Kuwait MD: Depression

Post by Dr. H

Post by Dr. H – A family medicine resident working in a polyclinic in Kuwait

Its been a while since I’ve posted due to the fact I’ve been on holiday. Now its back to reality and I was thinking about what my next blog post would be, when I saw this patient and realized that it should be on the least discussed ‘taboo’ topic in kuwait – depression.

I see so many patients who are truly suffering with this disease, however with the lack of supportive services in Kuwait, they continue to suffer in silence, told by their families to ‘become more spiritual’ or ‘just snap out of it’.

So first off.. what is depression? Depression is a mood disorder that causes a persistent feeling of sadness, and a loss of interest. There are many other associated symptoms, such as trouble sleeping and loss/gain of appetite. There are many theories on the etiology (cause) of depression, one is biological – So it basically says that there are certain ‘chemicals’ in the brain, and when you have depression, these chemicals are a bit off, so you get symptoms. Its multifactorial, theres a lot of other theories, it’s still poorly understood what causes it.. but the bottom line is that it’s a disease. Yes a disease. Just like asthma is a disease.. ever asked someone to ‘snap’ out of asthma?

So.. back to my patient.. I saw a 30 something year old lady, who has been suffering with lack of sleep, low mood, anhedonia (loss of interest), and has been this way for the past 3 months. She was miserable. It was taking a toll on her work, her marriage, and her kids. She did every medical test out there, most importantly her thyroid (gland that produces hormones, when dysfunctional can mimic depression), all her tests came back normal. So I started discussing depression with her, and the treatment options available. I was met with ‘shno depression? lesh tgolin 3ani maynona’ ‘what depression? why are you calling me crazy?’. She refused to discuss treatment or medication and stormed out. This just highlights a huge issue in Kuwaiti society, the taboo of mental illness.

Depression can be very successfully managed with medications and lifestyle modifications, but mention an antidepressant and 90% of patients will refuse.

You must be thinking.. what about psychiatrists? doesn’t Kuwait have a new mental health centre? A centre dedicated to mental illness? Why not refer patients there? What is their role in improving mental health and increasing awareness?

Here’s a fun little fact.. people who get treated at the Kuwait mental health center wouldn’t be considered for jobs in sensitive positions, such as parliament, certain ministry of interior jobs, army, etc. that does a lot to defeat the taboo right? What a good way to move forward Kuwait! Its one step forward two steps back. On the one hand the ministry of health is improving mental health care, on the other they’re saying if you have a file in the mental health center or problems with your mental health then you’re banned from certain jobs. What kind of image does that project?

I was thinking of ways that mental health can be improved, and ways to increase awareness, and I remembered when I was in med school abroad, we had a student hotline and a suicide hotline. These were 24 hour hotlines that you call, free of charge when you feel suicidal, sad, overwhelmed, or unwell. You would call and there would be someone to hear you on the other end of the line to offer supportive services. I think implementing something like this in Kuwait would be a huge step forward, and easier to set up than changing the politics behind being banned from jobs for following up with a psychiatrist.

We’re a long way away from defeating the taboo of mental health in Kuwait, but I think small changes and an increase in awareness would go a long way. So if you’re reading this, and you notice that you or a friend or relative has been suffering with low mood, loss of interest, change in appetite, trouble sleeping, or anything similar, please go to your polyclinic and discuss it with your family medicine doctor. There are a lot of resources out there, antidepressants can be prescribed by your family physician in the polyclinic, and you can be referred to a more specialized clinic if need be. Please do, thats what we’re here for!

(If anyone has any questions, or is suffering with anything similar please do not hesitate to contact me, I’m more than happy to help)

Post by Dr. H – A family medicine resident working in a polyclinic in Kuwait

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25 comments, add your own...

  1. Tinderbox says:

    ur best bet to treat clinical depression in kuwait is to visit a private dr like Dr Ansari. That way you can stay off the govt loony list and get actual help along with access to the more effective medications.
    from what ive seen Tib al nafsi in kuwait is primarily a place for addiction control more than anything else. The whole file thing is a disaster and ive personally seen people get into issues with law enforcement at checkpoints after a civil id check brings back some mental health history and a trip to the police dept for verification.
    Mental health in kuwait is the ULTIMATE taboo, often more damaging than even a criminal record but that’s to be expected from a still highly underdeveloped society that thinks perfection is actually “achievable” lol.

  2. meh says:

    If only people knew the medication involved in depression, more people will be depressed.

  3. Yey says:

    how to contact you Dr. H?

    (If anyone has any questions, or is suffering with anything similar please do not hesitate to contact me, I’m more than happy to help)

  4. Altaf says:

    Hello Dr. H. Many patients suffering from undiagnosed subclinical or Hashimoto’s thyroiditis can be symptomatic – depression and anhedonia among those symptoms- although standard thyroid profile tests will be normal and within range. The polyclinics only test TSH and FT4, which are poor indicators of the real role of hypothyroidism as the culprit in causing depression. There are also recent studies advocating the use of a small amount of T3 medication such as cytomel and liothyronine in the treatment of,depression even among patients who are not hypothyroid.
    I am telling you this because I am a Hashimotos and thyroid hormone resistant patient who was misdiagnosed over and over and over by the polyclinics (depression being one of my symptoms) and government hospital endocrinologists who are very lacking and ignorant in updated knowledge and expertise regarding hypo and hyperthyroidism and treatment of these patients with T3 medication (and thus helping treat their depression WITHOUT antidepressant medication with all their awful side effects.)

  5. khaled Rashidi says:

    i think there is some kind of hotline in kuwait for this i cant remember it i saw it’s advertisement once .

  6. M says:

    I honesty believe that mental depression is spiritual, and cannot be fixed with conventional medicine. As Allah (SWT) says : “And whoever turns away from My remembrance – indeed, he will have a depressed life…” 20:124. I believe when it comes to diseases of the heart/soul, only the remembrance of Allah (SWT) can cure it. May He cure us all inshallah :)

    • Dr. H says:

      إِنَّ اللَّهَ أَنْزَلَ الدَّاءَ وَالدَّوَاءَ وَجَعَلَ لِكُلِّ دَاءٍ دَوَاءً فَتَدَاوَوْا وَلاَ تَدَاوَوْا بِحَرَامٍ ” .‏ …

      ‘For every disease there is a cure’ -prophet pbuh

      • M says:

        I agree, but with all do respect Dr. H, some diseases are different than others. For instance, diabetes- as you’ve stated; is purely physical, and the cause of it is physical as well, so we can fix it physically. Depression on the other hand is not physical; although it can impact us physically, but it’s a mental issue, therefor we choose a different route.
        Depression happens when we feel helpless, when we feel that we are not in control, so why not turn to the One who controls everything? Indeed with every hardship there comes ease, I suggest that people should at least talk to God or even pray to him, even if they don’t believe in him, and see how comforted they feel. I ask that Allah cures us all and relieves us from any negativity.

        • Fawaz says:

          Its literally people like you that make it such a taboo.

        • Dr. H says:

          Depression happens when certain areas in the brain become overactive and others become underactive, and the misbalance between these areas makes the person more aware of negative memories, negative information from the surrounding environment.. ur consciousness becomes a magnet for all things negative in the world.

          The reason why some areas become overactive and others become underactive is not fully known, but studies have shown that the concentration of serotonin receptors changes, and there are higher levels of inflammatory chemicals than normal which have toxic effects on neurons involved in these circuits.

          So yes.. with all due respect. It is a physical disease.

        • DrQ80 says:

          Depression is not simply spiritual. It may have different triggers, yes, but the actual depression can be genetic. Clinical depression has an actual chemical imbalance in the brain, hormones change and shift / alter (dopamine, serotonin, all the hormones that regulate mood) and thus have the end result of depression.

          Depression isn’t simply being upset – its real, and it can be deadly serious.

          Now, I don’t mind everything you said, yes spirituality can have a positive effect on people, if practiced correctly and being surrounded by the right people, in the right environment. But a hadeeth also said “اعقلها و توكل” when it comes to matters of life. You don’t simply leave things up to God when you haven’t done everything you can to fix it.

          Even though your intentions seem genuine, please don’t try to guide people with that mentality – it only feeds the taboo further, and we as physicians are trying our best to get people to seek help rather than run from it.

    • Dr. H says:

      People who have diabetes need meds, same goes for certain cases of depression

    • aaa says:

      This is actually a harmful belief to have though. Clinical depression manifests itself physically and is not just a mental issue – the reason medications can treat it is because your body chemistry has an effect on your mood whether you want to believe it or not.

      You don’t tell someone with a broken hand to just believe in their hand healing

      • M says:

        I agree it can manifest itself physically, but depression is not something like a broken hand, or a bruise etc. The outcome of depression can be physical yes, but it isn’t physical in essence. You know what else can effect your body chemistry and mood as well? The remembrance of Allah (SWT), as he says “..Unquestionably, by the remembrance of Allah hearts are assured.” 13:28. Many things can effect our mood, but I believe the best medicine for depression comes from Allah (SWT).

        • aaa says:

          You can feel what you want but people don’t get the treatment they need because of this mentality. Let people treat it as they want to.

    • Q8D says:

      Go preach elsewhere.

  7. A says:

    I was suffering from Anxiety a little over 2 yrs back. There is a system in place in Kuwait.
    I’m not sure about the whole issue with the file and jobs. probably it’s just for Kuwaities.
    I tried to work through it for a few days then went to the local clinic. the Dr directly referred me to the clinic in Rumaithiya.
    However, the issue is the service is not available round the clock and every day. The clinic gives you a date which is like 3-4 weeks away after every session and the session lasts only like 10 – 15 minutes.
    The Dr suggested me to take Cipralex but I was shit scared to take any meds thinking it would make it worse. I bought the mds but never took it. eventually some situation in my life changed and that helped me get to a better stage. I still get it sometimes though. But it’s not as worse as it used to be.
    I didn’t mention at work that I was suffering through this and took a number of holidays because I was just not able to gather the courage to get to work. I don’t know what would have been the reaction if I mentioned this at work.

    • M says:

      Hello my friend,

      Life is one difficulty after another, but there is always ease after hardship. Tough times only means that the times of ease are near. Since you still get anxiety sometimes, may I suggest that you turn to God for help? It won’t take anytime at all. Try to read some of the Quran, or talk to Allah about what is making you anxious (even if you don’t believe in Him), or maybe do something that makes someone else feel good (i.e giving charity, compliments, smiles). Don’t worry about the things you cannot control, indeed life is hard and can be too much to handle at times, but remember that there is always a bright side, see the world as beautiful and trust me it will be!

  8. vampire says:

    Thank you for the post..
    Depression started with me when i was a teenager. Took me almost 20 years to seek help. More awerness needed.

    The most important part of the treatment was to educate the ppl around me how to deal with a person having depression.
    Thanks again

  9. Brian says:

    Websites like Plus Guidance will get you into contact with therapists over Skype. It can certainly change your life and is well worth the money paid.

  10. K8 says:

    I agree, I am undergoing treatment for Post natal depression. My husband and his family told me to pray, and that mental illness is only found in western countries. (im british) glad to see it acknowledged and that there is hope for people like me

  11. AbdulRahman says:

    Hey Doc!

    I would like to know if there are any charities that help with depression in Kuwait.

    If so could you share it as a reply?

    Thanks a lot

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