Bi-Polar Disorder

[dddave]

A young Thai woman I have recently become acquainted with clearly suffers from Bi-polar disorder. At her low points she frequently talks of suicide. She takes medication for Hyper Thyroid which I suspect plays a role as well.

She makes less than B10,000 a month in a clerical job so expensive major hospitals are out of the question.

Is anybody aware of any accessible and affordable mental health facilities for a Thai in her financial position?

[harrry]

First start would be her local government hospital. They can either treat her or refer her to a Government Psyciatric hospital if needed. Treatment will be free. Medication can be somewhat heavy but often is better than no treatment.

[Thanyaburi Mac]

Check out the Rajanukul Hospital down at Din Daeng area.

Lots of years ago with I was doing work with the U.S. Indochinese Refuge Program, we had a Lao gal there who was afflicted with schizophrenia. Sad case as she died before being able to move on to the U.S. to join her family in southern California.

Check out this www site: http://www.dmh.go.th/english/admin1.asp

Mac

[Ijustwannateach]

You may wish to check around at the resources listed in the pinned topic regarding Mental Health Resources. Even though some of these do not primarily serve Thais or act as public services, they would serve persons with Thai partners and will probably be aware of some other options appropriate to your friend's situation.

[Sheryl]

As she does not have much money she needs to get treated within the government health care system.

The main government psychiatric hospital is Somdej Chaophyra, located in Thonburi.

Somdej Chao Phraya Hospital

Address: 94 Klongsarn Rd., Bangkok

Tel: 437-0200-8

It provides both in and outpatient care for the full spectrum of pyschiatric problems. Being a government hospital, waits will be long with some red tape but with patience she'll get what she needs. Treatment will be free unless she requires a medication not on the standard drug list, in that case she would pay the medication cost only.

[dddave]

Thanks for the suggestions. I think the Govt. hosp. suggested by Sheryl is her best option.

Now comes the hard part: convincing her to take the initiative and seek treatment. When she is down; everything is hopeless, when she is up: "Problem?..What problem?"

[harrry]

Unless she can recognise the problem you are unlikely to effect any change.

[dddave]

Unless she can recognise the problem you are unlikely to effect any change.

Recognizing the problem is one thing; having the courage and commitment to face treatment is another...for anybody.

[rosbif]

My wife has been undergoing treatment recently for this, starting at Bumrungrad, and it certainly wasn't cheap - neither the consultations, nor the treatment. It's tough to talk about this sort of thing in Thailand, Thais equate any kind of psychological disorder with being mad. I'm not sure that it will be easy to find psychiatrists who are competent to treat this away from private practices. Plus it's not so easy to diagnose. The patients are often reluctant to reveal the extent of the problems, disguising the extremes of mood, their frequency, etc. They can be quite manipulative. To begin with my wife was diagnosed as simply suffering from depression - it was only when I gave a lengthy description of events and symptoms to the psychiatrist concerned by email that the diagnosis was looked at again - my wife had simply avoided mentioning most of what had been going on.

One other thing, the frequency and speed of the mood changes is one way of differentiating bipolar syndrome from borderline personality disorder.

Just for info, a 30 minute consultation with a psychiatrist specialising in bipolar at Bumrungrad runs to about 1500 baht, medication not included.

[paulian]

You didn’t mention where you are from or the lady. Banglamund hospital in Pattaya, a government hospital, maybe able to help her. Anyways, I can not emphasize the importance of proper medical treatment and diagnoses. I have a friend who has had Bi Polar disorder (Manic depressive) for many years. All the usual symptoms. At times major depression, at times extremely happy.

However, after many years of medical supervision and medication after medication as they evolved, he settled on one that was quite effective and is using it today with great success. The medication is Bupropion SR, also known as Wellbutrin. He started a few years ago at 150 mg a day for a week and then moved up to 2 Tabs a day after a couple of weeks (300mg) and is now taking 300mg a day. It is like he never had the problem. This drug is also used for smoking cessation and is marketed under the name of Quomem in Thailand, I believe. It certainly should be prescribed by a physician, however it certainly was the answer for my friend.

http://mental-health.emedtv.com/bupropion-sr/bupropion-sr.html

http://mental-health.emedtv.com/bupropion-sr/bupropion-sr-dosing.html

[Polsci]

As a Thai who grew up in the United States, I had PTSD from being in a war zone (thanks to our world leaders!). So I sympathize with the OP's friend and feel the OP's pain for having witnessed her going through her depressive moments and even suicidal thoughts.

Logically, the first order of business for me (and everyone) is to seek modern medical treatments. I did. And I met many other patients like me and those diagnosed with long-term clinical depression. Insurance premiums were affordable through work, but had I been billed directly, I'd have gone bankrupt. Unfortunately, any of the meds didn't work. On top of that, long-term treatments are prohibitively expensive and unsustainable.

Only thing that works for me is holistic healing treatments. It cost me just trips to local libraries to borrow books with subjects on healing and to read anything inspiring. Turned out that an early retirement, yoga and medication cured me. I got off meds. I got off the (career) fast track and now live a much, much simpler life (for someone with a prestige government career who flew premium class and lived in a posh neighborhood in Washington, D.C. suburb). Enormous financial adjustments were carefully made (I survive on just a little more than what OP's friend makes monthly). No more multi-tasking, shopping, partying, caffein, alcohol, too much TV, excessive internet surfing, and idle chats (and gossiping). They over-stimulate the already-restless mind. Thais tend to keep busy that way. She may have to cut down on many of these if she's doing all of them.

Yoga makes me stronger than when I was wearing a full gear with a 10-lb, bullet-proof body armor and a Kevlar, in addition to running 6 miles a day and lifting weights. When the body is supple, the mind is also flexible. No, not the competitive yoga to bend the body into a pretzel shape, but the yoga that brings stillness and inner calmness. OP's friend can do that at home (or with OP; I don't know OP's life situation). In fact, it's better that way. I learn yoga from YouTube. In Thailand, it's Ruesi-Dutton. Same principle. And on YouTube as well.

Meditation is Thais' second nature. Thais go to temples; whether or not they realize that sitting quietly for a long time and hearing the archaic hymn over and over from Buddhist monks' chants is a form of meditation. The chantings in Pali essentially say that impermanence is permanence. OP's friend shouldn't have any problem with this.

OP, you sound like a nice person with the warm heart. You can read to her spiritual books depending on your own religious beliefs (and, a big plus, help her expand English vocabulary, too). Or you learn Thai with her, reading something insightful. Regardless of her career progress, she should find something less stressful. Money and job promotions are not everything.

You cannot medicate unhappiness forever. I do believe depression and other symptoms of mental illness are a clue that your body wants you to make major changes in your life.

My two-cent is if she's going to a mental ward anyway, why not a holistic approach? It costs her nothing except making some changes (resulting in saving more money) and finding a quiet time to re-examine her life and put it in different, positive perspective. It's likely she'll transform her outlook and gain greater wisdom.

And don't forget to breathe. Deeply.

Edited November 2, 2011 by Polsci

[Sheryl]

A few comments on posts above:

1. PTSD is not at all the same as BPD. If she truly has BPD, she needs medication and indeed would be unable to avail of meditation and the like without it. Once stabilized on medication, such things may indeed be invaluable, but they do not remove the need for it. There are other problems that may indeed respond fully to such approaches alone, but true BPD is not one of them.

2. Wellbutrin (buprion) -- most people with BPD would require a mood stabilizer with it. Indeed should never be given/taken by someone with BPD without initial medical supervision. The big danger is that anti-depressents (which is what that is) given alone often trigger or aggravate mania in people with BPD, with sometimes catastrophic consequences. Indeed the diagnosis of BPD is sometimes first made after anti-depressents were given for was initially thought to be a depressive disorder.

[pcdude]

Having suffered with BiPolar for the past 30 years, I do sympathise with the OP.

Being a PC guy, the medication I recieved always put a haze over everything I did, so I stopped it and tried living with my ups and downs.

Having Schizophrenia as well, was a shock to me, as I was dignosed of this 6 years ago. (I thought I had extra sensory super powers... as I could smell things that other people couldnt)

Anyway, its a rocky road and when on a high level, it seems like "whats the point, I am fine"

Then there is the downhill spiral which for me, meant solitude, dark rooms and just trying to get through my angst.

I did the pschiatry thing to no avail, as it only supplies the tools to get over the situation, but when it hits... it hits hard and fast....

The best thing to do is simply be there, even if its in another room... Let her know that you care...

And yep... Im going through an episode as I type!

[uptheos]

OP you said that she 'clearly suffers from bi-polar disorder', but you don't say that she's been diagnosed with bi-polar disorder. Bi -polar disorder has been used far too frequently, since the original name of Manic Depressive Psychosis seems to have been phased out. If she's manic depressive, then she will certainly need evaluating by a psychiatrist that knows his onions and there aren't too many here. The treatment of choice is normally Lithium Carbonate, but this needs to be monitored very closely with blood tests. From what you say about hyper (overactive) thyroidism, it might be worth exploring this avenue first, before you go running of to psych. Is it Autoimmune or is it possible that she's had thyroiditis or some other trauma to the thyroid gland that hasn't been picked up yet. Has her thyroid had a complete scan or are you just going with the blood tests that are not always 100%? Diseases of the thyroid gland are easily confused with depression, mania and a whole host of 'psychiatric type' symptoms, so I think your first port of call should be a top class endocrinologist and rule out anything untoward with hey thyroid..

Hope all goes well.

PS If you're 'acquainted' with her, maybe you could help with the cost a little?

Edited September 23, 2012 by uptheos

[Sheryl]

this thread is almost a year old so I wouldn't necessarily expect a response from the OP.

BTW the combination of schizophrenia and BPD = schizo-affective disorder. It contains elements of both but is a distinct condition.