Lifestyle Choices

Arrange for Early Psychiatric Appointment

The most important thing you can do for the depressed person is to help him get a psychiatric referral. This could be self initiated or made by a doctor at a polyclinic or by the general practitioner. Early treatment leads to early recovery from the illness.

Patients may feel apprehensive about contacting the clinic. If so, you may wish to assist in making an appointment and accompanying the depressed person to the doctor. Many persons may be reluctant to seek treatment for various reasons. They may deny they are unwell because they are afraid of being given a psychiatric diagnosis, and of the stigma attached to mental illness. Be patient and continu_e to persuade the person to seek help. You may say something like, “You may consider yourself to be quite well, and do not see the reason for consultation. Let the psychiatrist talk to you and decide if you need treatment or not. If you do not require treatment, he is not going to waste his time by prescribing treatment for you. I will go with you to the psychiatrist’s clinic and help explain matters to him. Is that alright with you?” Some have the notion that they will be sent to the psychiatric hospital and confined there. This is not true; most depressed people do not require hospitalisation, but only need outpatient treatment.

Encourage Adherence to Treatment

Encourage the patient to stay with the treatment until symptoms begin to abate. Try not to make it sound as if you are nagging the patient about medications. A pill box is very useful. It has compartments for each day of the week and this facilitates treatment adherence. Many can’t remember if they have taken medications for the day, hence a pill box is ideal for such patients. You may ask if there are any pills left in the pill box at the end of the week. If so, then the patient probably did not take his medication regularly. It is acceptable for “as and when necessary” medication to be left over but those that need to be taken daily have to be consumed.

Do not get overly worried or upset if, in the course of the week, the patient forgot to take one or two doses. This will not result in a relapse. What we are more concerned about is that the medication is not taken for several weeks in a row.

Initially there may be no improvement, but the patient should be reminded not to stop treatment as it will take a few weeks for antidepressant medications to take effect. If there are side effects such as mild headaches, taking simple painkillers such as Paracetamol (Panadol) is fine and the medications should be continued. However, if side effects are severe, for example, if rashes, nausea, vomiting or distressing drowsiness develop, get the patient to stop the medications and contact the psychiatrist or clinic to bring forward the appointment.

Some patients have a history of taking drug overdoses. For such patients, it is preferable for the caregiver to keep all medications under lock and key and only leave the day’s supply with the patient.

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