Bipolar Disorder

His family came for consultation on behalf, as he wouldn’t come no matter what. According to what his family (wife, son & daughter-in-law), he is in such a hypomanic stage, with spending spree, agitated mood, and not sleeping much day nor night.

However, we were surprised to know that the man has been taking anti-depressant himself. The son said that he was depressed few months ago, so he willingly went to the general hospital to see a psychiatrist, and got some anti-depressant medication. He has since then been taking it, and got better from depression.

Now that he’s in such a hypomanic stage, imagine he’s still continuing with the anti-depressant?! He gets even hyper and manic. He doesn’t listen to his family’s advice to stop the anti-depressant, as he feels good taking them, energetic, filled with drives, jovial… (but manic in others’ eyes).

So after consulting us, we’ve given advice to the family that they will have to find a way to stop the man from taking the anti-depressant but to start with our medicine. Few days later it was the date for the man to go for appointment in the general hospital, where he usually just collects medicine as the appointment bookings for the psychiatrist is always full. So when the son accompanied him there (he’d never accompanied his father to the hospital), again the nurse asked them to collect the same medicine as the appointment booking is full. This time, with the advice from us, the son refused. He said the man’s condition is no longer the same, he can’t take the same medication. They sent him to Accident & Emergency department where the man was asked to do blood test. Only with blood test result coming out few hours later, they got to see the psychiatrist doctor.

Here it shows the importance to regularly have follow ups and reviews with psychiatrist doctor rather than continuously collecting and taking medicine (which is very common in most government and some private practices, most likely due to the shortage of clinical staff and doctors). As people don’t usually get depressed all the time with medicine (other than dysthymic disorder which is another case), they do recover, so they shouldn’t really be taking anti-depressant for long term without medical review, even if it is just a maintenance dosage, review is still needed and important.

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