Hello and thank you for your question to JA. I wish I will be able to help you. I am not sure did I get from your description did you quit all the medications and which are the medications you were taking before you discontinued and which are other medications you took before that. Could you please elaborate. I would like know which combination of medicaments helped you the most before in your opinion. Thanks Dr. Fabio Goderecci................Disclaimer: this psychiatric/psycho-therapeutic advice is for educational purposes. It cannot substitute a medical/psycho-therapeutic evaluation/treatment having place in person at the practice of a licensed psychiatrist/psycho-therapist. This advice should always be applied under the personal supervision of a specialist at her/his practice. If your situation is an emergency you should visit an emergency unit right now.
I would have thought that AMS in Dhahran would have more than one psychiatrist available to you - forgive the assumption that you live in the Eastern Province. I do not think that you are going crazy, but I do think from all of what you tell me that you need a thorough re-evaluation, and more support in addition to the medication you are on. I do not know what the position is now, but previously counselling support was limited to person centred therapy, which is ok as far as it goes, but I feel that you need something that is more solution-based rather than mainly supportive. My suggestion would be t that you would benefit from some Cognitive Behavioral Therapy.
CBT is based on the fact that what we think in any given situation generates beliefs about, and reactions to that situation, and also causes the behaviour and feelings which flow from those beliefs and reactions.
These ‘automatic thoughts’ are so fast that generally, we are unaware that we have even had them. We call them ANTS (automatic negative thoughts) for short.
If the pattern of thinking we use, or our beliefs about our situation are even slightly distorted, the resulting emotions and actions that flow from them can be extremely negative and unhelpful. The object of CBT is to identify these ‘automatic thoughts’ then to re-adjust our thoughts and beliefs so that they are entirely realistic and correspond to the realities of our lives, and that therefore, the resulting emotions, feelings and actions we have will be more useful and helpful.
Cognitive therapists do not usually interpret or seek for unconscious motivations but bring cognitions and beliefs into the current focus of attention and through guided discovery encourage clients to gently re-evaluate their thinking.
Therapy is not seen as something “done to” the client. CBT is not about trying to prove a client wrong and the therapist right, or getting into unhelpful debates. Through collaboration, questioning and re-evaluating their views, clients come to see for themselves that there are alternatives and that they can change.
Clients try things out in between therapy sessions, putting what has been learned into practice, learning how therapy translates into real life improvement.
Please visit this website for much more detailed information on CBT:
Also, there are good free CBT based self-help resources here:
Also, there is a book called ”Feeling good - the new mood therapy” by Dr. David Burns. It has a hand book which gives you practical exercises to work through and further instructions on how to better use CBT. I really do recommend it.
Cognitive Behavioural Therapy Workbook for Dummies By Rhena Branch, Rob Willson is also pretty good.
In addition, CBT is readily available online, and that can be a very, very effective approach.
If you like, I’ll see if I can source some reliable services for you – let me know.
I think too that you would really benefit from being able just to talk – now I understand that it may not be your ‘thing’, but I have known that some ladies feel that they get a lot of support from their local community Aramco Womens’ Group – it has got to be worth a try.
Just as an aside, I worked for Aramco Medical Services myself during my time in Kingdom – long before it was Saudi Aramco !
In the immediate term, I suggest you ask your local Health Centre to get you an urgent referral to Psych Services so that you can get the re-evaluation you so urgently need. It is clear that your medication regime is ineffective, and that HAS to be resolved as a first step.
Finally, on the page here you will find a listing of therapists in KSA who have a formal training in CBT - it would be well worth talking to a couple of them.
Also, go on to Google and search for ‘Bipolar Forum’. There are several to choose from, and I’m sure that one of them will be to your taste, where you can interact (albeit at a distance) with people who know what you are talking about.
If there is anything else I can do to help, please let me know.