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.”

Alex_Smith · ‎23-01-2018

Hi Dr Kim,
A few friends and myself have recently become very worried about some increasingly strange behaviour in a close friend of ours. On the frequent occasions that we see her; she is commonly putting herself down with offhand, negative comments about her appearance when compared to others, comments about being worthless and that no one loves her, saying that her parents don’t love her as much as her sibling who has recently been struggling with gender issues (the starting of these comments coincides with her sibling going through a gender change), destructive messages online to friends who had different sexualities to herself (this happened when she was in a bad mood and lead to the ending of most of those friendships), she has also seems to have a trigger (to get mad, often violent, to shout and also storm off) when the questioning of ones gender comes up in conversation (this has happened a few times and she seems to calm down after talking about it), and also is easily upset at any sort of criticism.
I’ve asked her if she was alright in the past and she has replied that she was fine. Also when asked if she’s seen anyone to help, she replied that she had seen a councillor for a little while but it hadn’t really helped. I definitely feel like she needs help but I am unsure how to seeming that she seems to have issues with her parents and the help of a professional was not helpful for her?

Sophie_M · ‎23-01-2018

Hi tdpat!

Just wanted to check in and let you know your question is with Dr.Kim and there should be a response to you by tomorrow! Thanks for your patience here!

cfalz · ‎24-01-2018

Hi Dr Kim,

Lately I’ve been feeling this constant pressure building up inside of me. It feels like no matter what I do I just can’t relax or shake the feeling of worry closing in on me.

Many times I’ve just been sitting watching TV, reading a book, etc, when the pressure seems to build to an unbearable point. My chest will hurt, my heart will start beating fast, I struggle to catch my breath. It’s terrifying me and I just don’t know what’s happening.

I just feel like I’m losing control. I’m constantly irritable, moody and worried. I’m always in a state of feeling inferior and worthless to those around me. I struggle with intense perfectionism as the idea of failing sends me into one of the ‘attacks’ I mentioned above. I just can’t seem to find any positivity about myself or my life.

Please give me some insight on this issue.

Thank you

Dr_Kim · ‎24-01-2018

Hi Tdpat
I hear from your post that you are trying very hard to be a good partner , a good step parent and also look after yourself . I am glad to read that you have been to your GP and got yourself some support from them and also a counsellor . That is a great start.
The fact that you are having panic attacks is a sign that things are not ok and you are absolutely right to seek help.
Being a step parent is really tricky . There is not a magic way that you can do that will work for everyone, but there are a few good guidelines that might help. I have found that the Stepfamilies Australia website has some great information on it to help for example
http://stepfamily.org.au/wp-content/uploads/2017/05/being-a-stepparent_web.pdf

You can also call them on 03 96392576 for specific advise around step parenting.

I also think that it will help if
1. you and your partner are on the same page when it comes to both of your roles when it comes to the children. It might be important for you both to understand that you both have expectations about how you both should should feel and behave to the children. maybe your counsellor might be able to help the two of you to be able to talk about these things in an open and supportive way so that you can clear the air and be more understanding of each others roles in this step family. You can also call Relationships Australia on 1300 364 277 or Family relationships advice line on 1800 050 321
2. you continue to work with your GP and psychologist to learn ways to manage your anxiety. ( NB go back and talk about not tolerating the medications) . You might need to learn how to cope with rising frustration and irritation in a way that isn’t harmful to you but also isn’t harmful to the peace of the household .
3. You come to terms with the understanding that you dont have to LOVE your stepchildren but you do have to be kind and nurturing to them. Thats the deal . You must work with your professionals to find a way to do that because YOU are the adult and they are the child and that means you have the responsibility to take the high road in this situation. I know it might sound unfair, and as i say you dont have to love them ( or even really like them ) but you do have to find it within you to be kind, tolerant and gentle .

I know this all sounds easier on paper than it is to do in real life but you are already along the way to doing the things… just keep going! Good luck

Dr_Kim · ‎29-01-2018

Hi AlexS
This is a really good question as I really think it is just about impossible to “make” someone get help unless they want to get it. (the exception to this is if they are clearly a danger to themselves or others or if we think someone has developed a thought disorder where they are not able to care for themselves)

So how do we help people that we care about who we think might need help. The general advise I would give you is to
1. Be honest about the things you have noticed that worry you and
2. Reassure them that you care and that you want to be able to help them find the next steps to take.
3. Give them a couple of ideas to choose from eg . “ I am happy to go to your GP with you to discuss that you are not getting better” or “Would it be helpful if I sit with you while you call Headspace and make an appointment” or “I am happy to try and help you find a therapist that better suits you”. Which of these sound like the best next step for you ?

However, in the end she may not take you up on any of these offers. If that is the case, I would suggest that you accept that is all you can do at the moment and gracefully retreat a bit until
1. your friend is ready to work at her problems or
2. you can cope with the worry of her not changing.

Try again to offer support at another time. Maybe this time she might be more receptive. In the meantime, get on with your life and take care of yourself.

If you really think her behaviour or thinking becomes disordered or strange to the point that she is unable to really function, I would suggest you don't take the responsibility of that on. Let her know that you are really worried for her well being and then “hand ball” it to a responsible member of her family . She might be upset initially but better that she is temporarily upset than no-one does anything and she gets seriously unwell.

https://headspace.org.au/friends-and-family/

Dr_Kim · ‎30-01-2018

cfalz said:
Hi Dr Kim,

Lately I’ve been feeling this constant pressure building up inside of me. It feels like no matter what I do I just can’t relax or shake the feeling of worry closing in on me.

Hi Cfalz,

The symptoms you are describing sound like you may be having having panic attacks. That is awful for you, but the good news is that there are plenty of people who have walked this path before you and have been successfully treated.

Firstly let me briefly explain whats going on..

There is a primitive or reptilian brain (your amygdala) that sits on top of your spinal cord deep in your brain. It controls the “fight , flight or freeze” reflex that we have as a response to perception of danger . This was a very handy evolutionary response when we were cave men as it allowed us to very quickly respond to predators and not get eaten!!

Overriding that is our thinking brain or mammalian brain (the cortex ). This part of your brain has all the filing cabinets in it with information about making sense of the world around us and deciding how to act . So if we hear a noise outside and use our cortex we can “ think “ about whether it is really a sabre toothed tiger, or just wind in the trees…

Guess where your response is coming from ? I think you might be responding to what your amygdala has perceived is a threat . And your amygdala is thinking that not being perfect or good enough or worthless is YOUR sabre toothed tiger and is responding with what it thinks is a life saving response. Is it rational ? No! Does the Amygdala care ? No! the Amygdala is doing its job . It is protecting you !!!

So the treatment begins with you understanding your brain and body better. Look at Beyond Blue or SANE websites for more info on Panic disorder .

The 4 forms of therapy are
1. Lifestyle - better exercise, eating , sleep
2. Mindfulness programmes ( Apps e.g. Headspace or Smiling Mind ) or a programme ( e.g. Open Ground)
3. Therapy - ask your GP for a referral to a psychologist to help you through this.
4. Medication ( maybe ) if things are really bad - via your GP

Once you feel the panic attacks are better controlled, you might be able to start work on the sense of worthlessness that is triggering them . This can come from so many places that it is a good idea to work through it with a trusted counsellor.

Here is a video to look at that might be a starter for you, but it is really important to work this through with someone trained to help you

demonblaster · ‎31-01-2018

Hi Dr Kim & all

I'm Bipolar 1 & 2 moreso now, having 8/10 majors a yr but know the mania's more type 2 now sort of lol sometimes it's between 1 & 2 ( the excitement levels I've almost sadly got sorted ) Majority psych have said I have very good insight which helps get through.
Question Am I still a rapid cycler or ? amidst various research read different terminology when they increase to this often.
Making good progress with emotional control to slay the beast, HATE pulling mania down lol think mentally moreso than meds (psychiatrist because of late diagnosis 46 yrs didn't think would work much which I felt they haven't either going by the yrs before in cycles & since being on them if they have worked it's taken a yr or more but continued & with GP supervision reduced mg dose) WHEN I get complete control does it still stay which I've been told it does but in between cycles have little motivation for most things, ? tho am sticking with a couple of things. Brain needing rest? but for yrs have wondered if I can get that balance of motivation working in between times to even it all out possibility of it going? It's like opposites as you'd know in the ups & downs but also in cycles & out.

Also I this cycle now which I shouldn't have done & rang Dr yesterday to check if I'll be safe reduced 1 of my pills. I'm usually rational throughout luckily but yeah shouldn't have but how long if mania's going to come back would it be after doing that? cause I did have a little zoom yesterday but not sure if I'm in mania or heading into now again & I know when I'm coming down cause don't need the sleeper family not sleepers but hypnotic ones BUT found out I do/have have auditory hallucinations, not bad ones just as if in a club and heap of people talking, wasn't scary quite nice soothing & was told that could be beginning of major mania so time will tell and I'll be ok lived without meds for yrs. Am aware coming off can bring it on & often maybe cause I forget so much to take em have mini ones in cycles

Seeing GP 8th feb

Sorry long post thanks

Thanks

demonblaster · ‎31-01-2018

Sorry to my understanding type 1 is more likely to have visual audio hallucinations and more? if that's correct from research yeah.

Actually I can sometimes defina a voice, scared me cause it was loud last night but blocked which I've heard thoughts we need to have but figured this isn't thoughts it's voices anyway thx

Ggrand · ‎31-01-2018

Hello Dr Kim,

I just want to say Thankyou for putting this little video here to watch.

It is very interesting and easy to understand. I needed to watch that, I will watch it weekly until it sinks in. Thank you.

Kindness only,

Grandy,

Bethie · ‎01-02-2018

Hi Dr Kim

My husband was diagnosed with Retrograde amnesia mid last year. All CT and MRI came back negative. Hes slowly getting better after registering 2 on the memory test. When he goes anywhere he cant remember he still has basically a breakdown to a large extent feeling inadiquet. How long can this type of amnesia effects last? I am currently his career because he still finds it hard to remember to eat and find his way home from even the shops and constantly forgets his phone