Are there any alternatives to anti-depressants for severe depression and anxiety?

Doctor's Answers 3

Thank you for sharing your problems with us.

It looks like you still have symptoms of depression (lack of interest, negative thoughts). It will be good to recall all the medications that you have tried before in the past and your response to them. You can write them all down on a piece of paper so that you can show it to your next psychiatrist.

It may be worthwhile for you to try seeking treatment from another psychiatrist in another restructured hospital or from the private sector.

Treatments for depression oftentimes include talk therapy (cogntive behavioural therapy) and/or medications. It is important not to give up on treatments too readily but to give yourself another chance to get better.

Response to a medicine likes antidepressant takes time (e.g, 4 to 6 weeks for some) and it is hence important not to give up too soon. Do hang in there and find the help that you need.

I wish you success in finding the psychiatrist with whom you are comfortable and who is able to help you sort out your depressive condition.

Thank you for your interesting question and I'm sure its a problem that many of us face these days. Sadly, you are not alone and if you scratch under the skin of most people, they will be having similar issues, but they may have been brave enough to seek help.

I won't try to replicate Dr Ethan's excellent post, but I was reading through and I thought I would add a line about exercise.

You see, exercise has been proven to be an effective treatment in mild-moderate depression, either as a stand alone treatment or in conjunction with others.

I know it seems like an epic amount of effort to exercise when things do not seem to be going right around you, but please do consider it.

I hope you start to feel better soon.

BW

Dr Dinesh

Thanks for your question, and I’m very sorry to hear that you are going through such a horrible time.

I can only imagine how tough it must be.

Before I answer further, I’m going to give the caveat that it’s next to impossible to offer advice about any psychiatric problem without seeing you face to face, or at the very least, having all the salient information about mood, sleep, suicidal ideation etc.

I’m going to assume off the bat that the diagnosis of depression has been established by the doctors you’ve seen. Contrary to what most people think, depression isn’t just a “mood problem”, but a full fledged medical condition diagnosed if you’ve experienced for longer than 2 weeks at least 1 of the following 3 key criteria of:

1) Low mood

2) Loss of interest and pleasure

3) Loss of energy

From what you’ve told me, it certainly sounds like you fulfil all the criteria.

There are some other medical conditions which can mimic depressive symptoms, e.g. Thyroid disorders etc – which is why it’s important that you’ve also had all of that ruled out by doctors (easily done with a few blood tests). Again, I assume your doctor has done all of these.

Moving on to your next point – you feel that “the psychologist and psychiatrist are not helping”. Yet, you mention that you’ve not been receptive to the idea of anti-depressants that they’ve suggested. I can understand why you don’t want to take medications, due to a fear of reliance and side effects. This is especially common in Singapore, I guess due to culture.

Having said that, how “effective” a doctor is, is also limited by how open you are to his treatment and treatment methods – the best surgeon in the world will be useless if you don’t agree to a potentially life saving treatment that he’s suggested.

Anti-depressants have a great evidence base. Having uncontrolled depression is far more debilitating than any side effect of an antidepressant that you may be worried about (according to my doctor flat mate with depression himself). There are also several different types that can be switched around by your doctor, depending on how well you tolerate each anti-depressant’s side effects.

They are also not addictive, although they do need to be stopped gradually to prevent rebound effects. The thing to bear in mind is that it will take time to work: weeks to months. So even if it feels like it’s not working, it’s crucial for you to persist. I know that’s easier said than done, when every day with depression can feel like a week!

In a nutshell, my suggestion, if I were in your shoes, would be to continue seeing your psychiatrist, and to persist with a trial of antidepressants as proposed by your psychiatrist. Things may get worse initially, but they will almost certainly get better after a few weeks. And you’ll have your psychiatrist and psychologist to support you every step of the way.

Similar Questions

Are there any alternatives like psychotherapy that are able to completely replace medication for anxiety and depression?

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.

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How do I get help for mental illness in Singapore if I can't afford it?

If you are attending a school, you can approach the school counsellor for help. You can also approach a family physician for help. The doctor will then assess your condition and then treat you at the clinic or refer you to the appropriate facility. You can also seek treatment at the polyclinic. There are social workers at various hospitals in Singapore and they will assess your financial status and assist you in whatever way that is possible.

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