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]

Next question:

Do you have any suggestions for people with social anxiety finding casual employment?

[Dr_Kim]

Social Anxiety is a difficult issue in any work place but especially in a casual workplaces as you may have to meet new people on a regular basis and be exposed to the negative self talk that is induced by these interactions in powerful and intense ways.

You can however see it as a great opportunity to really challenge your social anxiety and negative self talk.
The first step is to develop "mindfulness" or an awareness of the thoughts in your head and where they are coming from . Start to notice the thoughts in your head an see if you can distinguish thoughts that come from the anxiety part of your brain from ones that come from the healthy or rational part of your brain .

Once you can start to become cleverer at sorting out the thought origin you can then develop different strategies for the different thoughts. For rational thoughts, by all means, give them due consideration, but If the thought is coming from the anxiety part of your brain you choices are to challenge it (CBT) , accept it (ACT) or distract yourself .

You could challenge the thought with asking yourself what evidence you have for those statements, or just accept that anxious thoughts are going to pop into your head and accept them as part of your internal landscape (oh , hi anxious thought !! you again !!) , or get busy to move away from them .

These techniques are covered by therapists or you can read up on them in Sarah Edelman's book "Change Your Thinking" or Russ Harris' book "The Happiness Trap". Headspace or Smiling Minds apps are great fir development of mindfulness.

[Chris_B]

Our next question is about schizophrenia:

Can Schizophrenia or Schizophrenia-like conditions be detected via a medical scan of some kind? If so, how would one go ahead with getting such a scan / test preformed?

[Dr_Kim]

In my experience, schizophrenia is still being diagnosed clinically. Meaning, it is diagnosed by taking history from the person (and his or her family or friends) and doing a thorough clinical exam to observe first hand the behaviours and thought patterns. This may have to take place over a number of sessions.

I do not know of a definitive blood test or scan that diagnoses schizophrenia at this stage, but there are researchers investigating these sorts of possibilities and new ideas are being looked at all the time. Lets hope they come up with something that we can use clinically soon!

[Chris_B]

Our next question:

What are the best ways to support a partner who has PTSD?

[Dr_Kim]

PTSD is a such a difficult and distressing illness for both the person and their family as one may never quite sure when the person is going to be triggered and thus become anxious or upset . Also, people with PTSD , often can feel quite upset and guilty and having the illness leading to being emotionally labile and generally anxious . So they might can come across in all sorts of ways - irritable, snappy , moody or maybe withdrawn, down, “not fun” ..Or a combination of fine one day and not the next...

I think to be supportive , it is important to separate the person from the illness. Maybe try to understand in what ways your partner’s PTSD affect them . Does it make them feel anxious in large crowds, does it make feel upset when they are expected to do a certain task , does it make them feel jittery on public transport etc… Once you have a clearer understanding of the flavour of the symptoms , then it might be easier to support them to avoid it or to help them to manage if it happens without judgement or blame . You can at time both be upset with the PTSD and its affect on your family or relationship but that is different to being upset with the person and blaming them for having it.

So for example , if you know your partner doesn’t respond well to lots of crowds in enclosed spaces , then maybe choose to not take the packed tram that has just arrived. Suggest that you guys wait for the next one . Without blame or impatience. It just is.

[Chris_B]

Our next question is a big one!

What represents the largest unmet need in mental health care in your view? What indicators might help measure and monitor this?

[Dr_Kim]

This is a really broad and important question and I hope I’m equipped to give it justice. What to put first ? Do I say the common things ? Management of anxiety ? Management of depression ? or maybe the one that causes so much havoc to so many families - Drug abuse and dependance ? There are so many competing needs in mental health - from the milder end of the spectrum right through to severe psychosis . Access to mental health service in rural and remote Australia, Indigenous mental health issues, youth mental health and that of the aged population.

I feel that I can’t really say which is the greatest “unmet” need as they are all worthy candidates but on a personal level I worry a lot about the ability we have as a nation to provide the sort of care to our Indigenous youth that they need. As a group they have the highest rate of suicide in our nation and a terrible amount of drug abuse and trauma. As to what indicators might help to measure/ monitor this, I’m afraid that is really for my clever epidemiology colleagues to work on.

If your question added “what would I do with heaps of funding mental health?” i might like to see more effort put into high school mindfulness training . That is teaching kids to understand the way their minds think , react , respond to the world around them, to remain calm and observe their responses in a non judgemental way … Might this help us to be a less violent , more tolerant, happier, calmer community ? I’m not sure , but wouldn’t it be great to do some trials and find out?

[Chris_B]

Thanks for your questions everyone, that's all we have time for this week.

[MOD NOTE: If you have a question for Dr Kim, you can ask it in our rolling ASK DR KIM thread here.]