Apakah indikator untuk difikirkan sama ada perlu mendapatkan rawatan di klinik pakar psikiatri
by Prof Dr Ramli Musa under 1. Anxiety disorders, Panic disorder & rawatan berkaitan August 3 2018
As salam,
Jika anda ingin bertanya pada saya soalan; Doktor adakah saya perlu berjumpa pakar? Sebenarnya anda adalah orang paling sesuai menjawap soalan tersebut.
Mengapa? kerana setiap individu mempunyai senario berbeza.
Saya nyatakan sekali lagi panduan bagaimana mengetahui sama ada anda perlu mendapatkan rawatan dari klinik pakar psikiatri;
Ada 5 indikator utama untuk difikirkan
Walaupun skor DASS tinggi, (perhatian lebih pada skor sangat teruk).
Keputusan mendapatkan rawatan pakar psikiatri bukan hanya berdasarkan DASS skor.
Ada 4 indikator perlu mendapatkan rawatan lebih serius
- Kemurungan sehingga banyak tanda-tanda fizikal seperti hilang berat badan, lemah badan, ganguan haid, sembelit.
- Menggangu fungsi minda seperti tumpuan dan fokus
- Tanda ini sangat penting; keadaan kemurungan atau anxiety sehingga menggangu prestasi kerja atau pelajaran serta orang sekeliling.
- Mempunyai niat serius untuk menamatkan riwayat.
Maka nilaikan sendiri…
However as I said in the explanation of DASS interpretation, we don’t only judge based on the score.
There are 4 other indicators to say the condition is alarming.
1. affect your body or presence of physical symptoms; in your case constipation which leads to haemorrhoid and significant weight loss
2. affect mind function; thinking and concentration,
3, affect your work function; which you did not really elaborate on it.
4. Presence of suicidal wish or idea.
Hence it is a good consideration to seek a professional help.
regards
Prof Dr Ramli Musa
Pakar Psikiatri / Psychiatrist
Universiti Islam Antarabangsa Malaysia
Assalamualaikum, saya ingin bertanyakan soalan…
seseorang pesakit dijangkiti penyakit berat , adakah ada kaitan dengan penyakit mental?
salam,
Penyakit berat agak umum. Saya hanya mampu menjawab ; ada kemungkinan
Assalamualaikum, saya nak tanya, tunang saya ada masalah susah tidur, btw sebelum ni dah baik, dia ada beritahu saya, dia keliru fikiran celaru dan saya dapati bila saya baca Al quran dia ckp dia keliru, dan dia suruh saya berhenti tapi saya baca lagi, dia memang ada ambil ubat olanzipine… so apa yang perlu saya lakukan Prof doc? Terima kasih
Salam, Siapa yg prescribed Olanzapine?
Boleh berjumpa doktor tanya mengapa prescribe Olanzapine?
Apa nama penyakit tersebut.
Ia sebenarnya lebih dari apa yg anda ceritakan di sini.
assalamualaikum dr, saya merupakan seorang guru dan warden disebuah sekolah, skrg saya mempunyai mslh stress yg melampau sehinggakan saya selalu menangis dan saya jadi benci orang yang selalu push saya apabila saya lambat bertindak atas sesuatu. ada satu tahap, pelajar saya membuat salah sedikit saya, saya rsa macam down,dan saya rsa pelajar saya x hormat saya, ketawakan saya, pandang sinis terhadap saya walaupun mungkin itu hanya perasaan saya. kesannya, saya x mampu berhadapan dengan pelajar saya. seolah-olah saya takut dgn mrk. apa yg patut saya lakukan ya?
Salam, Jumpa kaunselor atau psikologis atau psikiatris
Assalamualaikum Doc.. score sy menunjukkan saya mempunyai anxiety yg sgt teruk. Dan sy memang akui. Saya mula alami masalah ni sejak form 4. Sy jadi ketakutan tak tentu fasal. Takut jumpa orang. Takut pergi majlis yg ada byk crowd. Ketakutan sy jelas terpancar di wajah apabila nak senyum pun bibir jadi menggigil. Masalah ni sangat2 mengganggu urusan seharian sy. Byk cita2 saya terpaksa lupakan kerana tak mampu nak berhadapan dengan org. Sy tertekan sgt dgn masalah ni. Ada ke ubat ubatan yg boleh bantu sy
Salam,
Elok berjumpa pakar psikiatri, masalah nampak serious
Helo dr, sy mengalami anxiety ni semenjak sy memakai fat burner utk exercise sy. Adakah supplement seperti fat burner boleh mengakibatkn anxiety/panic attack?
Ya boleh menerukkan, ia meningkatkan sympathetic stimulation dan tahap metabolism
doctor.. saya sangat takut pada bos hinggakan saya mengigil dan tidak langsung boleh berfikir. saya bekerja di bidang perbankan. terutama melibatkan repot. saya panik dan blank. hanya apabila disoal oleh seorg individu. lain2 saya tak bermasalah.. cuma dengan dia seorg. mungkin kerana dia terlalu garang dan saya pernah dibaling dengan report dan dituduh menipu olehnya. saya telah mendapat surat dari klinik untuk refer pakar. adakah saya betul2 bermasalah.
Inshaa Allah nanti berjumpa doctor akan menjawab lebih yakin bila tahu semua tentang Puan
As salam, doctor, I’ve been thinking a lot abt should I get a help from pakar, or should I just go to klinik biasa first. My score for the Dass, extremely teruk for anxiety depression and stress. Yes I admit that I’ve been through anxiety disorder since I was 15 years old and now I’m 22 years old, it became more worst. My anxiety attacks me whenever I go to Tempat yg crowded especially when I’m alone, my whole body jadi lemah, bgetar, pening seakan2 nak pengsan, mual, and the worst part is I can’t breathe properly, and it hurts. Sometimes I felt takut yg melampau and keresahan yg melampau, overthinking, rasa bersalah, and also saya susah nak tidur malam, especially when my anxiety attacks me, I slept for 3 hours or in other case more than 11 hours, tapi kerap terbangun dari tidur, macam tdur ayam only bc of that I always feels tired biarpun sometimes tidur more than 11 hours. In my case I didn’t lose weight, instead I gaining weight drastically.
salam,
Bunyi spt Panic Disorder, elok berjumpa pakar.
Assalamualaikum Dr, ada tak rawatan psikiatri secara online, yg kerajaan?
Salam, tiada
Assalamualaikum dr, adakah saya perlu berjumpa dgn dr sbb keputusan saya
Depression:8
Anxiety:24
Stress: 22
Dan keputusan in merisaukan saya
Assalam. Doc. Sy ada kecenderungan utk membunuh, bukan niat bunuh diri tapi bunuh haiwan & manusia. Latar blkg sy, sy berumur 16 tahun dan ibubapa saya warga PDRM. Sy tidak mengalami psikosis atau dgr suara2 pelik suruh sy bunuh org tetapi sy terbayang gambaran yg sy mencekik mak saya, kaunselor atau guru sy dan sy gembira dgn gambaran tu. Sy pernah cederakan 5 kucing perliharaan sy sehinggakan keluarga kami terpaksa buang semua kucing di jalanan takut2 sy mencederakan mereka. Bukan sy tak sedar ketika itu, sy sedar cuma sy rasa gembira bila buat benda tu, dan sy tak rasa bersalah membunuh kucing sy cuma takut di pandang serong oleh masyarakat. Sy juga sgt suka memerhatikan kwn2 saya yg depressed, lebih2 lg yg menangis disebabkan sy. Sy sudh 10 kali mnjlnkan sesi kaunseling sekolah, tp saya hanya seronok melihat reaksi kaunselor yg keliru dgn masalah sy. Sy takut sy membunuh org satu hari nnti, dan ibubapa sy sebagai warga PDRM yg mendapat malu..
Salam,
Berkemungkinan besar anda ada masalah OCD.
Saya pernah melihat pesakit OCD dengan ada obsession membunuh. Sebenarnya bukan dia ada niat membunuh. Ianya adalah sejenis obsession.
Jumpa pakar
Salam dr
Saya tak tahu yang saya alami depression atau tak. Tapi saya dah buat test ni sebanyak 3 kali dan yang kali ke 3 makin teruk pulak keputusan. Saya rasa saya seorang yang ceria tapi bila malam saya mudah menangis rasa nak menjerit nak baling barang. Ada sekali saya terbayang saya gantung diri sebab saya berfikir sambil tengok kipas yg berpusing. Keputusan dass saya
D 24
A 18
S 20
Mohon pendapat dr
Salam,
3 test menunjukkan keputusan teruk.
Anda kata ceria tapi kerap menangis dan ada fikir menamatkan riwayat.
Maka elok berjumpa pakar.
Salam,
3 tests menunjukkan teruk
anda kata anda ceria, tapi kerap menangis dan ada fikir menggantung diri.
nasihat saya berjumpa pakar. ada tak kena
Salam doc, sya ibu kpd 3 org anak. Sya juga bekerja sbg guru tdika. Sya pernah mengalami masalah sesak nafas & menagis secara tiba2. Air mata kluar tnpa berhenti. Bila blk kerumah, sya lebih suka sendiri @ tidur dan biar anak2 main sendiri. Sya jg rasa mlas dan tak nak buat apa2. Pernah stu thap saya rasa nak pergi jauh tgglkan anak2 dgn suami.
Skor dass sya 22,24,14.
Adkah saya perlu jmp dgn pakar?
https://www.ramlimusa.com/apakah-indikator-untuk-difikirkan-sama-ada-perlu-mendapatkan-rawatan-di-klinik-pakar-psikiatri/
Salam Dr,
Boleh Dr emailkan kepada saya bayaran fee utk bertemu dengan pakar pskikiatri di klinik Dr. Ofis saya dan klinik Dr di jalan Lim Hoe Lek sangat dekat. Terima kasih.
Salam,
anatara 150 hingga 200 bergantung keadaan
Aslmkm doktor saya kehilangan suami 3 tahun lps. 6 bln pertama saya mendpt tekanan melampau dr tmpt kerja kerana difitnah dan juga tekanan dr keluarga yg hnya mementingkan perasaan org lain berbanding saya yg kehilangan suami. Sejak 3 tahun ni saya susah nak tidur mlm kdng smpi jam 1 pagi mata terkebil2 lagi. Klu dpt tidur pun tiap mlm saya akan terbangun setiap jam. Saya kerap menangis bila sendirian tetapi saya tetap nmpk riang didpn rakan sekrja. Kadangkala saya rasa fikiran saya kosong x dpt berfikir dan waktu jugalah saya akan rasa pening sekejap. Pernah buat timdakan bodoh menamatkan riwayat dgn menelan pandol 10 biji dan teguk cola. Nasib tak jadi apa2. Cuma saya tidur lama. Dan pernah nak berhenti kerja serta merta dan pergi jauh dr keluarga. Ini saya tak risau yg saya risau bila kesabaran saya hilang wlp kesalahan anak2 hanya kecil saya boleh bertindak memukul dan menjerit kpd anak2. Bila saya mula marah saya berusaha utk kwl tapi kdngkala saya gagal. Rengekan dan sikap memberontak anak menyebabkan saya bertambah marah. Dan saya sering takut saya akan mati dan anak2 jadi yatim piatu. Adakah saya dlm keadaan yg teruk saya telah ambil 3 kali ujian. Keputusan lebih kurang saja. D 26 A26 dan S24. Tapi bila saya sibukkan diri saya dpt lupakan fi
Alhamdulilah, lagi bukti DASS memang tepat.
Ia kemurungan
Assalamualaikum dr , saya pelajar ipt . saya tidak pasti sama ada saya mengalami depressi atau stress yg normal. Saya sedang final exam . Sebelum ni saya perasan saya suka duduk di tempat yg takde orang dan menangis tanpa sebab . Bila study untuk exam , saya tak boleh ingat langsung apa yg saya belajar & saya rasa sangat takut untuk pergi ke mana mana . Saya rasa nak menangis & ingin bersendiri .
Keputusan DASS saya
D: 22
A: 28
S: 26
Apa yg patut saya lakukan dr ?
Hi doc. Saya ad penyakit psychology which is sy pun xthu axienty, depression, bipolar atau apa since 7 tahun lps.
Lately ni prestasi kerja sy merundum, sy depress, rambut byk gugur, xsuka nk bergaul dgn org, hilang minat dgn perkara yg sy sepatutnya suka buat, sy lebih suka menghabiskan masa sy sndirian di atas katil, rasa diri useless, senang marah, emosi xstabil, rasa terlalu malas walaupun utk suap makann di mulut.
Dulu sy blh kawal lagi walaupun same things happen. Kejap dtg kejap xda. Tapi sy smkin worse.
Antara faktor yg buat saya mcmni:
1. Sy homoseksual (bernafsu kpd lelaki). I hate this feeling. Bertahun2 sy melawan perasaan ni. 😢
Sy manusia biasa bernafsu doc. Sy ingin juga someone dlm hidup saya. I nk rasa cinta nk rasa apa yg org lain rasa dgn pasangan mereka. Sy redakan perasaan dan keinginann ni sy beronani setiap hari (3-4kali sehari). Sya rasa sgt teruk. Sy xblh tahan ketagihan ini. Sy blh jadi gila kalau x beronani.
2. Saya mempunyai 12 org adik beradik, family sy ssh. Sy ank num 7 dan hnya sy yg dpt smpai ke universiti. Yg lain2 tidak bersekolah dan ad yg smpai ke spm shj. Pendek kata sy harapan keluarga. Bnda ni juga membuatkan saya sgt tertekan.
Saya cuma nk minta nasihat doc apa yg harus sy lakukan sbb saya xmampu nk menanggung beban yg terlmpau berat ini. 😢
perlu ditangani isu homosexual itu dahulu. Yg lain akan terungkai dengan sendiri. Bila telah atasi isu homosexual, then baru ada pasangan hidup, boleh kahwin dan ada anak. Hidup akan lebih bermakna.
Saya ingin tahu bila beronani, anda bayangkan pasangan wanita atau lelaki?
Ini adalah fantasi sexual
laki
salam dktor. keputusan dass sy
pertama 26,18,24
kedua 28,22,18
suami sering outstation kebelakangan ni. kami tiada anak,buat sy selalu sunyi sndirian di rumah,selalu memikirkan untuk cederakan diri sndiri supaya suami balik dan berada di sisi saya. saya juga selalu bercakap kasar dgn suami ketika dia berjauhan. adakah saya perlu jumpa pakar,atau keputusan saya akan lebih baik bila suami pulang nanti? terima kadih doktor..
Maaf saya kurang pasti apa sebenarnya masalah puan.
Perlu kaunseling.
Itu terbaik
DASS mencadangkan kemurungan
Assalam dr. Sy seorang pelajar. Skala Anxiety saya agak teruk 26-30 dan stress 24-27. Kadang2 sy kena panic attack (sy x pasti). My head suddenly hurt and bad memories keep coming. I cant breath properly and tears keep flowing. But it happens like only for less than 6 min after Im holding myself back. I keep doubting myself if im not study enough or if my friend study much more than me that will make my result look bad but in reality im still one of the top student (although my result isnt “that” good). Nowdays, my anxiety isnt that bad but sometimes it still attack me. Idk if I have a good reason to meet doctor about my problem cause sometimes I find it funny and might embarassing myself. When it comes it hurts so much that I cant think properly and my small problem seem bad. I tend to be very careful when stating my opinion with friends and teachers because im scared I would be judged as someone who talked without brain that makes me lose interest to speak in a group. I still want talk more but these will do. I have a very important exam coming soon and I dont want panic attack or anything affect me on the important days. (I was once left one page on exam paper which contain 10 marks empty because Im very panic and uncomfortable during the examination 😅 (well I dont realize I left it empty)) Thus, I really need your opinion, should I meet caunselor or this is just minor and it is not necessary to meet one?
Salam, Yes meeting the counselor is a good idea.
You are having many intra and inter-personal conflicts. Partly due to childhood upbringing.
saya sering merasa bersalah kpd ibu bapa saya kerana merasa menyusahkan mereka. saya menangis dan rasa tidak berguna. saya juga kadang-kadang susah nak tidur.
Salam,
Sila nyatakan ujian DASS
Hello doctor, I’m a high school, currently still a student because of Covid-19 when I was supposed to be waiting for my SPM results already. From the past year (2020) even before Covid-19 started (in Malaysia I mean), I’ve these tendencies where I refused to go to school. Sometimes I pretended to be sick only so that I’ll not go to school. After the first MCO ended, school reopened again, and despites not wanting to, I went to school anyway because of my parents. Though later after that, I started to refuse to go to school, giving my parents plenty of excuses like I’m sick or purposefully waking up late so that I’ll be not going to school. This went for two weeks, until my parents had it enough with my behaviour and started to push me to go to school. The first day I came to school, most of my classmates notice these changes in me, like something on me seems weird and they keep asking if I’m okay. One of my teachers even asked me if I’m okay, but those questions only triggered me to cry, I didn’t cry in front of my classmates, but I did it in front of my two close friends during recess. Talking about which, on that same day, the school counsellor even handed us a form for mental health, kinda similar to the one I just take from this website. The questions written just feel relateable to me so much that it made me want to cry, and I refused to answer the sheets as I don’t want the teachers (also others) to find out about my situation. I ended up didn’t submit the form and went to the toilet to cry. My two close friends comforted me and I told them about me not submitting the form. One of them told me that I shouldn’t do that, saying that perhaps I can get help from filling the form. Though, I disagree, because I don’t want the teachers to find out about my situation as I’m kinda known in the school, among the teachers especially, because I’m an excellent student both in my studies and co-curricular activities. I’m also afraid that my parents will find out about this too. When I went back home, I told my twin sister about what happened at school, this being as my twin sister was the only one who knows about my ‘situation’. She just comforted me after that.
About my situation, as I’ve taken the test from this website, I always find myself staring blankly in the distance and had so much thoughts going, sometimes good, most of the times bad. I also cried almost everyday, and not motivated to do everything, and that includes my hobby (I love drawing). I always find myself in my bed, crying my eyes out, trying to scream, but held my voice as I don’t want others to hear. Everytime I finished crying, I’d sleep, but I feel restless. Most of the time I don’t want to sleep, because I don’t want the time to pass, I don’t want to go to school. But my head hurts so much from thinking and crying, that I ended up sleeping anyway, but I only slept for a short while. I also realised that my mouth always felt dried, the reason why I always had a bottle of water in my room for that purpose.
For the case of refusing to go to school, I don’t know myself, I’m not sure. I just don’t want to see their face (the teachers, the students, everyone), even the thought of it made me sad, or stressed? I feel empty, it also made me cry and I felt like vomiting everytime.
I sometimes overreact in situations, where my family just wanted to have a light hearted conversation but I get too worked up and made the situation ‘tegang’, whenever this happened I’d excuse myself and cried in my room silently, and blamed myself for what happened.
Lately I’ve been doing self-harm. I learnt that some people do self-harming because they felt empty and they wanna feel something. But it my case, I just wanted to clear my bugging minds by focusing on the pain I made on myself instead.
School will be reopen this Wednesday (20/1/21) and I’m still not prepared for it. I’m afraid that I’d do something stupid in front of everyone in school like crying or anything. Trial for SPM will also continued on the day after that, and I didn’t have the motivation to face it. I no longer studies. At the same time, I’m also afraid of not doing well. Big part of me no longer care about that as I already feel distastes on the tip of my tongue whenever school-related is mentioned. But small part of me is worried of it. SPM is a big examination for every Malaysians. What if I didn’t do well? Received bad grades and didn’t have the chance getting accepted into any universities or colleges?
Also, for the past years I always wanted to be a doctor, I had this dream ever since I was in kindergarten. But as I grew up, I realised it during late 16 of my age that I no longer wanted to pursue this kind of goal anymore. I wanted to do something that I love instead which is drawing. It took courageous (and numerous crying) for me to talk to my parents about this and I’m glad they’re fine about it. But when I found out that illustration related courses will cost me a big COST, I started to doubt myself, I don’t want to burden my parents. I don’t know anymore, as I write this comment, my mind is a mess. I just woke up from sleep, and I just dreamt about my add math teacher, in that dream I felt really restless, what more waking up. Which get me to this, ‘taking test online’ to find out what’s actually wrong with me.
I’ve hemorrhoid and my weight has gained lately. I was 45kg when I was 15, but as of now, I’m already past 55kg, is that normal? I also had this situation where I eat, and once finished I felt bad of eating and felt like I shouldn’t have ate. Sometimes I felt like vomiting, but I just never had it in me to do that, until several days ago, I tried to force myself to puke because I feel full.
I also rarely contact my friends anymore. I don’t know, I just felt reluctant to talk to them. As whenever I tried to talk to them, they always mentioned something school-related and as mentioned, this makes me feel sick. I know it’s not their fault because they didn’t know about my situation but I don’t want to explain myself to them, they’ll not understand. For this instances, I decided to not talk to them instead.
For the whole online school case instead, I’ve been skipping all of my classes. Never attend one. I even went far as muting every school-related group, ignoring my teacher DMs (as they only demand their assignments to be submitted), and even blocked the Whatsapp App. I actually wanted to uninstall the whole app, but I’m worried if emergencies happened, so I decided to keep the app anyway all whilst keeping the app blocked. But as of lately, I’ve the app unblocked already but the school-related groups were still muted.
Weeks ago, I told my mother about my situation and she tried to understand my situation eventhough it’s clear in her face that she seems to be doubting me. But I’m still glad that she said she’ll try to find help. But what worried me is that the school reopening is just around the corner, and she never mentioned about ‘the help’ that I asked and seems to forgot about it already. I don’t want to talk to her about it again, because the time I told her about my situation already had me a lot of courage to even speak about it to her. And also, most of my siblings are living in the house currently because of Covid-19 and I don’t want them to find out about my situation. The only one who knows about this is my mother and my twin sister.
My mother once said this to me after I told her about my situation,
“Ummi cuma nak tengok akak happy macam remaja-remaja lain”
and that sentence made me tear up. I felt like it was my fault that I’m like this. Why can’t I be like others where they just simply enjoying life and looking forward to tomorrow?
I sometimes had this thought where I want to end myself, but being a Muslim, I always believed that Allah hate those who killed themselves. And also the fact I don’t want to bring shame to my parents and family, I rationalised my thinking.
As I write this, my hands are trembling, and my feet feel cold, I’m also crying currently.
For the test, this is my result,
Depression 38
Anxiety 24
Stress 22
As salamulaikum,
You may want to do some reading on “School refusal” and this is a common disorder encountered by psychiatrist especially child psychiatrists. Kids with school refusal commonly have high anxiety level.
We commonly will not regard them as someone with disciplinary problem.
The problem is generally is not easy to overcome virtually and to be more specific in this website.
It requires face-to-face sessions with a psychiatrist.
Antidepressant and antianxiety would help a lot to facilitate the anxiety plus family and school interventions.