Category Archives: Depression

Euthanasia

This is the first time I came across this word. Euthanasia.

It’s also called “mercy killing”, or “painless death.” This is the definition from google “the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma.”

I searched about it after hearing a patient telling me about “legalised suicide” in some countries. She isn’t depressed, but she was for quite a period of time. When she was thinking about ending her life and making plans about it, she came across this idea – that it’s legal in some countries and even some with the assistance of a physician. (You may read more about it on google, especially the Belgium’s “Euthanasia Act”).

She asked me, “isn’t that nice? So it wouldn’t be so painful. And less trial and error. Maybe it’s just a pill and it’s done”

I’m aware of quite a number of patients of high risk suicidal, yet they are still around because they are scared to do it or scared of pain. I’m thanking god that they are scared of pain and hence they are still around, and hence I still get to help them.

I asked her, “Joey, do you still want to end your life now?”

“No, but back then yes. I didn’t do it because I was scared, but it would be good if it’s legal and I can die painlessly” (N.B. even if it’s legal it’s under certain kind-of-strict conditions, it’s definitely not that simple)

“So now you are ok to live on?” “Yes”

“That’s the thing.” I explained to her, “Joey back then wanted to die. That was Joey with depression wanted to commit suicide. But does Joey (without depression) want to die?”

“Ehmm I guess no” (She’s no longer depressed now)

Actually that’s all I want to say today. You feel like there’s no purpose to live on, you want to die, you might even feel like a burden to your family, or it’s such a suffer living… But it’s you with depression (or other mental/physical problems) who are thinking so. It’s not you. It’s like when you’re enraged (very, very angry) you shout that you want a break up or a divorce, but you don’t mean it at all. You regret it later on. So when your emotion is not like the usual you, you can’t make the decision to take away your own life, it’s not (the original) you, yes it might feel so real, but no, you don’t mean it. So don’t do this. Please seek help. It can be treated, and you can be like many of my patients, who are grateful that they didn’t/couldn’t make that move.

 

Please give yourself a second chance. Malaysia suicide hotlines:

The Befrienders
03-7956 8144/ 03-7956 8145
www.befrienders.org.my

Life Line Association Malaysia
03-4265 7995
http://lifeline.org.my/cn/

Agape Counselling Center Malaysia
03-7785 5955 / 03-7781 0800
http://www.agape.org.my

Related read (in Chinese): 识别自杀的预警信号

Problem-Focused & Emotion-Focused Copings

She didn’t think that she would need any professional mental help. That’s why she only came after quite a few months her colleague introducing our clinic to her. She realised that she is talking to herself, cursing, mumbling, and in this persistent low yet agitated mood.

It’s not difficult to understand why she’s in such state. She has a job herself and has four children, the second child is epileptic and can’t tolerate western medication, so she suffers from recurrent and unprovoked seizures. She lives with the husband and his family, including the mother in law, who doesn’t get along with her and is always criticising her. The husband’s brother works for the husband, and has recently moved in to their house with the wife and two dogs. She wasn’t happy that nobody sought her opinion regarding this. What’s worse is the brother in law and wife who never take proper care of the dogs’ hygiene. They live there for free, and never help out in any house chores. Sometimes they even use her car to take the dogs out, leaving the car seats with fur without cleaning. The mother in law would get in the way if she tried to say anything to the brother in law.

How about the husband? She’s been married to the husband for over a decade. The husband doesn’t care about all this. He usually comes home late, and is often drunk. She said he has been found to have mistress many times, some lasted for few months, some years. So this has left her in such paranoid state, is consistently suspicious that husband has another mistress yet again, and is always trying to track and check everything. So she lives in this house with her children, with almost no support and help, and with people who seem to always make life difficult for her.

What do you think? …? …?

My first reaction was fairly direct, “Why is she still there?” Yes she did mention that when outsiders look at her, most would think that she seems to lead such a happy and complete life. Is she?

Has she recognised what her problems are? Is she able to solve these problems effectively? Perhaps she can solve some of these, how about the remaining issues? Can she cope with them? Can she see the way out at all?

I do not think medication is going to do her much good, if any. I’d say this is why everyone should learn problem-focused coping strategies and emotion-focused strategies. Have you heard the famous inspirational by Reinhold Niebuhr,

Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

For me, it is telling us to solve the problems that are within our control (effective problem solving!), and for those stressors that we can do nothing about, we accept it (building psychological resilience, mindfulness, thought defusion, acceptance of negative emotions etc). And of course, what comes before, is the insight, the wisdom to identify the problems in your life and know to which category they belong to!

Psychosis to Depression?

It all started in December last year. She presented some elementary hallucination, poor sleep at night, poor concentration and drowsiness in the day. She wasn’t hearing voices, but some knocking sounds (similar to when one is knocking the doors).

So she sought psychiatric help, was put on antipsychotic and stimulant (Ritalin, normally prescribed for ADD, ADHD or narcolepsy). Her symptoms soon got much worse, seeing ghosts(?)., talking irrationally and was then brought to general hospital, where she was put on more antipsychotic drugs.

Few weeks later, her family took her to see another private psychiatrist doctor after she was discharged. The consultant diagnosed her with bipolar disorder, based on the fact that she was once an outgoing and independent person, and prescribed her with Lithium.

Throughout the few months under the care of the psychiatrists, she took and tried many medication including antipsychotic pills, she gained over 20 kgs. She gets really depressed about her weight. For when before the first episode end of last year, she bought some slimming pills online, which acted as appetite suppressant. That was when she was 20 kilograms lighter than what she is now. She wouldn’t even want to look at herself in the mirror, when she thinks about her weight, she thinks life is meaningless. She doesn’t know how she has got here and how to find the old self. She has been unable to work for 10 months now.

It all started mild. She has no family history of mental illness. The team can’t help suspecting those slimming pills that she took, which could affect and alter her brain and nervous system. Of course we wouldn’t know whether there is a cause effect relationship for definite here (and we would never know), but it is important that you know what pills and medicine you are taking, those that you buy online, and those that you are prescribed by professional doctors. I am not saying that everyone should question his/her doctors and the diagnosis and prescription, but when in doubt or think that something is not right, seek a second opinion. Also, do not believe everything that’s said on the internet, but sometimes online resources might provide us with some basic and guidance.

美丽的网红(网络红人)

我还没第一眼见过她,柜台帮她登记的同事就已经通过电话告诉我,“她真的很漂亮!陪她一起来的男士也超帅!”

一方面期待看到她,一方面心里”默默地自卑”。

她的话不多(有些患者一走进来,我可能连问问题的机会都没有),通常答案都很简略,或者想很久,但是答不上来,最后还是“我不知道”。过程中,她透露自己的一些过去,恋爱史,陪她来的男士只是朋友,她目前单身,已经五年了。也说到为自己过去的行为感到沮丧后悔,想忘记它们,通过催眠消除它们(没办法直接做到);再提到未来,觉得迷茫,工作迷茫,交不到男朋友也迷茫。

这点让我好奇,以她的外表,拜倒石榴裙下的观音兵肯定不少,她说有自己喜欢的人,但都爱玩,不想认真。而她,希望安定、谈一场细水长流的恋爱(几年前的她也曾经比较爱玩,但是已经过去了)。可是要嘛她对对方没有意思,要嘛对方只把她看成”玩“的对象。五年前分手的时候,也是因为对方还不想定下来,还是很爱玩,和其他女生暧昧,去夜店夜归等,两人不停吵架最后女生提出分手。她觉得男生是不可能专一的,最后能回家就好。

这让我想起很久以前和一个朋友的谈话,说她的一个朋友,不停地爱上有妇之夫,每次都很受伤,下一次却也还是重蹈覆辙;另外一个朋友也是,每次总爱上playboy,每次都被玩弄,身心受伤,但还是没有从中吸取教训。我们最后觉得,有些女生,总是会被一样的人吸引,总是会爱上类似特质的人。

这个个案中的女生,是个网红,拍很多养眼美丽的照片,网上的追随者与粉丝很多。男生会怎么看这个女生?(就会有男生说,有些女生只适合玩在一起,娶回家的绝不会是这类)而这个女生又会怎么看对她有意思的正经男生?又或者,她的生活圈中,有这类男生而同时又是她会喜欢的吗?会不会她总是不会看上所谓正经、或者想认真和她安定下来的男生?大家想想自己的过去,会不会觉得总是被类似特质的人吸引?

说到这里,想起最近一个好朋友的妈妈过世了,我不停在担心她的表现(太坚强),会不会是没有和自己的情绪接触(not in touch with her emotions)。毕竟东方国家,从小就被教育把负面情绪压抑,从来没有机会感受和接受。这个女生,也给我一样的感觉,总是“美美的”,没有什么表情,她的情绪起伏不大,笑容很浅,说到自己最难过的事情,也只掉了一点泪,就算我说,可以哭,可以难过,可以和这个情绪感觉相处…

或许你很羡慕有些非常漂亮的人,但是,有时候没有这点特质,反而让你的人生更顺利、更有优势。虽然我也还是会羡慕她长的如此赏心悦目,但也就只是单纯的羡慕,和更懂得感恩。

心理问题/精神疾病病友互助小组(吉隆坡/巴生)

在国外,不管是什么疾病,互助小组(support group)都是蛮常见的,比如抗癌勇士、强迫症患者等。过去也曾有好一些病人问过我,在马来西亚有这种小组吗… 所以在这里我提出一些意见,有兴趣或有其它看法的人,欢迎联络我…

互助小组类型:

  1. 抑郁症、情绪障碍
  2. 强迫症
  3. 焦虑与焦虑相关障碍
  4. 精神分裂,妄想、幻觉相关障碍
  5. 照护者、患者家属

什么是互助小组?做些什么?

  1. 每个月或每两个星期见一次面,大约一小时
  2. 认识和你面对一样或类似问题的人
  3. 轻松讨论一些主题(由我引导)
  4. 彼此分享、鼓励、支持、学习

语言

  1. 英语
  2. 中文/广东话

地点

  1. 吉隆坡欧阳专科医疗所(Jalan Pudu)
  2. 巴生Manipal Hospital Klang (Bukit Tinggi)
  3. 巴生河流域一代的咖啡馆

必要条件:

  1. 病人的意愿(不是被逼的;愿意出席、参与、讨论、分享、聆听)
  2. 至少三人才能进行
  3. 尊重其他人、尊重隐私权(不泄露其他人的隐私)
  4. 承担费用(行政、材料、场地等)(若有)

目前这只是初始阶段,如果你有什么意见和想法、或者有兴趣参与的话,请留下联络方式,也可以电邮 hello@huibee.com 或致电/whatsapp 017-2757813

英文版本:http://huibee.com/2017/08/support-groups-in-kl-klang/

Support Groups in KL / Klang

I’ve been asked about support groups quite a few times and been thinking how I can start this. It’s definitely something very common in western countries, I’m not sure how it will work here in Malaysia. Now I’m proposing the idea here, and for anyone who reads this and is interested in any of the support groups, please get in touch, let me know what you think and how we can start this and get it going!

Support groups for:

  1. Depression or mood related problems
  2. OCD (Obsessive Compulsive Disorder)
  3. Anxiety or stress related problems
  4. Schizophrenia and psychotic related disorders
  5. Carers (immediate family etc)

What is it? How does it go? What do we do?

  1. Meet monthly or every fortnightly for an hour or so
  2. Getting to know people who share the same or similar problems
  3. Casual discussion following a theme that we set (led by me)
  4. Sharing, supporting and learning among/from each other

Languages:

  1. English
  2. Mandarin / Cantonese

Venues:

  1. Klinik Pakar Au Yong, Jln Pudu, KL
  2. Manipal Hospitals Klang
  3. Some cafes in Klang Valley?

Requirements:

  1. Patient’s willingness! (is not forced by others to join us; willingly attend, participate, share and listen to others)
  2. At least 3 to form a group
  3. To treat others with respect and maintain confidentiality
  4. To share the cost of a small administrations/materials/venue fees (if any)

These are just some ideas for now, if you have some ideas or are interested, please do leave your contacts (email or contact numbers) below or get in touch by emailing hello@huibee.com or calling/whatsapp 017-2757813