Don’t try this at home: exec self-medicates for depression, apnoea – and solves problems he spent a fortune on with doctors in vain
Derek Chan has become an amateur pharmacist and armchair doctor in his quest to relieve chronic conditions, after running up big bills in Hong Kong for largely ineffective medical treatments; it worked for him, but he doesn’t recommend it
Self-described amateur pharmacist and armchair doctor Derek Chan (not his real name) is living proof that where there is a will there is a way to overcome what ails us – even if it means taking matters into our own hands. Or, in his case, his nose.
He has cabinets chock full of medicine and health supplements in his Beijing home, having shopped online for St John’s Wort, 5-HTP, gamma oryzanol, gastrodin and other potential remedies for his depression.
A finance executive with a multinational company, Chan was diagnosed with the debilitating mood disorder seven years ago, when he was working in Hong Kong. He turned to self-medication after years of expensive but mostly ineffective medical treatments.
By the time he was transferred to Beijing three years ago, he had spent hundreds of thousands of Hong Kong dollars following orders from general practitioners, specialists, psychologists and psychiatrists, but felt no relief.
“My symptoms included migraine, stomach ache, fatigue, muscle pain, mood disorder, poor memory, lower intelligence and productivity. I found it hard to concentrate. My brain was not sharp as before. I fell into the habit of avoiding complex tasks and looking for an easy way out,” Chan says.
A gastroenterologist subjected him to a painful gastroscopy and colonoscopy which failed to find anything wrong with his insides.
“My general practitioner referred me to a psychiatrist, saying that my stomach cramps could be due to nervous tension.”
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His medical insurance did not cover mental health treatment, so extended sessions with psychiatrists and psychologists put him under undue financial stress. A session with a psychiatrist who prescribed antidepressants and sleeping pills for a week cost HK$2,000; an hour with a behavioural psychologist cost around HK$1,500.
When he relocated to Beijing, he began to study medical journals and research papers online, to find his own remedies.
“Early researchers suggested that a lack of serotonin is the main cause of depression. Therefore, doctors advise ingestion of antidepressants to boost serotonin in the brain. But it was later discovered that brain-derived neurotropic factor, or BDNF, instead of serotonin, is the crux of the issue,” Chan says. “The brain releases the hormone cortisol when it is subject to stress.
“Cortisol reduces BDNF levels and causes inflammation in the brain, which causes dendrites to wilt. Dendrites are treelike projections arising from the neuron [a nerve cell that is the basic building block of the nervous system]. Healthy dendrites are dense and thick. The thicker and denser your dendrites, the sharper your brain.”
To boost BDNF levels, Chan began taking Prozac, gastrodin, the anti-inflammatory spice turmeric, and other supplements. Three years on, this self-prescribed regimen, coupled with meditation and light exercise such as jogging, has alleviated his depression.
“I feel my brain’s function has returned to the top state before I developed depression, with better cognitive and problem-solving skills and long-term memory,” he says.
Chan acknowledges self-medication can be dangerous, and says he does not recommend this course of action. But he says Hong Kong doctors’ standard approach to treating depression has inherent shortcomings.
“Not their usual high-functioning selves, people who have depression are likely to have reduced job performance. Further subjecting themselves to expensive private treatment will hardly help with their mental state,” he says. “But there are long queues for the public sector. That’s why many depression sufferers are in a helpless state in Hong Kong.”
Non-governmental organisations in Hong Kong do offer psychological counselling services that charge according to patients’ salary levels, clinical psychologist Sarah Ip Miu-yin says. Some charge less than HK$1,000 (US$125) an hour.
“For those who cannot afford [prolonged] private mental treatment, their private doctors can refer them to the public sector,” Ip says.
“Patients have to get the latest diagnoses for the right prescription. Mental illness is not like having a cold. It’s better to consult a specialist who can advise proper medicine dosage and combination according to the patient’s condition. Self-medication is risky,” she says.
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After finding his own way out of depression, Chan adopted a self-help approach to another condition from which he suffers, sleep apnoea, or interrupted breathing during sleep. It was diagnosed two years ago and was caused by a deviated septum – a bent nasal bone and cartilage which blocked his air flow.
“For years, I could fall asleep easily but I didn’t feel refreshed upon waking,” Chan says. A sleep test at St Teresa’s Hospital in Hong Kong showed his breathing was interrupted more than 40 times during an hour of sleep, which explained his daytime drowsiness.
His tonsils were removed to improve his breathing, but a year later the sleep apnoea returned.
After extensive online research, Chan paid HK$2,000 a month to rent a positive airway pressure machine, but it caused intense nasal dryness and severe discomfort. He also tried some innovative remedies, including an anti-snore chin strap, the Provent nasal valve and the AveoTSD tongue stabilising device. All failed.
Then he read about German ear, nose and throat specialist Dr Peter Renner’s invention, the AlaxoLito nasal stent. When inserted into the nose, its metal mesh expands to widen the nasal airways. It looked like an ideal solution, but is not for sale outside Europe.
“The concept of using the stent to prop open the airway when sleeping gave me the idea of using endotracheal tubes,” Chan says. The tubes are normally inserted into the windpipe through the mouth to help people who are unconscious or can’t breathe on their own. He bought tubes that fitted easily inside his nose to keep the airway open, “which greatly improved my sleep”.
Having found his own solutions to these two conditions, Chan has concluded that chronic ailments are difficult for doctors to treat.
“A method that works on one [patient] doesn’t necessarily work on others. If a patient has to try all the methods, and get them administered by different doctors until finding one that eventually works, all the medical consultations and follow-up sessions will cost a fortune.”