Depression patient's resonance

Emilykoh SG

Over the past 15 years with the IMH clinic, I have seen some of the best doctors as well as the worst! As a chronic illness patient, we are likely had a negative experience with a doctor. It is just part of the process. Documenting my recent ghastly experience might help to prevent others from becoming victims who suffer as I have suffered.

Owing to reluctant to consume long term medications, I tried to reduce the intake of medications previously. This results in severe headache and partial remission of depression. Despite experiencing side effect of the medicine, I also tried to end the treatment. After many years, I learnt this ultimately reduce chances of complete resolution of depression and prolong the illness.

A psychiatrist sees me for the last three visits - I felt he is not open to supporting me through this experience without taking over and sabotaging my endeavors. Merely disregard that my depression have been relapsed perpetually more than six months. As noted by many registration clerk, security guard and pharmacist, I have physically and mentally suffered from blister, scratch, bruise, fracture of ankle and severe enough to cause loss of efficiency and disruption to daily house work. I shun conversation with the clinic staff, because I will start sobbing uncontrollable.

On 6th Sept 2010 I call for an early appointment due to having severe headache - the pain is identical as forget or lesser dosage of Fluoxetine happens previously. I was so distressed by the circumstances and comments given by him that day. I have had escape from his room middle of consultation - not angry but overwhelming. For example:

1. I am psychologically reactive by forbid the new drug

2. Intricate to find remedy for my illness, ask me to see other doctor

3. Expensive medicine needed and if I opt for Fluoxetine, one 20mg will be given

4. My cry spells have erratic his work.

5. Remedies are intolerable, better not to take any medicine.

6. He claims I did not tell him I have react skin rash due Mirtazapine, until I show the cream he have prescribed to me last visit.

On the same day, a private psychiatric have prescribed the same drug but heavier dosages to bring the symptoms under control. As he mentioned when previous medications are substituted with new ones, the tendency is to prescribe a small dose and observe closely so as not to expose the patient to further side effects. This results in insufficient therapeutic response.

Morning

Evening

2X20mg Fluoxetine

1X100mg Fluvoxamine

1X40mg Propranolol

1X1mg Lorazepam

1X50mg Hydroxyzine

Now, the cry spells and headaches are gone, but the depression and anxiety are still present. The Fluvoxamine dosage increased 50mg weekly for first two weeks or until maximum benefit is achieved. I am neither an expert nor a professional in medical qualifications. Rather, I feature these insights to all the medical professionals – from the perspective of my 18 years experience as Depression patient with IMH and Australia.

During early of this year, the psychiatrist asked if I felt depressed during the intervening three months. I replied in the affirmative and he asked further questions, I was incapable of articulating my thoughts clearly. I attempted to respond, my mind drew a blank and unable to properly represent myself. As result, a lack of understanding of my conditions leads to not receiving the treatment I needed. Perhaps create the questions list in form of paper, so the caregiver or patient can be provide the information under dawdle condition.

A psychiatrist has altered my daily concoction from Lorazepam 3x0.5mg to Diazepam 2x5mg with virtuous intention without reciprocated understanding. As result, my conditions of anxiety and panic attack get worsen and develop further depressed due to sleeplessness. Usually, my mood worsens in the evening when everyone coming home and foresee a long night ahead without proper sleep. I find Diazepam shoddier my anxiety and panic attacks. In comparison the side effect might be less significant, also inefficient function in life noted.

Fluoxetine is substituted with Mirtazapine middle of this year. In divergence;

1. The drug B side effects are more tolerable as indicated under the table.

2. There is a tendency to prescribe higher dose in future, which I may be unable to afford as Medifunded patient.

3. Often I eat to get the filled sensation and drug A create empty emotion.

As Fluvoxamine is a substitute and 50mg obviously is insufficient restorative response. Hence, combination with Diazepam becomes my trepidation.

Drug A

Drug B

Mirtazapine 15mg

Fluvoxamine 50mg or Fluoxetine 20mg

Water retentions

Sweating and breathless

Hungry

Light headed

Increase appetite

Decrease appetite

Retardation, drowsiness and skin Rash

Agitation, irritation and Palpitation

Urine impediment

Dry month

Hot feeling

Cold feeling

Mood worse in the morning

Mood worse in the evening

Non standard drug

standard drug

Often social worker and doctor will ask “you don’t want to work right?” commonly the words they used are crueler. Although I have requested job recommendation but I have withdraw due to anxiety and panic attack (e.g. headache, abdominal complaints and heavier limbs). I likely occurrence slow speech, disorganized or perplexed of thinking and sentences sounding incomplete when present in person during the job interview. Frequently get eliminated. A moment or two, I was employed, but unproductive and atypical features occur and eventually eradicated. As a graduated with accountancy, grown up in blue collar with abusive mother, man chauvinism father and sex enthusiast brother. This direction is not my preference obviously.

Envisage three month my mood should be improved if trigger prevented, as promised by current private doctor. This document also serves as means of providing appropriate medical care needed.

I am looking forwards go Library to read news paper, borrow books used to bring pleasure, read during the insomnia, exercise to get better strength. Which I have been lack of ability to enjoy craze since early this year. To present ourselves in the clinic exertion needed and talk to doctors are nerve-racking. But we made it. So don’t forsake us, since we have not surrendered yet.