Depression, Anxiety, & Insomnia
Ask Dr Beng Yeong Ng about:
- How to get good sleep
- Sleep disorders and insomnia
- Dealing with anxiety
- How to take care of your mental health
Dr Ng Beng Yeong received his medical education and postgraduate training in Psychiatry in Singapore. He was subsequently awarded a scholarship to pursue his interest in Organic Psychiatry and Neuropsychiatry at the Maudsley Hospital, UK. He was a Senior Consultant Psychiatrist with the Department of Psychiatry and Sleep Disorders Unit, Singapore General Hospital (SGH). He also ran sessions at the Urology Centre, Singapore General Hospital, where he treated patients with sexual concerns.
He was Head of Department, Psychiatry, SGH, from 1 July 2006 to 31 Dec 2015. His book, 'Till the break of day: a history of mental health services in Singapore, 1841-1993' is often used as a reference text by many young psychiatrists and mental health professionals in the country. The book is now in its second edition.
He is also known for his research in dissociative trance disorder, which was done when he worked at the Institute of Mental Health. He was President of Singapore Sleep Society from 2006 to 2008. He is the founding President of College of Psychiatrists.
Thank you for asking such an important question. It is important as many people have this problem. Rumination means that a person keeps thinking about a problem, a situation or a scenario over and over again, just like the way the cow would chew its food repeatedly. In my clinical practice, I treat many patients with insomnia problem and one perpetuating factor for insomnia is the propensity to ruminate. These persons go to bed and their minds will start to wander. For instance, they would think about the events that happened in the daytime and what would happen the next day.
It looks like you are in a very challenging situation. It is indeed hard to strike a balance as you not only have to care for your depressed spouse but also take care of your child’s needs and your own emotional and physical health. Depression oftentimes not only affects the individual but the family and loved ones as well. May I offer a few suggestions or pointers: First, when your partner goes to see his doctor or psychiatrist, you may want to accompany him and let the doctor know about his condition and behaviour at home.
It must be quite difficult for you as most patients with bipolar disorder find the depressive phase the most difficult to deal with; most of their time is spent in the depressive phase, rather than in the high or manic phase. I do have a few suggestions. First, to consider the use of lamotrigine, a mood stabiliser, which is known to be effective for the depressive phase. Second, to consider the use of an antidepressant. This recommendation is a bit controversial as there are fears that the antidepressant may tip the person over the balance and cause the person to become manic.
It must be a very difficult journey for you to come to grips with depression all these years. I would suggest that you stay with an experienced psychiatrist and let him or her explore all the treatment options with you. Given your multiple episodes of depression and the chronicity of symptoms, I would think you will need a combination of three medicines: Antidepressant to help improve the mood Antipsychotic to stop the voices (auditory hallucinations) Mood stabiliser (to augment your response to the antidepressant).
When a person is overwhelmed by stress, he may become more irritable and be less patient towards individuals around him, especially to his loved ones and family members. When we do not feel good, we generally do not sleep well or rest well. All that will also affect our ability to tolerate frustrations, challenging social interactions and difficult moments at the workplace. We tend to take our loved ones for granted, and are more likely to allow our true self (including our angry emotions) to be manifested.
Schizophrenia is thought to be due to abnormal levels of chemicals in the brain. The commonly implicated neurotransmitter is that of dopamine. Many studies have shown that when there is excessive amounts of dopamine, the brain becomes excitable and many abnormal experiences (like hearing voices when there are none, and perceiving things that are not there) can arise. Schizophrenia is often perceived as a neuro-developmental disorder with a biological basis. The typical age of onset is that of early 20s for males and late 20s for females.
It will be good if you can keep a diary for two weeks and document the periods if your tiredness throughout the day and see if there is a fixed pattern. Consultation with a doctor who has special interest in sleep diosrders would also be useful. The following disorders are known to be related to disturbances in natural biological rhythms are disturbed: sleep disorders: Disruptions in the body’s natural rhythms can lead to affected sleep, including insomnia. jet lag: A disruption in circadian rhythms when traveling across time zones or overnight.
In order to recommend the appropriate treatment and intervention, we would need to identify the basic or fundamental problem or diagnosis. There are four possible situations that may cause someone to have lingering suicidal thoughts. First, the person could have an underlying depressive disorder. When a person is down, he would tend to look at things in a negative way. Some depressed individuals will go on to have thoughts about worthlessness, uselessness and constantly ponder over the meaning of life. A depressed individual oftentimes also has doubts over his ability to solve life's problems.
Thank you for posing such an interesting question. Many patients at my clinic have asked me this question before. For anxiety disorders, the commonly used medications that are useful include SSRIs (serotonin specific reuptake inhibitors) and benzodiazepines. For SSRIs, there are some side effects that patients may experience, for example, nausea, vomiting, loose stools, restlessness, insomnia, and others. For benzodiazepines, there are potential side effects too, like sleepiness and oversedation. These medicines need to be prescribed by a doctor.
Thank you for asking such an important question. It is important as women who have postnatal depression may harm themselves and/or their babies. Postnatal depression is moderate to severe depression in a woman after she has given birth. It may occur soon after delivery or up to a year later later. At my clinic, most of the women report that their mood symptoms start within the first three months after delivery. The following are important factors to appreciate when trying to grasp postnatal depression:1. Changes in hormone levels during and after pregnancy may affect a woman's mood2.