May 03

Brain doping / drug abuseIt’s very simple now to order drugs over the Internet, and most pharmacies in Asia will sell medicines over the counter that are only available by prescription in the West. Most popular products in the online catalogs are amphetamines, potency pills and antidepressants. But self-medication is actually risky, particularly with amphetamines (such as Ritaline / methylphenidate),  which can enhance performance and concentration leading to dependency and requiring withdrawal treatment at specialized clinics or psychotherapists after months or years of abuse.

According to a study of U.S. pediatricians, the number of ‘doping’ students has increased by 75 percent over the last 8 years. Often the drugs are used incorrectly, like when the cause of poor concentration or erection problems lies somewhere else than where the drug attaches. Erectile dysfunction in men aged less than 55 years, for instance, mostly has purely psychological causes. Habitual intake often leads to overdosing and increased susceptibility to disease-causing side effects. At some point, the user might in fact just treat the withdrawal syndrome (for erectile dysfunction this is often fear of having sex without first taking the drug) – they feel no significant effect of the drug anymore but can not discontinue its use and thus enter a vicious circle. Multiple dependencies, like the use of amphetamines during the day and then in the evening intake of alcohol and / or tranquilizers or sleeping pills, makes everything even more complicated and dangerous. Abuse of prescribed medications causes more accidental deaths in the United States than anything else except automobile crashes, which kill more than 30,000 Americans every year.

The first signs of psychological dependence on drugs can be feelings of insecurity or fear if no intake is possible, or if there is an increase of the dose over time, but the effect of the drug doesn’t feel the same or is completely absent. Another alarm signal could be if over the years, more and more substances are taken in without consulting a medical doctor (this also includes food substitution drugs, injections of hormones, tranquilizers, sleeping pills, nose drops, etc.).

In most cases, drug dependence is admitted very late, after diseases of the organs have developed or accidents occured (often caused by a lack of concentration). For the psychological withdrawal, a combination of psychotherapy and support groups is very effective, but a medical checkup for possible physical damage is also essential.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011)

Jan 14

When they hear the word ‘depression’, many people think of sad or hopeless individuals who can’t cope with a life event, who are living withdrawn and are often crying their existence.

But in fact this is only rarely the case. In a U.S. study published in 1996, for example, only a third of the patients suffering from depression could name a stressful or dramatic experience that took place before the disease kicked in. And it is by no means only negative events that can trigger depression in some people, but also such as the birth of a child or winning a business contract. That not all people who experience dramatic events develop depression also suggests that other factors such as stress or genetic factors may be involved. For patients themselves or their environment is therefore usually not even possible to identify a potential reason for a probable depression – which usually leads to long delays in search for the correct diagnosis for the malaise they feel in.

Physical symptoms are another, often misinterpreted facet of depressive disorders. Headaches, insomnia, reduced memory and concentration, but also other kinds of physical pain, digestive problems or a general lack of energy are typical physical symptoms of depression.

The lack of perspective that is typical for depression, quite often also leads to self harm. Most people who commit suicide previously suffered from an (often unrecognized or untreated) depression. But it doesn’t need to be suicide: other self-defeating forms of behavior, such as alcohol and drug abuse, self-destructive eating habits or risky driving are, as studies illustrate, linked to depression in about 60% of the cases.

Particularly in older men, depression often manifests on aggression, particularly of the verbal kind, like ranting, looking down or lashing out on others or constant cynicism. Again, these persons are only rarely aware that they actually suffer from depression, but explain their inner discontent and anger with external circumstances over which they usually can’t complain too loudly and often.

About 20-25% of women and 7-12% of men suffers with depression at least once in their life time. However, the real figures are probably higher due to the frequent misdiagnoses and years of suffering without a proper diagnosis and adequate treatment.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011)

06.01.16