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.”

[Dr_Kim]

Kelljoh said:Looking for advice on the value of retreats for teenagers suffering anxietY, depression and EDNOS. Are any recommended for teenagers specifically? Any help or guidance would Ben appreciated.

Hi there,
I can’t give you specific names of retreats but here are a few things to consider ...

1. What is the aim of the “retreat”? Is it for intensive treatment for the teenager ? Or is it "respite" for the family or the teen? Or is it a hope that doing it intensively will mean a quicker road to recovery ?

If you want intensive treatment, you might also consider an inpatient stay at a private hospital that often has intensive teen programmes that run over a couple of weeks followed by outpatients visits. You will need to get private health insurance first though, so something to consider.

If it is for “respite” or a circuit breaker, then there are lots of options that are not necessarily “retreats” and may be cheaper and in fact do the job.

Be wary of the idea that you can rush recovery … it is often a long slow road to control of symptoms.

2. Do your homework on retreats - some may be excellent but I am concerned that many offer a transformation that is not realistic in a couple of weeks. Stay away from anything that offers too much! Make sure that there are reputable and qualified people in charge and keep your GP in the loop. If it sounds too good to be true , it probably is!

3. I worry about silent retreats for people who are not feeling OK in themselves. Sometimes they are offered as a way to find inner peace , but I don't think they are a good idea for teens or people who are in distress.

I hope this gives you some food for thought. You can also ask advice from your nearest Headspace centre or ask on eHeadspace.

 

[green123]

Hi Dr Kim,

I am feeling so indecisiveness with life choices. I change my mind every five minutes and am fearful to commit to anything. I am contemplating doing more post graduate study, however, I can not commit to anything, but do not have a full time job and concerned I won't find one without post graduate study at University.

I am so confused and lost it is causing me a lot of stress.

how can i clear my mind and make a good decision?

[Guest_9809]

Hi Dr Kim,

Hoping you can help me here. It may seem a very minor concern for some, but it is currently stressing me out!

I have been diagnosed with PTSD as a result of a particularly traumatic incident a number of years ago. A recent DASS survey has me falling into the Severe bracket for Depression, the Very Severe bracket for Anxiety, and Severe for Stress. Although the test was only done within the past month, I suspect that I have probably been at similar levels for around 6 months now. I have had a lot of highly stressful and upsetting situations in my life over those 6 months.

I know when we are under a lot of stress, it somehow triggers hair follicles to speed up their shedding process, and we tend to lose a lot of hair in a relatively short period of time. I have been losing a LOT of hair every day now for something like 2 months. I've read that its normal to lose between 50-100 hairs in a day. But surely thats only for a relatively short period of time? And I just seem to be dropping hairs all day long, I seem to be constantly tangled up in the stuff! Seems like much more than 100 too. I am getting worried that soon I will have none left. Thankfully I have thick hair naturally, but this cant go on for too much longer.

Is there something you can suggest I do to help? Is there some way that you can tell if it is purely stress related, or whether it could be as a result of something else, like some dietary deficiency or hormonal thing? When you go through a 'moult' how long does it normally last for?

Your advice would be much appreciated. Oh, and since my profile name doesnt give any clues, I should state that I am a post menopausal female in my mid 50's.

Taurus xx

[Dr_Kim]

green123 said:

Hi Dr Kim,

I am feeling so indecisiveness with life choices.

Hi there ..Maybe this procrastination is a type of anxiety - perfectionism can sometimes be that. Sometimes we are so scared of making a wrong decision that we end up on the starting line and not moving forward at all. We can be pretty hard on ourselves sometimes. We can feel that if can dont make the right choice now then our future self  will be unforgiving.

The thing is, none of us has a crystal ball. We just do the best given the information we have at the time. If we move along a path that seems to be feeling OK , great ! However if turns out that the path we started to journey along is not not right, how about trusting that our future self will be able to work something out and turn onto another path ? 

Anxiety likes to catastrophise and see the worst case scenario but in reality we all just journey along and make decisions in good faith all the time.

So my advice is embrace the uncertainty , take a path , dont expect to be "right" but simply a path you are walking.. its ok whatever it turns out to be .. your future self will forgive you and your current self might need to trust your strength.

If you are really struggling please see your GP to get some help to manage anxiety.  

Please look at a wonderful podcast from Brene Brown on Vulnerability and embracing the difficulty we all have in not being perfect.

https://www.ted.com/talks/brene_brown_on_vulnerability
 

[Dr_Kim]

Taurus4826 said:

Hi Dr Kim,

Hoping you can help me here. It may seem a very minor concern for some, but it is currently stressing me out!

Hi Taurus

I am sorry to hear of your struggles with your mental health and hope that you are getting support and making some changes to improve things for yourself ( Lifestyle , therapy and medications)

Regarding the hair loss, you are on the right track . It may very well be due to severe stress however it can also be due to some medical conditions and I would definitely see your GP about this . A bolod test and maybe even a referral to a dermatologist with an interest in hair loss can be of value. 

I have recommended medications with success for hair loss, but they have to be used in the right situation - so you need to be seen by a doctor and properly checked out to see if you are a candidate.
 

[Suesuesue]

Hi Dr Kim,

After a few bumpy years, I'm feeling isolated from everyone and everything in my life.

My husband walked out (and into another relationship) after 12 years together, we lost a number of friends through divorce, but mostly he was my best friend and the person I would have normally turned to in situations like this. I was left a single parent of a 9 month old baby, my situation started to exclude me from old friends and new mum friends, as they were all in "new family" mode and we could no longer relate to each other. I had no career to return to so I returned to study with much younger class mates. I drift between my single friends and married friends and don't seem to fit anywhere, in fact I'm often excluded by these exact reasons "oh we didn't invite you to a families BBQ as we thought you'd want to go out and not be with boring couples" "we didn't invite you out because we figured you'd have to get a babysitter". Inviting myself along or trying to invite others out is becoming such a chore and feels forced and unnatural. I've never felt like this with friends.

Adding to this, 12 months ago my father unexpectedly committed suicide. I feel like I'm floating and don't belong anywhere, like I don't have a family or friends. I've lost more friendships and connections as it's made people feel so uncomfortable, emotionally exhausted and disconnected from what I'm going through. Adding to this as a single mum who's studying I'm living in affordable housing where no neighbours talk or acknowledged each other. I could go days without having any communication with adults. Sometimes I go to the supermarket so I feel connected to society.

I feel so alone and I've been trying for 4 years to connect with people and I just can't seem to do so. I'm in my early 30's and I'm socially, emotionally and financially disconnected from everyone around me and I don't know where to go or what to do from here. I'm generally a very positive person who thinks I've been pretty upbeat and proactive in trying to solve this, but after so much time I'm broken and at a loss.

Is it normal to feel this disconnected after similar situations? What services can I use to help combat this? I've seen a physiologist through my Dr on a mental health plan, unfortunately they were terrible and told me to practice mindfulness. I have also seen a professional after my fathers death and she was wonderful but their service was for suppport after suicide, not a wholistic approach.

Thanks

[Dr_Kim]

Suesuesue said:

Hi Dr Kim,

After a few bumpy years, I'm feeling isolated from everyone and everything in my life.

Hi there,

Oh My Gosh ! YES , what you are experiencing is absolutely normal. It is so common for people to feel dislocated socially after a change in “status” . I hear it all the time. I hear it from people who have become widowed, or people who have become divorced, or people who have a bereavement like a SIDS or people who have a family member suicide or overdose. Its like people shuffle backwards because they feel awkward and dont know what to say or worry they will say the wrong thing. So yes .. what you are feeling is not your imagination , it does happen.

I would see this time in your life as an opportunity to sort out good friendships from those that are not going to last and to make new friends that suit who you are now… The really good ones will be there for you.. but you also have to know how to evolve and be your “new best self” . 

So who is this “new you’? Well, I think there are a few things that need to be sorted through with a GOOD counsellor . Get another recommendation from your GP and start again as this is important!  There is no way your self esteem didn’t take a battering through both your husband leaving you AND your father suiciding. My goodness… you are clearly amazing for just keeping going with a young child AND trying to study ( good on you!) 

It may be that you will need to start being more explicit and open ( vulnerable )with friends about what you want / need from them . e.g. just stating to your friend “ Please dont hesitate about asking me to the BBQ if I am the only single person there .. Its not awkward for me, its better to get out  than be stuck alone at home”.

Look at this you tube clip on Vulnerability for inspiration
https://www.ted.com/talks/brene_brown_on_vulnerability

It may also help to expand your circle of interests/ friends via various low cost activities , e.g.
https://www.meetup.com/en-AU/

Dont forget the other golden rules about being your new “best self” - eating well,exercising and getting enough sleep. It is important to feel physically well and healthy in order to feel mentally good too. 
 

[Crazy_train]

Hello Dr Kim, I am a 36 year old male and have developed a severe fixation, severe depression, I have a bad drug addiction (weed approx. over 100 cones a day) I sleep less than 3 hours per night, I have more than 20 showers per day, sometimes I hear voices the voices don't tell me to do anything and I have no conversation I can just hear familiar voices calling my name and when I check no one is there. I only enjoy being on my own and I have no hobby or no interests. Today I could hardly move my whole body went weak, and I am pretty tough and I felt severe pain in my neck, back, legs to the point I was almost in tears. I like simple things only anything that's complicated or requires thought I can't handle. I never want to go out, I never go out and I live daily with suicidal thoughts. I have come to the conclusion that I need some help in a hospital but I am scared of my reaction and what happens, what happens when I start getting angry in hospital, what happens if other patients annoy me or don't give me space, what happens if I feel trapped or cornered and I may get super angry. What happens when I am still awake at 2am swearing and muttering and carrying on. How long can it take to recover is it overnight a couple of nights a week.

Thanks Dr Kim

[Just Sara]

Firstly I'd like to congratulate Crazy Train for posting with your full-on current situation. It takes courage to reach out. I've just returned from a psych facility (10 days) with amazing results and would advise anyone in doubt to explore voluntary admission as a means of being professionally assessed and get the support needed, as well as learn positive techniques and healing habits. Good luck with your search for help.

Hi Dr Kim;

Around 3 months ago I managed to finally stop anxiety/panic in its tracks, but this was replaced with depression. As I've said above, I've returned from hospital feeling confident and well.

What strikes me is the change in my metabolism which is causing loss of muscle mass and increase in fat around my body. (My weight has stayed the same) I'm struggling to lose weight even though I'm eating well and exercising.

I spoke with my psychologist and GP about this, and was told my body is transitioning from overloaded adrenaline and cortisol production, (acting as a steroid?) to a normal chemical balance. Is there anything I can do to support this process and how long will it take to normalise?

I've lived in fear nearly my whole life from many traumatic experiences. Feeling confident as I do now, feels odd, but peaceful all the same; it's new and taking time to adjust to the lack of 'urgency' of the last 50 yrs.

I feel others will benefit from this information, as it seems common to go thru depression after anxiety.

Thankyou for your time...Sara

[Just Sara]

PS...The only medication change I've had is an increase in my AD. That has only been in place for about 5 days. My body has been changing since anxiety waned...Sara