General Practice Services

Depression and Anxiety

Holistic Health Reset Program Cost : Rp. 3.700.000 – 20.000.000
+ Depression & Anxiety Program : Rp. 2.000.000 – 5.000.000

Depending on Diagnosis & Treatment needs.

What are Depression and Anxiety ?

Yes, Depression and Anxiety can be classified as separate problems, however a more holistic view is to look at, and perhaps rule-out, both together. Treatment at BSI does address them separately or together as needed.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how a person feels, thinks, and behaves, and can lead to a variety of emotional and physical problems. Depression can result in difficulty with normal day-to-day activities, and sometimes causes feelings of ‘life not worth living’.

More than an occasional case of ‘the blues’, depression isn’t a weakness per se, and rarely can a person simply ‘snap out of it’. Depression may require long-term treatment. At BSI, our first approach is with diagnosis of endocrine and environmental / physical causes, which are nearly always overlooked in main stream medicine or psychotherapy. We endeavor to explore and treat root causes, which in turn can make psychological therapies much more effective, if indeed they are needed after physical systems are in balance.

Occasional anxiety is a normal part of life. However, people with anxiety disorders frequently experience intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).

These feelings of anxiety and panic tend to interfere with daily activities, are difficult to control, are often out of proportion to the actual danger and can last a long time. People with high anxiety may find themselves avoiding places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. More than one anxiety disorder can occur. Sometimes anxiety results from a medical condition, or diet, or environmental anomalies that require change or treatment. High anxiety can often lead to depression.

And depression and / or anxiety can directly relate to high blood pressure, obesity, cancer, stresses of all types, rapid aging, and more.

More About Depression

Although depression may occur only once during life, multiple episodes are common. Symptoms may occur most of the day, nearly every day and may include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss, or increased cravings for food and weight gain
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking, or body movements
  • Feelings of worthlessness or guilt, fixating on past failures, or self-blame
  • Trouble thinking, concentrating, making decisions, and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches


For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities, or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

Depression symptoms in children and teens

Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences. In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or low body weight.

In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Depression symptoms in older adults

Depression is not a normal part of aging, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:

  • Memory difficulties or personality changes
  • Physical aches or pain
  • Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication
  • Often wanting to stay at home, rather than going out to socialize or doing new things
  • Suicidal thinking or feelings, especially in older men


Causes of depression

As with both physical and many mental disorders, a variety of factors may be involved, such as:

  • Biological differences. People with depression appear to have physical changes in their brains.
  • Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that affect depression. Neurotransmitters and how they interact with neurocircuits are involved in maintaining mood stability and can play a significant role in depression and its treatment.
  • Hormones. Changes in the body’s balance of hormones can cause or trigger depression. Hormone changes can result with pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or a number of other conditions. Keep in mind that every decision a person makes stems from interactions from hormones.
  • Inherited traits. Depression is more common in people whose blood relatives also have this condition.
  • The adverse effects of Covid-19 inoculations and or nasal swabs.


Risk factors and warning signs of suicide

To be diagnosed with major depression, a person’s symptoms must fit the criteria outlined in the DSM-5.6

These symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must not be a result of substance abuse or another medical condition. Doctors must rule out other mental health conditions that can have a depression component but are not strictly a major depressive disorder (e.g., bipolar disorder and schizoaffective disorder).

To be diagnosed with major depression, a person must not have had a manic or hypomanic episode, which would then warrant a diagnosis of bipolar disorder.

More About Anxiety

Common anxiety signs and symptoms include

  • Nervousness, restlessness or tension
  • A sense of impending danger, panic or doom
  • An increased heart rate
  • Breathing rapidly (hyperventilation)
  • Excessive perspiration
  • Trembling
  • Feeling weak or tired
  • Trouble concentrating or thinking about anything other than the present worry
  • Insomnia
  • Gastrointestinal (GI) problems
  • Controlling worry
  • The urge to avoid things that trigger anxiety

Several types of anxiety disorders exist

  • Agoraphobiais a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem. Bad diet can be included here too.
  • Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.
  • Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they’ve occurred.
  • Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.
  • Separation anxiety disorder is a childhood disorder characterized by anxiety that’s excessive for the child’s developmental level and related to separation from parents or others who have parental roles.
  • Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
  • Specific phobias are characterized by major anxiety when you’re exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people
  • Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.
  • Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don’t meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

Causes of anxiety disorder

For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness.

Examples of medical problems that can be linked to anxiety include:

  • Heart disease
  • Diabetes
  • Thyroid problems, such as hyperthyroidism
  • Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
  • Drug misuse or withdrawal
  • Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications
  • Chronic pain or irritable bowel syndrome
  • Rare tumors that produce certain fight-or-flight hormones

Sometimes anxiety can be a side effect of certain medications, sugar consumption, caffeine, bad diet, and more.

We can rule-out anxiety disorder as a results of a medical condition if:

  • No blood relatives (such as a parent or sibling) have an anxiety disorder
  • Anxiety disorder was not experienced as a child
  • You don’t avoid certain things or situations because of anxiety
  • You have a sudden occurrence of anxiety that seems unrelated to life events and you didn’t have a previous history of anxiety

Risk factors, that may increase risk of developing an anxiety disorder

  • Trauma. Children or adults who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life.
  • Stress due to an illness. Having a health condition or serious illness
    can cause significant worry about issues such as treatment and the future.
  • Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety – for example, a family death, work stress or ongoing financial worries.
  • Personality. People with certain personality types are more prone to anxiety disorders than others.
  • Other mental health disorders. People with depression, and other disorders often suffer anxiety disorder.
  • Having blood relatives with an anxiety disorder. Anxiety disorders can run in families.
  • Drugs or alcohol. Drug or alcohol use or misuse or withdrawal can cause or worsen anxiety.


Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as:

  • Depression (which often occurs with an anxiety disorder) or other mental health disorders
  • Substance misuse
  • Trouble sleeping (insomnia)
  • Digestive or bowel problems
  • Headaches and chronic pain
  • Social isolation
  • Problems functioning at school or work
  • Poor quality of life
  • Suicide


Take steps to reduce the impact of symptoms if you’re anxious:

  • Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
  • Stay active. Participate in activities that you enjoy and that make you feel good about yourself. Enjoy social interaction and caring relationships, which can lessen your worries.
  • Avoid alcohol or drug use. Alcohol and drug use can cause or worsen anxiety. If you’re addicted to any of these substances, quitting can make you anxious. If you can’t quit on your own, see your doctor or find a support group to help you.
  • Receive diagnosis and therapies with BSI International Clinics.


Tests and Scales for Depression

First, interview about day-to-day life and their feelings. These feelings must also be accompanied by at least five other common symptoms of depression, including:

  • Change in appetite, losing or gaining weight
  • Sleeping too much or not sleeping well (insomnia)
  • Fatigue and low energy most days
  • Feeling worthless, guilty, and hopeless
  • An inability to focus and concentrate that may interfere with daily tasks at home, work, or school
  • Movements that are unusually slow or agitated (a change which is often noticeable to others)
  • Thinking about death and dying; suicidal ideation or suicide attempts

Determine The Causes

Second, talk about:

  • Diet and environment.
  • Caffeine
  • Sugar addictions
  • Chemical exposures

Third, ask about drugs and medication, antibiotics, vaccines, etc.

Fourth, perhaps ask the patient to answer the self-assessment test, links to pdf below.

Fifth, request blood and urine, and include, if needed, Thyroid / Pituitary, Lipids, Hormones.

Laboratory Tests & Prescription

Sixth, after analysis, make prescription based on interview and results, with integrative emphasis on mental well-being. Use the same prescription as usual, with added meds and therapies added as needed.

Key to diagnosis is to first rule out physical causes, beginning with full Level 2 Analysis, with emphasis placed on imbalances in the endocrine system, and body systems in general..

Feelings of sadness, low mood, and loss of interest in their usual activities must mark a change from a person’s previous level of functioning and have persisted for at least two weeks.

Common Depression Tests and Scales. May we suggest you take one or two of these tests, and print and bring along the results to your first appointment, if you want.

Patient Encouragement

Modern drugs suppress depression or anxiety but do not usually cure. Natural remedies take time and require diligent participation by the patient. Constant monitoring of mood and attitude is required, as is full commitment to diet and medicines. Several days are needed for the program to work. Changes and improvements are generally observed daily. Once normalcy is observed, continued therapy is probably required. Perhaps for one or two months, with long-term dietary and lifestyle changes fully enacted.

The patient must be patient. Impact exercise is key, in order to stimulate endorphin activity.