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]

Kymbo7 said:

Hfor the past 2 weeks especially the past few days i have had i think a few panic attacks and feeing of lossing everything.

Firstly, I love the resilience in that you state clearly and proudly that you are “ strong and determined” and I think , reading between the lines, your life has not been easy so these personality traits have been so valuable. Go you!

You clearly have survived childhood abuse which is just an awful thing to happen to anyone.Clearly you have some deep well of strength that keeps you going. However, it is no surprise that you are have some psychological “scars” or emotional problems  from your early experiences.

These  may explain some of the feelings and thoughts you have now.
http://www.nctsn.org/trauma-types/complex-trauma/effects-of-complex-trauma
 
Some of the scars and emotional bumps may be  part of the abuse scars… when your brain mixes up time and space , so that dramatic events that should be firmly locked into the “memory” folders of our brain somehow keep popping open and FEEL like they might be happening or about to happen in the present.

Obviously this then causes our bodies to become geared up for something”bad” to happen and out comes the old “flight or fight” response and we end up feeling all jittery, anxious and stressed.
 
I have also noticed that it is not uncommon that people who have had difficult parental relationships can struggle with happy and healthy adult relationships. There are many theories as to why this happens, but the gist of it is its not your fault . It is due to you trying to find love in the wrong places. An old pathway set up in your brain from your childhood.
 
The constant loop of this faulty brain wiring can of course make us feel down and like we are going crazy , but its not your fault and it is treatable.
 
I feel you do need a good therapist to teach you and guide you through the healing childhood trauma . The Blue Knot Foundation specialises in this area and may be able to give you the name of some one close to you who has a good understanding of this work . Ring their helpline to enquire: 
http://www.blueknot.org.au/Helpline
 
You sound like you are trying hard already - trying to be a good mum & NOT drinking or smoking and writing this post. Maybe visit your GP too and see if they can help develop a good team of HEALTHY support around you. 
 

[Dr_Kim]

Cmb80 said:

Hi Dr kim,

I am just wondering if there is support out there for womb trauma whilst you were in the womb?

I think what you call “womb trauma”,  i call "grief and loss". There is no doubt that your mum must have been struggling in your post natal period . I don’t know the details of your particular case  but if you read  attachment theory , you can see that so many of our deeply held beliefs about our worthiness come from those early years and our desperate need to form attachments to primary care givers .

Sometimes these attempts to connect are not met due to the mums ( or dad’s) post natal depression or illness, or poverty or family circumstances beyond their control. 

There is  a lot written on this , but check this article out for example
https://internal.psychology.illinois.edu/~rcfraley/attachment.htm

To help you sort out the maze of all this stuff, I would head to a therapist who has some experience in this. In general , family therapists are pretty well versed in this stuff: https://www.aaft.asn.au/find-a-therapist/

Your hunch is probably right that early events are still causing ripples in your present day life. Good news is that , with motivation, you can make changes. 

[Dr_Kim]

Kid_in_denial said:

Hi Dr Kim.

I am in early stages of being diagnosed (with what I can't say because there have been many names put on the table) however I am only seeing a psychologist at this time.

You write so beautifully .

Is it being slow ? Maybe … I don’t know but you did say that there have been "many names put on the table in the past" which indicates to me that things are maybe not straight forward. 

Some conditions are super easy to diagnose .. and others are a bit more tricky .. so it is hard to be sure what is happening with you. 

What I do know is that you should feel like you are in partnership with your health professionals and if you are feeling impatient and agitated by the slow pace , maybe you can state that in a calm and non threatening way. Just ask them where they are along the journey ..How are they going ? Ask for an update . Maybe that will help you to feel like you are part of the “team” .

Maybe write down the answers in your head that you feel they need to hear and haven’t asked for yet , and ask if they might like to see that list.

I would stay on the ship even though it's hard not knowing the route or the destination. 

[LANA07]

Ive got 9 week old baby and am suffering from postnatal depression. Imjust suffering from overwhelmed n emotions are all over the place and think im not doing enough for my son . Wanting some advice.

[steve_53]

dr kim im curious whats the best way to recognise depression in elderly parents i have an elderly father (73) years old whom for thirty years at least maybe more argues with himself on his own then when you try and talk to him about what hes arguing about he says oh its nothing if there is family discusson at any time and things go awry then he brings out the blame game of his inlaws have ruined his life he swears and curses at small things ( like a spanner falling of a bench and i call it carries on for ten minutes yelling and swearing ) he will fall asleep as soon as he sits down after doing something small.he will always bring up the bad things that have happened in his life .when i do get to have conversations with him if i ask him does he have any plans in the future i get the same answer (oh we will see what goes ) which is frustrating to my self he lives in a messy house and expects family to be there to do his bidding clean up after him all the time . when we have cleaned up after him before within two months the house or the shed is back to the same state as before . my question is does he in your opinion need help for depression and if so where do i start ( i will say one thing he wont recognise if he has a problem as far as hes concerned hes as healthy as a horse and will tell you so ...........he has to be right all the time and if you start to try to gently push the point it ends up with him yelling and screaming to get you to back away . knows he how to manipulate to get what he wants with arguements ) so once again where do i start and where do i go thanks any advice hopefully will help

[Dr_Kim]

LANA07 said:Ive got 9 week old baby and am suffering from postnatal depression. Imjust suffering from overwhelmed n emotions are all over the place and think im not doing enough for my son . Wanting some advice.

Firstly, I think it is great that you have the strength to be able to put your hand up and say that you might need some help in sorting out your emotions. We often put the bar up super high for mums and give them the expectations that this should be the most wonderful time of their lives and that mothering should come naturally and be the most enjoyable, fulfilling experience. 

Now, for some women that is true. But for many it is a roller coaster of emotions and feelings, driven by all sorts of things including exhaustion, hormones, expectations, their own early childhood experiences, early role models , previous mental health issues, current supports, current health, baby’s health, the birth … and the list goes on. 

The best advice I can give you is to have a place where you can openly and freely discuss all this without judgement . Start by calling the PANDA helpline 

http://www.panda.org.au/  - 1300 726 306. 

You may need to go to your GP or Obstetrician if things get too tough … but take advice from the trained staff on the help line and check in with your doctor if things are not improving . It is important not to ignore this. I'm so glad you are getting onto it.

[Dr_Kim]

steve 53 said:dr kim im curious whats the best way to recognise depression in elderly parents i have an elderly father (73) years old whom for thirty years at least maybe more argues with himself on his own then when you try and talk to him about what hes arguing about he says oh its nothing

This is a tricky one.  I have a position on this that you may or may not like but here goes:
 
I think people have a right to self determination and sometimes the way they determine themselves is not the way WE think they should be! But it's not our job to tell them how to live . They have a right to that choice.

We do however have a right to choose how we engage with them given those choices. 

An exception to this is if you feel the person is not in sound mind or unable to make decisions to keep themselves safe.
 
Lets give an example.  Say you have a parent ( or an adult child) who chooses to live in a really dirty house. You wouldn’t want to live that way and you feel it is socially unacceptable and you have tried to get them to change to no avail. 

You can 
a) Refuse to see them until they  clean up their house 
b) Refuse to see  them until they let you clean up their house 
c) Organise and pay for cleaners for them ( if they permit this)
d) Keep meeting them and trying to get them to change ( often leading to arguments) 
e) Just accept it and for the sake of the relationship meet them NOT at their house so you don’t have to be confronted by it and don’t discuss it
 
So.. what is the best option for everyone? The thing is , in human relationships there is no PERFECT option , but usually one that means that both parties are required to give a little for the sake of the relationship. 
 
With your dad ,if we respect his self determination, I would suggest that you put boundaries around what you are prepared to do and not to do for his house, but do not expect him to change . If you are ok with cleaning his house ,and can do it without anger or resentment, then do it. If you can’t  then don’t. Ask him if he will accept a cleaner from the council or privately (if you can afford it ). If not , then I guess he lives in a very messy house ( until he can RESPECTFULLY ask for your help) 

If you are concerned that this is not personality, but depression or dementia, then the best place for that assessment is his GP. 
 
If you are worried about him, as in concerned about his ability to cope on his own with his hygiene and cooking etc, the GP can set up an assessment where a team comes to his home and can see how he is doing. 
 
You don’t have to be the one to make the call on this . I would find a way to get him to his GP and let the GP know of your concerns ahead of time . Make a double appointment . 
 
Maybe you could speak to a therapist who has some training in family therapy to help you sort out how you deal with the mixed feelings we all have around caring for our parents and balancing the push - pull that often goes on in this relationship . Having boundaries are really important so you don’t end up feeling angry and upset . But so is finding a way to care for and love him .
 

[steve_53]

thank you dr kim

yes i agree that he has to live his life the way he wants to so if the family cant handle him living in a dirty filthy house and hes not clean then is it best to leave him to his own devices and see what comes along the track later on . ok and yes the gp sounds like an idea i might just have to speak with the gp on my own first maybe thanks for your input very helpful

[Manfie]

Hi Dr i have a question regarding my sister inlaw. She has onex again gone on social media and said some very hurtful things about myself and the rest of the family. She always will say that its her depressions folt and it makes it so hard for us to believe because not matter how much we try and help she doesn't do anything to help her self but then blams it on use saying we dont care avout her and her kids i just dont know what else to do to help and im sceard.

[_FallenAngel_]

Dear Dr Kim,

It's the first time I'm asking a question here.

I watched the movie 'To The Bone' recently & I don't know how to feel. I cried several times during the movie. One thing that really got me was the character's relationship with her mother- the relationship I have with my mother is not exactly similar but my mother had to deal with my two older anorexic sisters until their uni days but they recovered after getting married & having children but they set solid examples and became my role-models as I looked up to them growing up, did exactly what they did. My mother called me yesterday & goes she can't force me to eat, if I don't want to eat it's entirely up to me. I'm grown up & knows my well being. She goes, she was raising 4 kids my age :'( I think it's not that she doesn't care but cud it be she has given up on me?

I am concerned about my ED because I so desperately want to be thin. I promise myself to lose x kilos in x time but then I also want to be healthy. It's disconnecting me from my family not that I was ever super close to anyone...!!!..but it's creating even more confrontations between us as well as tension & because of it I'm restricting more. I have started to hate the sound of food (before it was just the look) & absolutely hate when people sit and eat in front of of me on trains, buses(creates so much regression within), only my boyfriend & my brother are allowed but then also I often walk away for the fear consuming their calories thru air. I feel very alone in this & they think it's funny. I don't mind them laughing at least gives them something to laugh about. Every time I weigh myself, if I have lost weight I'm unhappy & if I've gained def. I'll be UNHAPPY!!

The end of the movie really moved me. When she had that dream of her looking down at her emaciated, dead body. I went to the bathroom and cried as I drew parallels to that. When she woke up realised it was just a dream & she actually went back home & hugged her stepmom & sister and went back with a renewed will to fight. It really moved me. I wish to do that. I want to have a wakeup call that forces me to start working towards health. Nothing has worked for me as a sufficient wakeup call- in all these years, & I always find a way around it and make excuses & as a guy living with this illness in a girls world it has been very easy to go unnoticed.

Could you pls give me some advice Dr Kim? Your own personal standpoint? Anything. Thank you.

Regards,
(A Whirling Dervish)