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.

[Chris_B]

Our next question:

What about the person who functions okay but cannot get a job due to paranoia and anxiety? No assistance anywhere

[Dr_Kim]

When you say that someone functions normally but can't get a job due to mental health issues such as anxiety or paranoia, I'm thinking that maybe their mental health issues are impacting on them in ways that are more severe than they acknowledge.

I mean if someone is unable to work because of some sort of disability, either physical or mental, I think that would impact enormously on not only their self-esteem but also practical things like paying the rent!

So I would get help from a mental health professional to deal with the anxiety and paranoia in the workplace even if in all other aspects, the functioning was pretty "normal" .

There are strategies and techniques one can learn to help to calm one’s self and control unhelpful thoughts that may be very useful. As a start, maybe pick up the Sarah Edelman book "Change Your Thinking".

[Chris_B]

Our next question is from a concerned parent:

I have a couple of questions, how or is anxiety and depression transferred from one generation to the next? Our sons paternal grandmother has anxiety, his father has anxiety and now our son has anxiety. 2ndly our son is having difficulties getting a sleep pattern which appears to exacerbate his mental health. We sat down and discussed a time to wake up each morning and go to bed each night and agreed on the times, he has not yet adhered to this fully. I then discussed if he wanted to re negotiate the times etc, he did not. I am not sure what I can now do. I have taken him to visit the local mental health centres and groups in our area. He spends nearly all day every day in his room. Have I set the bar too high for him? What should I be doing? He has currently deferred from Uni.

[Dr_Kim]

My understanding of the genetics of anxiety and depression is that there isn't an identifiable gene as yet but there is a sense that it may only be a matter of time until we discover it as the predisposition to anxiety/depression does tend to run in families. That said, there is also an important input from environmental factors as to whether that gene is expressed or not.

A good illustration of this is with some cases of schizophrenia. One may inherit the gene for this illness which remains dormant until the person takes drugs or has some other major stress and then it may emerge and become clinically active.

With your son, it is great that you are "hanging in there" with him and trying to keep getting him help, develop strategies and talk to him. For sleep, you might like to discuss with his GP the use of Melatonin together with sleep hygiene techniques to "reset" his circadian rhythms and get him back into a better cycle. I think the sleep is important but part of a bigger problem.

However, depression is clearly having a major impact on your son (I assume you have excluded other possibilities e.g. drugs) if he is unable to continue with his studies and he may need to have all 3 types of treatment offered to him ie. medication, therapy and lifestyle factors (diet, exercise, sleep and mindfulness).

I would put some alternatives to him and ask HIM to choose what one he would like to try first, and then ask him how you can help him to implement the change. If he is unsure, offer a few suggestions and get him to choose one. I feel that by getting people to partner with you on their treatment plan, you are a little more likely to get success. Also that way you avoid the feeling of you "setting bars" for him and him then disappointing not only himself but you.

Also, don't be shy to tell him that you need to get a good team of professionals around you if you guys start to feel overwhelmed... Keep looking until you find GPs / therapists community groups / support groups that can help you both on the journey of getting back on your feet.

[Chris_B]

Our next question is about managing depression in a relationship:

Hello, Im female, early 40s and been seeing someone for 6mnths. We are on holidays and I've only just realised fully the extent of his depression. He has v high highs and angry lows. He doesn't take it out on me physically but im on edge when he's low and he's currently on a huge manic high. Makes for a somewhat lonely (and ironically depressing) holiday. He has no idea how I'm feeling. If i tell him he rejects it and says how i should be feeling. I'm thinking of approaching the depression issue with him when he's in a more level situation but no idea how to. There's mental disorder history in his family. I feel quite alone.

[Dr_Kim]

I think you have good reason to be concerned about your new relationship, but not so much because he has mental health issues, but because

1. He clearly is in denial about them
2. He is deflecting and making you feel your enquiries or concerns are unreasonable
3. He is unable to listen to you and be open to caring about how his behaviour makes you feel.

So, just to be clear ... I don't think that just because he has a mood disorder it's a deal breaker as many people have wonderful long term relationships in spite of their mental health issues. The thing that concerns me is his poor management and self-awareness.

I agree that you need to calmly but assertively tell him how lonely his behaviour makes you feel and put YOUR feelings and needs in the relationship clearly on the table.

If he is still completely unable to hear you or to have this conversation in a respectful way, you may need to consider if you can cope with this long term. I think it would be a mistake to think that you will change him or fix him if he doesn't think there is anything wrong with him!

[Chris_B]

Our next question is about looking for signs that someone you love may be suicidal:

Hello, I'm the concerned wife of a 46 year old who suffers from severe anxiety and depression. He has previously made an attempt on his life some 20 years ago. He is also an alcoholic and has had an extremely difficult year. A work mate of his recently committed suicide. This has hit my husband hard. He has become what I believe to be obsessed with the deceased's girlfriend , who he doesn't really know, and the process by which his friend suicided. Is this 'normal' ? What should I be looking out for?

[Dr_Kim]

I understand why you are concerned. His current history of severe depression and anxiety and the past history of a suicide attempt are risk factors that one shouldn't ignore.

It is important to look for change in behavior- change in sleep patterns, drug or alcohol use, work behavior, moodiness, withdrawal from activities, or just a "gut feeling" that he is not ok .

I think that you have that feeling that this obsession with the late partner may very well be one of the red flags... and I would encourage him to come with you to his GP or therapist to have an open conversation about your concerns .

Voicing your concerns about his risk of further depression or even suicide will not "make him do it” or “make him depressed". There is no evidence that enquiring about suicidal thoughts makes people suicidal - in fact, probably the opposite. It is often a relief for people to be able to share these scary thoughts.

However, I think it is often hard for family members to be the ones to manage these tough conversations, hence, go to a trusted health professional to help you.

[Chris_B]

Our next question is to do with coping in the aftermath of a divorce:

Dear Dr Kim, I have just got a divorce last May and it was my ex-husband that initiated it for reasons that did not make complete sense. I have been engaged to this person for a year and a half and married for about 2 years and 8 months.

I tried to understand the reasons, he cited that he did not stand my parents, that they interfered (even though we live separate to them),money issues (even though he was extremely reckless with his spending and racked up huge amounts of debt).

During marriage I told him he will need to work to pay that off and contribute to the mortgage as we agreed at the start of marriage - He grew sick of my reminders and quickly resorted to a divorce even though I had no hand in his recklessness but chose to stay with him as I loved him until he decided to walk away.

3months after the divorce, I discover on facebook through a second account I made (my usual one has been blocked by him right after the divorce) , that we he was in a relationship since a month before his request for divorce.

Needles to say, ever since the divorce day and up until yesterday after my inadvertent discovery, I was devastated emotionally and physically and have lost interest in life. I have a good job in the health profession and I tried to pull myself through and eat as much as I can... but I cannot believe that the person I trusted for the last 4.5 years turned out to be a cheater who used me and fooled me.

I belong to an ethnic religious minority here, dating is difficult - I knew him through a dating website and helped him through to get his residency status here out of pure intentions for marriage.. and this is how I get re-paid. Totally shocked, devastated, can barely talk,lost all confidence in myself(despite being known as beautiful and young and happy)....

Just don't feel like I have a will to continue... Very frustrated and feel very used. I helped a person come here for a better life and for marriage but at the end he stabs me in the back ..

I wake up every day in the morning with depressed moods, sometimes I sleep during the day to'escape' but wake up with shaky hands and irregular or fast heart beats - I feel scared from nothing - and just completely  'flat' - I do not want to rely on medication, I tried watching online videos that help give me a perspective on my pain and the person I lived with and the fact that I fell in love with a dream that was not true.

I just feel like I want to escape all the time - but don't know where - just feeling gittery and scared and teary.

[Dr_Kim]

Hi there. What a difficult time for you. I have a few thoughts on your post.

Firstly, you describe some symptoms like “not having the will to continue” and “depressed moods’ and “shaky hands” and I am unsure whether you have a history of depression or anxiety but I am concerned that either you are having a relapse of your mental health issues or maybe an adjustment disorder to the extreme grief and frustration of your betrayal and loss.

Either way, these symptoms are really difficult to endure without support and I urge you to seek some assessment via a Mental Health professional so that you can start to manage your symptoms better. This isn’t necessarily medication, but sometimes you do need a trusted professional to help you to see when maybe the time might be right for even that move.

Secondly, it sounds like you are angry both at him AND at yourself for believing in a “dream that was not true”, for being “fooled” and for staying with him even though you saw him as “reckless”. I feel the responses we have in these situations are often complex where on the one hand we can be really furious and outraged , but on the other hand we want to love someone and try and help them be their best selves and maybe even don’t want to open the possibility that we can’t manage the situation.

I want to state clearly to you that you are NOT responsible for the actions of others. You can only be responsible for the way YOU behave. When I read your account, I can’t see ANYTHING that you should be ashamed of - you tried to be a good person, a helpful person, a loving wife, an understanding partner. You can move forward with your head held high. You have your youth, your good job, your family , your beauty , your usual good disposition.
How he chooses to move through his life (with dishonesty and disrespect) is now NOT your concern and HIS burden.

I feel that you do need some help in letting go of your grief and anguish over this situation so you can re write the story in your head. This is not a story about how a man robbed you or crushed you .. you can make it a story about how you LEARNED SO MUCH from this and come out of it so much stronger and wiser, with self-knowledge that you maybe didn’t have before.

Find a good therapist to help guide you on that path … Start some reading… Maybe even try a book I read a while ago called “Women who love too much” which goes into why women can fall for bad guys.