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.”

[_lucy_0806]

Hello Dr Kim and thank you very much.

I'm dealing with depression and anxiety (which I am on medication for) whilst going through in secondary school. About 6 months ago I started to have thoughts similar to intrusive thoughts, but more of me visualising injuring myself or commands of sorts in my head. It started off with visualising self harm, but more recently it's become things that would kill me if I were to act on them. I've only acted on them once. Sometimes if I'm not visualising myself self harming there will be a voice of sorts telling me to self harm.

I'm too scared to tell anyone about this except maybe my psychiatrist, but even that scares me. I don't want to do any of these things, but there's this urge that's hard to resist when I have these thoughts. How can I get rid of them? Why am I having them? How can I try to tell someone about them?

Thank you again!

[Floyd78]

Hi there,

where is the best place to seek assistance with employment when one has bipolar disorder? a mentor program or similar in Sydney, NSW.

Thank you

[Sophie_M]

Hi Floyd78, we can't provide recommendations for services here on the forums. Please give our support service a call on 1300 22 4636 for further options.

[Dr_Kim]

_lucy_0806 said:

Hello Dr Kim and thank you very much.

I'm dealing with depression and anxiety (which I am on medication for) whilst going through in secondary school. About 6 months ago I started to have thoughts similar to intrusive thoughts, but more of me visualising injuring myself or commands of sorts in my head.

Hi and thank you for the question.

It is hard to be exactly sure as it's hard to make a diagnosis from afar and without really spending time with someone. However , it could be that your anxiety has kind of morphed into another form of anxiety called obsessional thinking that is playing repeated unwanted and unbidden thoughts in your head even though your “rational” or healthy brain doesn’t want them there and wants them to stop.

A well known example of OCD thinking is the one around hand washing where someone has intrusive relentless irrational thoughts about their hands being unclean in spite of another part of their brain knowing full well that they are in fact fine.

It may be that your depression and anxiety are in fact getting worse but it may be a tricky form of OCD or something else entirely…

Either way, there is no reason to not share this with your health care team at the very least as they will be able to take all this in their stride and sort out how to help you. If it is OCD for example, it is treatable so you should definitely get it looked at. In fact, most mental health conditions that cause this have treatments, so I cant think of a good reason not to share this. I don't think that you will be immediately hospitalised or anything if that is what you are worried about, but I do think you need a bunch of self care strategies to help you sort your way through this tangle of most troubling and difficult symptoms . 

If you need to talk to someone about how to manage intrusive suicidal or self harm thoughts in the meantime , please call LIFEline on 131114, as they can talk you through some ideas .

So, dont panic about this but do get help!  I have heard all sorts of weird intrusive obsessional thoughts so this may just be a variation on that . Please check with your psychiatrist. Good luck and I hope you find relief from them soon. 
 

[xXAngelEntityXx]

Dear Dr Kim,

I am writing to you as I need advice badly on how to over come my mental health been fighting it since a young age. Lately it’s just gone out of control, I want to fix it for myself and my partner. I really do not want to lose him from my mental health dragging me down to constant crying every day. Some advice and some ways to learn how to deal with it.

I am really struggling so much right now. It’s the first time I’ve actually asked for help and I am scared of it. Especially losing my partner he means so much to me.

thank you in advance.

[Ezim]

Hi Dr. Kim,

My childhood friend has mental health issues, they've been seeing counsellors and on meds with government support since our late teens, we're in our late 30's now.

I don't have a large circle of close friends and I'm really struggling with how frequently they cancel our catch-ups. I make plans around them (with my toddler in tow), and at least 95% of the time they cancel, with little warning. Since learning about their mental health issues in our 20s, I've tried to be supportive and not put pressure on this friend to show up, but it feels as though it is to the detriment of my mental health.

In recent years they've moved hours away from where we live with their partner, and have struggled with employment and maintaining government support. I've had a baby and had post-natal depression with isolation and anxiety issues coming up that have been lurking since childhood, I was seeing a counsellor about this, but friends cancelling on me seems to re-trigger these issues for me.

Should I approach my friend about how them not turning up effects my mental health? I don't want to contribute to their problem. Could my not making them take responsibility for their actions be making their situation worse over decades? Might they think that I don't need them to show up?

At the same time I'm tired of trying to maintain friendships that consistently let me down. I've been thinking that I need to plan activities for my toddler and me, and if my friend turns up that's a bonus. I just can't tell my toddler that we're expecting this friend, because then they start asking where this friend is. I'm not sure how to stop the sting of them not turning up for me though, without going back into counselling.

Can you recommend a way of negotiating this issue with my friend, and any strategies to better cope when they don't come through for me?

Many thanks for your time, E.

[Dr_Kim]

Hi , I am so glad and honoured that you have chosen us here at Beyond Blue to reach out to for help given this is your first time to take the courageous step of being vulnerable and asking for help.

Its hard to do.
Its hard as we have to first admit to ourselves that something is not ok before we can admit others that something might not be right.

Lots of things move us to the place that makes us reach out for help and the affect on our partners is definitely one of them.

As bad as crying every day is, it sounds that you may have a mood disorder ( like depression) and the silver lining is that it is a treatable illness. This means that with some good strategies you have an excellent chance of getting better.

There are a number of ways to “deal” with it but first you need an accurate assessment so you should probably get to a GP or school /Uni counsellor if that is available to you.

It could be that you could benefit from some lifestyle modification like exercise or diet change , or it could be you will respond to therapy/ counselling. Some people even need medications.

There are a couple of great books that you might like to read that are geared to the general public and super easy to grasp . One is “Change Your Thinking’ by Sarah Edelman. The other is “The Happiness Trap “ by Russ Harris. Maybe these books will help you to really understand what is going on and give you some useful tips.

However , please dont be shy to use a GP. They deal with mental health ALL the time and should be able to guide you into local resources.

Other ideas are askizzy.org.au or Headspace centres or the Beyond Blue helpline.

[TheDuke]

Hi Dr Kim

I know I need help and medication is required but am stuck in an anxiety spiral.

I was prescribed an ad and it made me more anxious. I then was prescribed a benzo to help the initial period without success. I have stopped the ad but now still using benzo prn. I am now afraid of nasty effects coming off the benzo.

what a crappy paradox!

My gp is a good guy and I know he is genuinely concerned. My brother (also a doc interstate) is urging I see a psychiatrist ASAP. But I can’t get an appointment any time soon

I don’t know my next step.

To get through each day I am so needy. I am beginning to feel ashamed. I feel I may well need some intensive treatment perhaps even as an impatient. But stuck waiting a long time for even a psych appointment.

[Dr_Kim]

Hi and thanks for your question.
I think I may have a strategy for you that may help you to manage both being kind to your friend AND taking care of yourself !
Watch this YouTube clip from Brene Brown on Boundaries and Empathy .
https://youtu.be/vSbOIas6jFc
Basically it sends a message that in order to be kind we need to have boundaries otherwise we can get angry and inadvertently project that on others or ourselves .
Watch the clip and if you like the way she presents things , there is lots of her other talks on YouTube ( from her TedTalks ) . They might help you to successfully feel that you can calmly and clearly state your needs and what feels ok for you ( and what doesn’t !) with out feeling that by doing so you are somehow robbing them of their needs. In fact you may be very honoring and respectful by being so honest and open with them about your needs .
By making it clear to them that the friendship is important but so is your self care , you are showing them that you are
1. Brave enough to take the friendship to a better place
2. The sort of person that has learned how to take care of your own needs.
You sound like a lovely person but you are so right to put boundaries around poor behaviours.

[Chris_B]

Hi everyone,

After 2+ years and hundreds of answers, Dr Kim's time on our forums is sadly coming to a close. We'd like to thank Dr Kim for all her valuable advice over the last couple of years, which continues to read by thousands of visitors every month. While this thread will be now closed, it will remain online as a read-only resource.