Ask Dr Kim | Archived live chats

[Chris_B]

Good afternoon everyone, Dr Kim is here and we're ready to start.

Welcome Kim, our first question is below:

I am a 23 year old female with contamination-focused OCD. Do you have any advice about how I could deal with anxiety over my boyfriend's health? He is the only person I kiss and share drinks with, which means that if he does get sick, I will be likely to get infected. I really love and care about him, so the anxiety is not just about fear of contracting germs and illness, but also wanting him to be healthy and well.

[Dr_Kim]

Good afternoon everybody.

OCD is a form of anxiety that is very sneaky at times. The key to tackling it is accessing the healthy, non OCD part of our brains that want us to be more peaceful and logical and not be a slave to the unhelpful thoughts and actions. If your OCD feels it can’t “hook you in” by its usual means, it may try another method to get you started on the roundabout of worry . So it sounds like your OCD which you acknowledge usually takes the form of worrying about you being contaminated, is trying to start up another pattern of obsessional thoughts about not only your health , but now your boyfriends. Use your “healthy” brain to be mindful and aware of this sneaky new tactic and see if you can feel more powerful against the “OCD” part of your brain that is trying to keep you locked up in unhelpful thoughts. Go back to what has worked in the past for you around thought-challenging, thought-ignoring, or accessing the parts of your brain that allow you to distract yourself.

[Chris_B]

Thanks Kim. Next question:

Dr Kim my anxiety precedes my depression. Some days I feel too overwhelmed to leave the house. Should I force myself somehow to get out or should I accept my anxiety & stay at home?

[Dr_Kim]

I often find that depression and anxiety end up together , meaning many people get depressed if they have anxiety for long enough and many people get anxious after having depression for some time. You are alluding to an important aspect of fighting these difficult mental health problems - keeping going and taking small steps every day . I think it is really great to try and do something every day that challenges your depressed or anxious parts so that your healthy brain can be reassured that it is still there ! So even getting up , getting dressed and going for a walk can make us feel like we are being a bit healthy , a bit normal and not only a victim of the depressed or anxious parts of us. So my advice is to keep trying to get out, but if you can’t , please be kind to yourself and try again the next day giving that “healthy” brain another chance to show the “anxious” brain that its still there and wants to try and keep moving forward!!!

[Chris_B]

Thanks! Next question:

Hi Dr Kim what options are there when someone is described as "treatment resistant? For example a person could be severely depressed but Drs offer no medical alternatives. If you have treatment resistant depression what is the point of remaining on medication?

[Dr_Kim]

“Treatment resistant" is a term that can mean lots of things so I can’t be sure that it means the same thing to you as it does to your Health professionals. I wonder if they might mean that your medications are not having the sorts of effects that you hoped they might have? I think in this situation one might have to think of pulling out all stops and really working hard at the non medication aspects of getting better to see if they improve the medication response. I’m talking about things like increasing cognitive therapy, support groups or intensive outpatient programmes and then the lifestyle factors like diet, exercise and sleep hygiene and mindfulness meditation. I know it sounds like a lot of hard work and energy for someone who is depressed, but you sound like you really want to get better and want and need to support to do it.

[Chris_B]

Thanks Kim. On a bit of a similar theme:

Dear Dr Kim what to do when I've tried everything suggested to overcome depression but it remains?

[Dr_Kim]

I would be interested to know what you mean by "everything suggested", as I feel that treatment for depression comes under 3 main headings: (1) medications, (2) cognitive therapy and (3) lifestyle options. If you have tried all three together, and you still feel that you are unable to achieve the results that you would have hoped for, my suggestion is to not give up. Have a break, and try again. Depression for some people can be a chronic illness, but at times people can get differing responses for reasons we don't fully understand. So persist, and try again - you may, surprisingly, get a response in a few months time to the same things you are trying now.

Don't forget social supports too, having a team around you to keep you going is such an important part of the journey. Don't give up.

[Chris_B]

Thanks Kim. A really interesting question up next:

Hi Dr Kim. Thankyou for your time. I am well read on Anxiety since my first major attack in 1983. Your opinion on the long term physiological ramifications of anxiety attacks would be greatly appreciated. Kind Regards. Paul

[Dr_Kim]

Well, this is a really interesting question. We know that anxiety and stress cause certain hormonal changes to occur in the body. These hormonal changes were put there to allow our bodies to be able to run or fight predators when we were under threat. However, they were never meant to be around for extended periods of time, or very often. In modern times, with long-term chronic or repeated stress, these hormones (such as cortisol or adrenaline) have been associated with other medical problems like high blood pressure or heart problems. There are good mental and physical health reasons to try and strive to reduce anxiety levels in the body. There has been good research to show that reduction of anxiety symptoms through treatments like mindfulness meditation can alleviate the physical symptoms and restore the body to good health, which is why it's good to concentrate on the lifestyle changes like diet, exercise, etc.