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]

Hi There,
You have nothing to be sorry for. I think I understood your dilemma. Basically you are stuck between wanting to be helpful/supportive and not wanting to be intrusive or invasive. How do we know when we are being a help or a pain in the ass?

This is a common issue with adults trying to work out how and when to support other adults when they perceive that there is an unmanaged mental health problem. In your case things are further complicated as you are not “officially” his partner at the moment so it makes it harder to know your place.

My view is that the best strategy is to be straightforward but kind and also be clear about your concerns and the impact on you.

So you may either ring him or write to him and state that you care for him and that you have concerns about the way his depression is affecting him. You have noticed these things and just state them briefly clearly 1, 2,& 3. ( eg you notice that says he wants to give up on life , or you notice that he is drinking more or that you are aware that his family / friends do not know about his depression / suicidal thoughts) .Then just state clearly that you worry about managing depression during his upcoming basic training.

Finally , give him concrete suggestions. Suggest for example that he does one of 3 things eg .. 1. Tell a family member or 2. tell his GP or 3. let you get him to a trusted therapist or whatever you come up with for options.

End by telling him that depression and suicidal thinking are potentially serious things and you care about him enough to not let this issue slide until you know he is safe. You look forward to his response .

Now if he doesn’t respond or if the response is very negative , you can either walk away feeling that you have done everything that you could have.

However, if you really had the feeling from your communications that he was in serious danger of self harm, then I would alert him to that fact and tell him that for your own peace of mind you will need to share the fact of his depression/suicidal thoughts with a trusted family member or friend or even a CAT team if it comes to that. It is an unfair burden to leave you with information of a such critical or potentially life threatening matter and expect you to be OK with that.

I hope i have given you some ideas on how to move forward.

[Wastson88]

Hi dr kim

I need some tips on how to deal with my anxiety and depression it is thqt bad to the point were i get angry at every little thing and very emotional

[Dr_Kim]

Hi watson ,
I feel that anger and irritability are common symptoms of anxiety and depression but can also come from unmet needs. I’m not sure why you are feeling so emotional but it could be that you are just in overload and can’t shove your feelings aside anymore. However , it seems that you need help as the emotional outbursts are giving you a clear message that you are not OK. Talking through your anger / emotions with someone should help to work it out and manage it.

So where to get this help?

1. I’m not sure if you are school age or Uni age, but if you are you can try going through a school counsellor or a Student Health Service.

2. Headspace would have psychologists available that would have expertise in this and see people aged 14- 25.
https://www.headspace.org.au/

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

4. Ask him to book a double appointment at your GP . Ask for a Mental Health Care Plan and a referral to a psychologist who can help.

5. Call the Beyond Blue Helpline if you are still confused!

So I think it is great that you are taking steps to help yourself feel less angry, be happier and feel more stable

[ohhmyyy]

Hi Dr Kim,

After a decade of waves (years) of anxiety and depression I started to see psychologists and mindfulness and cognitive therapy didn't do much so I started to see psychiatrists. In the past two years (because I have moved a lot) I have seen three psychiatrists. Each have given me a different diagnosis and different medication. I have been told I have Bipolar II, then BPD and now ASD.

As a result I have now been on several medications. I am going out of my mind and starting to lose faith in my overall diagnosis to the point where I would prefer to stop taking everything and go back to the anxiety and depression.

My partner says 'I always do this and just stick to what youve been told'. I understand all of these diagnosis fall under the huge confusing umbrella of 'the spectrum' but do I really have to go through a trial and error of medications to feel better? How can I trust this current diagnosis and medication treatment?

[Leeh70]

Hi Dr Kim,

‘I have suffered depression on and off but have always pulled through. However I’ve hit rock bottom and don’t know where to turn.

‘I’ve hit financial rock bottom, I hate my job, and soon will lose my house, I can tell my family they will be so disappointed in me as I am. I understand why people kill themselves.

i can’t afford a specialist where do I turn

Lee

[Birdie_4002]

Dear Dr Kim,

I am a teenager that is going through grief I have recently lost my beloved dog. She helped me get through tough times as I have an anxiety disorder. I feel like my whole world is closing in on me. I am always crying and I feel disconnected to the real world how do I cope with grief in a safe way. And how do I keep on living life and not feel sad all the time.

Kind Regards

Jaya

[Dr_Kim]

Hi Ohhmyyy
Your situation is not as uncommon as you might think. Psychiatry does its best to try and define what people are going through,categorise their experiences and put them into different “groups” so that the conditions can be studied, better understood and hopefully treated . However, I think that for many people they don't fit neatly into any particular group but show signs consistent with a bit of this and a bit of that .
In these situations, I try to get back to basics. I don't worry as much about the diagnosis, but about the symptoms . So I try really hard to work with the person to understand which symptoms are bothering them most. For example, is it the restlessness, or the obsessional thinking or maybe its lack of motivation or feeling hopeless ? For some its physical things like exhaustion or low energy, for others its more social things like feeling like no one "gets me" or that its hard to trust people. The lists go on…
I wonder if maybe you could write a list of the things that really bother you the most that you want to work on and then work with your psychiatrist on the ones on the top of your list.
So if one of your top things is exhaustion, for example - maybe you would look at what you could do on a physical level (ironically exercise often helps!) , what to do on a social level ( planning appropriate work and social interactions ) , on a cognitive level ( how to challenge the part of your brain telling you that you can’t do things ), and with medications (how are the medications helping or hindering this symptom ?)
I know this sounds tedious and long winded … but i think it avoids getting into he territory of trying to decide WHY you are exhausted and gets on with treating it.
I hope this approach might be helpful to you in working with your health professionals.

[Dr_Kim]

hi Lee, 
I am not going to argue about the rock bottom as things do sound pretty bad. I just feel that we always have a choice and I wonder if yours at the moment is to be the person who hits rock bottom, becomes super vulnerable and faces up to all sorts of difficulties taking one small step at a time , OR…. you become the person who hits rock bottom but is too frightened to share the shame or guilt of the place you are in so you run or numb yourself or even contemplate suicide. 
 
I am making it sound super simplistic and i am not in any way wanting to minimise the distress of your situation but i do want to point out that there is an opportunity to show yourself and your family how your can be brave at rock bottom . How you can look them in the eye and say it “OK , I’ve hit the bottom and I feel awful. However… these are the things I’ve learned, and these are the things that are important to me, and these are the things that I am going to do step by step from this place.”
 
Being the survivor of the "rock bottom" is something that maybe you can strive for and doing it with grace and without hurting others will be something others will admire you for.
 
So… how to do this? Well… I dont know your age/ life circumstances / geographical situation but I do know that help is available . Even if you cant afford private  specialist fees , there is help. A good first point of call is your local GP who is often aware of local services. Also PLEASE use supports on line or via helplines. 
 
Ring Beyond Blue helpline 1300 224 636 or Lifeline on 13 11 14 for other options .

[Dr_Kim]

Hi Birdie
Firstly, my condolences on the loss of your companion, your friend, your beloved dog. Pets are so special to us, especially when we have something like anxiety as they are ALWAYS loving and understanding . It is completely understandable that you feel the loss of this special relationship so acutely. You also say that you are a teenager which make me think that maybe you don't have a whole lot of experience in grief and how it should be and what it should feel like.

There are no rules about how you “should” express grief or loss (except that you shouldn't harm others) . I think you should be mindful and observant in a curious and respectful way of what your emotional world is doing. I think it is ok to be kind to yourself and just to notice and not to judge whatever is happening to you. So that if at this stage you are a bit disconnected , then just notice that and trust that maybe that is what you need at the moment. There may be a time where you need to push yourself to connect a little and then just notice how that feels.

Its ok to just observe your reactions to the loss without having to feel like to have to do it in a certain way.

However, part of the healing is starting to think about what support you got from whatever you lost. What did your dog provide for you? Non judgemental warmth ? Company ? Unconditional acceptance ? Maybe think about how you can start to thank your pet for teaching you the joys of these gifts but then to know that you might need to find these in other places at some point in your future …. and you will.

If you feel like your day to day functioning is starting to be affected though, or if your can't transition to new forms of support and love ,then I would maybe check in with your GP or school Counsellor for some tips on how to do this.

Also , try listening to an APP like Headspace or smiling mind just to help you with the Mindfulness/ acceptance stuff

Grief is tough so dont be hard on yourself for not having it all sorted out at your age.

[ohhmyyy]

This is brilliant thank you so much.