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.”

[Guest_9809]

Hi Dr Kim. Firstly thankyou for making yourself available here as a BB resource. We are very lucky to have the opportunity to have access to a mental health professional.

My question for you today is:

How can I best support a close family member who is currently going through a really difficult time after a recent traumatic event. He has been recently diagnosed with PTSD, and is currently seriously suicidal.

He is being closely monitored by a team of concerned psychiatrists and psychologists, and any ready means of harming himself have been removed. However I am still very concerned for his welfare. Although he does not live nearby, I do speak to him by phone on a regular basis and he seems able to open up to me. Which I guess is a good thing.

But I guess I am feeling a little out of my depth here. I'm concerned about saying the wrong thing to him. And also worried that I may miss some clue that could indicate an escalation of his current poor state of mind.

What should I be on the lookout for? Should I relay any concerns I have to his medical team?

Your advice would be appreciated.

Taurus

[Dr_Kim]

Sunnyflower said:I am 16 and doing my HSC soon.

Hi there, Its hard to know if you are depressed or not but it certainly really hard to hear that you are not feeling relaxed and happy in yourself.

Now, the thing is that a lot of adolescents actually feel those same sorts of things and so i don’t want to put a mental health label on young people who feel uncertain about themselves or who at times feel that they don’t like themselves or feel unmotivated as I feel that would encompass so many young people.

However it is all a matter of degree and the impact it has on your life style. For some young people, school is just not their time to shine, and they bloom later on .. so maybe this is you? However , I don’t know anything about your life & family situation and how supported you feel generally and what advice you get from them. If you feel alone with this and you feel it is happening very regularly or persistently , then you are right to seek help.

I am so pleased that you have reached out to a therapist to explore some of your thoughts and feelings ( thats pretty motivated!) and encourage you to pursue other options if that didn’t help . Maybe try something like the Reach programme (http://www.reach.org.au/ ).

When you feel “ stuck” it is important to take really tiny steps and celebrate those. Like writing this post was one of them ( go you!) Then you might try something else .. just small little goals, like making sure you do some form of exercise a few times a week (regular exercise is really good at reducing anxiety) , or pushing yourself to listen to a happy song you like every day or writing down one GOOD thing that happened every day. Sometimes we can get so focused on all the bad things that are going on that we keep gathering evidence to support that view and forget to see things that are NOT BAD .

So turning our attention, forcing ourselves to notice them, can sometimes help to train our brains back into being a little more “joyful”. I highly recommend Mindfulness programmes like Smiling Mind or Headspace to learn how to manage your thoughts in this way.

[Dr_Kim]

Curly Sue said:I am the mum of a 17 yo daughter in the midst of her HSC.

I have a rule in my head that says “Safety trumps privacy” . Meaning.. If I think someone is at risk , i will make them safe first and then deal with the fact that I may have betrayed their trust and broken confidentiality . I have found that mostly people are angry initially, but once they have calmed down, they realise that you did it for the right reasons - i.e. that you deeply cared about them and their safety and were willing to even cause distress to yourself in order to keep the person safe.

So if her diary entries were anything that you think implied risk to her safety, I would fess up and say that you are guilty of trespass and invasion of privacy , but you are also not willing to keep quiet about it and then live with the guilt of 1. something happening to her or 2. her having terrible sadness but feeling she has to cover it and not feeling she can depend on you for help/ support.

(Also ,I feel that if adolescents keep diaries it may be some deep seated unconscious way of her communicating this stuff to you anyway. Adolescents are part adults and part children .. they feel they “should" be able to mange this stuff like adults , but they often can’t , like children and its confusing for them. )

Its great you made the appointment with the GP. It is a good idea to leave it until after the last exam and then either take her with you to the GP if you feel you can’t do it alone .. and just put all your concerns on the table . Tell her you love and care for her and that sometimes its a mothers job to cross a few boundaries for the sake of good parenting.

Don’t be reserved or in any way apologetic to your daughter about doing ANYTHING that it takes to care and nurture her . She is SO lucky to have you as a mother, and even if the “adult" part of her is screaming at you for reading her diary, there will be the “child" part of her that could not be happier that someone is taking control and helping her and caring.

[Dr_Kim]

MsPurple said:

Hi Dr Kim. I have a friend I am worried about. I don't know whether she has an eating disorder or not.

Your friend definitely has disordered eating and mental health issues associated with that. What i mean is, that even if she is managing to concurrently eat a healthy diet as well as the chew/ spit binges ( which I doubt), she is suffering from a form or obsessional / compulsive thoughts around eating / diet / weight / body that consume a persons brain space and can overwhelm them at the expense of healthy thoughts and living. Initially , when they feel that they have found something that receives their anxiety about eating “Oh great, I’ll just eat and spit”, they can feel really happy … but in my experience, eventually the eating disorder part of the brain become restless and demands more and more .. and the person works harder and harder to try and satisfy it.

It is a terrible and sad cycle to get caught into. All I suggest you do is keep telling your friend that you can not validate the eating disorder part of her thinking or whats its telling her to do that you care about her, that you hope that other parts to her get the strength to fight the disordered parts of her and that you will be by her side to help her on that journey if she needs .

However, getting her to start the healing is going to be like banging your head against a brick wall. It must come from her. As a recovered EDNOS sufferer I guess you can understand that when your brain is in the thick of it.. it is super hard to see the logic that others present to you and you just feel they “ don’t get it “ or are overreacting. Make sure you look after yourself as this is really difficult and frustrating work!

I suggest you contact https://thebutterflyfoundation.org.au/ for more info on eating disorders and the role you might play for your friend.

[MsPurple]

thanks Dr Kim. I'll take that advice. I'll go to the butterfly website now and have a read. I have mostly looked on google. I was also wondering what the physical implications this kind of disordered eating could have on her body, long and short term? She says that she gets shaky after big binges and that concerns me because I am worried it may cause her to pass out one day.

Thanks again dr kim

[Touille]

Hi Dr Kim,

I need some advice about myself.

I'm normally a very scalable person and like crowds, but in the last year I went through a bad relationship breakup and some family issues. Now I find some days I like being around people, other days I'm very nervous and want to escape the crowds. I seem to feel like I don't trust many people. I have traveled a lot and lived overseas. I can't sleep and have gone to see a GP for anxiety who gave me anti-depressants.

Question is: Why do I feel so anxious and how can I recover to get my life back in a positive way? I don't even have motivation for some things.

Thanks.

Touille.

[ctjbns]

Hi Dr. Kim

I am a 33yo man who has been diagnosed with moderate depression many years ago. I have been prescribed SSRIs more than a few times, have had regular sessions with psychiatrists and psychologists both overseas and here, and still feel quite low. I read a lot about depression and suicide, and although I am sure I am not suicidal, it is something that concerns my colleagues. They even made comments on my email signature (which says "There is no worst death than that of hope" - a quote from a movie) and this has forced me to wear a happy mask whenever in their company, just to stop them bugging me.

I am what you might consider smart, with an IQ of 131. I do not enjoy activities most people find entertaining. It is hard for me "not to assess" someone's intelligence within the first few minutes of communicating with them. As much as a girl is beautiful or a guy is friendly, I can not form a bond with them if we can not find common topics to converse about. At the moment, the only people I enjoy talking "with" are my landlady and landlord, both in their 60s. When I go to a bar, cafe, or any other venue, I feel alienated even if I am in with a group of colleagues or meetup friends.

I am very calm on the outside, even to the extent of appearing numb. You can through a firecracker right under my desk and I won't even stop mid-sentence if I am talking. One of the psychologists I was seeing even tried to shock me emotionally by saying she could no longer see me because she wanted to date me, and my response was "Do I get a refund for this session?" in a very calm manner. Nobody around me knows of my isolation, and I have been trying to "cajole" myself by immersing myself into work and different types of activities such as photography, hiking, riding, bar hopping, sight-seeing, ... Still, I am left with a low mood and a feeling of"perhaps not being intelligent is a blessing".

Do you have any advice for me? Seeing another psychologist or psychiatrist, or anything?

Cheers,

I

[96HS]

I stay quiet at work, or bail out on my friends because I just don't have the energy to keep happy anymore. I don't know who to talk to because I'm known as such a happy person. I break down in hysterics probably 2-3 times a month once I'm alone. Once I'm around my friends I feel happy, but in the back of my mind I'm constantly fighting the feeling of breaking down and thinking of the next thing to say to seem like a functioning person.

I feel constantly run down despite getting 8hrs of sleep a night, during the weeks I fluctuate from bad to good, and during the bad weeks I get more burns/ accidents from just not having enough focus I guess.

I don't have the courage to speak up to my friends or boyfriend who is always very concerned when I'm quiet around him, I just make up new excuses whenever he would ask, I'm sick of this and don't have a gp to ask for advice. What should I do?

[gld]

Hi Dr Kim,

I feel like i am drowning and treating water is becoming more difficult.

My husband has been sick and now is recovering with his mental wellbeing. He has quite a few medical issues which have stopped him from working for a number of years.

With his bipolar i feel he has become self absorbed in his own needs and is there a way i can guide him to see his smoking habit can not be maintained with our other financial commitments.

Yesterday he asked me to buy him two tallies from the pub and i refused but i am scared he is going to take up drinking now his hep c is cured.

Looking forward to some information that may help our situation.

Gen

[Kilpatrick]

Hi Dr Kim,

As a doctor how would you know where to locate a high quality inpatient treatment facility for someone living with a history of decades long debilitating OCD? I ask as my sister has this issue and mainstream community treatment has been near totally ineffective due to the nature of her illness causing her to resist leaving the house and engaging these services.

It is apparent that inpatient recovery based therapy (as opposed to crisis stabilization) is the way forward. I am stuck working out where to find such a service. I am looking for something that is:

• Clinically evidence based
• Intensive live in therapy (not crisis stabilization)
• Expensive but relatively affordable. I am willing to sacrifice and work to raise $10-30,000 but I'm not a millionaire

I can no longer watch my sister suffer and live such a profoundly unhappy dysfunctional existence. Where do I start finding such a service? What would you do? Thank you for any reply.