Mental Health

My experience living with depression and schizophrenia in Thailand

People line up to walk on the glass as they visit Thailand's first skywalk in Bangkok, Thailand November 18, 2018. REUTERS/Soe Zeya Tun - RC15DDAD0200

There is just one psychiatrist for every 250,000 people in Thailand Image: REUTERS/Soe Zeya Tun - RC15DDAD0200

Amornthep Sachamuneewongse
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Mental Health

This article is part of: World Economic Forum Annual Meeting

Living with depression and schizophrenia has not been easy. When I first started complaining about my head to my family in 2015, they took me to the hospital, where a doctor recommended an MRI scan. The MRI came out clear, but my migraines persisted. It was suggested to my parents that I should see a psychiatrist. They said they had never thought about it. They didn’t know where to go, or who would be best.

We chose a well-known hospital in Bangkok, which had a small psychiatric department of just two rooms. I saw a doctor there for a few months, but I never got along with him. I felt that he didn’t understand me, and he told me to do things that didn’t feel like my “natural instinct”, if that makes sense. So in December 2015, without telling my parents, I signed myself into a proper psychiatric hospital. I started seeing a doctor and a counsellor. They understood me more, and for the first time in eight months, I felt like I wasn’t alone. I finally told my parents that I was now visiting a psychiatric hospital, not a normal hospital.

However, by the time I saw a proper doctor, my condition had worsened. I was diagnosed with major chronic depression and schizophrenia, because I kept hallucinating. I started receiving diagnoses from December 2015, but by March 2016, my mental health had deteriorated badly. I was self-harming and talking about suicide during my hospital sessions. This prompted the doctor to prescribe me electroconvulsive therapy (ECT). There were only three hospitals in Bangkok, according to the information we had, that delivered ECT. All three were government hospitals. Luckily my aunt used to be a nurse at the hospital we were told to go to, so I got my patient card swiftly.

My ECT treatment started in April 2016. I remember having to leave home at 6am to arrive and wait my turn, which usually came around 10am. I would wake up after my treatment at around 12.30pm, then go home. After receiving ECT 36 times, I was on the road to getting better. However, because of all the medicines I had been taking, I had gained 40kgs by then. This made it too dangerous to continue performing ECT on me. After two years of treatment, I have now gained 65kgs.

I remember that when I decided to commit suicide, and I was rushed to hospital to have my wound stitched up, the hospital closest to my house rejected my case, because it involved mental health. They are a big, well-known hospital in Thailand, but because they didn’t have a psychiatric department, they would not accept me. I still remember my parents pleading with them to let me stay the night and get better before moving me. I spent the night in the ICU before being transferred to a normal room, where I spent another two nights. After that, I was admitted to my psychiatric hospital for therapy.

I was lucky that I was working with my family at the time, so taking leave to get treatment wasn’t an issue. I don’t know what it would have been like if I had had a 9-5 job. I know that when I was depressed, I needed time alone, I needed to stay away from people, and I needed not to be disturbed. Since I was working with my family, I was able to do my work in any coffee shop I liked. I just had to make sure it got done.

Research shows that there are not enough psychiatrists in Thailand. There is just one for every 250,000 people. Given that the country has 1.5 million people suffering from depression, that ratio is daunting. Reforms are clearly needed in Thailand’s Department of Mental Health. We need to increase the number of psychiatrists and counsellors, make mental health programmes available for employers to take part in, and combat social stigma.

Even today, my close family members still think that I am possessed, and that my condition is nothing to do with my mental health. We need to educate people about the topic. It’s still discussed behind closed doors, if at all. There are only around five hospitals with dedicated mental health departments, and just a few more that have psychiatrists on duty. When I first went to hospital for therapy, I had to wait until they had a free bed. I used to think my doctor was playing a trick on me by telling me there were no free beds, so that I would say yes faster the next time he told me to get admitted. But he was telling the truth. When I was admitted, all 10-12 rooms were full up.

If I hadn’t had this experience, I would never have understood the importance of mental health, mental well-being and hospitals with mental health services. We need to break the social stigma around mental health. We need more psychiatrists, and more beds for people with mental health problems.

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