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]

reeg01 said:

hi Dr Kim

i am 16 and scared, i don't know what to do. It always feels like i'm letting someone down.

Tilly1357 said:

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?

Hi reeg01 and Tilly1357, I'm going to answer your questions together as I feel you are both struggling with similar things.

I am going to suggest that it may be possibly negative thinking or obsessional thinking. 

Either way , this way of thinking is NOT your fault . 

Sometimes , one's  brain can give negative messages  or interprets things in a negative way for no rational reason. Likewise , with obsessional thinking , it can get stuck thinking the same thing over and over again with no rational resolution and often with the belief that if you don do something or think something, there will be a bad outcome.

It’s like it's stuck on that radio station and you are finding it hard to change it.

This can start up due to all sorts of things .. sometimes it's genetic , or things in ones past , sometimes it's learned behavior, sometimes it's personality style , sometimes it's just bad habits .. 

whatever the cause in your case it is treatable but there is some work involved.

Look at books from David Burns who gives very practical ways to challenge these thoughts or Sarah Edelman's book " Change Your Thinking". 

If you need more help to challenge your thoughts , ask your GP for a referral to a psychologist to help you get the skills .

Also , please don't feel ashamed of this style of thinking as it's not your fault and it is is also super common !  It may be useful to tell your family or your partner  . It may even be that others in your family have experienced the same thing and can tell you what they have tried .. it may be valuable for you to feel you are not alone in this .
 

[Dr_Kim]

Peace Seeker said: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.

This is a tough one to be definitive on as I'm not sure that there is enough research in this area to be advising people to eat any way other than "healthy". 

By that I mean getting in the right number of calories and nutrients into your diet each day. My understanding is that as long as you attend to your nutritional needs ( and it seems that you are )it's ok to get them via a vegetarian or a carnivore diet . If you had concerns about things like zinc , omega 3 , B12 , iron in your diet , then you might want to discuss this with your GP or with a dietician to ensure your diet ticks all those boxes.

I suspect that your relapse may unfortunately be an example of a "triggerless" episode of depression. This is not as uncommon as you might think and in my experience many people can't really explain why they feel like they do. In fact it often makes them feel even worse when there is no obvious trigger to " justify" the feelings to themselves. ( not they are under such easy control or need a justification but that's how it can feel ) 

You may never work out exactly why you relapsed at this time and it's frustrating but you might have to just sit with that "not knowing".

You are doing ALL the right things though to get this episode under control and get yourself back on track .

The therapy , lifestyle changes, medications that have worked .. so I suspect that you will gain control again and get back to your life soon enough .

Don't be hard on yourself for having a relapse. Pat yourself in the back for having the resources and skills to identify what is happening and get on to sorting it out . 
 

[Ms_H]

Hi Dr Kim,

I'm slowly starting to feel better after a depressive episode lasting approximately 6 months.

How can I tell whether this is the result of the medication I've started taking, psychotherapy, or whether the depression is just starting to go away of it's own accord.

Some days I feel as though I'm completely out of the woods and that the last few months have just been my imagination, and then I'll have a few days of feeling really awful. Is this common?

Thankyou,

Ms H

[Dr_Kim]

Ms H said:

Hi Dr Kim,

I'm slowly starting to feel better after a depressive episode lasting approximately 6 months.

Hi Ms H,

I am so happy to hear that you are  emerging from your depression. Depression is often multifactorial and so is its treatment. I believe that it was probably not one of the factors that caused your depression to improve but probably a mixture of the medication TOGETHER with psychotherapy TOGETHER with the natural history of the depression just maybe getting better anyway.

The few steps forward and then a step back feeling you have is completely normal. I just hope that during your recovery you improved your skills and resilience  to be able to see it for what it is - a little step back , just a few bad days . There is no need to be panicked by it , just apply some good self soothing and calming strategies and ride it through until it passes. 

The thing is for many people depression doesn’t ever go away completely, it just takes a seat at “the back of the life bus” . This allows you to get back into the drivers seat of your life again .

However , every now and then , it tries to start to move forward and give you a hard time … your job is to look in the rear view mirror , see it coming and know how best to not swerve off the road , or allow the depression to unseat you .

Often , with practise you can develop your confidence at managing the dark presence at the back of the bus and know that ultimately, even though it spooks you from the to time , you won’t give up your drivers seat again. 

You are doing great , don’t doubt yourself but keep up with your therapy and meds and lifestyle work.

[startingnew]

HI Dr Kim

im wondering if theres any form of desenatisiation or exposure type thearapy for sexual abuse victims- i dont think i can give to much detail on here about the event but it still haunts me. i had to do a pelvic and abdominal exam the other day and that in itself was extremely hard and theres a chance i might need another one in the near furture so im wondering if theres anything i can do to get a little more comortable with those procedures?

i am not curretly seeing a psychologist but i am seeking a permanent one now as this will be my 4th one. i wont get to see another psych until after these exams are done so i cant talk to them and when i ask a helpline they tell me to speak to my psych so not much help there

any help is appreciated please?

[kanga_brumby]

Hi I am in an age care facility and requested to see a psychologist, back in November. It took until April to finally get them to move on it. Now I got a letter from the GP, handed to management, referred to a psychologist. Who wants to charge me $20 per session over the fee medicare reimburse. I was under the impression that I got 6-8 sessions per year free. Who is correct, as I cannot afford the fees here and medication plus psychologist on top. Something is going to give. At least I know I need help and trying to get it. So there is 75% of the battle.

Kanga

[startingnew]

Oh sorry when i say ill wait to get a psych until after the exams i am referring to my studies not the physicals

[Sophie_M]

Hi kanga_brumby, this would be a question best directed to Medicare, they would be best placed to let you know what your entitlements are, and they'll have all your details in front of them. 

[Dr_Kim]

startingnew said:Oh sorry when i say ill wait to get a psych until after the exams i am referring to my studies not the physicals

Hi startingnew,

There are many programmes for managing sexual abuse.  There are some that work better for some and others for others. 

I am interested that you have tried 4 therapists in the past and not seemed to find a person or a type of therapy that works for you over the long term. I wonder was it the relationship ? Or the type of approach they had ? Or would a support group be better for you?

I think it is it so crucial to feel like you have genuine connection with the person - like they really care , but also that you trust their competency as therapists as sometimes it is rough and you need to trust that they “know what they are doing”.

I am thinking that assuming you may have tried more traditional methods, you may want to look at 2 new but very interesting ways at looking at PTSD treatment . EMDR has a lot of good research behind it but doesn’t on the surface seem to make a lot of sense! It does however seem to work and it doesn’t seem to be difficult for people to do. Every big conference I have been to recently has reports on EMDR and it is far from “ flakey”.

The Richards trauma process is a little more intense and not researched but seems to me to “make more sense” as it works with unconscious resistance. 

Have a look at these sites and maybe read up a bit and see what you think .There is a directory of practitioners at the sites.  Maybe ring one close to you for a chat.

I am just thinking that doing something different might possibly unlock you from the past and allow you to not be haunted by it in your present.

http://therichardstraumaprocess.com/

http://emdraa.org/

You deserve to break free of your own physiology and the old 'warning systems” that keep telling you and your body  that there is danger right now , but it is only really an echo of old trauma from your past. 

My most sincere good luck on this journey.

[startingnew]

Hi DR Kim
thak you for getting
back to me
ive been diagnosed
with severe depression, severe gad, severe complex PTSD, health
anxiety and I do have mild social phobia.

Im up to my 4th
therapist yes. So the first one I was with for about 2 months but I
felt like I wasnt getting anywhere with her and I kept having
arguments wit my mum about her even though she refused to want to
help me. My mother only knows about the dog attack and not the sexual
abuse. Iv stopped telling her things as it makes it harder for me as
she doesnt support me anyway.

For the 1st
one although I liked her I felt I was going around in circles and the
constant aruguments with my mother and yes being 20 I shouldnt par
attention to it but I thought it was best.

The second therapist
I quite liked- she sent me to a suicidal prevention program which ive
just completed but during that time her fees have gone up and Im
struggling to afford them despite the medicare rebate and as you know
its only 10 per year.
The third therapist
is through the suicide prevention program and only does short term
therapy so just the program so I didnt have much choice to leave.

The 4th
theraist ive just applied through victims of crime and im hoping to
get a few free session to help me with the SA and to manage it so I
can move forward with this section.

Ive only been doing
therapy since novmber last year but ive been delaing with this stuff
for about 3 -4 years but I didnt know what the diagnoses were.

I was doing just
general therapy and then psychotherapy through the program and then I
was supose to go back to the 3rd therapist and do DBT
therapy.