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.”

[Chris_B]

Hi everyone - I see there are a lot of questions for Dr Kim this morning! We will have answers for you as soon as possible, Dr Kim has a full patient load and answers questions on here for us in between her appointments - thanks for your understanding on this.

[Dr_Kim]

Moonstruck said:

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??

Hi Moonstruck, I am a little confused about the discussions you are having with your GP and therapist about anti anxiety medications. It seems that you are concentrating on a type of medication called Benzodiazepines which help suppress our ability to develop a fear response to triggers. These drugs are great in alleviating symptoms but don’t help our brains to develop the ability to do better with the trigger next time . They are also likely to become dependance forming so most people in the mental health fields use them sparingly .

Other maybe more useful medications for anxiety are the SSRIs or SNRIs. These drugs are not addictive or habit forming in the way Benzodiazepines are and also don’t interrupt the new learning that needs to happen if people are to rewire their brains in better ways to mange anxiety. Thats why Drs prefer them in general if medications are needed.

So, I don’t think you should confuse things by having 2 GPs as that could be dangerous for you in the end if they both prescribe things the other doesn’t know about. Similarly , it is not a good idea to share medications with friends as you just don’t know what dose to take and how often and what interactions or complications they may have for you.

I wonder if you might have a discussion about why you can’t think about an alternative to Benzodiazepines … like SSRIs, SNRIS or other medications that may help but do not have the dependence issues of Benzodiazepines .

You may feel they are being unkind or not understanding , but I assure you they have your best interests at heart .It is really not in your best interest to have you dependant on these medicines and they are saving you from a terrible situation. It is easier to just “ write a script” , so the fact that your GP isn’t , probably means that they are pretty caring and don’t want to create another problem for you .

[Dr_Kim]

csteve said:

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

A BIG BIG hello to you!! You are very brave and I support you 100 % in trying to get help for yourself . You should not wait for understanding or approval before you get help. I absolutely hope that your family will respond positively in the long run to your move to feel happier in yourself and develop better control of your thoughts and feelings but you can’t hold off getting yourself sorted out. Many families find it hard to think about their child being given a diagnosis of depression or anxiety , so don’t use terms like that in the beginning . Maybe just tell your mum that you are going to talk to some one about stress or worries or sorting out what to do next year. Later , if your therapist thinks you need to tell your family about a more “severe” diagnosis , they can support you as to how to do this. Try a Headspace centre if you have one close by or even eHeadspace for a start . Or go to a GP and get a referral to a psychologist to explore your feelings .

You are worth it and you need to have safe space to explore whats going on.

[Dr_Kim]

Lost Girl said:

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

Hi Carol,

I understand what you are saying and it sounds logical that as the cause for the depression goes, the depression goes… but I’m not sure that is 100% how it goes all the time in practise. Depression can start up some bad “habits” of thinking in your brain that can be hard to break even when the thing that started the habit has gone . Also there is some times residual grief around coming to terms with whatever the trigger was (for you, pain) and how much it has “cost” you.

So I suggest that you keep working with your psychologist to challenge the negative thoughts and develop healthy thinking patterns in your head. Also get back into a healthy lifestyle that we know will disrupt depression - exercise , healthy diet , good sleep patterns and mindfulness. I think you can expect good mental health , but it may not follow your reduction in pain be as fast as you expect without continued work.

[Lost_Girl]

Thanks Dr Kim, much appreciatef.

[Moonstruck]

Thank you for your time and quick reply Dr Kim. I mustn't have explained myself properly. I've never used the word "benzo or benzodiazepine" to my GP or psych and am not familiar with them at all.

I've simply asked if there was anything I could try to help with my anxiety during the day....SSRI's have never been mentioned at all as an alternative - so it looks like I shall have to continue to battle every day completely on my own resources. The GP has said anti-depressants are not needed as I don't have clinical depression.

It is very very hard to get through this alone.

Thank you again for the work you do for this Forum .

[Dr_Kim]

Molly06 said:

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?

Yes!! If you have early Menopause ( and at 44 yrs old , that is a bit early!) this could certainly contribute to mood instability . Moods can became unstable around menopause even if you don’t have a history of anxiety or depression, but you are a bit more prone to it if you have a mental health history . I guess people with a past history may have brains that tend to be anxious or depressed at times and may slip into old bad habits of thinking more easily around menopause when the hormones are playing up.

Info on this can be found on the Jean Hailes foundation website: https://jeanhailes.org.au/

[Roadsy]

Hi. Could you tell me what happens to a person when they get the silent treatment or refusal to communicate meaningfully from their love ones.

[Sheryld]

Hi Dr Kim, I'm wondering if you can provide details for a bulk billing psychiatrist in the Narre warren area. Thank you

[Dr_Kim]

Roadsy said:Hi. Could you tell me what happens to a person when they get the silent treatment or refusal to communicate meaningfully from their love ones.

Hi Roadsy, the “silent treatment” can be given to people for lots of reasons.. and often it is not a conscious action. I don’t know why your particular loved one has blocked you but let me give you some examples from my work as to some things I have seen:

Sometimes the “silent treatment” is in fact what we call “ stone walling “ ( you can look up this term ) . It is about people becoming overwhelmed and unable to deal with things emotionally so they retreat behind a barrier as it seems like safer emotional ground.

Another reason is that some people develop an avoidant attachment style as a result of less than optimal early parenting together with their own personal coping strategy. (again , you can look this one up too!). These theories may not apply but if they do it can help you to understand the behaviour a bit more.

What it does to the person receiving the “silent treatment “ is another thing as it often provokes a feeling of being disregarded or unimportant, or even abandoned emotionally. These are very frightening and sad things to feel in a relationship and if your own self esteem is little shaky it is extra hard to put them aside and support the person on the other side of the issue. I suggest you work hard to strengthen yourself and know your own emotional triggers to best support your “ locked in loved one “.