Depression treatment in Chiang Mai

[Diddl]

https://www.therapyhelpcenter.com/

[technologybytes]

I don't know any of the answers, but its uplifting to see that by far the majority of responses here are positive and genuine with what appears to be some very good advice.

[Mcffee]

Instead of choosing zombiefying medication I suggest first consult the Chinese doctor at Munkala Clinic, Ratchamanka road (wooden house opposite the end of soi2) , that woman is wise and well experienced with many health and mental problems. Please try this first befor going to regular doctors who can't think out of the box.

Edited April 7, 2015 by Mcffee

[rethaier]

As a retired mental health worker I can tell you that the most effective medication I am aware of for the treatment of depression is Lamotrigine or Lamictal (both are the same). This medication was originally developed and is still used for the treatment of Epilepsy but by experience I can tell you it is great for depression also. You should be able to buy it without a doctors note, I know PharmaChoice sells it. It is not cheap at about 1900 baht for 30 tabs but if he takes 1 per day you will soon see improvement. I am not a doctor so I cannot give medical advice I am only expressing what I have seen and personally experienced. One great thing about Lamotrigine is it will not affect sexual function nor turn him into a Zombie. Good luck to you.

Edited April 7, 2015 by rethaier

[Sheryl]

There are a number of medications for this that will not turn him into a "zombie"; in fact antidepressents do nto usually have that effect (I think some people are confusing these with anti-psychotics, which are altogether different).

Best to have a trained psychiatrist determine which medication to try after a thorough evaluation. Not all depressions are the same. Also, prior medical history and any underlying physical risk factors can play a part in the choice.

[dotpoom]

Be very careful. Electro shock therapy is still considered a valid treatment here......

My first wife had "manic depressive psychosis" and received this treatment at regular intervals. Severe sure enough, but it did the trick every time. The problem (or maybe a good thing) was that she had lost all recent memory after every treatment.

I wouldn't dare to advise you in this matter but I sincerely hope you get guided to the right course of action and full credit to you in your support of him....I know, it is far from easy for you. God Bless.

[mikiea]

Be very careful. Electro shock therapy is still considered a valid treatment here......

that is because it is a valid treatment for some ailments. dude you watch to much tv soap operas, nobody has cooked brains for a long, long time, except in the moviex & tv. :-)

[frank0424]

Be very careful. Electro shock therapy is still considered a valid treatment here......

In Australia too. My father had it 8 years ago and a friend 3 years ago.

Worked out good for both of them.

[mikiea]

Instead of choosing zombiefying medication I suggest first consult the Chinese doctor at Munkala Clinic, Ratchamanka road (wooden house opposite the end of soi2) , that woman is wise and well experienced with many health and mental problems. Please try this first befor going to regular doctors who can't think out of the box.

huh. ... what.....? macky boyo ya got it bassackwards ....... first ya go to the doc, after no good results then you go to "traditional" med. practioners. and what box are you talking about ? that is such a tired old saying. i suggest you loosen up your bar stool seatbelt, i think your smashing your brains :-)

[connda]

Caveat emptor (let the consumer beware). I agree with others. Really start communicating with your husband and start doing your own research on depression, suicidal ideation, and the drugs used to treat it. Speaking from my own experience with resources mentions in this thread. The doctors my wife visited were essentially psychotropic drug advocates. In my wife's case, she was hooked on a legally prescribed drug that we wanted her to stop taking. Many drugs prescribed for psychiatric treatment can not only have side effects, but can be physically addictive. What I found in CM is that none of the psychiatrists that we consulted with could come up with a plan to take my wife off the class of drug she is addicted to. They all simply prescribed multiple drugs including antidepressants, and, more of the class of drugs she is addicted to. Why is that a problem? My wife does not have depression Plus I was struck with the impression that their treatment plan is drugs first and other treatment later if at all.

So, we are now very, very slowly tapering her off the class of drug she is on using a protocol that can be found on the Internet that was developed by a doctor specializing in that particular form of addiction, and she is under the supervision of our local Ampher physician who read the literature and understands what we are doing. Other than that, we both are trying to eat healthier, exercise more, and just deal with the changes that come with getting older.

So OP: Talk with the hubby. Research on-line. When dealing with a doctor or psychiatrist in CM or elsewhere, ask questions, get a feel for the doctor, if it doesn't feel right to both you and your husband, that doctor or clinic may not be the best choice. Find somewhere else. If he's Buddhist, visit your local wat and consult with the monks. If you're Christian, talk with clergy. And again, research on-line. Any meds the doctors give you, look them up on-line to find out what they are, what they do, side-effects, contra-indications, and what you need to do if you choose to stop taking them. Research the doctors, the facility, and any treatment program that they suggest. Look for alternatives. And research the interaction of drugs taken for depression and suicide. Just look up suicide and anti-depressants and read for yourself. Also look up antidepressants withdrawal. You don't just stop taking them. Withdrawal can be very unpleasant.

Alternatives: There is a counseling center at Chiang Mai University in the Faculty of Humanities. I was referred there for a completely different reason - they help expats make Wills. But they train Thai counselors. I got my reference to them from Lanna Care Net a few years ago. Now I can't find the email. There is also Mindfulness Based Cognitive Therapy that seems to work for many. Here's a link http://mbct.com/ Not sure you'll have any luck finding this in Thailand, but the Internet makes the world much smaller. Nothing says you couldn't talk to a counselor via Skype.

Best of luck. Feel free to PM me if you need to. Best wishes to you husband.

[connda]

I would highly recommend Dr. Ngamwong at Bangkok Hospital (here in Chiang Mai). My wife had been ill and seeking treatment elsewhere for quite some time, including Dr. Kittiwan, but she was not stabilizing, getting worse in fact, and every doctor she saw had a different idea what the problem was and prescribed her totally different meds, several of which ended up being worse than the ailment. Dr. Ngamwong is very patient and he spends enough time with her (and us together) in order to understand the underlying issues. Simply having a doctor that had time just to talk with her turned out to be so important to her. He immediately started to get her off the meds she had been prescribed elsewhere and prescribed alternate, lower impact, meds. Within just a few weeks my wife was out of the fog, and now a few months later and she's gradually going off all her meds and back to normal.

My wife's and I had experiences very similar to 'clokwise''s description. I wish I had known about him a year back. We probably would have paid Dr Nganwong a visit. But the treatment plan we came devised with our local physician is working to our satisfaction. Dealing with the human mind is not an exacting science -- their are a lot of diverse opinions in the profession and treatment effectiveness can be hit or miss, especially when it comes to psychotropic drug therapy, or for that matter, any form of therapy. And then the differences in culture. Probably a good thing the OPs husband is Thai.

[connda]

You have my sympathy. Living with a depressed/depressive person is just the hardest thing. Nothing you seem to do to help them brings them joy.

Just that empty, hopeless look. So hard for you.

It seems to me that many of the monks here are actually pretty good amateur psychologists, and they have a better understanding of thai people than we can ever have. We are currently dealing with a situation ( not as bad as yours ) right now, and feel it may be easier to get our thai man in front of a monk to talking openly than with a clinician. We would like it to become a regular twice a week kind of 'monk therapy' for want of a better term.

If your man already goes to the Wat that will be easier, but just an idea and you will know if it is worth a try. Also if you havent read books on Cognitive Behaviour Therapy yet, they can help you to 'manage' this situation.

Best of luck

I gotta agree with you. Culture here is just different than the West. A guy that does house work for us in our village was a nut case as an young adult. Bull-goose, nutso, crazy. He ended running around in the forest naked and acting possessed. The villagers brought him down from the mountains and to the wat. He ordained and stayed a monk for a number of years. Then left the monkhood and started a family and a normal life. You'd never know now. But the villagers say he was a nut job at that time of his life. Different culture. Different therapies. Who's to say a shaman and ayahuasca isn't just as, if not more, effective than traditional psychotherapy. Or here in Thailand, the structure of the Sangha and an devout meditation.

[connda]

You have my sympathy. Living with a depressed/depressive person is just the hardest thing. Nothing you seem to do to help them brings them joy.

Just that empty, hopeless look. So hard for you.

It seems to me that many of the monks here are actually pretty good amateur psychologists, and they have a better understanding of thai people than we can ever have. We are currently dealing with a situation ( not as bad as yours ) right now, and feel it may be easier to get our thai man in front of a monk to talking openly than with a clinician. We would like it to become a regular twice a week kind of 'monk therapy' for want of a better term.

If your man already goes to the Wat that will be easier, but just an idea and you will know if it is worth a try. Also if you havent read books on Cognitive Behaviour Therapy yet, they can help you to 'manage' this situation.

Best of luck

I gotta agree with you. Culture here is just different than the West. A guy that does house work for us in our village was a nut case as an young adult. Bull-goose, nutso, crazy. He ended running around in the forest naked and acting possessed. The villagers brought him down from the mountains and to the wat. He ordained and stayed a monk for a number of years. Then left the monkhood and started a family and a normal life. You'd never know now. But the villagers say he was a nut job at that time of his life. Different culture. Different therapies. Who's to say a shaman and ayahuasca isn't just as, if not more, effective than traditional psychotherapy. Or here in Thailand, the structure of the Sangha and an devout meditation.

I don't particularly think psychologists and psychiatrist are the only answer. My undergraduate work was in Psychology and after a one year internship working directly with inpatients from a major state institution -- well, let's just say the experience was life-changing. After that experience, I dropped any concept of post-grad work, dropped out of the university system, and spent the next few years in the logging industry. It was honest, clean work. It was like taking a bath after rolling in the mud for 5 years. Yeah, psychiatry is different now than in the late 60s early 70s, but..... My definition of 'professional' is much different than other individuals who may have an vested interest, or opinion about specific treatment methodologies, or who may be a stakeholder in something like a pharmaceutical company. Some people think that 'modern medicine' is the only answer. I don't.

As far as the suicidal talk. Yeah, he needs to talk with someone with a background in dealing with suicidal patients ASAP in order to get an accurate assessment of the OPs husband's situation and get that situation mitigated. After that though? I believe there are options that only the OP and her husband can decide on.

Edited April 7, 2015 by connda

[kerrysum]

And you are from where? You didn't mention it in your post.... But may I ascertain, you are not Thai? Just a thought....

[joshstiles]

Most likely you will not find any suitable medicinal treatment for depression in Thailand as I do not believe in medicinal treatments for depression.

However, I feel the best treatment for most mental disorders is Neurofeedback. There is only one unit that I know of in Chiang Mai that has this Neurofeedback System (NO). You can search google for more information on this ....I would recommend that you do. Unfortunately as you most likely already know, thailand offers little support for mental disorders. I strongly encourage you to seek additional info on NO. I apologize that I no longer have the contact information in Chiang Mai for this system and whether it is available to the general public at this time. These systems are used in the US and Australia and becoming more and more widely accepted as an alternative treatment for many ailments rather than any "magic pill". My sister is a psychologist in the US and licensed in the use of the NO system.

One additional nutritional note: The use of GABA can be useful in the treatment of depression. It is an amino acid already naturally found in the body. The problem is that I have not found it in Thailand (of course). It can be ordered via internet on a multitude of sites.

Good luck.

[Papayabokbok]

As described, this is a serious clinical depression with real risk of suicide. Monks and an understanding listener are nto sufficient. he urgently needs professional treatment.

If OP finds 800 baht consultation fee too high, as a Thai he can likely receive free treatment at Suanprong.

Moved to the health forum.

With all due respect, i told Dr Kittiwan i had a problem and was NOT offered free counsel.

Secondly not sure if you read my first post but i am a survivor of many previous attempts,

so i am quite aware of what helped me as i have taken the pills, cut, and been admitted, many times.

[Sheryl]

I don't understand your post. Of course Dr. Kittiwan's private clinic is not free. For free care, he would have to go to Suanprung (and this applies only to Thais).

[Bignose]

The flip side to the comments we normally see on TV, some excellent and thoughtful advice given with the very best of intentions, great to see and well done one and all.

Unfortunately I cannot give the OP any additional advice except to say she should stick with it, support you're partner as you are doing and there is a great chance you will both come through this very well.

Good luck and please update us when your partners situation improves...

[cheeryble]

Hi OP

I fully agree with professional help.

However as depression often seems to start with a trigger or triggers it would be really worth you (and better, your husband if his .english is very good) readin Feeling Good by David Burns.

The correct premise of the book is that it is unhealthy thinking which so often starts mental problems.

It gives a list so you can measure the depth of depression on the Hamilton Scale.

You may find it is not so deep as you think.....which may bring a little comfort, though even moderate depression can be ghastly and mild depression very uncomfortable indeed. But good to fix the degree of illness so you can clearly recognize improvement (example you may notice less tears)

So Feeling Good is basically a self help Cognitive Behaviour Therapy trainer.

The remarkable thing is that this stuff so often works.

The way you feel is led by the way you think....if you can examine and re-assess the thinking habits and replace them with efficacious ones it can really change s person. The book will show typical ways we think unhealthily and how to replace them, and personally I could almost "feel it working".

Best of luck to you and your husband its an awful thing, I know.

So hard for you to understand him but try to just accept that he is seeing the world in a different way.....a very painful and anxious one.

ps again I'd suggest this as an addendum to professional help.

pps try to enable as much social life for your husband as possible

Edited April 9, 2015 by cheeryble

[johnmcedinghburg]

I would to like give an comment About medication. I suffer many years with manic depressions.

For this i have had several kind of treatments and medications.

Now i would to give one important advice.

When your medication is working,Then make sure they Will not change THE brand as for example Sertraline is not THE same as other brand Sertraline.

I have iT just right now purchased 500mg Sertraline but other brand as before and have lots of trouble with iT.

So make sure that when you new medication that iT is THE same dont accept other brand.

THE same happende to me with depakine chromo 500mg at suandok, they told me sorry we dont have any more so we use other brand. I purchased iT now at THE pharmacia.

This is just my experience.

[Konini]

Hmmm...

Ive been there...Ate 64 tylenol once (teen) and put a blade to my wrist..(talk about painful!)

Been strapped down to hospital beds...etc....still battling the demons..anyhoo...

Off topic a bit, but good on you for sharing this. Many would be embarrassed or ashamed or any number of other things. That you shared your very personal experience in order to help is a very magnanimous thing to do. Good on you.