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.”

[Trixi3]

Hi Dr Kim, I would like to know what happens if you stop taking depression medications- ie. you run out and don't get anymore. I am also wondering how long does one need to stay on them - I am sure it varies from person to person - but is there a general standard or is it forever?

Much appreciated.

[Doolhof]

Dr. Kim,

Thanks so much for your very insightful response. A lot of what you wrote makes sense and clarifies the confused ways I have looked at life due to childhood experiences.

Today I will start a path of connectedness and trust! Thank you once again for your help and assistance.

From a very grateful Mrs. Dools

[Dr_Kim]

Cayden said:

Hi Dr Kim,

Im having a lot of trouble trying to talk/explain/understand about what i believe is my undiagnosed depression.

I think maybe we might need to stay away from putting a formal diagnosis on what you have but just accepting that there are days that your mood affects your functioning and days where it doesn’t. Unless you are considering medication , its probably not that important what you call it.

If on the days where you are affected, you simply cannot function, i.e. get out of bed, deal with your bathing or house, go to work , interact with people , well I think that you definitely need to see a mental health professional to help develop a strategy to mange this as this is clearly NOT OK even if you have good days in between .

If the the downs are milder and you feel bad and low and have less motivation and enjoyment out of life but can still function, maybe you can just call it something like the “grumpies” and begin to become mindful of them in your life. Notice the messages they give you, notice the things they try and stop you doing, notice the way they affect your analysis of things. Then, I suggest that you begin to call up your inner hero . The one that knows this is a “grumpy” day and can help you either be kind to yourself and accept that you are off the hook today, or can decide for you to fight it .

Lets give an example . You are on a grumpy day . You have an invitation to a dinner catchup with a friend . You don’t feel like going because it all feels too hard , you are tired and nothing feels like fun and you don’t feel like you will be interesting or fun .. (I am imagining a grumpy day ..) Maybe your “Hero brain” can step in and notice the process and say to you “Ok buddy , we’re on a really grumpy day - I’m going to give you the night off, but tomorrow you have to do the movie night " , OR “ Ok buddy , you’re on a grumpy day and everything is going to feel flat but that’s not real, its just the grumpies so push through and you may end up feeling a little better at the end of it”.

Don’t doubt your self, don’t stress about naming it , just act on it ! I hope this helps and doesn’t seem like I am trivialising your bad days.

[Dr_Kim]

Trixi3 said:

Hi Dr Kim, I would like to know what happens if you stop taking depression medications- ie. you run out and don't get anymore. I am also wondering how long does one need to stay on them - I am sure it varies from person to person - but is there a general standard or is it forever?

Hi Trixi3, yes it does vary, depending on the medication, the dose, the person ,the condition.

If the medication is longer acting, it tends to be less of an issue if a dose is missed. If the dose is larger and more days are missed then clearly the withdrawals symptoms are potentially greater.

Having said that, in clinical practice, I have seen people have a terrible time getting off small amounts of milder meds and others seem to have no problem at all getting off or missing days of larger amounts of stronger medication.

So, my general advise is to not to panic if you miss a day or two of your medication, but try NOT to do this. Once you get your medication back, do not take extra to make up for lost days. If you want to stop your medication, please discuss this with your health professional as you should probably talk through:

1.How you have come to the decision to stop medication
2. How to stop the medication
3. How to try prevent relapse
4. What to do if there are signs of relapse.

[Just Sara]

Thankyou Dr Kim for your lovely response;

Re lactobacillious, there have been studies (USA, Canada and France) using high doses treating autism in children. The premise relates to the connection between the brain (late onset autism in 1 to 4 yr old's) and the lack of active positive bacteria in the gut after large doses of antibiotics during childhood infections. (Especially ear aches) It's a very interesting subject.

Kind regards...Dizzy

[geoff]

hello Dr. Kim once again, there has been talk about people who have had ECT and at one stage I was close to having it, but the thoughts of watching 'the cuckoo's nest' is still embedded in my memory.
It seems to be a last resort in helping people, so is it still a common event, or something now to replace it and what do you think about ECT. Thanks Geoff.

[Moonstruck]

Dear Dr Kim - I thought you did not discuss medications, so have hesitated about posting this. (see below) I did post it on another thread, but see the subject of meds, side effects etc have cropped up in your column so you may have some advice for me??

6 September

I am really addressing this question
to anyone at all that can advise - I know Dr Kim does not discuss medication,
(some other Forum members and I have discussed my situation recently and I
appreciate greatly their support and views). You see, all the info seems to be
about the various medications, side effects etc.

My problem is different - I don't
have any meds to enquire about!!

At times my anxiety is overwhelming.
It has gone over into panic attacks - at times while driving. I have never been
diagnosed with clinical depression, neither I, nor my GP believe I have it -
but you can imagine at times my anxiety problem and over-thinking obsessively
makes me feel very down..i.e. somewhat depressed.
My problem re meds is...I don't have
any. When I've asked my GP for some anti anxiety meds, mild benzos or whatever
is available....she replies "You can become very dependent on them - so
I'd rather not". She referred me to a psych/counsellor who is very good re
listening and supporting me..when I told her the GP refuses to try any
anti-anxiety meds...she replied "You can become very dependent on
them"! YES I KNOW THAT!
people have advised to change GPs, to
GP shop around. The present GP knows all about my medical history and serious
condition that is monitored regularly by Brisbane specialists - a new GP would
know nothing of my physical condition at all- I would have to start from
scratch!! The prospect is riddled with anxiety in itself!

Can I see two GPs at once? Is that ethical of me? Can I see my present GP for my medical condition, and another for scripts for meds or do I just get more and more desperate, until I begin asking friends if I can "borrow" some of theirs when I am in a really bad way?

[csteve]

Hi Dr Kim, i'm 17 years old and havent spoken about how im really feeling to anyone but myself before. I don't really come from a supportive family or have many true friends to talk to. I just need some advice because i feel as though i could have depression. I want to tell my mum that i want to talk to someone professional like yourself but im scared as to how she react because she is one of the main reasons why i feel like this. ( i dont really want to go into why) I feel alone and that i can't move on or do anything with my life because i can't deal with this with anyone. I am graduating soon and dont know what to do next year and i feel like some advice would really help me. what should i do?

thanks

[Lost_Girl]

Hi Dr Kim,

I have depression caused by chronic pain, a 24x7 headache for over a year, specifically. My psychologist investigated and agreed it is caused by the pain there are no other underlying causes for the depression.

I have recently had a few days where the pain is much more severe. On these days the depression is much worse with negative thoughts, shaking, no motivation, feeling useless and crying. When this pain was relieved by new pain meds, I had expected the depression to ease up to where it was manageable with the antidepressants I take for this but it is not the case.

My question is, if the pain is causing the depression, eventually if the pain is gone or reduced to a tolerable level where I can function normally , can I expect to no longer be depressed?

Thanks

Carol

[Molly06]

Hi Dr Kim,

Im 44 , having bad year with anxiety and depression , I have been living with it for over 20 years. Usually it might be bad for a month or so and then right itself , I am on meds.

could my worsening symptoms be a result of early menopause ? Can this sometimes happen?