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]

Dean L said:

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.

The good news here is that you both recognise that you are BOTH bring things into this cauldron that is causing it to bubble over.
That is a good thing because if both of you can take some responsibility for the problem, then both of you can take some responsibility for the solution too.

I highly recommend that you see couples counselling to guide you through the maze of this one. You may need individual work too (her for PTSD , you for learning better skills at managing your communication) but I think often this can be done all together in couples work . 

If you are reading book type people there are some great marriage manuals out there but i think they work better AFTER having face to face counselling- e.g. Harriet Lerner “Marriage Rules” or Jon Gottman “The Seven Principles for Making Marriage Work”.

Get a referral from your GP or look up marriage guidance services in your state/ territory (Eg the Relationships Australia network). 
PS Dont Delay !
 

[Rockstar]

Hi Dr Kim I have a question about medication I have tried several for my depression I was on one and the Psychiatrist told me to increase the dose it didn't really do much just made me drowsy in the afternoon. He said next try another so I have been on it for 3 days and feel worse extremely tired and drowsy should I give it more time to work? Sick of these medications they seem to do more harm than good

Thanks Matthew

[missbeckz]

Hi dr. Kim

i will try and be brief.

I am seeing a new psychologist for my anxiety.

After two sessions she came to the conclusion that I have a controlling mother in law and my partner does not put me as a priority in his life (she hasn't met him or had him participate in any sessions).

Her conclusions were partly spot on especially about the mother in law, and she was correct in saying this is where some of anxiety stems from. I was happy we figured out where some of anxiety stems from...now to work on strategies.

We didn't work on any strategies. She told me I have two options...stay in the relationship, suck it up and watch my mental health decline further....or end the relationship to save my mental health.

as you can imagine I was in shock. I never thought to end my relationship. I'm happy and I love him. I argued with her and justified that I love my partner and want to fix things. But hearing my mental health will improve if I let go was too good to hear.

when I left the session I was hysterical. I stayed at my parents that night. They said my psychologist was putting things in my mind and days before seeing her I was perfectly fine mentally. I had a huge meltdown where I hit myself, ripped my hair out and threatened to hurt myself. I haven't had a meltdown like this in 5 years.

i guess my question is....can psychologists tell someone to end their relationship? Only after two sessions, without hearing more about my life and relationship and without hearing my partners side of the story.

my partner and I spoke about everything. Things are good but what my psychologist said is still playing on repeat in my mind.

any advice would be greatly appreciated.

[Sophie_M]

Hi Rockstar, as explained at the start of this thread, Dr Kim cannot provide advice on medications. Please consult your psychiatrist with any concerns you have.

[Dr_Kim]

Hi Missbeckz,

This is a really tough one as it is so hard to know what motivated your psychologist to say those things to you in such a dogmatic way and why she felt she had enough rapport with you to say suggest such an enormous step. 

There are occasions where therapists or doctors will make a big call like that in a short space of time - I’m thinking of situations where you think someone is at risk, but I agree with you that even if she did think this, she clearly hadn’t invested enough time in the relationship with you to understand how difficult it would be for you to hear such a thing. 

I feel terrible for you that you had such a hard time recovering from the shock.

Now lets process where to go from here … What can you learn from this experience ? What can you take away that is valuable for you? What can you use to help you to feel better in the future?

I suggest 2 things

1. You said you went seeking help with Anxiety. I suggest that is what you start with. Really get a good handle on managing anxiety and being able to notice, understand and regulate your internal emotional world better. You can do this with a range of things . Starting with lifestyle factors - exercise , diet , sleep and daily meditation apps ( Headspace or Smiling Mind). If you have time, money and live in town ,a group anxiety regulation programme like Open Ground might even be valuable. I feel this it important to for you to learn to manage really tough emotional states without self harm and melt downs.

You can also try a good book called “Change Your Thinking” by Sarah Edelman if you can’t get to programmes.

2. Then I suggest you tackle the underlying issues again, once feeling calmer and more able to weather emotional storms. Meaning ,It may be worthwhile to look at why the statement that the psychologist said hit you so hard and why it repeats in your mind . 
Is there some iota of truth in what she said that made you upset or was it that it was a load of rubbish and it upset you because its a pattern in your life that people have often told you what you think instead of asking you what you think and you're sick of it!

I really don’t know as I don’t know you… but once you feel calmer, more in control of your emotions … that would be the time to lift the lid on the tougher issues. 

Ask your GP for another referral and make sure you explain what happened and that you need someone who is going to GO SLOW and work collaboratively with you.

Good luck on your journey and I feel happy that you have your husband and parents around you on the journey.

[JSMNE]

Hi Dr Kim, I am new here. My partner has just been diagnosed with depression. He took himself to the Dr on his own accord. For the last 2 years I have noticed a change in him, which I didn't associate with depression and always blamed myself for the way he was / treated me and lashed out at him for being distant, tired, lacking enthusiasm and what to me appeared laziness. I fear that I have made things worse by my own behaviour from not understanding over the last 2 years.

He works FIFO and when he is away he is even more distant, staying up late with his friends and then will briefly talk to me before he goes to bed, usually just 1 word answers where I do all the talking and then says he's tired and is going. When he is home he keeps his room dark and barely goes out, and stays in bed all day while I'm at work.

He is now on antidepressants and has been for 3 weeks. He has now just old me he doesn't know how he feels or what he wants with anything anymore, including me. He doesn't talk about his depression for most of the time and when I ask how his day has been and how he's feeling he replies with "Fine." However, he then sent me screenshots of symptoms of depression in men and said he feels all of the symptoms except suicide, but this was over text and he won't say it in person. He no longer tells me he loves or misses me, or shows any affection, unless I say it first and he'll respond with 'you too'. He no longer hugs me and turns his back on me when we sleep..

He's a shell of the person he used to be, we were bestfriends and always seemed to be in a honeymoon period (we've been together 5 years) until about 2 years ago when I noticed the change. I've known him for 10 years, but I don't know how to support him or know if his behaviour is normal.

I want to support him as best as I can and get through it together.

Will he ever "recover" and get back to his normal self?

Depression runs in his family, grandmother (on mother side), father, uncle and brother.

[chachipaige]

Hi Dr Kim,

I'm new here and its for my husband that i joined.
he is 25 years old, working with his dad, surfer, eats healthy, good friends.

Basically i want to make sure I'm doing the right thing, and not treating it too lightly if its quiet serious.
My husband is a perfectionist, he has these episodes as well when (especially when a decision needs to be made) he can't cope and he's said before its like he can't think straight and gets so stressed. He'll take over tasks if he thinks he can do it better. He can be very emotionally disconnected when i need him the most (i had a break down and was telling him to stop talking with my hand over my ears on the floor in a ball and he kept at it..with no emotional thought to comfort me etc). People feel at times that they have to "tip toe" around him if he is in a bad mood. He doesn't seem like a happy person..laughs at times when watching tv or with friends but never really in day to day activities. Can get anxiety..but never (that i know of) has had an anxiety attack, very selfish and defensive.

I have spoken to him about it and how he scares me sometimes when he is so unapproachable, and he does recognise that he is like that.

i have just bought him the Swisse-mood tablets and i was thinking maybe we could try that for 3 months and see how he goes and if that makes him "normal" then maybe try a Dr in town because obviously there is an issue.

i was reading a little on OCPD..some of those symptoms are very close to my husband.
I'm just a little lost. i love him so much i just want him to be happy and content and not be so anxious about making the wrong decision.

i don't want to take away his dignity.

[Dr_Kim]

JSMNE said:

Hi Dr Kim, I am new here. My partner has just been diagnosed with depression.

You are rightly concerned about your husband and it does sound like he may be depressed which is quite prevalent in the FIFO community.

I suggest you look at info on how to support and understand a loved one with depression 
https://www.beyondblue.org.au/supporting-someone
Or 
https://www.sane.org/families-carers

Don't beat yourself up for not diagnosing his depression. You are his wife, not a health professional. However , acknowledging the misunderstanding now might feel validating to him. Tell him that from now on you plan to not on his side , not in his back!

You will need to make sure that you are in the very best head space to be able to support him as this may be a long haul. ( it can take 6-8 weeks for medication to kick in and some people's need to try many before they find one that helps )

So keep yourself healthy - exercise, eat well , rest , keep up social contacts , get family on board , get a counsellor if needed .
Be strong and positive so you can support him back to health with patience & with a whole lot of love and hope.

People do get better from depression. Make sure he has a great team around him - a good GP , therapist +/- psychiatrist. Offer to go with him and meet the team . 

Be with him on the journey but not responsible for him .
Your " old husband " is still in there but under a cloak of depression. Keep faith that with both of you working hard , you can lift that cloak and have that guy back again , albeit a little bruised maybe  from the experience.
 

[Dr_Kim]

chachipaige said:

Hi Dr Kim,

I'm new here and its for my husband that i joined.
he is 25 years old, working with his dad, surfer, eats healthy, good friends.

Basically i want to make sure I'm doing the right thing, and not treating it too lightly if its quiet serious.

Hi There,

Welcome to the forum and thankyou for your enquiries.

I think you are in a very common position. That sense that “something” is not ok with a loved one but not being sure what it is or if you are over reacting or being intrusive or controlling by asking him to seek help.

A few things come to mind:

1. I am not sure what is going on with your husband but I am concerned that you feel that he is unapproachable and that you don’t feel he an openly talk to you about your concerns and feelings. That must feel pretty lonely and hard for you. You are doing the right thing for YOU to not just put your head in the sand and hope it all goes away.

2. I wonder if he may have anxiety but is trying hard to not acknowledge it or manage it effectively. Why, I have no idea? I suggest you read up on Anxiety in the book “ Change Your Thinking “ by Sarah Edelman as it may hep you understand this condition and allow you to maybe explore this with him more confidently. 

3. You speak about him being emotionally disconnected . Is that most of the time ? Or only when he is very stressed ? There are many things that cause emotional disconnection and i certainly don’t have enough info to make a diagnosis for your husband , but it can be anything from personality style to mild Autism Spectrum Disorder, Depression to Severe Anxiety.. .. Really hard to say. Your GP or a therapist should be able to help with that. My hunch is that it part of the Anxiety .

4.You can’t make people change or be different if they don’t want to be . So if he point blank refuses to see that there is any issue with his behaviour , you then have to work on what you CAN control - namely , what YOU do. So you may decide to go to a counsellor yourself and work on strategies for living alongside him as he is , or lowering expectations or developing more compassion.. OR you may even decide that you need to place boundaries on some of his behaviours whether the likes it or not. In this way you are not colluding with him that there is NO problem .

I applaud you for not wanting to take away his dignity BUT in the process… don’t sacrifice your own !
 

[Jaz13]

Hi Moonstuck,

I believe it's well within your rights to see more then one Dr if the need is there for your health but not everyone is capable of being that honest with themselves so i do see the point of the Dr's saying you can become dependent, this can occur within 2 weeks of daily dosing so objectively you can see how Dr's might be reluctant to give out scripts when people are known to be depressed &/or Anxious.

I found myself in the same situation severe anxiety and stress i began to get migraines no longer then 3 days apart and i really couldn't imagine living that way for much longer. I had 3 failed attempts at seeing the GP, Hardest thing i had to do was tell the GP "Im not ok" i was shaking with fear with about a million thoughts racing through my mind and i couldn't get any of them to come out. Luckily GP was could see what was happening and tried to get me to talk more about it but i just told GP i literally can't talk about it right now, then gave a script to help me 'for now' but only gave me enough for a couple days. The GP asked that i return in 2 days, i thought more about never going back just so i didn't have to feel so uncomfortable again but then again i almost always feel uncomfortable.

So here i go thoughts looping around and around in my head as to why i should not and could not go back. Well I somehow committed to a promise i made myself and went back, (after all that supply was only for a couple days), Dr told me alright but i want you to see a psychologist (CBT treatment) to put it bluntly the Dr is fine to give me the script because i never ask more then what i should be taking and because I'm seeing the psychologist. It hasn't taken anything away from the anxiety but so far it has shown me a lot more about myself and i now see that not having a support network is a big deal. At times others would turn to loved ones, friends and family i turn into myself because that's all i know.

Don't wait for it to get worse, do what you can with what you have to be who you are!

Peace out Moonstuck

Jaz13