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.”

[demonblaster]

Sorry addit; if you go to All posts choose I suggest Anxiety or Depression section and top R) new thread

[Sophie_M]

Hi Dublin, 

Just letting you know that Dr.Kim has your question and will get back to you within the next 24 hours. 

There's been a delay with the long weekend and we just wanted to reassure you that your question has not gone unnoticed. 

Cheers!

[Dr_Kim]

Dear Dublin
Of course you are worried about your daughter. It’s hard to not have answers or know how to make her feel better .
I think if she has been seen by her GP and a Paediatrician and you have been reassured that there is no physical cause for her symptoms then I think that’s reassuring.
Of course if new symptoms arise or if you need medical review at any point then I think you should see your GP.
Now to manage the anxiety, a psychologist was a great start but it can take a while to be effective. Meaning , it can take some months of therapy and applying the techniques learned to get on top of things . However, I agree that if you feel that your daughter is not seeming to get better , a review with a child psychiatrist is not a bad idea . You would need to get a referral from your GP so have a chat with them to discuss it.
Another idea is another form of therapy if individual therapy isn’t really clicking with her . I find family therapy can be quite helpful with adolescents. This option might be worth discussing with her psychologist.
Just stay by her side and keep telling her that no matter what you will get through this together.

[Danta]

Hi Dr Kim,

My partner has severe anxiety and depression. She is on high dose medication at the moment for this.

One such issue we are encountering is that she has no sex drive at all. This is causing more anxiety in the relationship.

Is there anything you can suggest for helping to improve this for her. I understand we can't talk about the specifics of individual medications.

Thanks

[Elizabeth CP]

I have been seeing a psychiatrist for some time. My referral has run out so I need a new one. The original GP who referred me left several years ago. I changed GPs earlier this year after becoming dissatisfied with her. I haven't seen the new GP much & have never mentioned any MH issues so I'm anxious about going & discussing them with her. Do I go back to the old one who has the records re referral to psych or go to the new one & go through the process of explaining all my past history.

[Playingchess]

Hi dr Kim,


I have recently been diagnosed with PTSD resulting from emotional, sexual and at times physical abuse in a long term relationship with a narcissist. This relationship ended quite sometime ago however I still suffer consistently from night terrors. As a result of my insecurities and rock bottom self worth my most recent relationship ended quite suddenly as he felt he had given everything he could and felt used by me. He suffers from depression and severe anxiety himself and my issues were a guilt trigger for him so I understand why he had to leave.


Right now I feel a bit hopeless, not particularly depressed (I was treated for depression after my abusive relationship ended and did quite well recovering) or anxious, just hopeless..


I am seeing a psychologist who was great at identifying my MI - my abusive ex attempted to get in contact with me late last year and this triggered a major episode that is still ongoing and is the reason for me seeking help as I was evidently not coping at all and the breakup with my amazing partner has made things that much worse as I can’t help thinking that this will effect me for the rest of my life.


I have been focusing on mindfulness, rational thinking and changing my habits ie. I have stopped drinking entirely as I used this as a coping mechanism, eating healthy, exercising more for enjoyment than weight loss or fitness, reading instead of tv, deleting social media off my phone, the list goes on. I don’t wish to be medicated again, I found SSRI side effects not worth it for me..


. We both agree that the on going issue is the recurring night terrors as this triggers me as I have no conscious thoughts of my trauma. I feel so ashamed that this still effects me, I am a strong person to have survived what I went through and I don’t want it to define me or be the factor that means I could potentially end up alone instead of being able to exist in a happy relationship.


I don’t have another appointment for a few weeks and I don’t really know what to do now. I’ve lost my best friend and main confidant in my partner and I although my friends and family are really supportive and understanding I feel like this is something I need to sort out on my own now rather than relying on people and potentially hurting them like I did my partner.

[Dr_Kim]

Hi Danta
The issue of low libido on some medications is not uncommon and may be dose related. It is reversible once your partner ceases medication.
If the medication is clearly working and needed then supporting her to persist with it is clearly the right thing to do. If it’s not helping, then discuss with her doctors how to maybe try another sort that might not necessarily give that side effect.(note there are no guarantees- it’s trial and error)

Some people either need the medication or can’t deal with the hassle of trying another one at this point so they need to cope with the low libido side effect .



Already you are being super helpful to your partner by caring and not being blaming. My suggestion is that you might want to lower your expectations but think more in terms of shared together time / intimacy rather than sex as this lowers the pressure of having to have an “outcome”.



Those with low libido might not feel like sex but they might feel like a cuddle. So that’s a start to building back your intimacy.
I would also tell her straight up if I was her treating doctor that this is a common and well reported side effect but that to deal with it many couples choose to go ahead with some physical contact even though the desire of one partner is understandably low. They don’t need to read this as a sign that they don’t love each other or to get insulted or upset by it . That side of the relationship just is going toto be different for the moment and it might be wise to find non blaming ways around it that manage BOTh partners needs.



That sex and physical intimacy is a normal and ok thing to want (in the partner with the intact libido) and sometimes it’s an expression of deep connection, sometimes a physical need or sometimes a joined emotional need ... but whatever it is, there are no rules and during this phase of her low desire .. you guys may have to rewrite your “sex relationship rule book “ so that you both get it and there is total consent and joined expectations.

So in summary , I’m not sure that I can recommend a magic "antidote” to the low libido that is induced by the medications but I can recommend an open and honest discussion around BOTH of your needs and how they may be better met during this time of her recovery , This conversation may even be best had with her therapist present so she feels supported and doesn’t feel blamed or upset.

Look after yourself so you can look after her.

[Dr_Kim]

Hi Elizabeth CP

As a professional who as worked in this field for a long long time now … I would like to encourage you to PLEASE go to your new GP and be honest about your needs. You dont have to pretend to be someone you are not for them . Their job is not to “ like” you or approve of you , but to provide medical care for you. They work for you remember!! So its important that you provide them with all the information that they need about you that will allow them to get you the very best health care that they can for you. Psychiatric care IS health care and they should be well versed in how to manage this.

The fact that you have an existing relationship with a psychiatrist and just want a new referral, I assure you, is really EASY for them and they would be delighted to write it for you.

Is it possible that your anxiety about exposing this part of your history to her may be more to do with your own reluctance to accept it in yourself than in the reality of her accepting it in you. Believe me, any GP sees heaps of mental health so its not at all something she is likely to get “ judgey” about!

I hope that i have reassured you . I really believe that you owe it to yourself AND your GP to have an honest relationship and that you shouldn’t feel ashamed of your mental health needs. On the contrary, you should feel proud that you are being responsible and looking after yourself!

[Dr_Kim]

It sounds like you have been through so much but wow you have put yourself back on track in a way that you should be super proud of .
If I get your query right, it’s more about night terrors than managing your PTSD or relationship issues because to be honest I think you are doing such a great job with all of that - the exercise, diet , decreased social media, mindfulness, stopping drinking and even stopping your SSRIs . That is an impressive list ! 
 
I am not exactly sure about your night terrors as I don’t have a full understanding of their history but if they are a new symptom, they could be due to all the changes in your system.



They can be related to genetics, other health problems or idiopathic ( a fancy way of saying that we don’t exactly know why ) .
I would definitely talk about it with your health professionals- psychologist and GP and if they are unsure , maybe think of a consultation with a sleep medicine physician ( yes ! There are doctors who have expertise in this area !)
 
They sometimes do a study where they hook you up various recording devices that can read data on you while you sleep , providing info on your night terrors for analysis. Once they know the origin of them , the treatment might become more obvious to the specialist . I certainly understand why you want to quiet your unconscious mind and sleep peacefully - for yourself and for any future partners sake. 
 

[anonymousbear]

Hey,
I am very hesitant to seek help as I feel like its all in my head that I believe something is wrong. But I want to ask if I require professional help;
On a daily basis I find myself a normal teenager. But it seems like the smallest thought, sight, smell or sound can inflict intense feelings of sadness and/or anger. I am often very confused as to why I am on the verge of tears, it seems like for no reason. These feelings pass then return again within seconds in some cases but longer in other situations. I often go quiet and refuse to talk to people because I believe I am a problem and I don't want to ruin anyone's day.
Sometimes it feels like people are laughing at me or talking about me behind my back, this causes me to become embarrassed and upset although I don't really know. I feel sick a lot of the time and my hands shake.
At home I am always agitated and grumpy. I am unmotivated. It feels like I cry every night and my brain just doesn't stop thinking. It's like everything that has ever happened past, present and future is being processed in my mind from every angle and I over analyze social situations and this makes me very upset. I feel like people don't like me, I feel hopeless and annoying. Like I'm not important because whenever I talk people ignore me so I feel unheard.
I really hope I can finally figure it out, this has been occurring for 2 years now and I am tired of feeling like this. I don't like the person I am, it's not who I want to be.