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]

Crazy train said:

Hello Dr Kim, I am a 36 year old male and have developed a severe fixation, severe depression, I have a bad drug addiction (weed approx. over 100 cones a day)...

Hi there,

I am so glad you wrote in , but I fear you won’t like the answer as it's not easy . You are completely right when you say that you need help. You are smoking WAY TOO MUCH. Your brain is starting to not cope .. and I think you are at  risk of a psychotic episode. The voices may be the beginning of this.

I also note that you have suicidal thoughts and these can be very dangerous. Please make sure you have  a friend or family member with you, ring a suicide help line (https://www.beyondblue.org.au/the-facts/suicide-prevention/get-support-now) or go to an Emergency department if these thoughts are too overwhelming and you  are not safe.

I urge you to get help as quickly as possible in a supported drug rehab service. Ask your GP to guide you here. If you don't feel you can do this alone, ask a family member or friend to come with you. Print this response out and take it with you if it helps . Most inpatient programmes are 1-2 weeks but the recovery is actually much longer - meaning you have to work at it for 3, 6 or even 12 months as an outpatient to really make it effective.

OK . Next question I think you have is that you are concerned about the rehab and that it is going to be hard. Like will you get angry? Yeah! Probably , but if you think that you will be the first pissed off angry person in rehab, you are mistaken . Of course it will be hard but the staff have seen it all before and will help to guide you through it. Your life now sounds pretty awful, so I think it is worth putting in the effort of taking the risk of feeling angry and physically unwell for a couple of weeks in order to change it. The worst of the withdrawal is over relatively quickly 1-2 weeks .. however, lets be honest , the road to recovery where your brain doesn’t crave the old drug habit .. now that can take months! 

Old entrenched habits are hard to break but not impossible. Think about stopping smoking. It can takes months and months before the urge to light up stops flooding you. 

The good news is that medicine has come a long way in its understanding of addictions and doctors in the area can help to smooth things for you if you work in partnership with them and work really hard to stay on the programmes.

So, please please get yourself into a rehab programme as soon as you can. It isn’t fun , but it could be the beginning of a new start for you. I think you might have just taken your first step along the path to getting better just by posting here ! So good on you!
 

[Dr_Kim]

Just Sara said:

Hi Dr Kim;

Around 3 months ago I managed to finally stop anxiety/panic in its tracks, but this was replaced with depression. As I've said above, I've returned from hospital feeling confident and well.

Hi Sara

I am so pleased to hear that you are doing better after your admission to hospital. It is really heartening and inspiring to others to hear that you have “ stop anxiety in its tracks” after such a long battle . So good for you! It is not uncommon that depression lurks around alongside anxiety .. People can get depressed about the effects that anxiety has on their lives and people can get anxious about the effects that depression has on their lives . Also the neurochemical imbalance in the brain that causes them both is not that different .

There might be a number of reasons why your body is changing physically - the constant adrenaline/ cortisol, hormonal changes (I’m not sure of your age but I’m guessing you are at least in your 50’s and womens bodies definitely do change shape with hormonal changes of menopause ) , medications  or just ageing. Or sometimes we just have no idea.

In any case .. I would concentrate on wellbeing . It sounds as if you are doing pretty well in that arena . You are eating well and exercising and your total weight is not increasing . Your mental health is really great at the moment, so I would stand back and look holistically at the big picture and say that on the whole you are doing GREAT! If there is a shift in muscle / fat proportions … so be it. It may or may not have anything to do with whats happening in your mental health but I would just keep working on keeping fit - Keeping working on your cardiovascular fitness and muscle strength and eating healthy food most of the time and enjoying the peace of mind you have at the moment.

I hope this is reassuring and again I want to thank you for sharing your inspiring experience with us. Keep working at the depression with your health professionals … I hope that you have the same success with that as you have had with the anxiety . 
 

[Just Sara]

Thankyou Dr Kim for your response. I appreciate the encouragement and support. My thyroid's fine, so as you say, the change in my metabolism could be from a combination of causes. The same goes for treating this change too, there's many ways to support ongoing health, not just physical, but mentally too.

Sara

[FringeDweller]

Hi,Dr Kim

What therapies that focus more on feelings and emotions?

I've tried CBT, CPT, ACT, mindfulness, etc with little to no success, in fact they often brought up more confusion and emotions then they dealt with. Telling myself to think a certain way or word things a certain way doesn't seem to change my emotions and therefore doesn't change the feelings of depression and anxiety.

I've had a quick read of EFT (emotion focussed therapy) on wikipedia and it seems like an option to discuss with my current psychologist (or use it as a basis in finding a new psych). What other options are there?

When I've discussed with my current psych what hasn't worked or why I feel the current approach isn't working, she seems to get exasperated and starts asking me 'well, what do YOU want to do?'. I've explained that I don't know what will work or even what might work, I've tried everything I can think of hence why I've come to a psych for further assistance. So I thought this time if I come in with some ideas it might help.

[Weazel]

Hi Dr Kim,

I have recently been diagnosed with anxiety. My brother was killed in a car accident 10 months ago and my stepfather has stage 4 cancer. I carry a lot of stress in my life from my job, I'm studying at uni and I have 3 children. In the past I have been able to cope but in the last month I've hit a wall.

I've had an uncomfortable feeling in my throat for the last month which has caused issues with me eating. I've been to my GP multiple times, they've run blood tests, done an ultrasound on my thyroid and most recently have come back with that it's being caused by anxiety as all my test results are normal. Because of the uncomfortable feeling in my throat,it ranges from feeling like a lump at the top of my throat down to pressure around the base of throat where the little concave bit is. Anyway, because my throat feels uncomfortable, I can't eat. I have to psych myself up to it, I've never had issues with food before but now most days I'm surviving on toast and water. I'm concerned that the food that I eat will give me an allergic reaction despite having no allergies! I've lost about 5kg in the last month. My doctor has prescribed me some medication but I feel like I've failed myself by not being strong enough to cope with life so I can't take them.

I feel so trapped and held back by things and I feel like giving up. I have never had to fight with myself internally before. I know that my thoughts about food is irrational but even by knowing that, it doesn't change anything.

Anyway, I hope you can give me some advice that will help.

[Dr_Kim]

FringeDweller said:

Hi,Dr Kim

What therapies that focus more on feelings and emotions?

I can certainly understand your frustration.. however, studies have shown that there isn’t one particular mode of therapy that is better than any other. In fact, as long as the therapist is reputable and qualified, the thing that seems to be the most important factor is that you feel connected, supported and understood by them. 

So maybe, the thing to do is to continue to:
 
1. Work on your RELATIONSHIP with your therapist. Not in a creepy way!!  but I mean that you are honest with her about what you feel you have achieved / learnt / discovered in therapy and what symptoms still bother you. Work in partnership with her to help her to help you. You don't need to tell her what to do but it is great if you can give her feed back about how you feel. So you could give her an inventory of your emotional world and let her know how you are travelling inside. Then let her work out how to help you. Thats her job. 

Therapy is a long haul… it takes trust and a sense that the two of you can roll your sleeves up and tackle things together. Sometimes your combined work will bear fruit and sometimes it won’t, but at least you will have a partner and guide on your journey to feeling better . Hang in there and be honest but not directive.

2. Dont rely just on therapy to feel better. Therapy is one of 4 main areas that you need to work on in order to feel better from anxiety or depression . You also need to simultaneously be working on 

- lifestyle factors : Diet , exercise, sleep
- Mindfulness programmes
- good healthy daily routines
- Possible medications if your health professionals advise it.

I’m not saying that you shouldn't consider your options… and by all means explore things like group therapy or support groups or family therapy or even try another therapist ..however, bear in mind the first statement … Many large controlled studies have looked at the data and NOT found one type of therapy to be superior .. therapeutic success is in the relaionship you build.

[Dr_Kim]

Weazel said:

Hi Dr Kim,

I have recently been diagnosed with anxiety. My brother was killed in a car accident 10 months ago and my stepfather has stage 4 cancer. I carry a lot of stress in my life from my job, I'm studying at uni and I have 3 children. In the past I have been able to cope but in the last month I've hit a wall.

Hi and thank you for sharing your story with me. It reminds me again of the powerful connection between mind and body. It never ceases to amaze me how the body can help us to shine a light on things when our brains are being a bit slow to do it!

With you, I wonder if your inability to swallow is both literally and figuratively an inability to swallow…Both physically and emotionally .I think its hard to digest everything that has happened .

Its like both your mind and body have said “NO MORE!” I’m not swallowing ANY MORE! I’m full ! I am stressed to the max and I can’t take in anything else..

With everything that has happened in your life recently and everything that is on your plate day to day, it doesn't surprise me that you are feeling overwhelmed and have “hit a wall” . 

I think that the key to this is doing some work that allows you to unload some of the stress in your mind but also connect with your body and allow it to relax and “unblock”. I would start with a therapist, a great yoga / breathing / relaxation class and lots of Mindfulness . (I know you must be time poor with everything so maybe try the Headspace Mindfulness App in your smart phone ! )

Your GP did suggest medication . That might be necessary to allow you to relax enough to “ unblock” . If this is the case .. dont feel like a failure as it is a strong person who takes control and gets themselves back in shape whatever it takes! 

Anxiety isn’t rational which is why you can’t talk yourself out of it. You can “know” its irrational but still not be able to swallow. Please seek guidance for this as IT IS treatable. It is important to look after yourself so you can look after everyone around you too. 

[DesperateForChange]

Hi Dr Kim.

I have been previously diagnosed with obsessive compulsive personality disorder (OCPD) and clinical perfectionism. I struggle a great great deal with making decisions and often resort to copious and excessive amounts of research, deliberation and eventually avoid making a choice altogether. I seem to be extremely fearful of making the wrong choice, and this caused me to be paralysed and dysfunctional in so many areas of my life. I'm not confident that a generalist psychologist will know how to treat this. Unfortunately, when I use search engines like the Australian Psychological Society, there is no search parameter or filter for OCPD or clinical perfectionism. My questions to you are:-

1. How can I go about finding a therapist for these specific issues? Directories are so hit-or-miss....and this is compounded by the fact that I can't even narrow my search results by my presenting issue.

2. Can what I have be considered a specific phobia? This is an important question, because it determines whether I seek exposure treatment (which is typically effective for phobias)

Thanks in advance

[Kate2]

Hi Dr Kim,

I am at high school age and I think I may have anxiety. Some symptoms I have include:

- having fits of hysterical crying, particularly at night or when I'm tired, and feeling hopeless or like I don't know what to do anymore.

- when thinking about a task I get a feeling of deep dread that makes me really stressed.

- Being very stressed multiple times a day.

- Noticing that during these 'fits' if you will, I recognise that I shouldn't be worrying, but continue with the fit

I was wondering if you could help me distinguish if I have anxiety, or whether I'm not coping with my stress very well.

Thanks,

Kate

[geoff]

hi Kate, I'm not sure whether Dr.Kim is working over this long week end, but can I suggest you google 'difference between stress and anxiety and depression', this maybe able to help you with your question or until Dr.Kim gets back. Geoff.