SINGAPORE — The conversation Jason had with his psychiatrist was not about dosage. It was about desire. About function.
About whether the treatment that lifted the “invisible weight” of major depressive disorder was also costing him a part of his life he was not willing to lose. For years, Jason managed his depression quietly.
A digital and brand-strategy specialist, he was a high performer at work. He was in a happy marriage with a supportive husband. Inside, the symptoms were there: depressed mood, loss of interest in things he once enjoyed, fatigue, trouble sleeping, poor concentration, restlessness.
Five or more symptoms, as the diagnostic criteria for major depressive disorder require. He carried them alone.
Then came the antidepressants. His psychiatrist prescribed them. The drugs worked on the depression.
They also brought a side effect Jason had not fully anticipated: sexual dysfunction. This is a reality that affects many families across Asia. It is rarely discussed openly.
But it is a concrete problem that patients and doctors must face together, and the next steps are not abstract. They are decisions about which medication to try, at what dose, and for how long.
Jason’s path forward was not a single switch. His psychiatrist prescribed various treatments. He began noticing the sexual side effects after starting them.
The solution was not to stop treatment — that risked the depression returning. It was to talk.
Honest conversations with his psychiatrist. Understanding that the side effect was part of the treatment process, not a personal failing. What that meant in practice: adjusting the medication.
Trying a different class of antidepressant. Lowering the dose. Adding another drug to counter the side effects.
Timing doses around sexual activity. These are the concrete next steps that patients like Jason face.
They are not one-time fixes. They are iterative, trial-and-error processes that require patience and a doctor willing to listen. For the millions of people living with MDD across the region, the next step is the same one Jason took: start the conversation.
Many patients do not. They stop taking their medication without telling their doctor.
They suffer in silence. Or they quit treatment altogether, leaving the depression untreated. The decision to talk is a decision to stay on treatment.
It is a decision to keep managing the depression while managing the side effects. Jason made that choice. His psychiatrist made it possible by being open to the discussion.
What comes next for patients is not a single date on a calendar. It is a series of appointments.
A log of symptoms. A willingness to report what is working and what is not. For doctors, it means asking directly about sexual function — not waiting for the patient to bring it up.
For families, it means understanding that the side effect is the treatment, not the person. Jason describes himself as a natural mentor.
“Put me in a situation where people are challenged, and I light up,” he says. “I like decoding the emotional undercurrent and helping people feel at ease.” The man who helps others feel at ease has not always felt that way himself. But he is learning that managing depression is a process.
And that process includes managing the side effects, one honest conversation at a time.
