Got a question related to mental health? ASK DR KIM

Chris_B · ‎23-08-2016

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.”

Sophie_M · ‎24-05-2017

Hi abrahams, it's a little difficult for Dr Kim to answer this post without a bit more information. We would suggest having a read through this thread (which has a response from Dr Kim) to get more information about how to get the best out of the relationship with your GP:

https://www.beyondblue.org.au/get-support/online-forums/treatments-health-professionals-and-therapies/are-you-looking-for-a-doctor-therapist-or-support-group

3T · ‎24-05-2017

I just wanted your opinion on EMDR therapy I have been offered this by my physiologist I have researched it a little I have tried it during the session but found it took me back to the trauma, I was able to ground myself after but I really don't like them way it makes me feel

its like you relive it years after the event . Is there any thing you could suggest

Dr_Kim · ‎26-05-2017

Hi 3T, my understanding is that EMDR has been widely researched and used for PTSD and trauma so its certainly not strange that you had a go at it for this problem.

I also understand that it is important that the therapist be certified in EMDR so just double check that.

I don't think you should do anything that doesn't feel right . Tell your therapist how it felt and work out a plan together on how to proceed . It may mean changing tack, or maybe staying with it but slowing it down…

I also wonder whether having a chat to the Blue Knot helpline might be of value as they have a lot of info on trauma treatments.

http://www.blueknot.org.au/Helpline

Ateca · ‎26-05-2017

Hi, my now 16yr old daughter was diagnosed as suffering from social anxiety roughly four years ago. She has not improved over the years, if anything she has gotten worse. The thing is we have never really understood, is her condition considered a disability? I only inquire as we desperately want to get her help so she could find work and try and become a bit more independent. We just don't know where to start. She did see a counselor two years ago but it was a disaster sending her deeper into her anxiety. Any advice would be great.

Dr_Kim · ‎29-05-2017

Ateca said:Hi, my now 16yr old daughter was diagnosed as suffering from social anxiety roughly four years ago.

Hi Ateca,

It is really tough to watch your child not thrive and if anything get worse. I don’t consider social anxiety per se a disability but I guess there are times where it can be disabling. I would try really hard to stay away from that thinking. It is unlikely to be helpful in trying to get to her to believe that she can be OK in the long run.

Social Anxiety is like most anxieties; they are not fixed disabilities but really horrible and unhelpful (often outright mean!) thought patterns that create inaccurate information in someones head. They tell the person that things are DEFINITELY one thing but the reality of the situation is often so far from that. However sufferers can be kind of brain washed to their own negative thoughts .

The thoughts could be things like “Everyone is going to hate me" or “I never say anything right” or “ I never fit in”. Now of course most of us have these thoughts in a fleeting way but people with social anxiety have allowed themselves to scan for these thoughts and hold on to them and really believe them, not just see them as the normal “pre party nerves” that we all have and then flick them to one side and keep going.

This is the aim of the therapy game - to retrain her thinking to have the power to identify the “silly” thoughts and push past them, stick her tongue out at them and walk by. Its not to not have the thoughts, its to not be bothered by them.

The biggest piece of advice I can give you is that you must:

1. Never lose hope that there is relief out there for her ( and I say relief, not cure, as anxiety is rarely cured but with the right treatment is often much relieved)
2. Look after yourself . This means maintaining your work , social engagements , exercise , hobbies etc as it doesn’t help her if you are a mess yourself because you have let these things slide.

Now .. for your daughter. It is a tough gig to find the right help for anyone and especially for teenagers who tend to be very black and white thinkers and can love someone or hate them pretty quickly. So keep trying and normalise that aspect of the journey towards health. Make it seem normal to try a number of options .

So maybe think that this year you might try
-maybe 3 more psychologists to see if one might be the right fit
-a group therapy alternative to see if that works better or along side..
-other “lifestyle” things - exercise, healthy eating , sleep, mindfulness courses or Apps.

Some more ideas can be found on these websites:
http://www.reach.org.au/
http://www.psychology.org.au/FindaPsychologist/?utm_source=findapractitioner&utm_medium=button&utm_campaign=beyondblue
https://headspace.org.au/

hgbabu · ‎29-05-2017

Hi Dr. Kim,

I am 26, introvert, still studying, Living with my girlfriend - 25, Registered Nurse. I come form a background where I saw 4 out of 5 failed marriage including 2 in my own family(brother, and parents). Everything between us is fine, except that now she broke the mutual understanding of "staying unmarried and living in together forever" due to her family pressure. It seems that her family will disown her if she kept living with me without marriage. Now i don't know how to carry on. I can write a book on 'why not to marry' as i find marriage to be the biggest scam society has ever created, especially in our hindu culture. I believe one does not need to marry to love and live an happy life. But it seems that my philosophy will bring huge pain in my girlfriend's life and struggle in mine. Eventhough i love my girlfriend very much and have been an ideal partner. I know I can't convince her parents. I can't change myself either. Help me deal with this Dr. Kim?

blue_clock · ‎29-05-2017

Hi, I'm not too sure about reaching out but I guess it's easier if its all anonymous.

Im 17 and really struggling with my mental health. I even dropped out of school to avoid making my problems worse! I went in to headspace and my gp early March and it was pretty unhelpful, my gp just wanted me to get in and out and barely touched on the disorders she diagnosed me with. She didn't ask me any questions about how I've been feeling or anything, just diagnosed me with what I thought was going on. I've been struggling a lot with Anxiety and Depression, sometimes having a panic attack every 2 hours, but i think theres more to it than just that...

I've been getting uncontrollably angry almost to the point where I blackout and I don't know how to stop myself. My mum and I fight like two cats and I start yelling so loud the neighbours can hear word for word. I know all of my reactions are over the top but its like I become a different person and I'm really worried about it because after every fight, I just end up hating myself more and more. I used to deal with a lot of self harm when I started high school, but now I'm falling into that dark pit again and I'm scared the outcomes going to be worse than last. And not to be dramatic, but it just feels like I'm digging my own grave and I can't get out. Just trapped in my own head. I don't know why I'm like this, my mum has worked her hardest for me and all, I haven't had the worst life so far so I feel like I shouldn't be like this. I'm just going more and more crazy and its a cycle I can't escape from.

I'm sorry this is a lot and probably so mild but I'm just not sure how to get the help I need.

yeboiiiiii · ‎30-05-2017

Do i have an actual mental health disorder? I tend to have these thoughts that i overthink from like days to months and when i think about these things i literally cannot concentrate on anything else but that issue and basically my whole life stops for it. Example - i recently went out and drank too much and forgot the whole night (i hardly ever drink and this was the first time i actually blacked out). So the next day my nose was slightly sore and i couldn’t stop thinking about the possibility that my nose was broken, especially since this was the only kind of injury that would have a permanent effect on my face. I’ve thought about this for months even though there wasn’t much pain or any marks. But i can’t get the possibility out of my head that i did break it and just can’t see the difference. I know this is ridiculous but these sort of thoughts keep popping up and i can’t live my life.

Dr_Kim · ‎31-05-2017

hgbabu said:
Hi Dr. Kim,

I am 26, introvert, still studying, Living with my girlfriend - 25, Registered Nurse.

Lets look at the issues that seem to be swirling around and getting all confused.

1. You fear the breakdown of the relationship
2. You want to be true to yourself and your core beliefs
3. You want to honour your girlfriends wishes
4. You want to be respectful of your girlfriends family’s beliefs too

OK … what I think is that you are thinking marriage equals destruction of a relationship. ( and i can understand how you got to that conclusion )

BUT… I’m going to challenge that notion as my experience tells me that what allows people to stay together is not a marriage ceremony, but things like feeling heard by their partner and accepted for their strengths and their weaknesses. Things like respecting differences. Things like learning how to manage conflict in a way that isn’t damaging or hurtful. Things like being kind to one another. Things like a cup of tea in the morning or a hug after work.

There is nothing in there about whether or not you have a ceremony or not . Or whether or not 10 people or 100 people attend. I suggest that you think about what it is in the marriage ceremony that scares you. Is it maybe that you feel it puts the two of you on a trajectory where the next step is divorce ? My view is that the ceremony has nothing to do with that . Its the way you treat each other every day, day in, day out which is going to determine whether you guys make it as a couple or not.

One thing you didn’t mention is whether your girlfriend wants to get married or not. If she wants to.. then I think you might have to really think about a way that the two of you can manage your fears of divorce and separation as a consequence of marriage ceremony in order to honour her dream/ desire and design a small and congruent ceremony that maybe you can get your head around.

If she is only getting married to please her family then that is different . Then maybe she needs to look at if she is prepared to push you so far out of your comfort zone in order to be a dutiful daughter for them and is that a role that she might need to start challenging if it is going to get in the way of your relationship.

Maybe just as you fear divorce after marriage , her fear lies somewhere in failure if she is not a “ good daughter”.

You might not convince her parents that marriage is the only way to go and this is her decision as to whether she wants to stand up to them on this issue or not. YOUR job is to search your heart and head and for both of you to honestly state the fears that lurk under your positions as then you can really decide what to do.

A relationship is full of compromise and stepping down from positions… but more than that it is about LISTENING to each other without judgement & with an open heart. Often you have to give up being right about something in order to be able to really connect with someone.

If you are having trouble sorting it out , go to your GP and ask for a referral or call Relationships Australia for a counsellor
https://www.relationships.org.au/

Dr_Kim · ‎31-05-2017

blue clock said:
Hi, I'm not too sure about reaching out but I guess it's easier if its all anonymous.

You are definitely on the right track if you are asking for help. That is the first step so congrats on doing that. Its super easy to blame everyone else but its much harder to say “maybe its me” . Its great that you can acknowledge the work your mum has put in. At 16 you are not meant to have all the answers but its good to start asking questions of yourself.

It is true that it is going to be important to start to learn to regulate your emotions a bit better so that you don’t feel so “uncontrollably angry” all the time.

So where to get this help?

1. I would highly recommend trying to get back to school . You didn’t mention what happened at the Headspace but I’m wondering if you could check back in with them and look at a back to school programme. In my experience being away from school often leads to worse problems than staying in school , so trying to get back in to some sort of education is important to consider but is overwhelming without support.

2. Headspace would have psychologists available that would have expertise in adolescents and be able to help you with your mental health issues . Its a long haul though . Its not going to be better in a few appointments - you are looking at a a good 6-12 months at a minimum to help retrain your brain to be better at sorting stuff out and responding better.

3. The Reach foundation has some great programmes that you might like to look at
http://www.reach.org.au/

4. Book a double appointment at your GP and take a list of your concerns to them. I think asking them to help you with a Mental Health Care Plan is a start . Advice on the lifestyle changes that help with depression and anxiety might be helpful too.

So I think it is great that you are taking steps to be happier and feel calmer but I don’t think you can do it alone. You definitely need help! So get a good team around you - a GP you like and a psychologist you like … you might need to try a few before you find the right ones so don’t give up .