Are there any alternatives like psychotherapy that are able to completely replace medication for anxiety and depression?Mental Health Psychiatry
I’m an 18-years-old student who has been clinically diagnosed with Persistent Depressive Disorder and Generalised Anxiety Disorder. I had previously been placed on various medications such as SSRIs and benzodiazepines, but would strongly prefer not to take any more medications after discussion with my psychiatrist, due to various side effects and the fact that medication effects tend to wear off. My family also disinclines from the idea of antidepressant use. I would like to know if there are any other viable alternatives to taking medications for my condition, such as psychotherapy.
For many patients with Persistent Depressive Disorder (the old term is dysthymia) and Generalised Anxiety Disorder, the treatment will be on an ongoing basis.
The first task is to find a mental health professional whom you are comfortable with. Many doctors in Singapore are trained in providing talk therapy, typically cognitive behavioural therapy (CBT) and supportive psychotherapy. For supportive psychotherapy, a typical session will include checking on your symptoms and life situation. The mental health professional will then explore with you how you cope with stresses in the pasy and how you can harness your inner potential to deal with the current challenges. For CBT, the therapist will help you identify the maladaptive thoughts that emerge in your mind and think of ways and means to work with you to modify those thoughts to make them positive or neutral ones.
Many patients told me that a combination of a low dose antidepressant and talk therapy work for them. So I would also urge you to seriously consider this option as well. Antidepressants are not addictive or habit forming. For someone who has been taking antidepressants for many weeks, if he or she wants to stop taking it, then it is advisable to gradually decrease the dose of the medicine to avoid withdrawal symptoms. The doctor who prescribes you the medicine will be able to guide you on how you can wean it off.
Hope that you will find the mental health professional that best meets your needs.
Dr Ng Beng Yeong
MBBS, MMed (Psychiatry), FAMS
MOUNT ELIZABETH MEDICAL CENTRE
#15 - 05 Singapore 228510
Thank you for asking this question for the benefit of everyone.
It sounds that you are having a tough time, and its double whammy when the treatment gives you unbearable side effects.
Unfortunately in medicine, it is often times a zero sum game. Everything seems to have its "costs" and "benefits".
Fortunately for you, there are alternatives, like psychotherapy or more commonly known as talk therapy. The good side is that if it works for you, the effect is equivalent to medications, and the effects lasts way longer than medications. The down side is that, not every psychologist is made the same. Please keep your eyes open and look out for the following words.
1) "Clinical Psychologist": means they are trained to do one thing and that one thing in their life is to treat patients like you.
2) Post graduate qualifications like masters in clinical psychology.
The more down sides are the time, you have to invest in the time, typically a hour each session, and at least a couple of sessions before you would actually see improvements and some patients might even take a couple of months, that become couple of years for full treatment.
Also the perceived costs might be higher.
There are some GP clinics that have psychologists though, and you might be able to use medisave for the treatment of these conditions.
Take care and hope you will be treated some day.
PS: I would stay away from other things like hypnotherapy and general counselling, they might help some people, but notice that they usually don't happen in hospitals, for a good reason.
Dr Paul Ang
MBBS, GDFM, MRCSEd
266C Punggol Way
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