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]

gld said:

Hi Dr Kim,

My husband has had an episode and is currently taking lithium, antipsychotic, suboxone and a another unrelated health drug.

Hi Gen , I can certainly see why you would be concerned about this behaviour . It is definitely not ok and I would check your concerns with his doctors. Are the doses right ? Is he taking the right combination ? Is he taking any other medicines unbeknown to the prescribing doctor (or to you) ? Is he using alcohol or other drugs of addiction? Is there a new medical issue brewing?

There are certainly concerns that need to be reviewed by someone medically trained and who has your husbands medical history.

Good luck and good on you for seeking assistance with this.

[gld]

Hi Dr Kim,

Thanks for reply to my post.

I did go to my Dr who knows my husband as he has been under her treatment. After i explained what has been going on she did not hesitate making an appointment for him with his Dr the next day and i went with him to his appointment. His Dr is getting him to take full blood test which we are going to do first thing Monday as i can not take any more time off work [one car and have to make sure he follows instructions before blood test]. The tests are checking lithium levels/ other drugs, blood sugar and other things.

I feel glad i did go as it has calmed me down somewhat. Just is difficult as he just has not been the same after the incident earlier last year because of his forgetfulness. His health issues are complexed with no sight of a resolution at present and some we need to adapt too.

He seems to follow the Dr's instructions.

Gen

[lightworker17]

My anxieties are 100% due to my Manager and work stressors which is why I have had concerns about the EAP. The Organisation does promotes use of EAP etc. and good mental health of their staff etc. Like a lot of employers what they say and what they do are two very different things. I now feel at a stage where I don't care if my employers know whether I have been or not. I will try the EAP and see if this helps. Thank you for your help.

[Jessi98]

Hi I'm a 18 year old that recently finished high school and came back from a holiday fromAmerica. I have had major anxiety and anxiety attacks in the past but ever since I can back from America I've had major panic attack each day where I can't breathe and I have screaming attacks where I end up crying. I've been have anxiety attacks about dying. I know we will all die one day but everyday I wake up thinking about it and getting super anxious to the point of a anxiety attack due to not wanting to die. I feel on edge all day and it's stopping me from doing activities. If I don't do anything at all my mind slides back to it and it starts all over again.

I was wondering what you suggest as a treatment or things I could do at home to train my brain to not think about it or to calm down when I have a panic attack. Any advice will be helpful.

[Ashley2]

I'll try to make it short. I'm 17 yrs old and have been dealing with depression for roughly 2-3 years. Lately I have been quite happy with myself and my life.

A couple days ago I found out that my girlfriend had cheated on me for a couple weeks. After I found out I broke up with her but I have been unable to cry even though I feel really sad and angry. I'm confused as to why I can't let out my emotions and instead become distant to friends and family.

Please help me to find out why.

[jellydog]

my hubby is having ect , he has just had his 5th one, he has become so paranoid and full of guilt and anxiety even about things that happened 30 years ago. he feels it has made him worse, has anyone else experienced this after ect. I thought ect stopped negative thoughts. he wasn't like this before he had it

[Dean_L]

Hi everyone

My wife suffers from PTSD caused by a traumatic first marriage. I also have come out of a marriage where yelling and screaming was a normal daily thing.

We are mostly in a good space but when we have a fight, all hell breaks loose. It doesn't matter the content of the argument, as soon as I change my tone or show frustration, she falls into a deep PTSD cycle.

I am not doing a very good job at all...I do my best...She has lost trust with me and her emotions

I would love some guidance.

[Dr_Kim]

Jessi98 said:

Hi I'm a 18 year old that recently finished high school and came back from a holiday fromAmerica. I have had major anxiety and anxiety attacks in the past but ever since I can back from America I've had major panic attack each day where I can't breathe and I have screaming attacks where I end up crying. I've been have anxiety attacks about dying. I know we will all die one day but everyday I wake up thinking about it and getting super anxious to the point of a anxiety attack due to not wanting to die. I feel on edge all day and it's stopping me from doing activities. If I don't do anything at all my mind slides back to it and it starts all over again.

I was wondering what you suggest as a treatment or things I could do at home to train my brain to not think about it or to calm down when I have a panic attack. Any advice will be helpful.

It does sound like you are having classic, intense and distressing panic attacks. That is awful for you, but the good news is that there are plenty of people who have walked this path before you and have been successfully treated.

Firstly let me briefly explain whats going on

There is a primitive or reptilian brain (your amygdala) that sits on top of your spinal cord deep in your brain. It controls the “fight , flight or freeze” reflex that we have as a response to perception of danger . This was a very handy evolutionary responce when we were cave men as it allowed us to very quickly respond to predictors and not get eaten!! 

 Over riding that is our thinking brain or  mammalian brain (the cortex ). This part of your brain has all the filing cabinets in it with information about making sense of the world around us and deciding how to act . So if we hear a noise outside and use our cortex we can “ think “ about whether it is really a sabre tooth tiger, or just wind in the trees…( probably the latter given those tiger are now extinct!!) . 

Guess where your responce is coming from ? I think you are totally responding to what your amygdala has perceived is a threat . And your amygdala is super jumpy at the moment , seeing imaginary threats everywhere and going into going into adrenaline pumping flight mode.  Is it rational ? No! Does the Amygdala care ? No! the Amygdala is doing its job . It is protecting you !!! However, your cortex , later can see that is “ got it wrong” which is why you are writing to us and trying to stop the process.

So the treatment begins with you understanding your brain and body better. Look at Beyond Blue or SANE websites for more info on Panic disorder .
the 4 forms of therapy are 
1. lifestyle - better exercise, eating , sleep
2. Mindfulness programmes ( Apps e.g. Headspace or Smiling Mind ) or a programme ( e.g. Open Ground)
3. Therapy - ask your GP for a referral
4. Medication - via your GP

Some people need all four to control their symptoms. i suggest you get to a GP to help guide you through this.

[Dr_Kim]

Ashley2 said:

I'll try to make it short. I'm 17 yrs old and have been dealing with depression for roughly 2-3 years. Lately I have been quite happy with myself and my life.

A couple days ago I found out that my girlfriend had cheated on me for a couple weeks. After I found out I broke up with her but I have been unable to cry even though I feel really sad and angry. I'm confused as to why I can't let out my emotions and instead become distant to friends and family.

Please help me to find out why.

There are no rules about how you “should” express grief or loss (except that you shouldn't harm others) . There is no rule that says that you must cry in order to “ release” the pain or the anger etc. 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 your self and just to notice and not to judge whatever is happening to you. So that if at this stage you are a bit distant and shut down , 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 this betrayal and the loss without having to feel like to have to do it in a certain way.
If you feel like your day to day functioning is starting to be affected though, then I would maybe check in with your GP or Counsellor 
Also , try listening to an APP like Headspace just to help you with the Mindfulness stuff .

[Dr_Kim]

jellydog said:my hubby is having ect , he has just had his 5th one, he has become so paranoid and full of guilt and anxiety even about things that happened 30 years ago. he feels it has made him worse, has anyone else experienced this after ect. I thought ect stopped negative thoughts. he wasn't like this before he had it

ECT is thought to be a helpful treatment for many people with severe and drug resistant depression. I am not an expert in this, but my understanding is that it can have some cognitive after effects. The main one that I have heard people relate to me is the memory loss. I am a bit unsure about his reaction and i would definitely bring your concerns to his treating psychiatrist. He or she may not speak to you alone, but go together as a couple and talk it through.