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.”

[Insomnia_Nights]

Thanks for your reply.

I talked to my GP today and he seems to think that the only way to get "free" service is to be admitted to a hospital which for me is entirely inappropriate due to the state the mental health wards are in.

There seems to be some interesting links/possibilities on the sites you suggested so I will check there.

Thanks again.

[Dr_Kim]

james1 said:

Hello Dr Kim,

I think I've posted to you before, but I 'have' BPD and I'm currently in a relationship where I can feel things fraying. I know I have certain habits where I turn everything into a game or a story and if the other person doesn't play or listen along, I treat it as rejection.

James , I am a bit in awe of you!
 
How wonderful that you have been diagnosed with BPD and you are able to take it on and work at it so effectively. This is no easy task for anybody, and especially for those with BPD. Its easy to get stuck in the belief that others should be the ones to sooth you or make things right for you. However it seems that you are able to be mindful of the pitfalls of this condition and not fall into the traps of being hypersensitive to rejection or creating drama in order to feel relevant or get reassurance with the make up. 

The reason that your BPD thinking jumps out of its box and the behaviours “ creep back in” is that there is no cure for this , but there is just you controlling it with your vigilance and continually shoving the rogue thoughts and behaviours back into the box. 

If you and your partner feel that the relationship is one you both see a future in and are committed to really working at, I think it is a wonderful idea for her to come with you to a session or two so she can develop an understanding of it and help you to keep a look out for the BPD appearing and also help you to manage it / calm it  . 

BPD doesn’t need to be a “deal breaker” for relationships , but I also think it can’t be ignored. So if you can work together against letting it into your relationship , then I think that is a wonderful construct for the future . 
 

[Dr_Kim]

kanga_brumby said:Dr Kim my son was diagnosed with ADHD we have found out since it wasn’t . But instead he should have been diagnosed with Autism. I am wondering is that a physical or physiologic ability. ( I don’t see it as a disability as he has abilities. He has the ability to annoy his dad, sister cousins teachers) he is currently in main stream school struggling a little not in all things just some. From what I have heard this is normal for his type of Autism. The good people caring for him have been made aware of everything the school is next. Thanks
Kanga

Hi there,

I don’t now how old your son is but I imagine it is super confusing for you ( and maybe him!) to be given multiple diagnoses and be unsure what is going on. This is quite often the case though as:
 
1. Many of these disorders share characteristics so things like Autism Spectrum Disorder , ADHD and Learning Disorders can all have some things in common. 
2. Some children have more than one diagnosis . For example, it is possible to have ADHD and a learning disorder which obviously complicates things.
 
My belief is that the cause of Autism is still not fully understood. I don’t think anyone really knows if it is a “physical” issue in the brain or a genetic issue or a biochemical one or something else? … I think we are getting closer to it as there is plenty of research going on. 
 
It is great that you are able to see his abilities , not just his disabilities . I think it is important that the team of people around him ( including school)  are aware of what is going on though as a team approach to behavioural modification and learning are ideal. It sounds as though your son is in good hands and that you are working hard to maximise his experience at school which is great . 
 
Parenting is often a bumpy ride and with a child with any sort of chronic disability , it really turns up the dial on the work rate required. It seems like you are trying hard to get your head around things to ensure that together with him and your family , you allow him to be the very best version of himself. 
 

[RileyGermain]

Hi Dr Kim,

Im a 19yo female and was diagnosed with bipolar disorder two years ago when I had a psychotic breakdown. Since then, I have rebuilt my life and have come to discover that I have Borderline Personality Disorder (BPD). Living with BPD is insanely hard and whilst I am functioning, I just feel like I'm never going to live properly and I'm constantly paranoid at people seeing there is something wrong with me. I have a psychologist but my psychiatrist recently moved to the UK. Im studying at uni but just failed the only subject I am doing because I didn't attend any classes because I couldn't get out of bed on some days. I lie to my friends and family and say that I am doing well, but I am not. I should be, but I'm not. I don't know what to do with my life and what direction I should take. With BPD, I lack a sense of identity and I'm just worried that I will never find it. How can I ever become a functioning human being if some days I cant get out of bed because I am too depressed, and others I can't leave the house because of crippling anxiety. The main reason I havent been properly doing uni is because I am too focused on my unstable friendships and relationships and keep sabotaging myself. I am currently sleeping with someone that has a girlfriend. And have repeatedly lost all my friends when they realise I am 'crazy'.

Im on medication and have been for 3 years. I also drink heavily to self medicate.

I guess what I'm asking is, how do i find motivation to live when everything seems awful? How do I move forward from the past and make a decision on what I want to do with my life?

Thanks,

[james1]

Thanks for the feedback and reassurance Dr Kim. I know I slip up sometimes, and sometimes I realise I've slipped up later, but hopefully some of these twice a week sessions actually stick somewhere. I'll have a chat to my psych to see what she says as well about inviting my partner to one.

[Dr_Kim]

RileyGermain said:

Hi Dr Kim,

Im a 19yo female and was diagnosed with bipolar disorder two years ago when I had a psychotic breakdown. Since then, I have rebuilt my life and have come to discover that I have Borderline Personality Disorder (BPD).

Hi there , 

A few things strike me about your post . 

One is that you are clearly able to take some responsibility for your actions and your thinking .You are able to be mindful of when your thoughts get self sabotaging and when you slip into unhealthy patterns like drinking too much or sleeping with the wrong people to sooth or distract yourself . 

This shows a lot of strength of character as this is definitely not easy to do .

I am concerned that you are not getting psychiatry support at the moment as your situation is complicated by your Bipolar. This illness needs close management and almost always needs medication oversight by a psychiatrist especially as you have the added burden of crippling anxiety and severe depression , the BPD and problems around identity and maybe self esteem.

I really think a open and frank discussion with your GP and psychologist is a starting point. I would consider getting another psychiatrist on board and maybe even think about a referral to a DBT program which is an intensive outpatient program for those with BPD. 

No one can really move forward if they are really unwell.

However, you sound really determined to get yourself together and I think that with some support and eventually being honest about what's going on, I hope you can find your strengths and get on with your future . 

Accept help , work hard , get well , come to know yourself , be honest with yourself first , then be honest with those around you and I hope the paths to your future will feel less scary . 

Make that long appointment with your GP ! 

[anomaly]

Hi

Could you please let me know how does one deal with an overwhelming amount of pain inside?
How to let it out bit by bit without exploding?
I have tried everything..... With no success.
Any suggestions are greatly appreciated.
Thank you

[Dr_Kim]

Hi Anomaly, I'm really unsure what to tell you as there are so many causes of people having emotional pain and suffering. There are also so many ways to approach it so I don’t know what you have tried and what you haven’t.
So I guess I might give you a brief overview of approaches and then suggest that you check this with a trusted mental health professional.

Basically, the treatment looks at managing the pain AND trying to find the cause of the pain.

Sometimes we are successful at helping people understand the reason why they are feeling bad, and other times there seems to be no “rational” or obvious reason, but they just feel bad. Some common causes of pain are trauma or grief and loss.

Whatever the causes though, learning how to manage feeling bad “without exploding” is clearly really important. There is no one way that works for everyone. Usually there is a combination of things that work enough to turn the dial down a bit.

Things that people try are things like:
1. Lifestyle changes - regular exercise (I’m talking minimum 30 minutes 3-4 times per week of something like brisk walking), healthy diet, good sleep hygiene
2. Mindfulness programmes - learning good mindfulness techniques via a teacher , a group class or an App like Headspace or Smiling Mind.
3. Good activity structuring - ensuring you have something to do every day and hopefully something with some purpose each day.
4. Counselling / therapy - finding the right therapy or you . There is no one way that is right . Some people need trauma informed therapy ( e.g. look on the Blue Knot foundation website ) or others really respond to EMDR for things like PTSD . Keep looking until you find what works for you , including family therapy or group therapy options.
5. Medications- if you haven’t found the right thing ,ensure that you get a fresh evaluation from a psychiatrist so you can be sure that all options have been exhausted . Your GP can organise this for you.

I hope this helps you with some options along your path to feeling better.

[Possum_Magic1]

Hi Dr Kim

I have recently turned a corner with depression but not having much change since. Maybe little changes but what is an average time frame to full recovery?

Possum Magic

[kellie2]

So this is the questions . i have panic attacks tigered by a variety of things one is high intensity training, only sometimes andd. Generally the first one will be something eles and then training will be really hard for a few days.

I am training in a groups enviroment. They are the same group and we are training to compete in our sport.

My coach is aware of the situation but not the others. So the question is do you think i should tell them.