Got a question related to mental health? ASK DR KIM

[Chris_B]

Hi everyone,

This is a thread for asking questions of our resident GP and counsellor, Dr Kim, who pops into the forums regularly.

PLEASE NOTE as per our community rules, Dr Kim won't be able to answer questions about medications, these are best discussed offline directly with your mental health professional.

UPDATE - 01/03/2018
BEFORE YOU ASK DR.KIM PLEASE CONSIDER THE FOLLOWING POINTS:

• Dr Kim's time is limited! We cannot provide an ongoing dialogue with Dr Kim in this thread - one post/question per person please
•  We'd recommend you have a look through the forums before posting here to see if your question has already been answered by Dr Kim, our other members, or if there's information about it already on the beyondblue website. If a question pops up that has already been answered previously, or if alternate resources are available, one of our moderators will reply and direct you to the link.
• When writing your question, imagine you are speaking to someone in person i.e. provide a clear and detailed post with enough information that outlines how Dr.Kim can help you.

Background

After 20 years of experience working as a GP, Dr Kim realised in 2003 the aspect of her work she enjoyed most was talking to people and understanding the way they think and behave – and so she underwent training in counselling and therapy, where she now solely works.

Her experience includes working with a wide range of mental health issues including anxiety, depression and adolescent mental health.

“Given my training I also see couples, siblings, parents with their children and entire family groups,” she says. “In this work I hope to give families the skills to understand one another and have the strategies to communicate and manage relationships that are distressing them. I believe strongly that best therapy is achieved when there is trust in the therapist's ability but also their genuine desire to understand and help.”

[Wanting_to_help]

Hi and thankyou

I will try be brief

i have anxiety and depression have since having pnd with first baby almost 7 years ago but is now managed and am managing well

my question is for my sister in law

she is suffering depression at the moment after a bad end to a bad relationship she has a nearly 2 year old daughter and all the family support

but my question is she seems to be pushing her little girl away she seems to just want to sleep all the time I'm talking will drop her child of at say 8:30 in morning will go home to bed and sleep till 5:30 at night she loves her child and adores her but just seems to always need to be away from her and wants to sleep all the time and if mother in law says no she gets cross

guess the question is how do we best help her she is seeing councillors but seems to be getting no were my mother in law is so stressed and dosnt no the best way to help her we all just want to help but fell by having her child for all the time we are making it worse How do we help

[geoff]

hi Dr.Kim, I just want to ask a basic question and that is 'why do people always feel so tired' when they have depression. Geoff.

[geoff]

hello Dr. Kim, most of us know that we pretend to be happy when we are with other people in depression, I've gone through this just as so many others, we can laugh and it seems to them that our depression has gone, but when these 'friends, family' leave, we once again collapse which surprises them and probably angers these people who are supporting us, so that's when our support stops, because they can't understand why one minute we can enjoy ourselves and then suddenly go back to our little dark hole.
Why does this happen. Geoff.

[Dr_Kim]

Wanting to help said:

Hi and thankyou

I will try be brief

my question is for my sister in law...

I can understand why you are so concerned for your sister in law and her child. It sounds that either your sister in law is using sleep as an avoidance mechanism or she is unwell or having a response to a medication or a drug that is very unwelcome.

You have rightly alluded to the fact that children really do need their primary care givers attention during their formative years. It is really important for children to believe that they can trust their caregivers to support and nurture them both physically and emotionally when they need it. No parent does this 100% of the time in a perfect way, but if you feel that this is not happening to a large extent most of the time for this child , then I think it is important to draw attention to this for the child’s sake by gently raising your concerns with this mum who you state loves this child dearly.

Please to not approach it in a blaming way as many people with mental health problems can’t help the way they are feeling or behaving and feel guilty already about not being OK. I would approach from the point of view of the child and clearly look at what the child needs and how you might be able to support her to provide that for her child.

Also discuss with her if SHE is concerned about how tired she is and if SHE would like to be able to tolerate or enjoy her child more at the moment. It may be that she would like to be present whilst her child is being bathed or fed but doesn’t have the energy to do it alone, so maybe having someone to come over and help her would be a first step.

Maybe she needs to see her GP and discuss this symptom of exhaustion and the impact its having on her life. The GP and therapist may be able to discuss together with her whether all medical issues have been excluded and when a trial of medication may be necessary.

[Dr_Kim]

hi Dr.Kim, I just want to ask a basic question and that is 'why do people always feel so tired' when they have depression. Geoff.

Thats a really good question and I’m not sure if a neuroscientist would cringe at this answer as it is a bit basic .. but it’s how I understand things.

When we are depressed , the neurotransmitters in our brains are not at the right concentrations at the right places. Neurotransmitters are chemicals that carry messages from one nerve cell to another. So with the lowered concentrations of neurotransmitter in the space between the nerve cells, the nerves find it hard to “jump the gap” from one cell to another . This is why people with depression can also find it hard to concentrate or study. I think it also makes people tired.

Another reason may be that depressed people may also have some level of anxiety together with their depression. I find they can travel together ! When people are anxious, they produce hormones like cortisone and adrenaline which are the “fight or flight” hormones which increase heart rate, breathing rate, blood flow through large muscles etc.

This increased activity which goes on “under the radar “ often without us really even noticing it can drain our batteries a bit and leave us feeling tired out as if we have been running away from something dangerous!

[Dr_Kim]

 hello Dr. Kim, most of us know that we pretend to be happy when we are with other people in depression, I've gone through this just as so many others, we can laugh and it seems to them that our depression has gone, but when these 'friends, family' leave, we once again collapse which surprises them and probably angers these people who are supporting us, so that's when our support stops, because they can't understand why one minute we can enjoy ourselves and then suddenly go back to our little dark hole.
Why does this happen. Geoff.

I have had this discussion may times with family members . They can be a bit stumped with a diagnosis of depression when they saw the person laughing with a friend just 2 days ago!

I think many people believe that a depressed person must have a frown on their face and be crying most of the time or else they do not have a mood disorder. This is a little bit simplistic. Mood disorders are diagnosed mostly by how someone thinks or feels inside their heads. How they view themselves and how they interpret the world around them.

The impact that these thoughts / feelings have on their behaviours may influence whether the depression is considered milder or more severe , but many people with depression still manage to do regular things in their lives and even can "have a laugh with friends” .

Only the most severe end of the spectrum have this thoughts ALL the time EVERY day and are rendered completely unable to partake in any type of normal daily activities.

People with depression often tell me that they live behind a kind of facade or mask where they can “put on a brave front “ for a while and go to social functions and act normal but it is exhausting for them. They are usually having to coach themselves to keep up the mask and keep the pretence going to looking normal, not only for everybody else sake , but so they can hide the illness and fit in.

So I guess I would explain that depression, especially in the mild to moderate forms, is not an absolute state. It is something that can ebb and flow a bit, that one can have good days and bad days, but also that what people see on the outside isn’t necessarily what is happening on the inside for people.

[james1]

Hi Dr Kim,

I realise it may be different for different doctors, but what is your opinion on the place of a GP in someone's mental wellbeing?

I ask because I've had a history of bad GPs and it's getting to the stage where people including my psychologist are suggesting I talk to my GP about medication.

The trouble is, my GPs have always tended to be script happy, out the door, types.

So I don't actually know what a "good mental health GP" is actually there to do. Talk? Support? Prescribe? The boundary between GP-Psychologist-Friend-Support is really blurry to me.

I hope that's enough of a question to know how to respond!

James

[Ouat]

Hi this is my first time posting. I have been suffering from anxiety and depression for the last few months and its only getting worse. I have been thinking and worrying contantly about my health and was wondering if your thoughts can create a sensation by obsessing thinking.

[Shaz1]

Hi,

I've been having treatment by my dr and physcologist for a few years for severe depression and anxiety. I'm at a loss what to do/try next. I freeze whenever (which isn't that often) I have appointments with either of them. I can't talk and they may say something that's totally wrong, but I can't speak up to tell them.

I don't have a support system other than those two professionals. How do I break the walls down again to try and get help?

I've been treated as I'm not worthy my whole life, people generally do not like me. My physcologist said its the depression speaking. I don't believe it, I know when people ignore me, make some excuse to not see me. Etc

Guess I'm just trying to figure out how to live "happily" by myself?