3. Medical Helps - finding a good doctor is useful in managing depression and bipolar disorder

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Some people are apprehensive of seeking medical help as they did not want to be put on medications due to the side-effects of medications. Some may not want a diagnosis by the Doctor or Psychiatrist.
For a long time, I didn’t want to seek professional or medical helps. Partly because I didn’t know or didn’t think my condition is a medical illness. Partly because I believe as a Christian I should weather the episodes by looking to God and waiting on Him alone.

It was during a very severe relapse of clinical depression in Dec 2006, through the encouragement of my employer and colleagues, that I was led to seek medical help as I was extremely suicidal and could not cope with my work and life. Thank God that by His mercies I reacted well towards the medication. After a week of being on an anti-depressant (fluoxetine or common brand name Prozac), I began to feel better. I was more functional and able to continue with my work. I did experience some side-effects of the medications such as dry mouth, constant waking up in the night, etc but I got over them after sometime.

In my experiences thus far, it is most important to find a good doctor/physician/psychiatrist.

Find a good doctor
I thank God for providing for me a very good lady doctor early in my endeavour to seek medical help, through the recommendations of my employer who knows this lady doctor. I was treated by Dr Sim of LP Clinic in Singapore. Some details on her Clinic are given at the end of this article.

Dr Sim is a very concerned and kind psychiatrist. She always has a smile on her face. She listens attentively to my description of my symptoms and experiences. She reassures me that with the right medications and other helps, my condition will improve and I can lead a close to normal life and be productive. She is always very positive, hopeful and encouraging. I thank God for using Dr Sim to help me.

For some months after I first got better in April 2007, I did attempt to seek medical help from a hospital where I can get subsidized fees for consultation and medications, due to financial constrain. But somehow I find it difficult to really communicate with this male doctor. He is a very nice doctor and genuinely concern for his patients. I somehow prefer a lady doctor and due to other reasons, especially a bad relapse recently, I saw it as providence and of necessity to make a switch back to Dr Sim when the Lord provided for me financially through the kind love gifts of some church friends.

Thank God that my condition has improved tremendously under Dr Sim’s care once again. Dr Sim not only monitor my medications and adjust the dosage accordingly, she also taught me how to recognize early symptoms, how to adjust my medication when necessary, how to arrest a relapse or shorten an episode by using other coping strategies. She is equiping me to handle this illness so that I can be more functional.

I realize that it is important to find a good Doctor as well as a Doctor that I can work together with on a long term basis. My Doctor is my partner in treatment and recovery. It is important for me to find a Doctor that I can speak openly with, who will listen to me and emphatize with me, who will offer helpful suggestions and be invested in my recovery.

This illness is not like other illness where a Doctor just need to know the symptoms and then prescribed the standard medications. Bipolar illness is a life-threatening and chronic illness that affects different individuals in different ways. It is there necessary to find a Doctor who is willing to understand me, my make up and personality, how this illness is shaping or effecting my life and help to work with me on the medications that will help me to function more stably in the long run. A Doctor who is willing to explore with me the possibilities of my relapses or the causes of worsening symptoms and advise me how best to manage my medications and illness. This I have found to be possible with Dr Sim’s help.

I thank God for His kind provisions of love gifts through various friends in my church who gave of their substance anonymously and very generously. It is with this merciful provisions of God through them that enable me to continue treatments with Dr Sim.

Medications
When I was first given anti-depressant in Dec 2006 during a severe relapse of depression, I was reluctant to take the medication. Though I have taken the first step to seek medical help, I was nevertheless still very apprehensive as to whether I should be taking medication. I was not sure whether as a Christian, I should be relying on medication to get better or I should just pray and wait for God to restore me.

I hold on to my medication for 1 month. During that 1 month, I tried self-help techniques besides praying to God daily for deliverance. I tried to walk every afternoon during my lunch break. I attempted to challenge my negative thinking patterns. Depression tends to cause my thoughts pattern to become very negative. I tried to do things that I enjoy in the past. But none of these things helped very much. At the end of the 1 month, I was still very depressed. Finally, I decided to give the medication a try. I thought to myself, could my condition really be a medical condition? I have tried other ways. Why not give these medicine a try?

Thank God that by His mercies, just about 1 week after starting on 20mg of fluoxetine every morning, I began to experience its effect. The medicine didn’t cure me of depression but it lifted me up to a more functional level. I was able to cope better with my work and life. I am learning that medication cannot cure me. But during a severe relapse of depression, anti-depressant can help to lift me up to a level that I can function and then make use of other helps. I did experience side-effects such as dry mouth, waking up in the night several times, etc etc but I got over them after sometime. Generally, it has helped to shorten my episode of depression. Without medication’s intervention, I will have to go through it for at least 3 to 6 months, or even a year or two, as there is a cycle to it. It is possible to get well without medication, but it takes a longer time and much suffering during the waiting.

I was on the anti-depressant for some four months when some happy things began to happen in my life. I discovered some of my late father’s markings in his Bible and Hymnal, revealing the possibilities that he might have known something of the saving grace of God or possibly he has trusted in the Lord as his Saviour. I was thrilled at this discovery. I have prayed for my father’s salvations for years and though at times he has indicated his trust in God, I have no assurance of his salvation when he died of heart failure in April 2001. I was overjoyed in this wonderful discovery and cherish the hope that he might be with the Lord now and that I may see him again in eternity.

At this same period of time, my mother visited my church for the first time. She is not a Christian and has no desire to go to church. But upon the kind invitations of some church friends, she finally visited my church and heard the Gospel preached. She enjoyed the friendship of many of my church friends and she know some for them for many years already as they have visited us in the past years.
These 2 events brought so much joy to me that I find myself not able to sleep much at night for many nights. I often sleep for about 3 hours only and then I will wake up feeling very excited, happy and with many thoughts. I have racing thoughts and felt the urge to type our my thoughts and feelings. I also talked very fast at times. So I started writing to my friends and I developed my website to share about my illness and God’s goodness. This happened for a few weeks and I was extremely exhausted to the point of almost collapse due to the exhaustion.

When I was finally able to meet up with my Doctor, I explained my experiences to her. She immediately told me that I cannot be on anti-depressant alone as I am prone to bipolar disorder as I was experiencing hypomania symptoms. She immediately gave me 2 other medications ie. mood stabiliser (lamotrigine 25mg, brand name Lamictal) and anti-psychotic (quetiapine 25mg, brand name Seroquel) to be taken every night. She also asked me to stop the anti-depressant as I was hypomania at that time.

Ever since then, I have been on Lamictal and Seroquel. My Doctor told me that I will need to be on Lamictal for lifelong as it is able to stabilise my mood in the long run and lessen the mood swings. I will need Seroquel also as it helps to prevent relapse of depression in the long run. But whenever I fall into severe depression, I will still need to take anti-depressant in order to be lifted up to a more functional level. Lamictal and Seroquel will not lift me up when I am in severe depression. But they act as maintenance medication and can help to prevent future relapses if I manage my condition better.

I am currently on 100mg Lamictal and 25mg Seroquel every night. I hope one day I can manage my illness so well that I can be on lower dosage of medication or without them eventually. But I know that at this point of time, I still need to continue with the medication in order to be more functional. Although the medication have their side-effects, at least they helped me to be functional. Without the help of medication, I will still be in severe depression and will have to wait for the cycle to run its course before I can function.

The frightening truth was that my condition has worsened over the years. My interval of my relapses were closer and my symptoms were more severe and less bearable. I believe that medication and other helps will help me to get better and cope better. So I am learning other coping strategies too. I will share more in my next post

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Contact information :
Dr Pauline Sim
Consultant Psychiatrist
L P Clinic Pte Ltd
Provides psychological services for adults and children
Mount Elizabeth Medical Centre
3 Mount Elizabeth Suite #05-01
Singapore 228510
Tel: (65) 6735-4526
Fax: (65) 6735-4527
Consultation Hours:
Mon - Fri : 8.30am - 5.30pm
Sat: 8.30am - 1.30pm
Sun & PH : Closed
After Off Hrs: (65) 6535-8833



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