Materia Medica Malaysiana

Ready to deal with the blues

ARE more Malaysians suffering from depression or developing anxious personalities?

Medical and pharmaceutical professionals say the number of patients seeking treatment for these disorders has increased a hundred-fold over a two-year period.

"The demand for treatment in the form of medication and counselling has increased substantially over the last two years.

This is probably related to the change in our lifestyles with work pressures and the changing environment ," a spokesman for a pharmaceutical company said.

"There is also a greater awareness of the fact that these conditions are treatable. Previously, people thought that anxiety or depression were linked to schizophrenia but now they realise that if they have the ‘blues’ and cannot get out of it, there are treatments available," he said.

Psychiatrist Dr Lee Aik Hoe agreed: "Recent World Health Organisation studies indicate that five out of the 10 biggest illnesses which cause disability are psychiatric in nature, with two related to depression and two as anxiety disorders.

"I would say that the situation in Malaysia is in tandem with the rest of the world.

"The pressures of modern living, with less avenues to reduce stress, is one of the factors that has led to the increase. More people are seeking help because treatment for mental or psychiatric problems has improved.

"In previous times, it was a situation that people lived with," he said, adding that general practitioners had also been taught how to treat depression and anxiety.

"There is definitely an increase in the number of people coming to see me with symptoms of anxiety or depression," said an occupational health physician.

"I prefer counselling as the form of therapy but in severe cases, I have also prescribed drugs," he said, adding that patients were fond of asking for medication to help ease their problems.

One reason for the request for drugs may be related to Malaysians’ proclivity for quick fixes. "We want instant gratification for everything. We want our meals fast and if we are suffering from insomnia, we want sleeping pills to help us.

"Our dependency on drugs is just a symptom of our quick-fix nature," he said.

A medical doctor attached to the private sector said a majority of people seeing her help for anxiety-related disorders cited work pressures as the main cause of the condition.

"There are a greater number of people coming to see me with anxiety disorders and they do so because they cannot cope with the pressure of tight deadlines and so forth.

" I believe that while many of them realise that psychotherapy may help, they are still affected by the stigma associated with it," she said.

She added that many of her patients did recognise counselling as the possible solution to their problems.

"They are unable to opt for this treatment though because of the high cost associated with it. At this point, most companies do not recognise work-related stress as a health problem," she said.

She also said that she prescribed medication for the majority of patients who came to see her with anxiety disorders.

"Unfortunately, because I work in a clinic, I do not have the time to counsel them.

"But before prescribing the medication, I spend a bit of time with them to find out what the problem is and so forth.

"If the problem is work-related, I try to make sure that they come back for follow-up visits," she said, adding that she also recommended visits to a psychiatrist as a part of the treatment.

While recent scientific findings indicate that an anxious or fearful personality may be rooted in genetics, psychiatrists are quick to point out that the reasons for mental disorders are multi-factorial.

Malaysian Psychiatric Association president Professor Dr Hussain Habil said: "We know that conditions such as anxiety and depression are a result of bio-chemical imbalances to the brain.

"Indeed, these imbalances are linked to receptors and neuro-chemical changes, all factors that are closely related to genes."

However, he added that whatever the reason for the symptoms of such conditions, counselling and therapy are still a crucial element in psychiatry.

"Drugs are prescribed on top of counselling and therapy because while drugs may treat the cause of the disorder, it does not treat the effect, in this case the anxiety or depression that may have resulted in an individual," he said.

Dr Salina Abdul Aziz, of Hospital Kuala Lumpur’s Department of Psychiatry, said: "While scientists are beginning to explore the gene that causes anxiety, it still does not explain other factors contributing to such disorders.

"For instance, we do not know why some people have the gene but not the illness or even why the disorder takes so long to manifest as symptoms usually emerge in adulthood."