 by philo

[Lopburi99]

There are no quick answers to your problems, it seems you are looking for a magic bullet. Every health care provider you see will recommend you stop drinking.

You say you will head for home after some business is rapped up in Thailand, what is more important your health or a few odds and ends you can take care of later.

No one has a magic bullet to wellness for you, it is up to you.

Been there done that.

Moe is right. In thinking further, clearing up some problems here first may be beyond your capabilities at present unless you get some effective professional help which works for you.

It'll be interesting what Sheryl has to say. Personally I believe you should strive to get to the European hospital absolutely as soon as possible, utilizing whatever professional assistance you can get here in the meanwhile until you can depart.

In any event, I wish you the very best of luck. Depression is awful and takes all the fun out of life, BTDT, but it can be effectively treated thank God.

[bobjenssen]

I am 52, have been self medicating on alcohol for 20-30 yaers, but it is starting to take it's toll on the brain and liver (also the autonomous nerve system; abdominal spasms).

The deterioration got really bad after I married here 4 years ago, and got even worse after having a child (now children; don't ask why).

I now live separately from my wife (which I now am really afraid of (I would rather lose my left hand than see a missed call from her) - she is a hothead and can be cruel beyond belief) and children (who I feel very sorry, guilty and ashamed towards: and worry about every second).

I am not suicidal (only insanely self destructive).

I spend most of my days in my room, and has a tuk tuk driver bringing me water, food, beer, tissue etc. and collecting laundry. Once or trice a week I venture outside. I use my time working (academically via internet), and arrange as much as can for my children (foreign citizenship, passport, social security number, bank accounts, private health insurance here, free public healthcare in my country of origin, documentation needed by my wife to apply for child and widow pension when I die, etcetera etcetara).

I do not have the energy to go and see a phsychiatrist.

I sometimes take 5 mg Diazepam (one or three a week), but it doesn't help. If I take two I get even more depressed.

A few months ago I took Lorazepam 1mg one or two times a day, but I dumped them because I read they are even more addictive.

I once was given Trazodone 50 mg (8 tablets) when I tried to stop drinking, but I never took them.

Stopping drinking is not an option now, reducing from 20 cans a day to 10 could be.

So there you are: Anyone can suggest a DIY thing that can be combined with alcohol?

Thanks

bless you brother- I know how you feel, have been there, done that, I was a gambler ....

never think that there is not a 'way" out of this, there is, we just must find the one that suits you

please try calling mr martin edwards a certified addictions consultant, 0894001811

addictionshelp(at)hotmail.com

you are in our thoughts

[Mobi]

Philo, Although Tim is involved in the "Breathing Space", that is not the facility I was referring to.

I think the facility in Chiang Mai you have referred to is the same one that tim has connections.

The other, similar facility, but different ownership/management, is based I believe in Kanchanaburi.

Tim can provide details on both of them.

As far as I am aware, they are both detox centers with foreign management/doctors and are designed for foreigners.

[philo]

Philo, Although Tim is involved in the "Breathing Space", that is not the facility I was referring to.

I think the facility in Chiang Mai you have referred to is the same one that tim has connections.

The other, similar facility, but different ownership/management, is based I believe in Kanchanaburi.

Tim can provide details on both of them.

As far as I am aware, they are both detox centers with foreign management/doctors and are designed for foreigners.

Mobi

For the sake of courtesy:

There is an error in my post #31:

The two 'this' links point to the same site - ie. the detox center Breathing Space Thailand (a sponsor here - I didn't know) that you mention above.

The other one you are refering to (and I was supposed to refer to in the other 'this' link in post #31) is ChannahThailand in Kanchanaburi.

To be short - luxurious spa like detox centers (however good they are) is not what I am asking for here.

If - that is if - I decide to go to CM I think I will try to be admitted here.

Those who are alive will know ...

[moe666]

Philo, it seems you really donot know what you want. Believe it are not you have a future only 52 if you get it togethere you got 30 years in front of you.

Good luck to you.

[Ijustwannateach]

Philo, if I were you, I wouldn't wait to start seeking counselling help- by all means, if you are convinced that you are not in control of your drinking behaviour, then don't let yourself stop- but that doesn't mean you can't start seeing a counsellor. You're asking for advice, and you're rejecting much of the advice offered here, from some very experienced types. If you don't like the advice the counsellor gives you, who will you consider wrong? It's something else for you to explore, anyway.

[philo]

moe

You're right, I donot know what I want. That's part of the disorder(s) and/or illness(es). I went to an AA meeting yesterday. One of the guys said it is like being in a 'brakeless car accelerating downhill on a curved foggy road'. You are afraid to jump off and you are afraid of crashing. But sooner or later you have to chose or the crash will chose for you. This is common knowledge for all persons (not only people in AA).

justwannateach

To be honest, the intention of seeking advise in the 'Health, Body and Medicine' forum (and not in the 'I drink too much' forum) was that I consider a mixture of less alcohol combined with medication that is not too hard on the liver better than a large amount of alcohol alone. Most of the advise given here doesn't answer that question neither in the positive nor in the negative.

Every sane person (and also must 'unsane' persons - like me, and even most of the insane ones) understands that being happy, healthy, sober and drug-free is good. I do not need to be told that.

This thread will go nowhere. (May be a moderator could rename it 'Advise against self medicating on alcohol, There is help to be found' and move it to the 'I drink too much' forum.)

(Edit: language, spelling)

Edited September 7, 2009 by philo

[LaoPo]

When I have sorted out the things I need here, I will probably go back to Europe and demand to be admitted in a hospital with a psychiatric ward.

You gave the answer yourself; you don't need answers from others.

For the sake of your children...go home and do what you wrote.

You know very well you can't get healed in Thailand; go to the airport and book a plane; you can take care of things later, when you're healed.

Show your kids you're that father they need.

LaoPo

[gerryBScot]

Philo can you afford inpatient detox in Thailand? That's probably the first thing you need....a medically supervised detox where they will fill you up with pills to ward off the heebeegeebees and DTs and stuff. Do it gently. Generally they say, although I am no medic, that it takes about 7 days to detox the alcohol out of your system. Thereafter I would suggest you head back to the rooms of AA and see how you get on, preferably live in the AA rooms simply to get you out of being isolated in your own room and in your own head. Your own head is clearly not your best buddy right now! You say you identify with folk in the rooms. That bodes well. You will only be able to treat any other mental illness once you are sober. You are not necessarily going to get any better or even better treatment back in Europe or N America. Yeah there are specialist services and lots of them, but they all have their limitations and in the end a lot of the people who maintain long term sobriety do it in AA. I am unashamedly AA and if you want to talk further PM me. Unfortunately Philo your circumstances are all too common. I have been where you are at. My circumstances could not be more different today. There is hope for you.

[soloman]

I am talking from experience over a long period of time.

A. 1. Alcohol IS a depressant, however having said that, I think that having a few low alcohol beers (I add ice which waters it down and lowers the absorption rate) is better than heavy drinking.

2. Psychiatriactric help along with a prolonged course of antipressant medication is mandatory, and nothing to feel guilty about. It can take up to 6 weeks for the medication to balance out the chemistry in the brain and initially you can feel worse. Once the medication is effective, continue it - dont say to yourself "I feel better now, I can drop the medication".

3. Maybe after the medication kicks in, do some form of regular exercise - say walking say 30 minutes day.

4. I accept my need for medication, including sleeping medication. I have lost too many mates in the 50's age group to the alternative.

B. Then if you can find a little motivation, try a little at a time to socialise and maybe even find a hobby.

I am currently struggling at the B. level above- it is a struggle which I do for my kids.

[Hairy]

Philo, the drugs you mention in your initial post aren't antidepressants, and they're not "self-medicating". If anything, you're making it worse by playing around with these drugs as a way of numbing yourself. But you seem to take comments about that as "moralizing" (they're not, they are people trying to explain that that stuff is making your situation worse), so I'll stop right there and go on to the "SSRI 101" you keep asking for.

First off, if you are in or can get to Bangkok, Bumrungrad has a group of very good psychiatrists. I would particularly suggest you talk to Dr. Pichai Saengcharnchai or Dr. Spain Uneanong. Dr. Pichai would probably be better suited in your case; you need to go on a Monday to see him (according to Bumrungrad's website). Call and make an appointment ahead of time. Take a few days and go there, and you can go see some sights as long as you're in town. Bumrungrad is on Sukhumvit Soi 3, conveniently near the Nana skytrain stop. Parkway Inn is a nice hotel that is a close walk to the hospital (just a thought, there are other places nearby that are cheaper if you want to save a couple of hundred baht, like the Nana Hotel on Soi 4). [EDIT: I forgot that Thaivisa doesn't like people to put links to other sites in posts.]

And phone numbers:

+662 667 1555 - Bumrungrad, general line

+66 (0) 2255 3711 - Parkway Inn

It can be VERY hard to self-assess the effects of antidepressants. They're changing both how the world affects you and how you see the world. You think you're acting normally, but everyone is wondering why you're stumbling around screaming at lampposts, and then the cops arrive and figure you're on drugs, and they're sort of right, just not the type of drugs they expect.

Also, the modern antidepressants (SSRI's, SNRI's, Wellbutrin/bupropion) can take up to two months of "loading" before they start to work for a patient. You're stuck waiting and hoping, and if nothing happens, you have to stop and wait until you can try another.

There's no way to determine ahead of time which type is necessary for your neurochemistry, and the wrong type can really mess you up, or at the very best will do nothing whatsoever. Even with the right type, a particular drug within that type can still mess you up horribly. A relative of mine ended up in restraints for several days because an SSRI he was being switched to triggered violent, frothing-at-the-mouth psychosis. They had to tie him to a bed until the stuff washed out of his system. Other SSRI's didn't trigger that, just that one did.

I would also point out that these medications, during the startup phase, can trigger suicidal behavior. One theory I've heard is that they improve people's motivation before they improve mood, so someone is still depressed enough to want to kill himself, but now instead of being apathetic he's motivated enough to do it. I don't believe that theory; I think that they simply destabilize the mind enough to trigger the suicidal behavior -- as I wrote above, you never know HOW THESE DRUGS WILL AFFECT ANY GIVEN INDIVIDUAL.

Oh, and one more thing, these medications have a lot of side effects. SSRI's in particular are well-known to cause sleep problems, sexual problems (impotence, inability to orgasm), and auditory hallucinations (hearing voices), in addition to the aforementioned suicidal (and sometimes homicidal) behavior.

In other words, while these medications are "OTC" in Thailand, they're dangerous as all hel_l, and you really NEED a stable, knowledgeable, EXTERNAL evaluator to keep an eye on you. Without one, you run the risk of driving yourself over the edge. At an absolute minimum, you need a good friend who knows you well AND WHO WILL STOP YOU FROM CONTINUING if you're going off the rails. There are very few people who can do that -- even if you tell them in advance to keep an eye on you and warn you if you are acting irrationally, they will rationalize your odd behavior away as "well, maybe he's just having a bad day" instead of warning you. Ask me how I know. . . .

You have to ramp up to a full dose when starting SSRI's, and you have to ramp down when stopping. The ramps and dosages are medication-dependent. See a psychiatrist to find out what they are.

Overdosing on SSRI's is dangerous. It's better to miss a dose than to take a double dose. (You'll figure out you missed a dose soon enough. It's unpleasant, but it's a lot less unpleasant than doubling.)

One more thing with SSRI's is that for about 25% of the people for whom they work initially, they simply stop working after a short time. One week doing great, the next things are looking gray, and then feeling miserable AND suffering from withdrawal symptoms AND addicted to the dam_n things. If it happens to you, then at that point, GO SEE DR. SPAIN. Don't even think of messing with it yourself. There are ways to avoid having to withdraw completely, but you CANNOT know enough to do it on your own without training. That's the 900-level class.

Since you're a heavy drinker, DON'T use WELLBUTRIN (bupropion). Even a couple of drinks can trigger seizures (officially, even one can trigger seizures) when you take Wellbutrin. With your level of drinking, you'd be at serious risk, in fact I'd guess you'd be guaranteed to go into convulsions. You would have to give up alcohol completely before starting on Wellbutrin, and be off alcohol for the entire time you took it -- no "one drink and I'll stop" games, since one could lead to two, and two could put you in a hospital.

Edited September 11, 2009 by Hairy

[philo]

Thanks to all. I think I have given up the project already. I have contacted my former GP in Europe. He will get my journal and may be contact my former psychiatrist (now retired) to find out what medication I used before (20 years ago). He knows that I drink, so i guess I will be warned.

I have checked out some possibilities in Thailand also.

Hopefully I can get out of this mess ...

[carmine]

I am 52, have been self medicating on alcohol for 20-30 yaers, but it is starting to take it's toll on the brain and liver (also the autonomous nerve system; abdominal spasms).

The deterioration got really bad after I married here 4 years ago, and got even worse after having a child (now children; don't ask why).

I now live separately from my wife (which I now am really afraid of (I would rather lose my left hand than see a missed call from her) - she is a hothead and can be cruel beyond belief) and children (who I feel very sorry, guilty and ashamed towards: and worry about every second).

I am not suicidal (only insanely self destructive).

I spend most of my days in my room, and has a tuk tuk driver bringing me water, food, beer, tissue etc. and collecting laundry. Once or trice a week I venture outside. I use my time working (academically via internet), and arrange as much as can for my children (foreign citizenship, passport, social security number, bank accounts, private health insurance here, free public healthcare in my country of origin, documentation needed by my wife to apply for child and widow pension when I die, etcetera etcetara).

I do not have the energy to go and see a phsychiatrist.

I sometimes take 5 mg Diazepam (one or three a week), but it doesn't help. If I take two I get even more depressed.

A few months ago I took Lorazepam 1mg one or two times a day, but I dumped them because I read they are even more addictive.

I once was given Trazodone 50 mg (8 tablets) when I tried to stop drinking, but I never took them.

Stopping drinking is not an option now, reducing from 20 cans a day to 10 could be.

So there you are: Anyone can suggest a DIY thing that can be combined with alcohol?

Thanks

I have suffered from depressiom for some twenty years now. It is an aweful illness that someone that does not suffer can never understand.

Over the years i have been prescribed some many different types of medication, each with varying degrees of effectiveness. However, medication is not the answer longterm, merely a shorterm quick fix. Not for one moment think i am making light of your situation, when i say that you have to begin by helping yourself and change your lifestyle.

I would suggest as a start, go to your doctor for some medication to ease the alcohol urges. Stopping drinking alcohol is the first major step. It's a depressent in itself and will only increase you anxiety. I am fully aware this will not be easy but you are obviously an intelligent man and owe it to yoursely.

Secondly. get out everyday and do some kind of excercise, any excercise. It will help hugely with your sleep and general well being.

Thirdly, try and keep to regular sleep patterns. It may sound very routine but it will help.

Ofcourse my suggestions won't cure you but i do know they will help. Just waking up in the morninf feeling physically better, as opposed to twenty cans of beer inside you, will add to a feeling of greater self esteem and worth.

Taking this on board coupled with regular visits to a doctor will take some huge steps forward for you. It will be very hard but you can achieve this. The easy option is booze....please don't take it.

You have my best wishes

[KevinBloodyWilson]

When I have sorted out the things I need here, I will probably go back to Europe and demand to be admitted in a hospital with a psychiatric ward.

You gave the answer yourself; you don't need answers from others.

For the sake of your children...go home and do what you wrote.

You know very well you can't get healed in Thailand; go to the airport and book a plane; you can take care of things later, when you're healed.

Show your kids you're that father they need.

LaoPo

I agree with LaoPo, the answer is obvious, you already know what needs to be done but don't want to do it.

If you don't do it, you will likely die before your time. Write that in very big letters on your wall or somewhere and read it often.

[rixalex]

I agree with LaoPo, the answer is obvious, you already know what needs to be done but don't want to do it.

Yes the answer is obvious, but i think he's been told it so many times he just dismisses it in annoyance immediately and assures himself that these people just couldn't possibly understand what it is he's dealing with and why, for him, giving up alchohol is just not a possibility. He seems to think he's unique and in someway different from all the millions of others who have had exactly the same sort of alchohol related problems and who have overcome those problems by stopping drinking.

[misterkeeperofthereef]

I am 52, have been self medicating on alcohol for 20-30 yaers, but it is starting to take it's toll on the brain and liver (also the autonomous nerve system; abdominal spasms).

The deterioration got really bad after I married here 4 years ago, and got even worse after having a child (now children; don't ask why).

I now live separately from my wife (which I now am really afraid of (I would rather lose my left hand than see a missed call from her) - she is a hothead and can be cruel beyond belief) and children (who I feel very sorry, guilty and ashamed towards: and worry about every second).

I am not suicidal (only insanely self destructive).

I spend most of my days in my room, and has a tuk tuk driver bringing me water, food, beer, tissue etc. and collecting laundry. Once or trice a week I venture outside. I use my time working (academically via internet), and arrange as much as can for my children (foreign citizenship, passport, social security number, bank accounts, private health insurance here, free public healthcare in my country of origin, documentation needed by my wife to apply for child and widow pension when I die, etcetera etcetara).

I do not have the energy to go and see a phsychiatrist.

I sometimes take 5 mg Diazepam (one or three a week), but it doesn't help. If I take two I get even more depressed.

A few months ago I took Lorazepam 1mg one or two times a day, but I dumped them because I read they are even more addictive.

I once was given Trazodone 50 mg (8 tablets) when I tried to stop drinking, but I never took them.

Stopping drinking is not an option now, reducing from 20 cans a day to 10 could be.

So there you are: Anyone can suggest a DIY thing that can be combined with alcohol?

Thanks

[Sheryl]

Philo,

I appreciate that you are attending AA and that you are looking for a way to treat the anxiety and depression that are both a cause and a result of your alcohol use. Also that you have tried unsuccessfully to get help at many hospitals in Thailand.

For sure, valium (diazepam) and related rugs (lorazepam etc) are not advisable and indeed will worsen your deprerssion; they are, after all, depressents. In addition they are highly addictive and completely contraindicated with alcohol.

SSRIs are indeed the drugs of first choice for depression. HOWEVER, they can worsen anxiety, especially at first. The pharmacologicaql management of depression when there is a concomitant anxiety disorder is difficult and really, really does need to be supervised by a mental health professional. And that is without factoring in the alcohol use, which further complicates matters. In your particular case it would be best to start an SSRI not only under a pyschiatrist's supervision but as an inpatient, so that appriopriate emergency sedation can be given should you have a severe panic attack, which can happen when SSRIs are started in a patient who also has an anxiety disorder.

While what you say about Thai doctors/hospitals and mental health problems is often true, there are exceptions and some good, Western-trained pyschiatrists can be found at hospitals like Bumrungrad, Samitivej and Bangkok Hospital. There is also a recently opened private hospital exclusively for mental health problems called Manoram.

One poster has already given recommendations for pyschiatrits at Bumrungrad, if you do a search of thsi forum you may find other first hand recommendations at other hospitals as well. For Manoram Hospital info see thei website www.manoram.com

While alcohol is not absolutely contraindicated when on SSRIs, excessive alcohol use has been linked to exacerbation of SSRI side effects including, most seriously, suicidal ideation. As you may know, risk of suicide increases initially when someone starts on SSRIs, another reason why it would be wise to be in an inpatient setting initially.

Another point to ocnsider given your drinking is your liver function, as SSRIs are metabolized in the liver. If you haven't had recent liver function tests (ALT/AST), you should; simpel blood tests which any hospital can perform.

[rucus7]

I am a firm believer of " where there is life, there is hope" ( Cicero) and you apparently no longer get any enjoyment from alcohol. You may be ready to quit. It sounds as if your drinking is like a maintenance program. Just a routine that is no longer needed. I don't think the substitution of anti-depressants is a viable solution. Undoubtedly cessation will be unpleasant, however from the amount you are consuming not life threatening. Only you can make the commitment. Many programs exist that help people when they are ready. I hope you choose life , and all that is associated with it, pain, anger, hope, joy, depression, fear ETC. Life is not easy it is just life, be strong.

[fullwhenempty]

Addictions, be it food, alcohol, cigarettes, gambling, womanizing, chocolate and so on are ways in which we self-tranquillize. Having done all of them over the years I know how difficult it is to stop. The way I did it was to remove myself from all the stressors and an environment where habits are more difficult to break. I took off and left everything behind and didn't stop until I reached a lonely hillside in a foreign clime, where the nearest shapely ankle was attached to a goat. NO TV, NO media, NO radio. NO women. NO booze. Only a stark bulb, a book and hills covered in lavender.

I then went to work on myself, learning Yoga and meditation, eating more healthily, walking every morning, having an hour in the sun, lots of fresh air. NO over-stimulation of the nervous system, which was shot to pieces from years of anxiety and stress. And away from temptations. I tried many different therapies, none of which did the trick but collectively brought me to a realization that I was worthy of being saved. It also made me realize that the only person who was going to save me, was ME. I didn't think I had the inner strength or resources but surprisingly discovered I did. So do you. You may be an educated man but your problems are not of the mind. They are of blocked energy and blocked emotions and there are ways to unblock them.

It took a combination of escape from stressors, breathing exercises, positive thinking, detoxing, nutritious food, a woman who made no demands on me and starting to see myself as a valuable soul rather than a weak, useless body. I now help others with a combination of deep tissue cleansing and other techniques which address people's problems holistically. Individual therapies are fine but it is the whole person that needs sorting, not just the head. Psychiatrists did nothing for me, not that they won't be able to help you. The French tried seperating heads from bodies and it doesn't work.

There is a tendency for some people to go from therapy to therapy, practitioner to practitioner, never finding the magic bullet they seek. they sink wellls, hoping to strike oil and never get there because they don't drill deep enough. Keep that in mind.

I have seen many people drop their addictions simply by therapeutic fasting alongside dietary changes and emotional freedom techniques. Going cold turkey for a week isn't much fun but coming out the other side is incredibly rewarding.

Anti-depressants, namely Seroxat screwed me up for years. What's the point of coming off alcohol by taking something else which is almost as harmful? St John's Wort, I would take, plus 'Phyllanthus Amarus' to support and repair the liver. The Thais call this 'Luk Tai Bai'. It grows by the side of the road. Get some bitter herbs into you to clean your blood, kill parasites and balance your blood sugar. Also take a colloidal mineral supplement. Your adrenals probably need support too. Do a search for 'adaptogens'. None of these has any side effects. 'Ashwaghanda' and 'Shilajit' are Ayurvedic classics.

My way may not be your way but if it was me, I'd try the Thai detox and vomit (purgation) approaches. They are based on ancient proven remedies and they don't just treat young people. You'll be away from temptation and have no choice but to face yourself. It's also cheap.

And conduct an honest self-appraisal. Do you really want to get well? Until the answer is an emphatic 'Yes', don't waste yours, or anyone else's time. When a smoker comes to me with leg or lung problems and says I've cut down to 2 ciggies a day, I kick them out the door. Practitioners can help but they aren't miracle workers. Sometimes it comes down to a simple choice.

Do you want to live? Or do you want to die?

If you want to live, what are you waiting for? Get off your rear end and do something. Procrastinating just leads to inaction. Cure yourself of your addiction, then use what you have learned to help others.

Good luck and God Bless.

[rixalex]

If you want to live, what are you waiting for? Get off your rear end and do something. Procrastinating just leads to inaction. Cure yourself of your addiction, then use what you have learned to help others.

Brilliant post. I hope it has some impact.