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]

Moonstruck said:

Dear Dr Kim

I don't think you can help me with this, nor if I can explain it properly. I seem to have a problem with "over thinking, at times leaning towards these thoughts becoming a bit paranoid".

Hi Moonstruck

You are being hoodwinked by your anxiety into believing that its messages to you are “real’, the “truth”. But seriously, many of our thoughts and feelings deserve to go into the garbage ! Just because to think it doesn’t make it real.
 
The job of your centred, mindful brain ( or your pre- frontal cortex) is to sort out on the conveyor belt of thoughts and feelings, which ones are keepers and which ones go to trash. I can see from your post that you suspect that your own “sorting centre” might be getting it wrong at times. That instead of sending the “bad scenarios" into trash, you are keeping them as “real”.
 
The thing is when people have anxious thoughts (which I think you do) the anxiety centre in our brain just keeps pumping out all this stuff that winds us up. It makes us feel panicky and upset as if we are in danger or something bad is going to happen or we are going to make a bad choice or we might regret things. ( This is your anxious brain :"imagining clearly in my mind possible bad negative scenarios, the dialogue that goes on, the scenes taking place - all imaginary.” )
 
So, you don't have “ paranoid over thinking “ , you have anxiety. 
There are many different approaches to anxiety management -  there is Mindfulness meditation , CBT, ACT, psychotherapy, medications and of course .. lets not forget my beloved life style factors ( exercise, eating well and sleep)
 
There are great self help books around,( Change Your Thinking by Sarah Edelman is a great start) and you can also see your GP to get a referral to a counsellor who can help you get the skills to be able to sort out those thoughts on the conveyor belt a whole lot more effectively.
 

[Dr_Kim]

Morethanmoonandstars said:

Hi Dr Kim,

I'm a 50 something y/o woman and have been depressed most of my life.

Hi, your post is so full of both gritted determination AND hopelessness and exhaustion , that I don't know whether to give you a cheer for everything you have done so far or sit down and cry with you for everything you still need to do. And I think maybe the answer is BOTH.

You have done so well.. you have come so far. You have battled this demon for years and years and come at it from every side. I feel for you. I really do and I think that it would sound flippant to give someone with that much experience some advice in a few lines and think it's going to “hit the mark”.

However, I think that there is something to be said for not doing the hard yards alone. The image that comes to mind is when marathon runners are trying to dig deep and find some resources to finish there race, push through pain and keep going , they say that having people standing on the sidelines encouraging them helps so much. The people don't come on the track and actually push them along, but just the helpful words of support make all the difference. 

So, my thought is that maybe you might get some value from finding some sort of community that can do a bit of support from the sidelines. Now you say that you don't have family or friends or hobbies or interests. I wonder if you might be able to find some relief  by revisiting this belief about yourself, that you are “fiercely independent” .. and be less so.

Find a support group, or at least some sort of supportive community that might be of value to you.

If you literally have no idea where to start on this - try a church group or a community support group . If you have no idea where to start on this, ring the Beyond Blue Help line to discuss how to make a start in this arena. 1300 22 4636

We might all need to take a look at the way we see ourselves at times and see if we can’t come up with a picture that is somehow more helpful than the one we are keeping in our minds eye.

[Dr_Kim]

tiahleighj said:

hey dr kim,

will do my best to keep it short. I am needing some assistance.

Hi , 

I am not sure if you are trying to support someone else or you are worried about your own mental health.

When supporting someone else , I think it is best not to take the responsibility to make those decisions for them or about them when something serious like suicidal ideation is involved. I think it would be best to get them seen by a GP or an Emergency Department . If they won’t go and you are really concerned you can get a CAT team to assess someone in their home by calling your closest Emergency Department and asking about that service.

If you are wondering about yourself and if an admission to hospital may help your depression and suicidal ideation, again I think that is a really hard question to answer without knowing more about your history and circumstances. However, i think you should definitely seek some opinions about this from a trusted health professional - your GP, your therapist , a psychiatrist, an Emergency Department, or a CAT team .

It is really hard to assess yourself and decide on the best course of own treatment when you are in the depths of depression ( partly because severe depression can affect cognition , motivation, concentration, rational thinking etc). So best to collaborate with mental health experts about this.

Good luck and get help/ assessed ASAP!

[ChLiv]

I will try and be as brief as possible but I'm not really sure how to put this all in words.

I haven't been to a psychiatrist in a while because I felt that it was doing more harm than good but right now I'm so confused about what I'm feeling. Since leaving my hometown, my boyfriend and I agreed to do long distance. It has been 4 months since we've seen each other and will be another 4 before i see him again. We called the past two days but when i see him on video, i feel anxiety. I had separation anxiety as a kid so i know what it feels like. I feel so afraid that I'm falling out of love with him. And when he tried to be sexual, I felt ill and just wanted to curl up and cry. I ended up hiding my face so he didn't notice. He hasn't changed and is still very sweet but for some reason I get the feeling that I don't even know him. I don't want him to know that I feel this way because I know he will think he's hurting me but he isn't. I have no idea what brought this on and I really need your help to cope. I feel okay when I message him but as soon as i see his face i feel so ill. Please help me. I love him so much and I don't want to hurt anymore people in my life. I really can't keep going like this.

[Pdf]

Hi Dr. Kim

I got married in dec 2015. My husband is being very supportive. My husband's aunty she keep taunting me, whenever i meet her she keeps me stuff that I haven't done. She keeps saying stuff to my hisband as well. she always insults me and my husband in fornt of others. She keeps saying us that you are poor and my kids are best. But infront of her husband (husbands uncle) she pretends that she is nice to us. So many things had happened i feel so depressed about whats being happening. Last year me and my husband went to natural path and she said that i am suffering from high levels of anxiety. I took medication ( multivitamins for stress relief) for some time and then i stopped taking. From last two weeks i am feeling so depressed, my mood is always low, crying all the time. 4 days ago my husband asks me to go and visit him uncle. I already told him that i am not good. I am not going to their place. I cried so much that day that I didn't wanna go to their place. My husband uncle, he keep interfering in our life. That day we went there i was so quiet as usual when i visit them. My husbands aunty keeps showing that her kids are doing better and treated us like we are nothing. I was already so depressed i had fight with my husband,s uncle. Then, after two days my husband said you shoul say sorry to him because he is our elder. I said him sorry over the phone and he said that its all my fault. His wife haven't done anything wrong. I was the one who made stories. After that he said that is gonna this thing to my family and also threaten me if you raised you voice next time i will show my power what i am. My husband is being supportive through my suffering. He also suffered with me. My husband's aunty treated him like how she treats me. His uncle is keep saying me that i am responsible for all this problem. I am also having suicidal thought. I am so depressed all the time. no one is trying to understand what i am going through. He blamed me for everything. Now my husband also realised that he is protecting his wife and blaming me.

[reeg01]

hi Dr Kim

i am 16 and scared, i don't know what to do. It always feels like i'm letting someone down. i have not been diagnosed with depression or anxiety, but i often feel as though the world is crumbling around me. it feels like i do everything wrong, i haven't told my family because i feel as though it is my problem and that telling family will only make things worse. i often just feel sad and down on myself and i don't understand why. My boyfriend and a few of my friends know, but i feel like they don't really understand :((

i don't know what to do.

[Tilly1357]

I just wanted to see everyone's thoughts on why I might be feeling like this...

I'm not sleeping great, I always feel sick or overweight (I'm average weight) and I just cry all the time.. like my life is great but the way I feel about myself is horrible, honestly I just hate the way I am

though I'm in a 2 year committed relationship my parents are happily together so I don't think the problem lies there. I think it's with me... any ideas?

[Dr_Kim]

ChLiv said:

I will try and be as brief as possible but I'm not really sure how to put this all in words.

I am so glad you opened up to me, but even more so i am so glad that you were open and honest with yourself. 

You need to be curious about these feeing that are coming up for you, you need to scratch your head and wonder about them .. because they are on the surface of things incongruent . You love him in some parts of your head and heart .. but you are repelled in other parts. I am wondering if possibly , just possibly , he is inadvertadly triggering something from your past . You may very well be rejecting some old feeling or situation from your past that you dont want to experience again … and that is a totally understandable and important protection mechanism .. but also one that may need to be understood better by you so that fierce protective side doesn’t “overdo” it and extend into places its not welcome , like your current loving relationship.

It may be time to revisit a therapist and explore these or other possibilities if you can’t get your head around your responses on your own . But whatever you do ,  do not try to just shove them into a bottom drawer somewhere and pretend like they aren’t there as that is unlikely you work out in the long run. the responses are too powerful. 
 

[Dr_Kim]

Pdf said:

Hi Dr. Kim

I got married in dec 2015. My husband is being very supportive. My husband's aunty she keep taunting me, whenever i meet her she keeps me stuff that I haven't done. 

I am so glad you are trying to find a way out of this and have written to us. I am wondering if possibly you and /or your husband come from a cultural group where the way one treats or is treated by family is understood through that lens.

What I mean is, that different cultures have different ideas about what is considered rude for example and what is considered “the right thing” to do.

So I want to be both respectful of any cultural norms that may exist in your community, but I am not at all apologetic in standing up for the need for you to be respected as a person no matter who you are. Here in this community I believe that we can only be happy if we feel that we have been valued ,heard and respected, that doesn’t mean we always get our way, but it does mean that we have been at least considered and treated kindly.

This applies to everyone - men, women , young, old , gay, straight, able bodied , disabled, Christian , Muslim ,Jew , or whatever !

So.. back to you and your dilemma with your husband's uncle and aunt who seem to be treating you with disrespect .

I feel the first place to start is with your husband. You say that he is supportive. You say that also gets bullied by them . I wonder if it is time for the two of you to sit down and think about putting some boundaries around yourselves so that this bullying does not continue.

It may mean that your husband confronts his dilemma with his family first. He may need to look at why he has permitted them to treat HIM is such a poor way and now why is he allowing them to treat his wife in such a poor way ? What is he fearful of by standing up to them ? Is it his culture that prevents it ? Or is it his personality ? Or is it his fears of rejection ? Or is it past trauma that has led him to feel that it is too frightening to assert ones own needs?

I wonder if both of you need support each other first to work out these things and then together build some firm boundaries around things that are ok and things are not ok for people to say to you.

Talk about how to protect each other .. What to do if people cross the boundaries, remember , that you may not change people but you don't have to be near them if they are being cruel . You have the right to leave , hand in hand .

If you need some more help , maybe see your GP for a referral to a psychologist to help you out . 

[Peace_Seeker]

Hi Dr Kim
I've been diagnosed cPTSD and PTSD from multiple traumas as an adult. Any depressive or anxiety Period in my life has always been preceded by a significantly stressful event. By 2015 i had a toolbox full of coping strategies and positive lifestyle changes and I came of all meds and felt better than I ever have in my life. Eventually not even needing therapy. However for the last 5-6 weeks now I have relapsed into incredibly overwhelming anxiety and panic attacks. My tools don't seem to be touching this. I am now back to weekly therapy and just started back on Meds today. There was no obvious triggering event this time. The only real change I can determine is that I became vego in December. I eat almost an entirely vege based diet. But I do eat eggs daily. I'm quite health conscious and did my research. I'm careful to eat enough/balanced macro and micro nutrients from whole foods with a couple of supplements thrown in. My question to you is... do you think ceasing all meat could be the trigger for this most recent downturn? My thoughts are that this may be the case. Logically, as humans evolved the higher parts of the brain, meat was an important part of the diet. I'm someone genetically predisposed to anxiety and having also had brain changes from trauma. Perhaps that newly evolved part of my brain is already struggling to function without taking away (how good is hindsight) important combos of nutrients that are only available in meat.What do you think?