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]

Merci said:

Hi Dr Kim.

I have been taking an antidepressant for the past few years to help with panic disorder.

I wonder if it might be time to have a complete new look at your panic disorder / low mood / weight issues.

Maybe you are your best guide in this and i think you might need to really dig deep and think about what you want to do .. which direction you want to take…

I’m not sure where you live and how accessible care and therapy is to you but I think in your shoes you could make a case to at least trial a new therapeutic model …

Maybe something like this ..

1. Get  into really intensive mindfulness and relaxation training … Thats where I would be putting my money! For example ...

http://www.openground.com.au/individuals/mindfulness-based-stress-reduction ( Or other programmes via Anxiety Foundations )

2. Stop the exercise physiologist but keep moving - walking or doing ANY exercise you like as much as you can.

3. Eat Mindfully - get the book by Dr Ric Kausman “If not dieting ,then what” . He looks at not dieting , but just becoming in touch with the way we eat and what we are eating and why.

4. Possibly therapy . I’m not sure if you have been down this route. For some people it is important to look at root causes for their anxiety , for others  the behavioural modification to deal with it is the key.


Once you feel on your way , you then work with your GP ( or another one !) to slowly reduce your medication and see how you go… It may be a bit bumpy .. but worth it in the end . 

I’m not saying you should do this, but I’m hoping to open up possibilities for you and allow you to see this is YOUR life and you can choose to live it how you want. If you feel what you are doing isn’t feeling right , well go ahead and try something new in a controlled responsible way.

[SourceShield]

Thank you Dr Kim!

I have HFA.

And, I am going to be honest with you - I have lived in Brisbane for three, nearly 4 years now.

I had a great psych in Cairns - she helped me with MiCBT -Mindfulness integrated Cognitive Behaviour Therapy.

When I first moved to Brisbane, the first three 'professionals' that I went to, really put me off, for different reasons.

So, I gave up on that.In the last three years, I have been doing this by myself, and some days Im clearly not coping.

Im moving to Melbourne early next year, so I will definitely seek out the best and right support.

If you could please send through more on the 'specific therapies', as youve mentioned, I would really appreciate that!.

Oddly, I have good friends, but I dont like to burden them with all 'my' stuff, and so I have become very isolated, of late.

I function very well, most days, as mentioned.

I run my own company, and keep my HFA brain as active as I can.

Otherwise the down time...does my head in literally!

But, as I have gotten older, I have accepted that I just cant avoid or deny that on some days, I just dont cope AT ALL.

I know that this is probably true for many of us here on these forums.

And, on those days...I can do disruptive and even destructive things to myself.

Im feel ashamed to tell this to my psych back in Cairns, because, I know that she does actually care...I used to call her, but I stopped doing that because I dont want to worry her.

I agree re: marijuana.

And, I have in the last few weeks, consciously smoked much less.

Thats big for me Doc!

Its like I had to 'admit' that this is an issue, so I could see it for myself, to then do something about it!.

I also believe that a huge part of this is self-esteem.

I am a man of many talents and achievements - A polymath in fact.

But yet, I still hear voices from my childhood telling me that I am useless, and worthless, and should never have been born.

I go from being highly capable, happy and free, in one moment...to misanthropic and moody.

I have actually started a thread on BB about limiting beliefs, sharing what I have learned, and learning from others.

I will check out the resources you mention.

I will take this to a GP.

My name means 'warrior' Doc, I will not give up on this!

Im learning to fight the good fight.

Thanks again, Dr Kim.

I really do appreciate you taking the time to respond.

Trust is a biggie for me, and I will trust in your wisdom and knowledge.

Be well.

MuchLove.​​

[Karen003]

Hi there. I am interested in using the Sinclair method for healing from alcohol addiction. My GP is not trained in this area snd has suggested I contact you for specific advice regarding who/what/where may be able to offer support to me to pursue this method.

[Sophie_M]

Hi Karen003, we can't offer advice on finding a health practitioner here on the forums. Please give our support service a call on 1300 22 4636.

[Skitsospice]

Hi,

My husband touches me and takes photos of me while I'm sleeping. He knows it's wrong and that I don't concent. He does not do it all the time, there are often large gaps where it's fine and then sometimes clusters where it keeps happening. As a result I have found myself not able to sleep (wondering if he will do it tonight), also I have bad dreams about it, if a bright light flashes in my face (like the flash from his phone) I get flashbacks and get scared. I've started to not care about myself or my work. I just want to sleep.

It recently dawned on me that this could be PTSD?? Could it be if the trauma is still ongoing? Is it something else? What can I do about it, I feel like even if he stops it will always be there now.

Yes I have tried to leave but I want it to work out and he is so apologetic but this area is not really where I'm seeking advice.

[Dr_Kim]

Thank you so much so writing to me and trusting me with your story. I am going to state really clearly that it’s NOT OK that someone touches you for their gratification without your consent. Its no wonder you feel upset . This is a violation of your person and of your rights. There are not many issues that I am black and white about, but this is one of them.

His apologies are not enough. Its like if a guy hits a woman and then says sorry, is that ok? In my books, no. He needs to take action to manage his anger and impulse control so he doesn’t hit again. Saying sorry is not a good enough restorative action here.

So, if you plan to stay with your husband , I would suggest that HE needs to acknowledge that he has a sexual fetish that is unacceptable to you and that he needs to seek help to address it. That he continues to violate you and then apologises after is NOT an option for an ongoing relationship. I would insist that he seeks counselling and that you also seek couples counselling in order to regain trust in the relationship.

Now, to you. I feel like you are developing an understandable, unfair & problematic response to your abuse. A part of you wants to be on alert to make sure it doesn’t happen - thats the “ I’m scared” part .. the part that is scanning around you checking for danger, staying awake to check that you are going to be safe… but this is tiring you out and I guess eventually you "just want to sleep”.

Its really important that you take measures to address this violation / abuse as it is destructive for you and your sense of self worth - “I’ve started not to care about myself” . Those who are abused will sadly often come away with a feeling of somehow feeling bad about themselves even though they are not at fault.

I urge you to find the help YOU need to prevent this happening to you. Call 1800RESPECT or http://www.sass.org.au/directory/ to find help or see your GP to get advise on support.

Your gut is right ! This is not OK. Now is the time to plan a way forward.

[Guest_1055]

Hello Dr Kim

I just wanted to know about the connection between mental and emotional issues, such has depression, anger, mild anxiety and thyroid issues. I think I may have some sort of thyroid problem either hyperthyroidism or hypothyroidism, as I have many of the symptoms of both. Including a lump on the side of my neck. I have an appointment next week with GP. But I just wanted to know your thoughts here.

Thank you ever so much

Shell xx

[K808]

Hi Doc,

I've had anxiety and depression for almost 2 years now after being sexually harnessed at work (along with the general stress of adulthood).

I've seen a GP many times and did 6 sessions of therapy but never found it very helpful. I haven't spoken to a GP or therapist since early this year and have been silently struggling through list.

I've been feeling in the last few weeks that I am not coping and have considered checking myself into hospital for a break from reality but there's that little voice in my head telling me that I'm not sick enough for that. I am also worried about finances if I'm in hospital away from work and not having much sick leave left. Even though it happened/happens at work, to my knowledge, my boss at the time didn't record the issue.

I have dreams about being grabbed and wake myself up punching the wall above my bed.

I don't react well to many general medications. I was just wondering what my options are for improvement, short term and long term?

I'm sick of being scared to visit family and friends and being able to go down town shopping

[Dr_Kim]

Shelley anne said:

Hello Dr Kim

I just wanted to know about the connection between mental and emotional issues, such has depression, anger, mild anxiety and thyroid issues. I think I may have some sort of thyroid problem either hyperthyroidism or hypothyroidism, as I have many of the symptoms of both. Including a lump on the side of my neck. I have an appointment next week with GP. But I just wanted to know your thoughts here.

Thank you ever so much

Shell xx

Hi Shell, there is a definite link between what happens in the body and our mood. A good example is PMT or PND where hormones in the body can contribute to emotional lability or even depression. Your thyroid hormones have been implicated in mood too. Too much and some people can feel jittery and anxious, not enough and some can feel really exhausted, unmotivated and somewhat low.

The good news with thyroid is that the levels can be easily assessed with a blood test and the lump in your neck can be sorted out pretty easily with a few simple scans too if necessary. If you are either high or low in your levels there are medications to help with that.

Good luck and good move to go your GP to sort to out.

[Dr_Kim]

K808 said:

Hi Doc,

I've had anxiety and depression for almost 2 years now after being sexually harnessed at work (along with the general stress of adulthood).

Hi there, I am glad you wrote in as I think it is certainly time to do SOMETHING.. So have a plan.

If you are averse to medications , I suggest going down the “lifestyle” route to better health. Now that is harder in some ways as it entails you pushing yourself daily, but you do avoid the potential side effects of medications.

My list includes things like 
- Exercise. Studies keep showing that regular ( 3 /wk or more ) exercise is excellent for mental health - both depression and anxiety. So iSuggest start walking , or going to the gym , or biking or swimming… whatever you feel you can persist with .
-Eat well. Avoid highly processed foods and eat a healthy three times a day. Avoid long periods of not eating or excessive eating. Eat when hungry and stop eating when full i.e. eat mindfully ( oh and minimise the baddies like alcohol etc) 
- sleep well . Make sure you are going to bed and waking up at reasonable hours. If you are staying up a lot through the night and sleeping in .. it can be bad for your mental health. If you need help with this , look up “sleep hygiene” in your search engine for results
- Mindfulness practice. this is a huge one. If you can access to a good group like http://www.openground.com.au , great. But otherwise, one can also find other community groups , or even practise via an app. One like Smiling Mind or Headspace .
- having purpose . this one is a bit of a “roll your eyes” moment for many of my patients , but studies have shown that those who have something to do each day, especially if it is in the arena of volunteering or doing good for others , feel better! Sitting around without anything to do can feel like a relief in the short term , but isn’t real healthy for your mind in the longer term.

It is really important that you also do a bit of “cognitive” work . In that I mean understanding your responses , like your fear responses and avoidance so you can mange them better. Do this with a therapist ( try another if you have to ) or start with a good book . I recommend “Change Your Thinking” by Sarah Edelman .

Good Luck and  get busy on your “getting better” programme.  If you do have to resort to a trial of medication, don’t see it as a failure , just anther step on the journey.