Category: Lifestyle

Words Lim Teck Choon

All About Antidepressants 

Wait… medications?

Yes, sometimes medications are helpful in overcoming moderate-to-severe depression. Dr Amer explains that these medications, called antidepressants, are prescribed by psychiatrists, who are medical doctors specializing in mental healthcare or psychiatry.

Malaysia Has Good Psychiatric Care

Some of us may not know this, but Malaysia actually offers some of the best psychiatric care in this region. Dr Amer points out that many of the commonly prescribed and effective antidepressants used worldwide are available in Malaysia. Therefore, people with depression can find a good level of medical care in both government and private hospitals. It is only a sad kind of irony that awareness of both depression and its treatment is not widespread enough, causing a number of people with depression to either deliberately or unknowingly miss out on getting treatment.

Thus, if you suspect that you have depression or you believe someone close to you has this condition, Dr Amer gently recommends that you seek appropriate advice and help from a qualified mental health professional. The earlier the treatment, the better are the chances of recovery.

5 Things to Know about Antidepressants

1. Dr Amer stresses that antidepressants are not the be all and end all of depression management. They work to reduce the symptoms of depression instead of curing the condition, and are only prescribed when necessary. Some people with depression may be able to overcome it without any need of medication at all.
2. It may take a couple of weeks before you see the beneficial effects of the antidepressant you are taking. If you believe that you are not getting better even after taking the medication, don’t be too quick to assume that it does not work. Instead, talk to your psychiatrist about your options.
3. It is, however, possible that certain antidepressants don’t work on you. The psychiatrist will prescribe another type after he or she has performed the necessary evaluation to confirm that your current medication is ineffective.
4. Take your medications based on the recommended dosage and frequency, and do not stop without consulting your psychiatrist first. Some people stop on their own when they believe that they are getting better, and as a result, their depression comes back, sometimes more severely than before.
5. Avoid drinking alcohol or taking illegal drugs while you are on medication. Some people believe that the ‘high’ from alcohol or drugs helps them feel better, but research has shown that these substances actually negate the benefits of your medications and can even worsen your depression.

How Antidepressants Work

There are different types of antidepressants available, and each type has its own unique ways of reducing the symptoms of depression. Generally, however, they all work by influencing the way the brain works.

Our brain cells, or neurons, form a closely connected network called the brain circuit. All information is passed from one neuron to another, carried by substances called neurotransmitters. There are many different types of neurotransmitters, and some of them carry information that affect our mood – for example, serotonin, dopamine and norepinephrine. 

Generally, antidepressants help reduce the symptoms of depression by interrupting the transmission of specific neurotransmitters that trigger a depressive mood. Some work on a single neurotransmitter, while others may work on two or more.

The type of antidepressants prescribed depends on the symptoms and severity of your depression, other health conditions already present and whether you are pregnant or breastfeeding. Sometimes, a psychiatrist may prescribe a combination of two antidepressants for enhanced beneficial effects. If the need arises, additional medications such as mood stabilizers, anti-anxiety medications or antipsychotic medications may also be prescribed to help you better manage your symptoms.

Also, if you experience bothersome side effects, your psychiatrist may switch you to a different kind of medication. If you are also on medications for other health conditions, you should share them with your psychiatrist, as there is a possibility that these medications can react with an antidepressant to create potentially dangerous complications.

But Aren’t Antidepressants Addictive?

No, not at all, says Dr Amer. Some patients experience withdrawal-like symptoms when they stop taking antidepressants, but this is not a sign that they are addicted to those medications. Rather, it is more likely due to the body needing some time to adjust once the medication is stopped, especially if it is stopped abruptly. These symptoms usually go away on their own. If you experience bothersome side effects, you should let your psychiatrist know. He or she will either offer options to address these side effects or switch you to another type of antidepressant.

Is It True that Taking Antidepressants Will Ruin My Sex Life?

Because antidepressants work by calming your mood and reducing your anxiety, one possible unwanted side effect is that you also become too ‘calm’ to respond in intimate situations. Some people (both men and women) find that their libido is decreased. There are men who also experience erectile dysfunction, while women may experience discomfort during sex due to reduced lubrication. Delayed orgasm may also be experienced by both men and women.

Fortunately, this does not mean that your sex life is ruined if you are on antidepressants. Sometimes these side effects go away on their own, after your body has become used to the medication. If they persist, there are ways to manage these symptoms, such as reassessing the dosage or, if you anticipate having an intimate moment with your partner, taking your antidepressants only afterwards. Switching antidepressants might also be an option if the above doesn’t work.

Don’t stop your medication because it is affecting your sex life, as this may cause your depression to worsen. Instead, talk to your psychiatrist about the issue; he or she will be able to help you in this matter.

Don’t Give Up!

Medication alone is often not enough to help the person overcome his or her depression. Overcoming depression is a day-to-day process, often requiring a lot of energy and focus. Recovery may not be as quick as the person wishes, and in the meantime, he or she may experience broken relationships, loss of jobs and other heartbreaking disappointments.

In such situations, some people may become overwhelmed and feel that they will never become better. They choose to give up instead, thus succumbing to their depression.

It does not have to be this way. While depression is often portrayed as a lone person’s struggle, Dr Amer points out that the road to recovery is often easier with support from the people around that person.

This is why, while he respects a patient’s desire for confidentiality, Dr Amer would advise the patient to let at least one trusted person in on the fact that he or she is trying to overcome depression. This person can provide a listening ear and a shoulder to cry on when the going gets tough for the patient. Additionally, that confidante is welcome to ask for advice from the patient’s mental health professional if the need arises.

Furthermore, support can be obtained from various support groups (either in real life or online at places such as Facebook and Reddit) as well as from various non-profit organizations dedicated to helping people with depression and other mental issues heal.

WORDS LIM TECK CHOON

How hard is it to raise a dog or a cat? Well, it’s as easy as raising a beloved child – just give all the TLC your heart is capable of, throw in a heap of patience, sit through moments of exasperation when you realize that your little one can get out of hand and a big smile when, in the end, you realize that you will not change any second of the experience – as all the ups and downs are worth it.

HealthToday catches up with Dr Goh Kim Siang, a veterinary surgeon, who touches on a few things that everyone should know before adopting a pet.

THE SECRET HISTORY OF PETS

Humans are the only creatures in this world that keep pets. One of the earliest evidences was the remains of a human cradling a puppy found in what is now Israel, dating back to 10,000 BC.

TRUTH #1

YOUR KIDS AREN’T THE BEST PEOPLE TO DECIDE WHETHER YOU SHOULD ADOPT A PET.

Veterinary surgeon Dr Goh Kim Siang shares that companionship is one of the greatest benefits of having a pet. “For many people, just seeing their pet approach them for a rub or cuddle when they come home from work can be a good antidote to the stress they experience earlier in the day,” he says. He adds that older people may find a pet’s companionship beneficial in staving off loneliness.

“THE KID WANTS A PET!” IS PROBABLY NOT A GOOD REASON TO HAVE ONE.

Just as Mom and Dad will not have another baby just because their kid wants a sibling, it is not a good idea to adopt a pet because of a child’s whim. Dr Goh points out that children will be children – they may get bored easily or become fascinated by something else quickly. They may also eventually decide that having a pet is no fun and they don’t want it anymore.

Dr Goh goes on to say that the ultimate decision to have a pet lies with the grown-ups. After all, like it or not, the care and feeding of the pet will ultimately fall onto them. “Having a pet is a lifelong responsibility,” he emphasizes.

DR GOH’S CHECKLIST FOR PET OWNERS-TO-BE

• Does your residence have ample space for the pet to live comfortably in, move around and answer the call of nature?
• Can you and are you willing to allocate the time and effort every day to feed the pet, bond and communicate with it and, in the case of a dog, take it out for some exercise?
• Can you afford and are you willing to invest money in nutritious foods, vaccinations, medical check-ups and treatments and more for your pet?

If you hesitate to say YES to any of the above, you may not be ready to adopt a pet yet. Let’s think a bit more about the matter, perhaps even talk to a veterinarian or another responsible and loving pet owner to find out more about what being a pet owner is like.

BLACK PETS NEED MORE LOVE

Do you know that there is a National Black Dog Day in October? The day was created because statistics showed that, in the US, black or dark-furred dogs are often not picked for adoption. Hence, pet shelters, pet welfare organisations and dog lovers all came together to spread the word that a black dog is no less lovable and loyal compared to dogs of other colours. Also, black-furred dogs can be truly adorable, as evidenced by the Black Dogs Project (caninenoir.tumblr.com)!

TRUTH #2

TRAINING GIVES DOG OWNERS & THEIR FURBABIES A GOOD START IN THEIR RELATIONSHIP.

Research has found supporting evidence that training helps to establish a stronger, more harmonious bond between a dog and its owner. According to Dr Goh, it is especially important for adopted dogs which may have experienced abuse in the past – training will teach them to interact peacefully with humans.

WELL, HOW DOES TRAINING BENEFIT MY DOG AND ME?

Your dog and you do not speak the same language. In fact, you and your dog are of entirely different species, so it’s very likely your dog doesn’t think or see the world the same way as you.

Training helps both you and your dog bridge these differences, so that the two of you can develop a system of communication via simple words (“Sit!”, “Come!”, “Stop!”, etc) and touches.

Here are just some of the benefits from such improved communication:

• Your dog will learn which behaviour is acceptable and which isn’t. This will help your dog to react properly to unpredictable changes and situations that it will come across in real life.
• It teaches your dog how to interact peacefully with other people as well as with other dogs.
• You and your dog gain a better understanding of one another. You don’t have to scold or punish your dog often, and your dog will flourish in a less stressful and more loving environment. In the long run, this will promote a stronger bond between you and your dog.

GREAT! BUT I CAN TRAIN MY DOG MYSELF… RIGHT?

Dr Goh advises against this. While there may be books and YouTube videos for those who wish to train their dogs themselves, dogs are like babies. They have their own mind and can react in ways that are different from what’s demonstrated in those books and videos! Hence, what works for one dog may not work as well or even at all for another.

An experienced trainer who has trained many dogs of different personalities and temperament, on the other hand, may know a trick or two to deal with dogs that like to break the rules.

TRAINING IS NOT ABOUT SHOWING THE DOG YOU ARE

In the past, it was commonly believed that you need to establish a firm dominance over your dog to ensure good behaviour and loyalty. However, these methods tend to emphasize punishment over reward, and they often do not work on dogs with already problematic behaviour.

These days, evidence from research on pet behaviour has generated a shift from this ‘I’m the boss!’ style of training to one that emphasizes positive reinforcement and mutual respect between dog and owner. Dr Goh recommends seeking a trainer that adopts such an approach, as this approach has a higher likelihood of success in promoting good communication and stronger affection between the dog and its owner.

TRUTH #3

CATS & DOGS NEED BALANCED AND NUTRITIOUS MEALS AS WELL AS EXERCISE AND MEDICAL CHECK-UPS.

THE FACTS ON FOOD

You can easily purchase nutritionally-complete pet foods from stores or the veterinarian’s clinic to meet your pet’s nutritional needs. However, Dr Goh shares that there are a few things to take note of when picking the right brand for your pet:

1. Like human foods, pet foods have nutritional information panels (NIPs) on their package. Look at them before buying and take note of the sodium and fat content. Pick ones that have less of these.
2. Also, check the ingredient list. Ideally, cat and dog foods should have some source of animal protein and fat. You can identify these sources by the presence of ingredients such as beef, chicken, turkey, etc.
3. If you are unsure or are confused by the numbers and jargon on the food packages, you can always ask for advice or clarification from a veterinarian.

How about cooked foods? Dr Goh shares that it is increasingly common these days for pet owners to prepare their own homemade meals for their cats and dogs. In fact, November 1 is National Cook for Your Pets Day in the US! There are recipes available online for pet owners who wish to go down this route. You can check with your pet’s veterinarian if you have concerns about allergens, nutritional content, etc.

Just no table scraps, please. These are almost always foods with all the nutritious parts already eaten. It is best to delegate the table scraps to the waste bin instead of your pet’s food bowl.

ENERGIZE WITH EXERCISE

You are advised to be physically active for at least 30 minutes every day to maintain a healthy weight and keep the body functioning at tip-top condition. Also, daily physical activity helps to reduce risks of non- communicable diseases such as diabetes, high blood pressure and more.

Cats and dogs can develop these health problems too, especially if they become overweight. Hence, they also need to be physically active every day!

Cats are more independent in nature. Dr Goh points out that they usually get their exercise during their daily rounds around and outside the house.

On the other hand, dog owners often need to allocate some time to take their furbabies out for their daily workout. Dr Goh recommends a 2-3 km walk around the neighbourhood, a simple but enjoyable exercise that allows both dog and human to get their daily workout.

A MEDICAL CHECK-UP ONCE A YEAR

Just like humans, dogs and cats also can develop cancer, high blood pressure and other diseases. Most of these diseases can be treated or managed more successfully when detected early. Hence, Dr Goh recommends bringing your cat or dog to the vet’s clinic for a medical check-up once a year. HT