Category Archives: Basic & General

Is Meditation for you?

Basic & General, Issues & Debates

The patient called up to ask about her diagnosis, saying she’s applying for a meditation course (V******), and she’d have to clarify all her illness and past medical history, and also the type of medicine she’s taking and what they’re for.

This patient recently had a relapse and came back to us. She made the call just few days after the visit.

This is a course completely non-commercial. The participants only have to do some donations after the 10-day course, so that the course can continue to benefit others (especially if you find it beneficial, you’ll probably like to donate more, so more people get the benefits). It teaches some mindfulness training, and you explore yourself and your mind “deeply”. (to understand the course better you should visit their website or contact the relevant personnel, it’s not the focus here).

In the past there have been patients from the clinic who went for those meditation courses, whether they are commercial or not those courses usually lead people to a better, calmer self with clearer insight and mind. But unfortunately, quite a few of them had a relapse after attending those courses. Some of them have to quit half-way.

I’m not saying that those courses are bad, since mindfulness training and meditation are found to be beneficial for most people; but they may not be suitable for certain group of people, e.g. those who have a mental illness history, or still currently take medication or undergo psychotherapy for their psychological problems. This is especially the case when the problems are psychotic related or based as their psychotic symptoms (e.g. visual/auditory hallucinations) may be exaggerated during meditation. An assessment by the attending clinician may be more appropriate before going for it.

It doesn’t have to be your fault for you to change

Basic & General, Clinical Case Studies

She said he has been supportive all financially and mentally to the family of 5 since their marriage over 10 years ago. He has no bad habits, he doesn’t use violence.

But she wants a divorce. She was terrified yesterday, when she talked to him, regarding an outing with friends. She said it was the way he looked at her and the way he talked to her was scary.

She knew he has changed for her, since she initiated the divorce. But she said there are certain things that people can’t change, it’s in them, in their personality, long-standing habits (just wondering here, if it was his personality and long-standing, the problems would have been there before they get married isn’t it? Why wasn’t she scared?). So she insisted the divorce despite his efforts and knowing how responsible a husband he is.

So we gave up talking to the wife, we spoke to the husband. He thinks he has done nothing wrong, in fact he’s done well since the marriage.

But he wants the marriage back. He was told that if he continues with how he is, the wife is going to leave him. So despite doing nothing wrong, he’s the person who needs to change. We pointed out a few things that the wife mentioned, and asked him to start paying attention on them and changing them. So if he has tried hard enough to change, to improve his way of talking and treating her, looking at her, but she still insists the divorce, then at least he has tried.

It really doesn’t have to be your fault for you to change. If you want something badly you will have to initiate the move.

Be Positive

Basic & General

“Why not you try to find yourself some pleasurable activities, and go ahead to do it,  even when you don’t feel like doing it. You’ll be surprised at the end of it by how much better you may feel.”

“Can you give me an example of what I can do?”

“How about travelling? Going on a holiday?” (having known that this patient is financially capable)

“But there are so many disasters everywhere!”

“…”

A depressed man will only focus on negative aspects of things. He sees travelling as being involved in disasters or accidents and dying in other places, away from friends and family.

Just like myself – when I first started work, I remember so much of those family members or patients who were so grateful with their improvements after visiting us. Yesterday when I was discussing some cases with the doctor, I realized we’re now only focusing on the tricky bad cases, who don’t respond well to our treatments. We never really have time to even think about and appreciate the good ones.

This is how much we focus on the problems, and negative aspects of our lives. Once in a while we may realize how much we have in life (e.g. when you come across Nick Vijicic), but soon we forget about it and start to moan about life again.

This is probably so normal, as it is how we’re brought out up, and are taught to do. An engineer works in a factory will only focus on the machine that isn’t working and doesn’t realize there are 8 other machines that work completely fine and require no attention.

Of course, if they require no attention why do I pay attention on them? Of course, if my limbs are working fine why do I even think about them? Of course, if my tooth isn’t aching why will I realize how suffering it’s when it’s aching? Of course, if my mother washes all my clothes for me why will I still pay attention on it and remember to be thankful?

In fact if you think, it’s so damn easy to find something and feel grateful, happy about it. So, easy. But we only focus our attention on the bad, the negative, the downside. And when this happens in almost every aspect of your life, you’re most probably depressed.

So let’s try to do this when you’re disappointed, feeling a bit low, frustrated, unfairly treated, in pain, try to distract yourself from those negative feeling/thought, and think about something that make you feel grateful and positive, then focus on it/them!

Practice it often and hopefully we’ll all soon become happy people.

Caring for family who is mentally ill

Basic & General, Clinical Case Studies

This is a woman with PhD and was working in the UK when her mother was getting depressed, with insomnia and palpitation. Without much considerations she decided to quit her job and come back to Malaysia to look after her mother.

She has a younger sister who can’t manage stress and see us for some medications; another sister’s husband (brother in law) who is having fits and seizures. She also has a brother who abuses substance. So when she gets home being unemployed, she became the person to look after all these family members, like a … maid, but with a PhD and a highly paid job in UK which she left. Every day she wakes up around 5:30am, preparing meals, cleaning the house, preparing medicine for all ill family members, bringing them out for hospital appointments, collecting medicine for them from different clinics and hospitals.

Sometimes the brother in-law refuses to take medicine. Sometimes the mother refuses to exercise (or even move at all) despite advice from specialist doctors. Every day the mother moans about her problems and illness, winding her up. Her day usually ends at about 10.30pm when most of the family are settled down or sleeping.

When we spoke to her, she said she would probably, at some points, have to make an appointment and come to see a psychiatrist doctor and take medicine, as she really couldn’t take it anymore. All these caring work is draining her out.

It really isn’t easy to look after family who are mentally ill after all, what say a few members that’re unwell. These family members should win more respects, and should really get some proper support groups, perhaps just from each other, some time off, just to do something they like and to lead their own lives, yet it really isn’t that simple as said once the “job” commences…

Antidepressant & Anti-anxiety Medicine

Basic & General, Issues & Debates

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.