Tag Archives: Medication

The more you worry about having to take medicine, the more you need to take them

Yes, and that’s all the point I want to make in this post.

Recently I spoke to a woman in her late 50s who has problem sleeping. She has been a patient since 15 years ago, but was never regular with medicination.

She has used all possible means to make herself sleep, taking wine, using chinese herbs, exercise etc. She just doesn’t want to depend on medicines. But she always comes back to see doctor and collect medicine when all other methods fail and she really needs some sleep.

So yes, she came back again last week. And since that visit she has called up the clinic several times. Every time asking about

  • When can I stop taking these medicine?
  • Can I start to reduce them now?
  • Will they harm my body?
  • What are the side effects and possible side effects?
  • What’s going to happen in long-term taking these tablets?

These are just some examples, under one topic/question she can ask in so many different ways and for so many times. (Eh? OCD?!)

At the end everyone couldn’t stand answering her questions repeatedly. So I’ve got the job. I told her that through our experience with many patients with either anxiety-related problems or with insomnia, the more she worries about needing to take medicine, the more she has to take it, it’s always like that. I asked her what has the focus of life becomes now?

All kind of worries about taking medicine.

The medicine is not likely to help her much if she continues to worry this way. So she won’t get well, so she’ll have to continue taking them. So she will continue to worry about taking them… … See the vicious cycle here?

So I asked her back why not continue with medicine, but shift her focus of life in something more meaningful, to how to live more healthily and happily? How about developing new interests, learning yoga, going swimming, forming new social relationships, improving familial relationship etc etc.

When she’s able to shift the focus and live more meaningfully and healthily, she may not even need the medicine without herself realising that.

 


越是担心吃药, 越是需要吃药?

当这过去十几年来一向难入眠的女士, 用尽方法却还是不能好好睡一觉, 她就会回来看医生, 通常每一两年至少来一次. 而这次拿了药回去后, 就开始不断地”电话轰炸”诊所, 问什么时候可以停药? 现在就停可以吗? 停了马上复发吗? 这些药有什么副作用? 对身体有什么害处? 一定要吃这些要吗? 等等等等. 每两到三天就来一通电话.

详细解释许多次后, 她却不见得可以明白. 下次打来, 还是问回这些问题.

所以我告诉她, 经验告诉我们, “越是担心吃药的人, 越是需要吃药, 往往也得吃得越久” 想想这么个担心忧虑法, 你的生活中心全是什么? 生活还剩下些什么?

本来吃药可能很快有效, 但是你这么一直担心, 东想西想, 日想夜想, 人可能反而更不舒服更忧虑, 结果要吃更多药, 然后又更担心忧虑, …恶性循环, 对吗?

何不就相信医生, 继续吃药, 同时好好地, 健康地生活, 培养新的兴趣, 做些运动, 建立社交生活, 改善与家人的关系等等, 在这情况些, 也许不知不觉中已经不需要再依赖药物了.

In the news: Mum killed for asking son to take psychiatric medication

I heard this news on the radio this morning. It just somehow worried me wondering whether it was one of our patients, and I had this mother in my mind.

She used to consult doctor on behalf of her adult son and collect medicine for him. All the while she brings medicine to her son but according to her, the son doesn’t think he has any problems. The son isn’t very keen to take those many tablets and liquids, but she can always make him take them.

Recently she insisted to bring the son to come to see psychiatric doctor, despite the son saying he has no problems. She said he’s willing to come. But hey, if you think he has no problems, why would you come to see a psychiatrist? Are you being forced to come?

In our job we came to know a lot of family members who have to supervise the patient’s medicine. Though we never encourage forcing patients to take medicine. So this morning when I heard this news I was worried about some old parents who are very caring but also too anxious and sometimes stubborn being involved in this kind of tragedy.

We are not asking you to stop caring about your mentally ill family, but sometimes they’re no longer themselves when their mind is taken over by the psychiatric illness, you don’t know what they’re going to do, you can’t make usual expectations as if they are not sick. So please seek professional help! And no, you don’t have to take them with you, or force them to come with you!

TheSunDaily: Mum killed for asking son to take medication

Placebo effects in psychiatric drugs?

I understand a lot of anti-depressants, anti-anxiety and anti-psychotic drugs that we’re using today have had quite a long history, we’re talking about a few ten years. But is it possible, that what works in some of them, is not the active ingredients in it, but the fact that it’s prescribed and taken, and patient’s belief in the pill(s), so the patient feels better? (If this definition is not clear enough for what placebo effect is, please check google here.)

Recently we have this typical anti-psychotic drugs ran out in the whole of country (i.e. nowhere you can find this drug, unless some expired ones in an old patient’s drawer). So having no choice the psychiatrist has had to replace it with other drugs, drug A, a stimulant that works the same but will be more stimulating (so patients can’t take it at night to avoid sleep disturbances) or drug B, another anti-psychotic that’s more sedative (suitable for patients to take at night).

Most of the patients are fine after the replacement of this old anti-psychotic drug, whether it’s with drug A or B, some with other medicine more applicable and appropriate for their current situations. Except two patients.

They both claimed that after replacing the medicine, they find it difficult to fall asleep (a common symptoms of anxious people: difficulty getting into sleep). When we tried to explain that the old drug is non-sedative (not assisting you to sleep) but also non-stimulating (not making you more awake/alert), and that 95% other patients who’ve had the medicine replaced found no problems, these two patients insisted that they need this old anti-psychotic drug to sleep.

In fact for one of the patients, the psychiatrist has come to realize that she’s no longer present with agitation or any psychotic-related symptoms, and so has replaced it with a tranquiliser, which should in fact be sedative and make her sleep better, as compared to the old anti-psychotic drug. But still, she struggled.

As a psychologist, I’d always observed and noticed the psychological effects of psychiatric drugs. How’d you explain this? Can we start to prescribe some placebo to help patients to sleep better?

Antidepressant & Anti-anxiety Medicine

Well first of all, I’ve to emphasize that I’m a Clinical Psychologist, I wasn’t trained in any medical background, what I’m writing and sharing in this post, regarding medicine, is from my working experience with a lot of patients every day.

Quite often people come to a psychiatric clinic with more than one problem, so things like “depression with insomnia”, “anxiety depression disorder”, “OCD with negative ruminations” are not uncommon. So they are of course, often prescribed with a number of different types of medications, which may fall under categories of anti-depressants, anti-anxiety or anti-psychotic (there are other types, but not my focus today).

Over the months or years patients or family will then start to tail off some medications themselves, whether because they think they’ve recovered, or they no longer need certain med, or certain med isn’t helping, or certain medicine is simply too expensive to afford taking long-term… And what’s left in their prescription, is often anti-anxiety medicine (and their names are often ended with -pam, such as lorazepam, xanapam, diazepam, tranpam, or their family lorans, xanax…).

Anti-anxiety is also commonly known as tranquilizers. They usually act fast, so within 10 to 15 minutes the patient will probably see the effects, whether when they feel restless, unable to sleep, too much worries, having obsessional thoughts… And this is what people like about these -pams. The effects are obvious, immediate, straightaway, you feel better right after it.

As compared to many anti-depressant drugs, it makes you drowsy, sleepy, tired, lose of sex drives, increase or lose of appetite etc, but you may take it for 2 weeks or even longer and still don’t see any changes in your mood. People’re definitely losing confidence in them, especially because many of those anti-depressants are also expensive (one tablet of it could be 6 to 7 times the price of a tablet of a tranquilizer).

So well, why not the all of us take anti-anxiety drugs? If you can’t sleep, take it. If you’re an OCD patient, take it. If you’re thinking or worrying too much, take it. If you can’t go on planes (phobia on board), take it. It’s probably going to solve most problems one may have, why pay more for something that you don’t see effect?

What’s the problem with it? Well no problem, other than the problem that you will probably have to take this anti-anxiety medicine for your problem, FOR THE REST OF YOUR LIFE. This is because it solves your problem on the surface, not on the root, it doesn’t in fact cure anything, although you see the effect right away. Unlike anti-depressant drugs, it takes time but eventually when the right dosage is on, you don’t just feel better, you get better too! (A bit like taking antibiotic…) One important to note here, is that taking the right dosage is also very important, some people like to reduce the medicine dosage themselves (especially if they find out that the tablets are expensive), however, taking too mild a dosage will not help with your problem!

So now I’m offering a solution, take both, take all that’s prescribed and the recommended dosage, some will release your problems right now, ease your suffers, but some will act for the long-term, and get you recovered.

Who should be the one taking medicine?

About half an hour after she and her husband left the clinic, she made a phone call, saying she wanted to speak to the doctor. She asked how serious her “illness” is, what diagnosis she has had, whether she is going crazy etc. At first I thought she was worried about her illness and about not being able to recover. So I explained she just got mood disorder, sometimes a bit harder to control her mood and emotions, but it isn’t serious, and will recover taking the medicine and maybe with some self-help.

However, after my explanation, “but my husband said I’m ok, I don’t have any illness. I told him I need to take medicine, if I’m ok, why do I need medicine?” She, in an almost screaming voice, said this. I volunteered myself to speak to her husband, telling him the importance to have supportive family members in the process of recovery, and although not serious, his wife does have mood disorder, so please try not to upset her, but give her full support and care she needs.

Few days later when I spoke to her again, she has got much calmer having the medicine running in her body. She said her husband still shouts at her, but she has complete no interest in having argument with him now. One thing she still doesn’t understand, her husband is the main reason she needs to take medicine, or else she’ll probably be fine. But why isn’t husband the person who should be taking medicine?

I have encountered quite a number of cases like this, usually the woman who comes for consultation and treatment, quite often due to their partner who is very bad-tempered, easily agitated, or having some not very severe mental health issues, unfaithful, having another family or missus outside etc. The problem of the woman in fact originates from the man, but then the problem continues to develop and the woman becomes easily agitated, paranoid, suspicious, disorientated, … … then she’s coming for treatment!

Though here it’s still very important to emphasise, that there are a lot of women out there who cope with those kind of problems without developing mental health problems themselves, and able to go through it with their resilience.