Got a question related to mental health? ASK DR KIM

Chris_B · ‎23-08-2016

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.”

Sophie_M · ‎20-07-2017

Hi Manfie, thanks for your question. Dr Kim's time with us is limited, so we will sometimes refer members to her earlier answers if the situation is substantially similar. Dr Kim has often answered questions like this around setting boundaries with family members, and often refers people to the video below for further advice:

We would suggest going back to page 7 of this thread and reading the answer that Dr Kim gave to elbets about her mum, and the answer to gld on page 3, which touches on similar themes to your post.

Guest_128 · ‎20-07-2017

To Dr Kim,

Could you please read my latest post on my thread

obsessive love disorder

and if you can give me some advice on quicker options that are out there???

Later

Sophie_M · ‎20-07-2017

Hi 9 Names Later, you would be better placed to give our support service a call for advice on this - 1300 22 4636.

Dr_Kim · ‎20-07-2017

~FallenAngel~ said:
Dear Dr Kim,

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

Hi FallenAngel,

It’s interesting that you write about this film. I haven’t seen it but I have been made aware of the controversy around it . In fact The Butterfly Foundation who support education and understanding to those with ED’s have a fact sheet dedicated to this movie !

I like that you are mindful enough about your illness to see that it has a complexity which is infuriating you. You want a way out , you want to be healthy on one hand , but on the other you are absolutely a slave to the promise of happiness, or maybe fulfilment offered by the illness if you follow its rules.

It must be really annoying for you to feel stuck and alone in its grip.

You probably know all this stuff but here is a fact sheet on Anorexia Nervosa. One interesting point is that recent studies show that the female to male ratio is in fact almost equal !

I hope that I can offer you some observations that might give you hope.

People do get better from this illness. However they don’t do it alone and they don’t do it easily. You need a team around you . Get a good team - if you have exhausted your families resources and good will at the moment , then get a team of health professionals. Families often do get really exhausted by the illness ( as you do ) but don’t give up totally on your mum . She might be more on board when she sees you taking the first few steps.

Ultimately the team is there not to do it for you, but to cheer on the healthy part of your brain ( the part that wants to be better and get through this like your sisters did) and to ignore or not engage with the anorexic part ( the part that wants attention or satisfaction for weight loss) .

Now that will feel hard , it will make you angry as the anorexic part of you will most likely have a tantrum at being disregarded in favour of the what it sees as the boring ugly healthy part! This is where the team comes in helping you to gradually embrace the healthy side more and more and get to really know and like it . The anorexic part can then be reframed as in fact the boring ugly part! ( it won’t like that at all!!)

So you might get a sense of just how hard this mental work is . Its a battle, and its a tough one at that! The wake up call you seek is just another way that the anorexic part of you tricks you into avoiding developing a relationship with health . Its a jealous master. If you are serious about making a change , don’t wait for anything . Just do it .

If you need resources , look at the Butterfly foundation website for info or call their help line.

The very best of luck . Its a long hard road , ask your sisters ! But so worth it in the end.

Guest_128 · ‎20-07-2017

Ok thanks I will call them tomorrow.

Later

_FallenAngel_ · ‎20-07-2017

Thank you so much so much Dr Kim, for clearing away dark clouds lurking around me since last few days and giving me some sense of direction. Everyone with EDs want to win but they all lose over life miserably sooner or later. I cannot think of anyone who has made it through safely yet knowingly day after day having awareness I'm letting it happen to me. I'm scared of this illness but I'm living each day and the pleasure and promises of being able to fit into smallest skinniest jeans, so people would accept me, so I would be more appealing, I will have more friends, a better job and the list is so long but the price you pay is by refusing to eat and honestly that's the mindset you got to have.

To The Bone is not healthy for anyone suffering from any ED, it only details tips and tricks and is not healthy for those who have been inpatient or are struggling at home. I did watch it and I'm regretting it now but I believe literally never will be any film that can adequately depict a mental disorder. Society likes to romanticise EDs and make them appear to be "cool". And that causes people to always falsely diagnose themselves or even try to become the disorder.

Films like To the Bone will only give an insecure person the chance to believe that he/she has an ED just because they lack self-confidence or desire to rid themselves off a few pounds or worse, it will enable them to engage in behaviors shown in the film. it's worse than cancer because it really never leaves you 😞

as Dr Kim very wisely said:

"absolutely a slave to the promise of happiness, or maybe fulfilment offered by the illness if you follow its rules. It must be really annoying for you to feel stuck and alone in its grip."

its very true

Penne · ‎26-07-2017

My partner has depression and doesn't want to communicate with me and he never wants to do anything.He has know motivation.He is on medication but it doesn't seem to help him.We are now having time apart because that's what he wants space.He said that he is unhappy and doesn't know where he is Going in life.He disappeared last week for 5 hours as he has a problem with gambling his money away not sure if this a trigger from being depressed or just an addiction.I do worry about him and it's hard for me to cope with and I try to help and be there for him but it never seems to be enough to him.I am sure if he had the right medication it might change his patterns and just take the edge off. He is on anti-depressants and has been for the last year. But I can't see much change.

Dr_Kim · ‎31-07-2017

Penne said:My partner has depression and doesn't want to communicate with me and he never wants to do anything.He has know motivation.

Hi Penne,

In treating depression it is rarely as simple as just finding the right medication. It is usually a complex combination of medication together with lifestyle modifications ( like exercising regularly, eating healthy , sleeping well ) , cognitive interventions (usually via therapy) , mindfulness practices TOGETHER with the medication that allows a person the chance to get themselves back on track.

So, I think that it may be worthwhile really checking if you are somehow taking on trying to do all the work to get him healthy with the message to yourself that “he has no motivation”. It is true that depression can certainly affect one's motivation , but that is where therapy and mindfulness practice come in .

If he is AWARE of that being part of the illness and not necessarily part of him, maybe he can approach things differently . If he can see his gambling as a poor coping strategy or an addiction and take some steps to attend to it in that frame work , that would be another focus of therapy and mindfulness.

Medications usually don’t change these things alone. And, I am afraid to say nether do the most loving of partners . HE needs to be the one to drive the changes, with you only in the supportive role. If he won’t, or refuses to even see there is a need for it , then I think you have some big questions to ask yourself.

You may need to get some support yourself to work out how you can be most helpful to him , how to be most likely to affect change , or at what point you need to look after yourself if there is no change or likelihood of it. ( this last point is particularly important if your finances are linked and gambling is involved as many people have become unfortunate secondary victims of gambling addiction whilst trying to patiently wait for a partner to sort things out )

Maybe have a talk to him about your concerns about the lack of progress and ask if he would be ok if you went together to his GP so you could relay your concerns. It might be a start to get the GP aware and on board and also to see if your partner can tolerate your assessment of his mental state , but also your concerns for your own needs in the relationship which are just as important!

Help_Me_Rhonda · ‎31-07-2017

Hi Dr Kim, my partner has borderline personality disorder and myself have just been diagnosed with Bi Polar II. My partner is "crazy" to live with and I just want to "run for the hills". I love her deep down BUT I don't know if I can live with her disorder, ANYMORE (she is doing my head in). I know it is a difficult question to answer but with us and our conditions is it "sanely" possible for us to live together longterm. Thankyou for your time. Re-Mark.

Moonstruck · ‎03-08-2017

Dear Dr Kim.. often read on Forum about others' experiences with meds...mainly anti depressants it seems. is there anything else available for anxiety...or just anti ds for the depression?

In the past I often wondered and become somewhat frustrated (have given up on it now though)....just why neither my GP nor the psych he referred me to consistently refuse to give me any meds at all, to help through crippling anxiety, at times leading to panic attacks and going hand in hand eventually with bad depression....their stock answer was always "they can be addictive". I am not stupid...I KNOW that.

then why are so many on Forum helped along the way with meds and I am refused them? Surely the GP realises that there is a perfectly legal med, easily available for me to take every minute of the day if I choose....alcohol! I used to use it to self medicate for the anxiety and depression until it did my body too much damage...and for my physical health haven't had a drink for over 4 years!

but for some reason they refuse me the legal help of any meds at all...why is this?

I have done both depression and anxiety tests in their office and scored highly enough to warrant some treatment and been referred to visits with the psych...which involves only talking as you know.

I do have very mild sleeping meds which at the lowest points of despair have dipped into during the day just to get some relief! I would prefer not to do this, but it's all I have to ease my condition.

Recently I went through many weeks (still am to a certain extent) of deepest despair and grief...so very black. the lowest I had ever been in my life. I did not go to my GP for meds to help me because I knew he would refuse. ..why am i refused this help when it seems available to others?