Home » Anxiety » Page 2
Category:

Anxiety

Body Dysmorphic Disorder

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I have severe body dysmorphic disorder, GAD, bipolar disorder, and severe depression. BDD came around a time where I was also anorexic. I started to feel less than everyone because I was coming to terms with being gay also. Something I hate beyond words. The reason I”m contacting is that i feel I”m losing more and more grip of reality with every passing day but also have zero interest in wasting my time with therapy because there is no amount of therapy or no therapist who could convince me that it will ever get any better. To give you an idea, gay men message me all over the internet telling me I”m fat and ugly, that I can”t be gay because of it and many tell me to end my own life since it would be better since I”m too fat and ugly and look like a pig. There is not one thing ANYONE would ever convince me to like about myself and being gay isn”t a choice, I”m tired of people telling me I should consider therapy when It never worked for me and since therapists cannot change that I”m gay or that I look like this, WHY should I waste all my time and money going to therapy when there IS NOTHING, I MEAN NOTHING, they can do to make any of this any better. There is no bullshit POSITIVE thinking that”s going to not make me hate everything about myself or being gay. When you have spent almost the entire time you”ve been out (since 2007) being told that your life is worthless because of how you look means that PEOPLE will not get any better either. What should I tell people with the best ways why CBT is not effective for everyone. Not everyone also has 300 dollars sitting around to go to ONE therapy appointment that MAY OR MAY not work. Every day gets worse, but I know it won”t ever get better with how they are. Why do you feel the pressure to oversell the effectiveness of treatment at the expense of well-being of the patient? So many therapists do not care and just want money. So many use themselves as a well for people to almost figure out their own issues. I went to school for Psychology too- it”s become a joke. ALL ABOUT THE MONEY (From the USA)

I’m not sure I understand the purpose of your email. You sound clear and emphatic that you don’t believe in therapy, that therapists are only interested in it for the money, and since you’ve studied it you don’t believe in the science of psychology — that it is a joke. You also are unambiguous about having zero interest and not wanting to waste your time with therapists because nothing any of them could say or do could convince you that anything in your life will get better.

Yet, you took the time and energy to send this email to us. What were you hoping for with your email? This is curious because it doesn’t have a question, and doesn’t appear to be looking for help — certainly not assistance from a therapist. So why write to a blog called “Ask The Therapist,” when you have nothing to ask?

Maybe you just want to “Tell The Therapist” something. Maybe you want to tell a therapist that who we are and what we do are not valuable. That no matter what we do to be effective it wont work. That we are unable to change what is and thinking otherwise makes us foolish. In fact, it seems as if you’d like us to feel bad about who we are and what we do. That positive thinking is bullshit and that we should just give up. That we will never be effective because people don’t change.

It sounds like you want us to feel like you do. That is how it works, I suppose. When people are feeling bad they very often want to have others understand their pain by saying and doing things to create that feeling in others. There is a saying: “Hurt people hurt people.” The human tendency is to make others try to feel the pain we are feeling so that our situation, our life can be understood. I could be wrong about that in your instance, but without a question and with such clarity about how you feel it is one way to explain the contradiction of why you’d be telling instead of asking.

In my opinion one non-bullshit thing psychology has found is that if you don’t believe you can change you probably won’t.

Wishing you patience and peace,
Dr. Dan

0 comments

I Am Not Ready to Change, But Have Problems

by Holly Counts, Psy.D.
written by Holly Counts, Psy.D.

I have recently had increased anxiety and panic attacks due to being sexually abused. This has triggered me to have disordered eating in order to try to control my situation. I have been experiencing some anorexia and bulimia tendencies. I am now considered underweight by Bmi standards (17.5). I also believe I am experiencing depression. I want the depression and panic attacks to stop without the use of medication, and have considered therapy, but I do not want to give up the eating disorder. It brings me peace and a sense of control, and the weight loss has improved my self confidence.  I am not sure what to do next. Do you think a therapist will help me through the anxiety and depression without making me address the eating issues?  I am not experiencing any ill health effects and just want to lose 7 more pounds. Thank you!

 A: I think therapy is a great idea, and I’m glad you are thinking of giving it a try. I personally take a holistic approach to viewing problems and see individuals as a whole. In that light, the anxiety, depression and eating disorder are all most likely related to each other and might also be related to the sexual abuse you experienced. If you get help for the trauma, you will also be getting help for all the other symptoms you’ve described.

Most of the clients I have worked with who have an eating disorder are not eager to give it up either.It gives them a sense of control, but unfortunately it is based on false information. Body image distortion is very common, so what you perceive as looking good and boosting self-esteem, often looks concerning to others. Eating disorders can be quite dangerous and can negatively impact your body’s ability to regulate its own health.

I know it might be scary and quite challenging, to enter therapy with the idea that you might have to give up something you don’t want to lose, almost like giving up a friend. But if that friend is actually hurting you rather than helping you, it’s at least worth taking a look at. There are many ways to develop a sense of self control in your life as well as improving self esteem. By working with a therapist, you can dramatically improve your repertoire of coping skills. Rather than focusing your energy on what you might have to give up, try to focus on what you will gain if you can rid yourself of the unwanted symptoms. I would suggest looking for a therapist who specializes in trauma and abuse and address all your problems as a whole.

All the best,

Dr. Holly Counts

0 comments

Everything

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

For the past few weeks everything seems to go down the spiral. I’ve written to you before but unfortunately I haven’t got an response. I’m writing again with some hope that you will find time to help somehow. I’ve been on vacations and during the last few days I have “switched”. Meaning that I became more angry inside, much much more angry. I’ve been watching the most violent movies that I could find, biting myself, suffocating with different objects. I became more impulsive. I’ve thrown away my sleeping meds and limited by 50 mg my dosage of Setaloft which are antidepressants (before I’ve taken 150 mg) and I’m trying soon to go off them completely. I feel alone and detached from everyone. I live alone and got a cat. Recently I have been imagining without my will, that I kill it. I can’t really sleep well. During midnight I have the most energy and it ends up that I fall asleep around 2 am and got to wake up around 8 am. I’m having a mess inside my head. Wondering what would I feel if I’ve killed someone. But I’m too afraid of the consequences tho. My thoughts are loud and I can’t tune them. I don’t want any meds nor hospital. I’m attending therapy. I have lost father at the age of 12. Sexual abuse (“only” touching) by the age of 16 by step dad. Serious depression, suicide attempt, self-harm. And all that fun stuff. It sounds bad on paper but you just get used to it you know? Sadness and sometimes joy but never happiness or calmness. Mess, mess, mess. Have a good day.

It sounds like you are having a rough time. I am sorry that you are struggling. It’s good that you are in therapy, but adjusting your own medications is never a good idea. I understand the desire to adjust your own medication but it can be dangerous. You should be honest with your prescribing physician about not wanting to take it.

Your prescribing physician should also know about your symptoms including your energy in the middle the night, impulsivity, your violent thoughts, etc. You mentioned being particularly awake around midnight. Perhaps you are describing bouts of hypomania. Sometimes bipolar disorder is misdiagnosed as depression and subsequently patients are given antidepressants which can worsen their symptoms. Alternatively, you may have more energy in the middle of the night because you are no longer taking your sleeping medication. Had you not stopped, perhaps you would not have developed a sleeping issue.

Your symptoms may be linked to your medication changes. It’s possible that you need a different dosage of medication or other medication change.

The purpose of being honest with your physician, is so he or she can advise you about how to manage your medicine in a safe way. Adjusting it on your own or simply stopping altogether can potentially cause more problems. You don’t want to inadvertently cause more problems for yourself so it’s best to avoid doing things that are not in your best interest.

As for your symptoms, they are indicative of your potential inability to control your behavior. You seem to be doing things without being able to stop yourself. That would suggest lack of control.

The violent thoughts are particularly concerning. Violent thoughts are always indicative of something being wrong. It’s abnormal to be thinking about hurting or killing others. It’s always a sign of someone being in deep distress. In such cases, it’s imperative that you consult mental health professionals who can help to correct this problem. Without effective treatment, the concern is that your symptoms may worsen and you may engage in a violent act.

It’s also important that you avoid watching violent movies or engaging in activities that might increase your anger. You mentioned being on “vacations” in which you “switched.” Vacations are allegedly a time for relaxation, although, the opposite is often true. Since vacations tend to be short-lived, people feel great pressure to have the most amount of fun. In addition, traveling is stressful. Vacations aren’t always the stress-free experiences they are touted to be.

Your symptoms may be worsening because you have been watching more violent movies and engaging in dangerous behavior geared towards harming yourself. This is clearly making the situation worse.

In addition, if you’re on vacation, are you alone? Isn’t there anyone there who can help you? Vacation is also a time when some people choose to use illicit drugs and alcohol as a way to “relax.” If that’s true for you, you want to avoid this altogether.

I would recommend consulting your treating professionals and telling them about your symptoms. They need to know about your symptoms so they can help you. Too often, clients withhold important information out of fear. It’s always best to be honest and straightforward whenever possible. I hope this helps. Please take care.

Dr. Kristina Randle

0 comments

How Do I Deal with Auditory Hallucinations?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From the U.S.: I am 31 years old and female. When I was 23 I would work at a retail store night shift, would hear mumbling, laughing, vulgarity and talking all night, at the time I assumed it was just other people or co workers working in the aisle next to me. I would go outside and smoke at 3 am in the morning, the parking lot was empty, would still hear them, but, no one was there. Parking lot was empty. This happened night after night.

At the same time when I was around 23 I would get up in the middle of the night and hear music playing, would walk outside of my apartment, knock on neighbors door, I guess no one had music on. During this time in my life I would have these experiences maybe for a few weeks, on occasion a once out of six month thing.

When I was 26 my dad died, I became more depressed, and hearing voices became something that started happening more frequently. Over the years, I feel like, its just been getting worse, its a rare day when I don’t hear them honestly.
It’s like spending years having 2 people talking in the other room, constantly being watched.

It’s always the same 2 people but I don’t know who they are. One is an old male and the other is a middle aged female. They often laugh and talk to one another, vulgarity, profanity, mocking, they might comment to each other regarding something I do. During times when im “less stressed” I hear them but its very distant the background, like 2 people talking behind closed doors. When I am more stressed, I tend to hear them very loudly, and its persistent.

Some days when I get home from work all I do is listen to loud music the entire night to drown them out. I tend to struggle with social phobia. They never really talk to me directly or tell me what to do, they always talk to one another in third person, but, its constantly the feeling of being watched, all the time. I don’t really know what to make of things, I know this has been going on for a long time and I’ve ignored it because I’ve been afraid that if I tried to talk to anyone there’s no real help available anyaway.

Honestly, I’m agnostic, sometimes I feel like they could be ghosts, sometimes I feel like maybe I’m just depressed and its a chemical embalance in my brain, honestly I don’t care at this point, I just want them to go away. Lately I’ve just started drinking in order to deal with it, which, isn’t a healthy pattern in my life. I’ve thought about going to “couseling”…but im afraid of feeling like an idiot and I don’t know if I should take that step or not, I’d almost rather initially address the issue annonymously where I don’t have to feel embarrassed (too much) via online question.

It’s just at the point in my life where I can’t ignore it anymore I feel. Just would appreciate a feed back, opinions, not really sure what to do or how to approach this. Wondering if anti depressants might help improve things?

I’m sorry for writing so much for a simple question, I just would like any professional advice on how to deal with this, its effecting my life, I honestly dont want them in my life anymore. Please respond it would be greatly appreciated.

This isn’t a simple question and there is no need to apologize. I think you know what I’m going to say: Go get professional help! You’ve been trying to deal with this on your own for years and it hasn’t worked. Drinking may be a way to “self-medicate”, but it won’t help resolve the core problem either. You need the practical help, support and encouragement of an expert.

No professional therapist is going to think you are an “idiot”. Therapists don’t judge people. Our job is to help them. In your case, I urge you to see a licensed psychologist and/or a psychiatrist. People with that level of training are more likely to have the know-how to help you. If the psychiatrist you see only provides medication, not talk therapy too, then please also see a psychologist. You deserve to have someone in your corner who can help you deal with the current situation as well as your past experiences with these voices. Please. Really. Make an appointment with a psychologist today. You deserve it.

I wish you well.
Dr. Marie

0 comments

Can’t Stop Worrying About My Relationship.

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I’ve been with my boyfriend For about 8 months now, and this is my first real relationship. It hasn’t been easy, we both have depression, and I’m a generally jealous person. Over the summer, his ex tried to get back with him, and although he rejected her, it’s lead to a great deal of insecurity for me. About a month ago, almost two months ago, things started to get terrible. The first thing I remembered was that he saw a picture which aroused him, and that upset me. I knew it was normal, but I felt horrible for about a week. and then after that, I started doubting he loved me, something I had believed for months (this wasn’t because the picture incident). The next week, my fears moved onto something else, and everything’s been rotating. A lot’s happened in these couple months. I confessed to cheating 5 months before that, he forgave me, we moved on. I continued worrying maybe there was something I hadn’t told him, although he told me I didn’t need to say anymore, that it’s okay and he wants to be with me. to sum things up, there’s always something for me to worry about, there’s no break. I recently realized I used to flirt with men, that I didn’t even like, just because when they liked me it made me feel better about myself. So I started being careful about everything I said to guys, making sure I wasn’t trying to attract them. But I still worried, and So I’ve stopped talking to men online. But now I’m worried that maybe I’ve been trying to attract females as well, when I’m straight. I feel terrible about everything I’ve done, and even though my boyfriend isn’t concerned about my cheating again, I just can’t trust myself. I could say hi to a person, and hours later wonder if I was intending to attract them. I can’t tell the difference between when I’m trying to be friendly or when I’m flirting, and it’s driving me insane. And the worst thing is that even if I move past this, I’ll be worried about something else the second after. My boyfriend’s become fed up of me talking to him about all of this, since he has his own depression to deal with, and I understand that. I just don’t know what to do anymore; I can’t stop over analyzing each of my actions, and I can’t stop worrying and picking out details of my past mistakes.

Since you are still in high school I would encourage you to take the time to talk to the school’s guidance counselor. At the core of your issue is that you cannot trust yourself. This is important work for you to focus on. While the relationship concern is front and center now, trusting yourself will be important for your well-being for the rest of your life, Make learning how to improve this feature in your life the number one priority and you will see how the conditions improve. Often we can’t begin to trust ourselves until we talk with someone who can help us see our lives differently. You school counselor is the person to begin with.

Wishing you patience and peace,
Dr. Dan

0 comments

Child Behavioral Issue

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

Hello my stepdaughter is 9 and lives with her mother in a quite tumultuous house. although I believe the child is unaware her mother uses illicit drugs but is aware she is very promiscuous. Her mother also suffers from mood swings and can become very aggressive.
We have a quiet calm house and she spends every weekend with her father and myself she and I have a solid bond.
What I am hoping to get insight into is this: whenever my stepdaughter is experiencing excitement/ happiness she has a mood swing that makes her throw somewhat of a tantrum. For example, at her birthday party, she was excited then became very moody and said it was the worst day ever despite receiving a very special party and nothing obvious happening to affect her mood that I can identify.
We take her to events that she is excited to go to like fairs or theme parks and she goes from being excited to angry and sulky, stating that it sucks. She whines and throws a tantrum. I want to help her through this but don’t know what is causing it or how to address it. (From Canada)

Please do not consider this an official diagnosis at all, that could only be done by a mental health professional in person. These are simply some thoughts that would be rule-out scenarios if I heard this story in person.

The first thing I notice is a clear description of the mother’s behavior. The keywords are tumultuous, illicit drugs, promiscuous, mood swings, and aggressive. This collection of issues can occur as a result of many different possibilities‚ but the first one to jump out as a cohesive explanation is a bipolar disorder. Again — please realize I am responding to this much in the same way I might to a graduate school essay where a list of symptoms is given and you are asked to give a response that makes the most sense and why.

Take a look at this list of behaviors from the manic phase of a bipolar disorder from this article by Psych Central’s Margarita Tartakovsky:

  • Feelings of euphoria and elation or irritability and anger
  • Impulsive, high-risk behavior, including grand shopping sprees, drug and alcohol abuse, and sexual promiscuity
  • Aggressive behavior
  • Increased energy and rapid speech
  • Fleeting, often grandiose ideas
  • Decreased sleep (typically the individual doesn’t feel tired after as few as three hours of sleep)
  • Decreased appetite
  • Difficulty concentrating; disorganized thoughts
  • Inflated self-esteem
  • Delusions and hallucinations (in severe cases)

I’ve added the italics to show that each of the behaviors you’ve mentioned is clearly stated here as part of that disorder. In addition, bipolar disorders tend to run in families, meaning that if mom has these symptoms and if they were indicative of a bipolar disorder her daughter may have a predisposition. Again I want to emphasize this now is speculation on top of speculation. Yet, you have said that “…whenever my stepdaughter is experiencing excitement/ happiness she has a mood swing that makes her throw somewhat of a tantrum.” This means that she will have expansive feelings followed by irritation with rapidly changing moods that are destructive detrimental tantrums. You mention this with two examples in your email.

Again, if I were taking that test again in graduate school I’d make the recommendation that the child is evaluated by a psychiatrist or clinical psychologist to rule out childhood bipolar disorder, and this is what I’ll recommend for you and your husband.

Wishing you patience and peace,
Dr. Dan

0 comments

How Do I Stop Escalating the Self-Harm?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From a teen in England: I’ve had a problem with self-harm for a long time. It started when I was about 13 and I would just repeatedly punch myself in the face and slam myself into furniture to leave bruises all over my body. Adoring the attention people would give me as I got the reputation of being clumsy so others would get things for me, lift heavy items for me or hold my arm so I wouldn’t trip.

This was innocent enough but as the years progressed I began to want more. With me forcing myself to vomit over the floor so others would have to clean it up, throwing myself down a flight of stairs, drinking nail varnish remover, breaking my own nose by slamming it into a wall too hard, pouring boiling hot water from the kettle onto my arm, not eating or drinking for days to make myself faint, I also have become a frequent cutter and have scars littering my arms and legs.

You’d think I’d feel ashamed of my actions but in actuality, I just feel very proud of it all. I love seeing myself like this to the point I’ll stare at my scars in the mirror for hours. I do know deep down this isn’t healthy and I don’t know why exactly I’m doing it since I hate the pain, it’s the results I’m after. Most likely it is for attention. I was sexually assaulted when I was 8 years old so that could tie into it but I’m not sure.

I have been considering seeking help for my behaviour as I know it’ll just continue to escalate as recently I’ve been getting the urge to cut off my own fingers and to drink bleach. I’m just not sure what I can do to get help or if I even have a mental illness as in all other aspects of my life I function pretty normally.

As worrisome as this all is, it makes sense to me. You were sexually assaulted when you were 8. I don’t know what kind of help you got at that time but whatever it was, it wasn’t enough. You are still sending up flares – looking for help. You didn’t have enough language/vocabulary at the time to ask for the help and nurturing and caretaking you needed so you did what kids do, you started acting out your need instead of talking about it. Unfortunately, that need is like an emotional black hole inside. Nothing anyone around you can do is enough to take care of the little girl inside who is still hurting so, so much.

What you need is not, not, not a more dangerous method for hurting yourself. What you need is for someone to really hear that hurt little girl and to give her (and her parents) the tools she needs to heal. There are therapists who specialize in helping young women like yourself heal from trauma and move on in life.

I hope you have parents who can help you. If so, share your letter and this response with them. Ask them to help you find a therapist who specializes in trauma and teens.

If your parents are not the kind of folks who respect therapy, consider talking with your school counselor about how to get help. Since you are internet savvy, you could also do your own research to find local mental health clinics or practices that offer free or low cost treatment to women who have experienced sexual assault.

Please follow through. You need and deserve the help.

I wish you well.
Dr. Marie

0 comments

I Hurt Myself for Attention, Lie a Lot, and Have Anxiety

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I don’t know what’s wrong with me. I’ve cut, burned, and bruised myself more times than I can count for attention from others. I also made up a stalker who anonymously sends me hateful messages. It’s really just me sending them to myself. I try to stop doing it because it pushes people away when they can’t deal with it anymore, but I’ve been doing it for years. I love when people tell me what my “;stalker” says isn’t true. It makes me feel better about myself. I lie a lot. Sometimes, it’s over stuff that doesn’t even matter. I don’t even know why I lie sometimes. It just happens. I’m not sure if I have an actual anxiety disorder or if I’m just a naturally anxious person, but when I try to go to sleep, all I can focus on is the feeling in my stomach. I toss and turn for hours. I get anxious about stuff that logically makes no sense. I am extremely shy and awful at making friends. I constantly need reassurance in every friendship. I have never been in a relationship. I can’t even imagine trusting someone that much. I will probably be single the rest of my life. I have awful trust issues that stem from some pretty serious issues with my father who betrayed my trust when I was ten years old. I never got counseling for what happened and I definitely needed it because it completely destroyed me. I had a rough childhood. I need constant reassurance in my friendships to make sure I’m not a bad friend, but most of the time, the reassurance does not even help. I feel like a worthless friend, and I honestly am because there is not a single person I haven’t lied to. In order to make up for me being such a terrible friend, I try to help everyone with all of their problems. I can’t say no and that increases my anxiety. I try to solve everyone’s problems even when I can’t. I want to be there for everyone, even if we aren’t close friends. A lot of people confide in me. My anxiety keeps getting worse. Honestly, I’m terrified I’m crazy. What is wrong with me? I should be happy. I’m on a full ride to my first choice college. I have friends and family who cares about me.

I think it is very brave of you to be vulnerable enough to write this email. Since you are at a university it is time for you to get the counseling that you need for coping with and surviving a rough childhood. Now is the time to sort through the need for so much attention, the lying, and making up the stalker.

When people we should have been able to trust betray us it causes us to challenge our way of being. Much of what you are coping with is likely to have come from the difficulties in childhood. The university typically has very good therapists on staff who can help you sort all of this through.

You’ve taken a big step here by writing the email. I encourage you to take the next step and talk to a counselor at your school.

Wishing you patience and peace,
Dr. Dan

0 comments

Terrified of Past Paranoia Resurfacing

by Holly Counts, Psy.D.
written by Holly Counts, Psy.D.

To start, I should explain I’ve always been rather imaginative, a trait which hasn’t been lost as I’ve matured. I could think things into being, see the future, and I’d caused the death of my grandfather by picking up a penny which’d been facing tails-up. Mind you, I was well into high school and still find clues and symbolism where I know they certainly don’t reside. But these do me no harm, really. The most harmful of these was an obsession with my weight. The fear of becoming fat slowly morphed to the fear that I was already fat and my perception was warped, which soon escalated to the accusation that everyone else was keeping what I really looked like from me, frequently dropping hints as a sot of inside-joke. The size on my trousers had been changed as well-an idea I knew was impossible, yet still entertained. Needless to say, I became obsessive over the intake and burning of calories. Then, a couple years later, a light clicked and I realized how delusional I was. Mind you, the weaning process was slow and steady-it took months before I could drink juice without becoming anxious-but self-awareness is the first step to recovery. I’m learning, unfortunately, that this is an issue which doesn’t simply disappear. As of late, I’ve become aware of those same vain whispers. They are beginning to resurface and though they aren’t as loud as before, they seem to be getting harder to ignore. In October of last year, my family and I went on a picnic, to which I wore a sort-of-midriff. When my mother sent me the pictures she’d taken, I had so much anxiety I cried. It was such a dreadful panic. I thought I was over my fear of weight-gain, but something as simple as a picture set me off. Logically, I know I’m thin, yet I can’t fully convince myself. These thoughts have been building, and I’ve been trying to ignore them, but it isn’t working. I’m so terrified of this fear regaining its strength and avoid activities or clothes which may trigger the anxiety. How might I put an end to this before it becomes severe? (age 20, from US)

Thank you for writing in with your concerns. You have provided a lot of detail but you did not mention if you have ever sought professional help. It sounds like you have just worked on your issues through your own self-awareness and efforts to make personal changes, and it sounds like you have had some success with this approach.

However, since the issues are resurfacing, I feel that it would be best for you to seek help at this point. You describe paranoid/delusion thinking but I’m also concerned that you have developed an eating disorder. In either case, a therapist can diagnose what is really going on and help you develop a treatment plan. You don’t have to deal with this alone. You have already taken the first step by reaching out, it’s time to take the next one by seeking help.

All the best,

Dr. Holly Counts

0 comments

Question Regarding the Current Method Of Psych. Proceedings

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I have been restarting psychotherapy. I have been having a psychiatrist(meds.) for a while now. I started and stopped a year ago. I have been back at it since about February. Every type of medication works for a short while and then stops or causes me side effects (such as shaking, feeling even more depressed and having More mood swings….) –all of this happens in less than 2 months, Everytime!! (I do the first 3 weeks to adjust for all)

So, during my last appointment(on Zoom), I asked if it were possible for me to start my therapy as I’ve been with them for nearly 6 months now; I also wanted to know if it were possible for me to STOP any new meds.

I want to know what I can say/do. I told her that I am possibly pregnant; she just searched up the med. and told me that they won’t affect me until third trimester.

I was born disabled and don’t want ANY Meds. in my system!! I also don’t want to become addicted. My pain meds. barely work as well and I have to take them every day. I don’t need something else messing with my system and causing anything new and wrong!!

She just told me that I Have to Do BOTH(psych. AND Therapy). I just want to cancel out psych, as they gave me a choice in the beginning.

There is basically, only ONE facility that I can go to and this place is Always changing out doctors as they continue to leave; One reason I decided to stop in the first place.

I mean, I DO have a Right as a Patient to choose my method of help, right?? But will I get in trouble with anyone else for deciding to stop All medications?? I just won my SSDI case(they wanted to say I wasn’t disabled anymore because I turned 18). This is recent and although everything is still new, will removing my medication so soon affect me??

I don’t want to Have to LIE to them(psych.) and just have my pills sitting in a drawer and my record being falsefied….

Anyways, What can I do? What can I say?

If pregnant, I don’t want ANY New meds., no matter how LOW they try to make the side effects seem!!
All she was worried about was scheduling a therapy appointment and telling me to use Protection. It made me feel as though she just wants to earn her pay by adding another patient who isn’t allowed to leave. (If you could understand what I mean) THANK YOU FOR READING!! I REALLY APPRECIATE IT!! (From the USA)

I can certainly understand your desire to refuse medical treatment and yet want the psychotherapy. While the mainstream standard is typically to use a combination of medicine and psychotherapy together for the best results, there is also emerging evidence that some psychotherapy approaches may work better than this treatment as usual as these references on positive psychotherapy will attest to. On the other hand, there are legal rights that you should become familiar with in both your state and as a patient being cared for.

Naturally, I can’t give you medical advice, but I am certain that a physician had to evaluate you for your Social Security Disability Insurance claim. It might be worth it to contact him or her and explain your situation to see what might be recommended.

Also, the fact that you are pregnant means that you can get the opinion of the OBGYN specialist to weigh in on helping you with the medicine decision. You could also ask to be reevaluated by someone else at your clinic who might see the risk during the final trimester as evidence enough for them to honor your request.

In any case, I strongly recommend you find medical help to help you safely come off the medicine. You don’t want to do something unknowingly that might be dangerous or difficult. A medical opinion on this is essential.

Wishing you patience and peace,
Dr. Dan

0 comments

Feeling Like a 24-year-old Deadbeat

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I am writing to you for help. Almost every day, I am overcome with feeling of doom. A dull, gray doom in my belly. And with good reason– I’m 24 years old and I just can’t get the hang of life.

I’ve had severe social anxiety since I was a little girl– this feeling of intense aversion to social interaction has been with me literally since pre-school. I’ve been treated with medications of all sorts for 8 years now. I’ve had 2 regular CBT therapist with whom I had regular meetings, but that ended when I lost my health insurance. Additionally, I have been hospitalized for depressive episodes, and gone to in-patient clinics, as well as a 4-month long “dialectical behavior therapy” program.

But every time I think I might be getting better, it all comes crashing down. I’ve enrolled in and dropped out of 4 different colleges. I couldn’t find a way to fit in or summon the energy to go to class, and I could not life my mood enough to succeed.

Now I have a job that I generally enjoy, at a small business run out of my boss’s home. There could not be a less stressful job, I make awesome money, and I love my boss… but I keep not showing up to work for weeks at a time. This happened once last December (2 weeks absence), then again in March (1.5 weeks absence), and now last week I could not go in either. God knows how I still have the job– I think my boss bad for me, I know she cares about me, plus, as I said, it’s a really small place with no real attendance policy.

But I feel so guilty I’m sick about it. I know this is unacceptable, but I just feel.. doom.

But this time I think it’s the last straw with work. I just could not go to work. I don’t understand it– when I skip work, all I do is wallow and watch game shows, but at the time it feels like that small amount of solitude and peace is worth the trouble of yet another unexplained absence.

I could not blame her for firing me, if she does, but I’m terrified of confrontation. How can I just show up on Monday knowing there’s another “talk” waiting for me? I cry at the slightest negative remark about my behavior, even if I’m guilty of it. I am so timid it’s embarrassing.

I have a boyfriend and we live together and I love him, so that’s good. I have a supportive family. But I just feel like it’s really time for me to come into my own– I’m already 24! Yet I remain paralyzed and ashamed, anxious and unhappy. I can’t give up and quit my job, but I might have to, but I’ll never be able to get another job, especially in the public sphere, even though I have in the past… I’m so embarrassed because I was a top student in high school, I was supposed to have a bright future. But for some reason, I totally crumbled.

I know you will say that I should get back into therapy but what about in the short term? I am on antidepressants, my psychiatrist really listens to me, but they just don’t help– I can’t stop this lethargic, shameful, self-centered lifestyle. Please don’t think ill of me or that I am being whiny and that I need to grow up– I know I do. I just can’t quell this behavior; I’m not even sure I know what’s going on.

Please help me. Your words would mean so much. Thanks for reading.

I would characterize the way you describe yourself and your situation as harsh and hypercritical. It is unlikely that you would think this harshly of a friend or a family member in a similar predicament. You most likely would have more sympathy for others than you have for yourself. I have sympathy for the fact that you are truly suffering; I would suggest adopting this personal attitude towards yourself.

It is important to understand that having a mental health disorder is not your fault. It does not make you “self-centered” or “whiny.” You also should not feel “shameful.” Just like people do not choose to have cancer, people do not choose to have a mental illness. You are clearly not choosing your way of life. You are desperately trying to improve your life but are having difficulty. If you could help yourself out of this distressful situation, you would.

It also seems as though you are comparing yourself to other individuals your age and concluding that you are in essence a failure, “a 24-year-old deadbeat” to use your words. This is an unfair comparison. As you mentioned, you have been struggling with a mental health disorder since you were a child. You are comparing yourself to people who likely do not have depression or anxiety. Everyone’s situation is unique to their specific life circumstances. No two people have the same set of life circumstances, therefore a comparison of this nature will always be inaccurate.

You are having difficulty identifying the problem and knowing how to treat it. You correctly speculated that I would suggest returning to therapy. You have tried counseling on several occasions without success but that doesn’t mean you should give up trying. Finding the right therapist could make a major, positive difference in your life. The alternative is to do nothing and to continue suffering. Those would not be wise choices. Knowing you have a mental illness and deciding not to treat it is akin to learning of a cancer diagnosis and refusing chemotherapy.

What can you do in the short term? Ask for referrals and recommendations from friends and family. Ask your psychiatrist to recommend highly qualified therapists that have a track record of successfully treating depression and anxiety disorders. Another idea is to call at least 5 to 10 therapists and speak to them about your problem. Ask them specifically how they would help you and in addition ask if they have treated others in similar situations and to describe the outcomes of those cases. Make an appointment with the therapist who you feel the most comfortable with over the phone.

You should also surround yourself with supportive individuals. Fortunately you have supportive friends and family. Do not hesitate to utilize their support during this difficult time. Spend as much time with them as possible.

As for your job, you may want to speak to your boss about this situation. It seems as if she is an understanding individual. She may sympathize with your situation and suggest a short leave of absence. Your honesty with her may help to save your job. A leave of absence would afford you time to focus on your treatment. You may also be eligible for family medical leave. The Family Medical Leave Act (FMLA) is a federal law that allows employees to take a leave of absence for up to 12 weeks (usually unpaid) to care for an ill loved one or to “take care of one’s own serious health condition.” You could read more details about FMLA here.

I hope this answer is helpful. Please consider writing back and letting me know how you are doing. I hope to hear back from you in the future. I wish you well.

0 comments

Anxiety Is Ruining My Life

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From a young woman in the U.S.: Since around the age of 10 years old to now, it feels as if my anxiety has been a building pressure in my mind. At first in the very back of my thoughts, and now seeping into every second of my life. Conscious or not.

When I’m driving, when I’m watching Netflix, when I’m in the bathroom. Even when I’m asleep. The slightest bit of stress and anxiety is enough throw me into a panic attack and it feels like a spiraling, uncontrollable rollercoaster ride with no end in sight. It’s incredibly frustrating and leaves me feeling hopeless and like I’ll always be like this.

Now, I’m sure there are many reasons for this irrational anxiety. My early childhood sibling abuse, my molestation by another girl when I was 8, a year of bullying in the 5th grade, being separated from my older sister – who I had always been with my whole life and my closest friend, the countless times where someone I trusted and gave my all for would let me down. The list goes on.

Sometimes I feel too broken to fix myself. The thing that has pushed me to seek advice today is my panic attacks. Specifically, my night terrors have been escalating. Increasing in intensity and frequency. I’ll jump in the night and yell for my sister, tell her i’m dying and eventually fall asleep if I’m lucky, I don’t remember the next day.

There is a history of sleep talking and walking on my mother’s side. I suspect anxiety as well.

I’ve started to have a small moment of intense panic daily. I can’t cope, I can’t lie down to sleep because I’m afraid of freaking out. I often panic when trying to sleep. I hate driving because I’m afraid I’m gonna have a freak out in the middle of a highway.

I’ve tried calming myself with different tactics. Grounding myself – grabbing onto what’s real around me chanting “You’re okay. You’re okay” to myself. Looking like a loon. Or trying to imagine a calming, safe place to pull myself into. I can almost never calmed down completely by myself and I call to my sister. Usually randomly telling her I love her or asking her to tell me I’m okay.

I NEED someone else to soothe me and it drives me crazy. I’m not how I am supposed to be – and I know it. When I panic it’s like I change into a 6 year old version of myself that doesn’t know how to breath anymore.  Why can’t I control my own mind? I honestly feel like I’ve gone crazy sometimes. This hopelessness is not only sad and scary, it’s isolating. I scare myself.

What a hard way to live! This sounds so scary and painful! I’m am very, very glad you wrote.

What you are describing is consistent with a diagnosis of a panic disorder. This is different from an isolated panic attack. Your experiences of anxiety are happening frequently. If a panic disorder is untreated, it can severely limit one’s life. Often a person starts being intensely afraid of having another attack, which ironically brings it on.

It’s a good idea to seek medical advice because sometimes what looks like a panic disorder is in fact a signal that something medical is amiss. So do see your doctor. Bring your letter with you to help your doctor understand the intensity of the problem.

If you are medically okay, then please see a counselor who specializes in anxiety disorders. Panic disorder is extremely difficult to manage on your own. You deserve to get the attention that will give you relief.

I wish you well.
Dr. Marie

0 comments

Stuck in My Own House

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Firstly, thanks for whom takes your precious time to help me out.

Since birth, I rarely leave my house; only if in very need. As a result, now with 28 years old, I have never had a single girlfriend in my life and spend a full time day in my house only talking with my mom. With such loneliness I suffer now from a massive depression.

Tried to find relationships online, but only found sexual deviants that only wants you to make sex; the mental healthy people that I am looking for simply aren’t there.

Being alone I find no will or purpose to leave my home just by myself since when visiting places I don’t have nobody to share feelings and thoughts. I feel intense envy looking to other people in group or couples, as well.

Also, when living in the top homicidal country which is Brazil, I feel constant fear of being killed in a assault on the streets. That way I keep myself avoiding leaving my house more and more to the point of a hermit.

While other group social activities like college to meet new people, I tend to avoid after being mild bullied in school times. I don’t have any sort of social phobias, just don’t want to endure a possible bullying scenario in a college and pay expensive for it just to find someone to talk when life can offer me other happier options to socialize.

It has been like this for 12 years. Stuck in my house talking to myself only. No will to do nothing; just meet a special one.

Tried some therapists, but they don’t know quite how to help me. I am scared. Thank you!

Knowing “why” someone engages in a behavior is often helpful. At first, you might not have left your home because of habit. Your habitual behavior might have evolved into a phobia. Fear seems to be the root of your problem.

You mentioned your living in a dangerous country, as one reason for not leaving your home but this may be a rationalization. The vast majority of people who live in Brazil are aware of the crime problems, but they still leave their homes. If it’s safe enough for them to leave their homes, then it’s safe enough for you. It is always safer to stay at home, but much of the good that life has to offer lies outside your door. Playing it too safe, means one is not really living and I think you have described the quality of your life as being exactly that way.

You’re frightened of going outside of your comfort zone. You avoid doing things that make you feel uncomfortable. These are common experiences among people with anxiety disorders, particularly those with phobias.

When you think about leaving your home and become frightened and then decide against leaving, you have given into your fear. Each time that happens, your fear is being reinforced and strengthened. Your fear has probably grown stronger over time because it’s being reinforced. That will continue to happen unless you address this problem.

You could eradicate your fear by engaging in the very things that frighten you the most. In your case, that would be leaving your home even when you’re frightened, uncomfortable and don’t want to do it. I don’t suggest you try that without the assistance of a mental health professional.

Counseling is the ideal solution to this problem. You’ve tried several therapists but you should keep trying until you find one who can help you. Choose a therapist who specializes in avoidance behaviors and phobias. There are therapeutic solutions to this problem and it’s very curable. Please take care.

Dr. Kristina Randle

0 comments

I Can’t Get My Dad to Listen to Me

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

My Dad and I usually get on quite well. We have a lot in common, but whenever he cooks or cleans he doesn’t do the job properly. For instance, he won’t wash his hands before cooking or clean the sides down properly. I’m generally not that bothered by germs but everyone knows the basics of hygiene in the kitchen. I try to tell him that he should wash his hands, but he just get annoyed, and makes some excuse like he’s ‘thinking about other things’. 9 times out of 10 he doesn’t do the washing up properly either eg. there will still be oil on the frying pan. So when I try to do it or I tell him that it’s unclean he just gets irritated and says “your being rather annoying now” when I’m just trying to makes sure my sister and I get a healthy meal in a clean kitchen. My mum usually makes sure that the kitchen and everything else is clean but she’s away seeing her parents because my grandma’s going into surgery soon. Now my dad’s left with us he just seems incapable of doing even basic chores. I can’t keep pestering him but he doesn’t learn. It could be that he listens to my mum or that she does it usually and dad hasn’t had to do the washing up more than once every few days. I think it’s a bit of both.

I don’t know what to so because I try to help and do things so my dad doesn’t have to because it must be stressful for him with mum away but I can’t do everything. I’m just trying to look after my sister and making sure both her, me and my dad have a nice clean house to live in. The worst thing would be that my mum comes home to a bomb site of a house with plate piled up from dinner two nights ago. I just feel like it’s my responsibility to look after my family while mum’s away but I can’t seem to get through to my dad. What do you think the problem is and what should I do? Thanks (From London)

It isn’t your responsibility to look after the whole family while your mom’s away. Everyone needs to do their part — and it sounds like you are acting more like a mom than a daughter with your father. I would ask how you can help him rather than only try to help on your own. At dinner time you might be better able to influence if you did it by example rather than telling him what to do. Ask how you can help and wash your hands as you invite your dad to do so as well. Everyone is under stress while your mom is gone — don’t feel you have to answer for everyone and everything — just do your part.

Wishing you patience and peace,
Dr. Dan

0 comments

Brief Episodes of Psychosis?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Hi, this has been bothering me for quite some time. I am looking to get some clarity about some major psychological symptoms I suffered from in the past which actually became alleviated on there own. Now in hindsight I’m wondering what happened. I am a 36yr old female. When I was between the ages of 11-19 my home life was incredibly tumultuous and stressful. Not surprisingly, I suffered from insomnia and from 16-19 began taking a fair amount of Melatonin to try and get my sleep cycle back in order – which didn’t work. All of my symptoms only came on at night – not when I was sleeping but the house was quiet and everyone else in bed. I would have auditory hallucinations of people talking in the attic above me or outside my window. Always just low enough so I couldn’t make out what they were saying but loud enough that I was absolutely positive someone was there. I was also incredibly paranoid about people breaking into my house (and thinking I would hear people breaking in) which would lead me to be up and down all night checking out sounds and checking doors to make sure they were locked. This went on almost every night for months at a time over several years. Eventually, I moved out, began to create healthy limits with my family and the symptoms subsided. Aside from a few episodes of sleep-walking, everything was pretty normal until I was about 27-29. I moved into a house with my not-yet husband and was unhappy at my job but the stress was nowhere near the level of my previous home life. Again, the symptoms resurfaced. I wasn’t sleeping. I was stay awake or sit up in bed for hours because I kept thinking I heard people breaking into the house. I was hearing noises and get up again and again all night checking things out, only to have no signs of anything amiss. Eventually, the symptoms subsided, I quit my job and haven’t had these symptoms since. Yes, I do have a history of mental illness in the family – Bi-polor disorder, schizo-affective disorder and major anxiety disorders. Can someone explain what may have been happening to me? I appreciate this so much.

I doubt seriously that anyone could, with certainty, explain the cause of the events that you have described in your letter. Though I cannot conclusively explain the cause, I may be able to add some insight as to the possible cause. First of all, according to your letter these events only happened at night when the rest of the household was sleeping. This tells me that, in all likelihood, you were also trying to sleep or at least in a time period designated for sleep.

When we are awake we are conscious and when we are asleep we are unconscious. That would be simple enough if it were a binary system or a digital system where conscious was a one and unconscious was a zero but instead it is an analog system. If we think of consciousness as a one and unconsciousness as a zero, an analog system tells us that there are an infinite number of points between one and zero. There is a 1.0 and a .99 and a .999 and a .099, etc. In other words, there are many states between conscious and unconscious. These states are generally known as altered states of consciousness. You can think of a state of meditation, or hypnosis as an altered state of consciousness. An altered state is a mixture of the conscious mind and the unconscious mind. As you are very well aware, dreaming occurs during sleep and is a product of the unconscious mind. The unconscious mind is more than capable of producing every sight, every sound, every smell, every feeling and to produce these with the realism that at times seems actually more than real. Almost everyone has had a nightmare that was so real, so terrifying that they stayed up the rest of the night so as not to take a chance at returning to the same dream.

You stated in your letter that these events occurred during two specific periods in your life, both of these were periods of fear or anxiety. You also mentioned difficulty sleeping during these periods. Fear or anxiety inhibits the transition from consciousness to sleep. In essence, during these periods you were not asleep nor were you awake. You were in-between sleep and full consciousness and most likely experiencing an altered state of consciousness.

I hope I’ve shed a little light on a possible cause for the experiences encountered during your sleepless nights. Good luck.

Dr. Kristina Randle

0 comments

Trust Issues in Relationship

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I met my b/f in high school, we never were romantic until I was 18 and bailed due to trust issues in him, which hurt him. We talked randomly through the years and both had things in life happen. I grew up and accepted life, the past and change in people. He does not and resents the past a lot.

In 2015, we began talking again and have been together since then. We have always just connected and been able to get along with no issues. He still had issues with me from the past, but I just continued to prove myself.

In November of 2016, he asked to look through my phone to alleviate any trust issues. I knew it was wrong to do, but I said yes, because I know I have been faithful since. After 30 min of looking he found a text to my ex that was somehow saved from February 2016. My ex and I had broken up in 2015 and it had been bad for a long time and I knew I had no romantic feelings for him, but my current b/f felt otherwise.

I have never been good with break ups and even after spouts of being rude, I am a kind person and just try being nice. My text said, ” Hi, I am not going to be rude, we can talk if you want. I still feel the same for now about being together and know that upsets you.” He and I never did talk and I haven’t seen since 2015. My b/f said I betrayed him and am not trustworthy because he told me not to talk to him. He even saved the message and reads it now.

Since then he has shut me out and made me feel horrible. He states he knows I am not a bad person, am a lot of good things and he is confident I won’t do anything wrong now or in the future, but doesn’t change his mind. He doesn’t want to “leave” me, but won’t put in effort. All I have done is prove my love and loyalty, even now. I have even started going to therapy for myself. I don’t know what to do. I have never felt so strongly about someone and in 12 years have never let him go.I accept flaws, mistakes, human error and don’t judge. (From the USA)

 This issue isn’t yours to work on now. You’ve done your part, explained yourself, and your boyfriend is looking for ways to blame you. Scrolling back six months to find a text that said you didn’t want to be rude, but talking won’t change things to your ex isn’t cause for breaking up — unless you want it to be. Your boyfriend found something he wanted to find. Rather than see it for what it was, a statement of disengagement from your ex, he took it as a sign of betrayal. His insecurity, jealousy, and vulnerability has the best of him.

I’d be clear that he will either have to trust you or not, but that the issue is his to solve — not yours. If he can deal with it, that is great. If he can’t, don’t waste more of your time trying to prove yourself. He will find something to think he is being betrayed even when it isn’t the case.

If you want to offer going to couples therapy, I think that would be a very open gesture, but this may be something your boyfriend might want to try tackling on his own. The find help tab at the top of the page will help you find someone in your area.

Wishing you patience and peace,
Dr. Dan

0 comments

I Have Constantly Conflicting Views

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From a 13 year old in the U.S.: Hi, I don’t know if I’m too young for this, but I’ve always had trouble determining what I truly believe in. Almost all of my actions, thoughts, and beliefs conflict with one another. Sometimes talking to people is easy while other times it’s impossible. Sometimes I’m unbelievably emotional while other times I just can’t seem to understand people. I always considered this normal and human, especially for someone my age, but it’s gotten to the point where I honestly can’t tell the difference between what I really believe in and what I think I do.

In general, I’m often unsure of myself and don’t know how to interpret something, mostly my own thoughts. For example, I honestly don’t know if I’ve ever developed a crush with anyone since I really don’t know what that would feel like. This mainly becomes an issue when my morals change drastically, switching between a very normal view-point and something completely different from the usual.

I don’t know how to say it, but there are times when I just don’t understand myself. It’s like I’m a different person. I’m constantly changing beliefs, moods, and personalities to the point where I don’t know what I really am like. I’m good at hiding it, however, so no one ever believes me or takes me seriously. I can’t even take a simple personality quiz without sitting there thinking about what I really am.

I’ve always heard that it’s normal for teenagers to be questioning themselves, but I’m the only kid I know that downright questions their personality. It’s not too much of an issue now, but what if this continues when I grow older? I’m just tired of constantly questioning myself.

I’ve wondered what would happen if I died, but more on a philosophical view. I’ve never actually considered it, and I’ve never experienced any major trauma in my life. I have a habit of repeatedly washing my hands and preferring to have things organized, but sometimes I don’t care. I also find myself being very sensitive to textures. For example, if I see a sharp or rough surface, even if it’s in a picture, I want to touch it. Once again, there are days when this doesn’t happen at all.

What should I do? Is this normal? How can I tell my parents and friends so they take me seriously?

Your letter shows you to be a very sensitive young woman who is asking the very big philosophical questions. In addition, you do apparently have a tendency to be somewhat obsessive. That’s a combination that leads to the kind of thinking you talk about in you letter.

Please — Quit taking personality quizzes! They are, at best, a crude indicator. For a 13 year old with your questioning mind, such quizzes are not going to be helpful. In fact, they may only confuse you further.

I suggest you relax. In fact, I think you should approach your questions with curiosity and interest, not judgment and worry. Live your life. Find something to do that contributes in some way to making life better for others. Treat your body well by getting good sleep, eating well and getting some kind of daily exercise. Chances are, your questions and feelings will settle down on their own if you give them a rest.

I wish you well.
Dr. Marie

0 comments

PTSD From Plant Closing?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I have been suffering from many of the symptoms of PTSD, but have never been in a situation in any of the outlines. I did spend close to two years working in a plant that was closing. I was in a position that dictated the schedule of the dismantling of the physical plant and had to deal with the people that were losing their jobs. People I worked with many years, some went peacefully others struggled to hang on then became angry and destructive. Since this time I have had trouble concentrating, sleeping, I feel guilty, I worry that it will happen again at my current job, I get angry for no real reason and I am jumpy as though I have been caught in the act of doing something wrong. I also went through my wife losing her job, subsequent bouts of her drinking, drugs and attempted suicide by first police threatening to shoot and then by drugs. Could I be suffering from some kind of PTSD?

PTSD commonly occurs after a traumatic event and can last for months or years after an incident occurs. If you experienced those two years of working in a closing plant as traumatic then it would be considered diagnostically “a traumatic event.” Because you perceived it as a traumatic event and due to the other symptoms that you mentioned, it is reasonable to believe that you may be suffering from PTSD.

As you mentioned in your letter, your experience was distressing. You said you worked at a plant that was closing and had to schedule the dismantling of the plant and also had to deal with people losing their jobs. As you witnessed, many of those individuals had difficultly, understandably, leaving their jobs. One thing that is not clear from your letter is whether you had worked in the plant too before you were asked to participate in the closing process.

Unfortunately, many Americans are experiencing job loss. The latest jobs report showed that unemployment rose to 6.7%, worse than previously expected.

Psychologically having a job is important and losing one’s job can be devastating. Without a job, many people feel inadequate or believe that they have nothing to offer society and subsequently become depressed. For a large majority of people, their job defines who they are; it brings meaning, organization and stability to their lives. On a pragmatic level, losing a job can mean losing health care, financial stability, the chance to retire with dignity and much more.

Many factory workers work their entire adult lives for a company. Sometimes generations of families work at the same plant. Being laid off and having to physically dismantle the plant has be extremely demoralizing. And having to witness that take place and being part of that process, as you were, understandably, has negatively impacted you, to the point where you may have PTSD.

After your experiences with the plant closing, it is understandable that you would be concerned about losing another job or have trouble concentrating, sleeping or to be angry and jumpy. You also said that your wife has recently lost her job as well as experienced some traumatic events of her own. Having to deal with all of these unfortunate events must be difficult for both you and your wife.

It’s normal to have some reaction to the events you experienced but if you continue to suffer with PTSD symptoms then you should consider seeking professional assistance. PTSD is very treatable and the treatment usually consists of either medication or psychotherapy, both of which have been found to be effective.

I am sorry that you are having a difficult time and if you can, please try to seek help. Thanks for writing and please consider writing back and letting me know how you are doing.

0 comments

Psychotic Boyfriend Who Thinks He Is a Psychopath

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Hi, My boyfriend – who took lots of drugs and cannabis – had a psychotic crisis in March this year. He thought he was a psychopath (not a criminal one) and said lots of strange stuff. First I was OK with it then became very anxious of all that happened, i couldn’t sleep and became very tired. I didn’t have much news neither as he went back to his home country. I didn’t know how things were and became more and more anxious. Made myself movies. Read a lot about psychopaths and psychotic people on the internet and with the tiredness, not having much news I began to think I was a psychopath myself, that I am a very bad person and began to have flashes of me doing bad things to people and i got very scared so i didn’t sleep well again for weeks. Being very anxious. Sometime I am good but sometimes suddenly it comes back and I have panic attacks or very anxious time. I am very scared and it is not possible to live like that. I am scared to ask him if he still thinks he is a psychopath. I know it has never been linked with criminal stuff but I turned it into another way. I don’t know by his family if he still thinks he is. I guess he was just saying shit as he was not doing well.

But now even if my friends, family and psychologist say i am not a psychopath, i still have sometimes, when i am tired or when i have my period, much anxiousness back, images, nightmares etc. And sometimes i feel i got myself back and then it comes back. I can t detach myself from this psychopath word and convince myself I am not a psychopath !!! Being so scared .. Please tell me what you think. Of course you don’t know all the details of all that happened but what do you think ?

This could be an anxiety issue. There is a specific type of anxiety, called illness anxiety, in which people believe that they have some terrible ailment. It can persist without evidence and despite reassurances from friends, family and even mental health professionals.

If you don’t meet the criteria for psychopathy and there’s no evidence to suggest that your behavior is indicative of psychopathy, and the psychologist who evaluated you doesn’t believe that you have psychopathy, then it’s unlikely that you have psychopathy. Believing in reality is ultimately the best cure for anxiety.

Psychopathy is relatively rare. Only approximately one in 100 people is a psychopath. Psychopathy doesn’t come and go when you’re tired, anxious or menstruating. It is a chronic condition that begins in childhood. Nothing in your letter would suggest that you are a psychopath. Just because you fear it to be true does not mean that it is true. In fact, fears are often irrational and likely indicative of illogical thinking.

Mental health treatment is the best way to overcome your anxiety about having severe mental health disorders. If you believe in the facts, participate in treatment and avoid behavior that reinforces your fears, you can overcome this problem. Please take care.

Dr. Kristina Randle

0 comments

I Have Doubts about My Feelings and Mental State

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From a 13 Year old girl in the U.S.: For a long time now, I’ve have doubts about my feelings and mental state. Sometimes I feel like nobody can relate to my issues. My mother and I believe I have Anxiety Disorder. The Anxiety makes tiny tasks like speaking to a new person, getting seconds for lunch at school and even serving cake to my own family at my own birthday hard and scary.

I’ve believed for about 2 1/2 years now that the only thing I know how to feel or interpret is Fear and Anger. I know how to get mad, and I have trouble controlling anger, and obviously I know Fear as well. Other emotions like Happiness, Sadness and Love even seem as if they don’t exist in me. Countless times I’ve thought I felt happy, or truly depressed, and recently I believed twice that I loved somebody. Both times when I thought I loved, It faded and I can no longer care about them when I talk with them.

When I think I feel depressed, it seems to turn out as anger, because I never cry. It’s very difficult to move me. I don’t believe I’ve felt happiness since a long time if I ever have. I find it hard to smile when I talk with somebody, due to this I’ve become too skilled in faking emotions, and I believe it’s only part of the reason I confuse real with fake. In the end I always come to a conclusion that my mind is only trying to substitute these missing things from my head.

Recently I’ve felt like It’s getting harder to Talk to people at all. My mother is always supporting me and trying to help me, but I feel like she wouldn’t ever look at me the same if I told her that when I smile I’m just faking it, and that when I laugh at her jokes I never actually find it funny.

Even though my dad is not around, I prefer that he not be because he drinks a lot and makes no attempt to see me or spend time with me, he never really has. I have been bullied from about 6-10, but nothing serious. It really concerns me, and I want to be able to talk to my friends and family with a sincere smile. Any help or guidance is appreciated.

Whenever I hear symptoms like yours, the first thing I suggest is a visit to your medical doctor. There are many physical problems that can cause anxiety and mood changes — especially at your age. If you are still seeing a pediatrician, you might want to request a referral to an endocrinologist. It’s important not to jump to the conclusion that the problem is mental before checking out the physical. If you do have a medical problem and it isn’t attended to, it could get worse.

If are physically fine, then it would be helpful for you to see a therapist. It may be that you do have anxiety or you may be depressed. Depression doesn’t always show up as sadness. It can also show up as anger and feelings of emptiness. You also may have some unresolved issues regarding your father’s alcoholism and absence.

A therapist will be able to assess the difficulty and will make recommendations for how to treat it. Since your mother is doing her best to be supportive, it would be helpful if you included her in the appointment. With some coaching, she may be able to provide you with more helpful support.

I remind you that going for an assessment doesn’t obligate you to getting into therapy. You may or may not want to proceed. But the assessment alone may give you and your mom some new perspectives on your distressing feelings and what can be done about them.

I wish you well.
Dr. Marie

0 comments
Newer Posts
Older Posts

This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish. Accept Read More