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.”

[chris123456]

hey um il be quick ive had serious social anxiety issues for years now i covered it up with alot of weed but now im 26 and i think ive become delusional i cant be around people at all now without feeling like im going to die and have a heart attack my anger issues are on another level now i talk to myself i have the most delusional thoughts about people following me watching me spying trna hurt and set me up im convinced im being accused of things i know im not ive been a heavy weeed smoker since very young but atm im scared and anxious and paranoid belief i have no idea what to do anymore i can barely leave my home ive turned nearly everyone i know against me im sorry i just is there a way out of this for a guy whose completely ruined hes life and mental health to a very serious extent cause it honestly feels like i got no hope and this is going to get worse i just wanna be a good decent honest guy who can stand up and be a man and be happy to those he loves but right now im not capable it feels impossible felt like i had to write this cause right now not feeling the best sorry for the inconvenience and have a great day

[Dr_Kim]

Hi.
I’m sorry your depression has been so persistent and resistant to treatment. That is really hard.

You sound really motivated to try things and keep going , so may i direct you to a few wonderful resources that may help you.

There are a couple of great books that you might like to read that are geared to the general public and super easy to grasp and i feel present the CBT style of therapy very well. One is “Change Your Thinking’ by Sarah Edelman. The other is “The Happiness Trap “ by Russ Harris.
You could look at these resources https://www.aacbt.org.au/resources/online-resources/
There is also the books , website & podcasts of a very prominent CBT American advocate/ therapist David D.Burns . I’m hoping one of those will strike a chord with you.

Once you really get what CBT is about , then you can work out
1. if it is the sort of thing that you feel you are willing to work on ?
2. if the therapist you next engage with has the requisite understanding/ skills in CBT ( by knowing what questions to ask !)
3. Look up “CBT therapists” in your state if you want to proceed and ask potential new therapists what CBT training they have had.
4. Or ask your GP/ psychiatrist for more specific recommendations

I hope this is helpful .
PS There is an Australian Association of CBT therapists so you could possibly write to them and ask them about members in your area ?

[Concernedwife2018]

Hi Dr Kim
My husband has suffered bipolar and depression a majority of his life. 12 years ago the doctors got all his medication under control (it took some working out but finally found one that worked) he took it for a few years but then felt well enough and stopped taking it. He probly hasn’t taken it for 7 years and has been going great. However lately his depression has flared back up and he is not going well. I suggested he go to the doctor and get back on his medication, he doesn’t want to through concern that it will take lot of times of trying before they get the right one.
Since he was on them last time we have moved towns and he has a new doctor. This new doctor has his old medical file.
can he ask his new doctor to look back on his last medication and prescribe him that as he knows it works for him? - it may not this time but we thought it would be worth a start?

[Dr_Kim]

Hi , so it seems there are 2 main issues
- social anxiety
- marijuana use with paranoid / delusional thinking

Let’s talk about the social anxiety first . This is a super common form of anxiety which is really hard for all age groups but especially adolescents/ young adults.
There are many ways to treat it including therapy , medication, lifestyle changes and support groups . It is definitely hard but definitely treatable with time and a good therapist or psychiatrist on board .
Many people use inappropriate ways to try manage their social anxiety ( alcohol and weed being super common !)

The marijuana/ delusional thinking one is more immediate. There is a known association between Cannabis and psychosis so it is important that you dial down the weed ASAP .
I would suggest you get to a rehab so they can help you manage the thoughts, physical side effects and the anxiety of the weed withdrawal .
If you have great family support you might be able to do it at home but given your state of mind , it may be hard for untrained family members to handle your paranoid thinking .

Your GP should be able to advise you on whether Home rehab is suitable for you . You can get a rehab referral from your GP or you can find the nearest rehab center on the askizzy.org.au website

There is absolutely no reason why you can’t be the wonderful decent honest guy that you want to be. However you have a few things to tidy up before you get there .
First , get off the weed and then manage your social anxiety in a less destructive way ! I’m sure you will find ways to navigate the world that feel way better that just smoking weed to try manage it.

Good luck with this and good on you for getting on to sorting things out !

[Dr_Kim]

I would say that almost every patient is a bit nervous about anti depressants or anti anxiety medications as clearly they are designed to manage our thoughts so that makes them sound a bit sinister.
Most people don’t report to me feeling any different with respect to their core self . They don’t feel “ changed “ or that the medication has altered them . If anything, they tend to report feeling MORE themselves! They feel that with the depression or anxiety turned down a bit their true self can come through more !
Some do report feeling a bit blurry or clouded initially but for many that feeling fades .
Depression is not something that has to be there 24/7 in order to be diagnosed.
So the fact that you might find yourself out with friends and having an ok time or having a day where you feel pretty good doesn’t mean you don’t have it.
It is more about what is the mood like most of the time and how bad and for how long .
It’s true that a few bad thoughts doesn’t make a diagnosis of depression but I assume that your doctor took everything into account to make the diagnosis like how long the lowered mood was there and how bad your thoughts were etc
If you are unsure, talk it through again with your GP . Remember too that the medication is a trial .. you can try it for 4-6 weeks and see what you think .
Also don’t forget to try exercise and other lifestyle things if you haven’t already!

[Jamie88]

Hello i need help!!! Im married with kid's love my wife to bits. But i keep talking to woman online i cant help it. I feel so bad i want to stop but i keep going back online to chat. Please help

[Dr_Kim]

Hi there,
Thanks for your post . I think I understand what your confusion might be . You are wondering what is “wrong” with you as you feel that the thoughts and emotions you have are not always ok but are they not ok enough to be a diagnosable syndrome or illness ?

A couple of thoughts - one is that depression for many people and especially those on the mild to moderate end is not necessarily something that effects them in the same way every day all day . It can come and go and be of varying intensity. You can be having a good time with your friends one night but the next day feel your emptiness again . Or you can have a good week but then a few bad weeks .

I think that diagnosis comes in when the thoughts / feelings are very intense and also persistent and interfere with the persons ability to get on with things.

So a few bad days isn’t depression but persistent weeks and weeks of mostly bad days may very well and especially if the thoughts / feelings are meaning that you can’t do things you would normally do .



I’m intrigued with your statement about not being able to go to Headspace because they are “ anti labels” and that everyone around you needs one. I am wondering who around you needs one and why ? Do they not believe you without a label ? Do you not feel your feelings are valid without one? Do you feel that it won’t be taken seriously?

My sense is that the label is sometimes helpful but often it is a bit hard to too sure, especially in young people and that it is sometimes better to create a list of symptoms and work with those.
so for you , maybe your list might include things like (and I’m just guessing here!)
-Feeling empty at times
-Feeling uncertain about what my moods mean
- Not knowing who to trust with my feelings/ thoughts when I’m feeling empty
- Not being sure if these things are normal or not
- worry about being taken seriously

So if you were to develop a list for yourself … that might be a good start for you to work though with your GP or one of the staff at Headspace. From your list , they may be able to start getting the diagnosis , but if there isn’t a clear one , thats ok too. They may help you understand what is going on and also work through this with your family so that everyone is on the same page and maybe the need for a label feels less urgent .

I hope this is helpful- get back to your GP or Headspace or your school counsellor and see what they think of your list.

[Dr_Kim]

I am going to answer you question in a very tangential way as I really don't know but i’ll have a go at a couple of possibilities and hope that they strike a chord wth you.

I get that you have had major mental health issues as you state that you have had 10 years of depression/ anxiety, including 2 suicide attempts. Thus your attachment to people in grief and mourning may be something to do with some sort of externalisation of misery into something “real” from something amorphous and kind of vague .

Or is it possibly a form of common death anxiety that lives within so many of us and comes out in many ways. There is a great book on this called “ Staring at the Sun “ by Irvin Yalom if you are interested in this. Basically , this theory talks about various ways that we subconsciously try to deal with the existential issue of the fact that we are all going to die some day, so how to make our lives meaningful.

Maybe your behaviours are a sort of healthy subconscious working out these issues for you.( My clues were was the last line … maybe you are “ feeding off others peoples misery” to validate your own or Maybe you are "trying to prove that you are strong”… and alive ? )

I hope some of this helped to sort out the “ weird emotion “ but I think its a great discussion to have with a therapist / psychologist!

[Dr_Kim]

Hi There,

Absolutely! Your new GP will probably be delighted that you guys have done all the hard work already with your last doctor and have worked out the right meds at the right dose for him . Now all they have to do is advise him how to get on to the medication in such a way as to minimise side effects and to monitor the response.
My only caution is that sometimes people change and what worked years ago, doesn’t work as well this time.

However you if guys have learned something , it is that persisting and trying different things often does pay off!

Get him to the new GP and ask them to look back at the notes and try the old successful first! Good luck , I really hope it works again for him .

[Dr_Kim]

Hi Anon000
You seem like a pretty clever and switched on young man because i think you might be absolutely right .. I think you may be struggling with different aspects of anxiety. Anxiety can come in many different ways - like panic attacks or phobias, OCD or generalised anxiety , and sometimes the anxiety is focused on a specific area like social anxiety or anxiety around food for example.

I also think that personalty traits and family life and genetics can come into how anxiety affects a person.

Even in your brief post there are hints that maybe you have certain personalty traits that may predispose you to anxiety like perfectionism or putting up really high standards for yourself . You just mentioned that you try really hard for people to like you and to do well at football and to mange your studies.
You mentioned that things at home are pretty rough and that your Dad has some issues that really trouble you. At 15 , that is really hard to manage as you are still not old enough to fully take care of your like so you will depend on him and maybe even in some part of you want him to be a better father and role model , but also hate that you depend on him and want him to change which is really tough and confusing.

All these things can cause a young mind to feel really unsettled and overwhelmed and the anxious thoughts then really punish us. I think that anxious thinking might be what is happening to you with respect to all the strange thoughts around people not liking you and stressing so much that the hormones that are produced are literally making you ill. The “dead inside” feeling sometimes is a way people try to kind of shut off from things as a kind of protection mechanism . But I think you should check this all out with a health professional as it is all treatable and manageable with help.

You are not overreacting at all. I think you should take the messages from your body and your healthy brain that is telling you “something is not right here” . Go to your school counsellor , your GP or to your nearest Headspace and get some professional advise as to how to sort through it all.

If you get no joy there and need more ideas, call the Beyond Blue helpline or ask for help via the eHeadspace website.