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Depression

I Feel I am Going Out of Control

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

I’ve been feeling so bad lately, and I’m getting worried that I am losing control of myself. For the last months I’ve been more distressed than usual, and most recently very sad/angry/hopeless. It seems that I am a bitter, always angry person (well, i think i’ve been like this since childhood). But it’s getting out ot of control. Today my mom got home and realized I hadn’t done something she told me to, and got angry towards me. I got extremely angry at myself that I wanted to smash my head onto a wall, wanted to hit and bite myself (which I did) or even throw myself down the stairs. It is the second time in less than a month that I sef harm, and this is something I have had since childhood, but just recently is happening again. After that I feel so bad that I want to kill myself, and I feel strange, like dizzy/drunk/sleepy. I am sometimes  afraid that I could eventually lose all control and really harm myself or others with severe consecuences. I feel so embarrassed for this that I find it difficult to tell my psychiatrist, she still doesn’t know. I also haven’t been able to tell her that I feel so angry or depressed, because I think she may think that I have no reason for such feeling/thinking and it was my choice to be like this (This is what my mom believes and tells me). I go to psychyatrist because an anxiety disorder I was diagnosed with almost a year ago, and took clonazepam for several weeks, but I haven’t seen her since may. I think I don’t know what to do, as it seems to me that I’m caught in a vicious circle of anger/sadness and destructive and anti-social behavior, that I don’t know how to get out. Apart from that there are a bunch of thoughts that I don’t know how to control, no matter if I tell myself that I’m being irrational, I always end up thinking that I have a serious desease, that I may have cancer. Or how would it be if I died, had an accident, got in coma, etc. I sometimes wish this could be true, so I would have a reason to be such an angry person, but then I think that it must be terrible and I don’t want to face this situations. The truth is I dislike myself too much for being who I am, I think I’m weird and feel so embarrased of myself, nor I like how I physically am. I don’t know, I sometimes think I’m going crazy. All of this has become worse since I failed a subject at college. (age 21, from Venezuela)

A: Thanks for writing in with your question. The first thing you need to do is make an appointment with your psychiatrist and take this letter to her. There is no way she can really help you if you aren’t honest with her about what is really going on for you. She will not judge you and has no reason to question what you tell her. She is a trained doctor so it is very different than telling a friend or family member.

Based on the number of issues you are describing here, I also don’t think that medication is not enough. I would suggest that you ask your psychiatrist for a referral to a therapist or at least meet with her more regularly to work on anger management, self-esteem and positive ways of coping with your distress. I agree that if you don’t do more to get help now, you very likely could harm yourself or someone else. Why take that chance? You are ahead of the game because you are already seeing a mental health professional, but now it is time to be honest about how much pain you are in.

All the best,

Dr. Holly Counts

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How to Support a Depressed Boyfriend

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

I have been dating my boyfriend for almost a year. He has recently come into some hard times.  He lost his job, was forced to move back home, and has been faced with mounting financial debt.  He broke things off briefly because he said he needed to focus on himself while he was dealing with these issues.  While I felt hurt, he made the right decision.  A few days after breaking it off, he called to say he missed me and wanted to work on things. While things in his life were not improving, our relationship was still going well. But the past few weeks it has taken a turn.  A lot of times I try to reach out to him and get no response. I don’t think it has anything to do with our relationship but because of the outside stress he is facing.  When he has faced stressful times in the past, he shuts down and shuts everyone and everything out. I know this is his way of coping.  He usually is back to his old self within a day or two. The longer his situation remains the way it is, the more depressed I see him becoming.  And the more distant he becomes.  I try reaching out to him by text or phone and don’t get any response.  I leave him messages telling him to call me or text me but if he doesn’t feel up to it, it’s ok too.

If I try to give him space by not contacting him, he will call me briefly because I think he is worried I’m giving up on him.  Once he sees he still has my love and support, he goes back into his shell. I know this is his problem to work out.  I try to be supportive without offering any unsolicited advice. I don’t mention anything about his situation when we do talk, and try to keep the conversations upbeat.  If he does open up about his issues Itry to give him encouraging words, such as I have all the confidence that you will figure everything out and I’ll remind him of another time when he was faced with difficulty and pulled through. I feel it starting to take a toll on me. As much as my mind knows not to take it personal when he ignores me, it is just a natural reaction to immediately feel hurt.  I have tried just focusing on myself and going out with friends and family while he can’t be here with me.  But I feel guilty when I go out without him and have a good time. At times he almost seems upset when I’m out without him but turns down my offers to spend time with him.

How can I give him space but still be supportive? If I go without calling, he’s afraid he’s losing me.  If I call he rejects me. I want to be patient because I have all the faith he will get through this soon. What’s the best way to handle this situation? (age 37, from US)

I honestly think you are handling the situation quite well. You seem to understand that you can’t fix this for him and that the best thing you can do is love him through it. If he shuts you out, there’s not much you can do except be there when he lets you back in, and let him know, as best you can, that you do still support him and want to help.

The only thing I might recommend that you didn’t mention is to suggest to him that he get professional help during this difficult time. He may think that he can’t afford it with no job, but there are many agencies specifically designed to help those in need, not only with mental health issues but also with case management type things such as knowing what services he may be eligible to receive. He may appreciate you doing some of the research for him in terms of connecting him to an agency in his area.

Otherwise, I might also suggest you educate yourself on the issues involved in loving someone with depression. Two books that come to mind are: I Don’t Want to Talk About It and Depression Fallout

All the best,
Dr. Holly Counts

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I Feel Like I Have No Support

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

From a teen in the United Arab Emirates: I’m a 15 year old girl. I’m highly stressed when not in control. I cry very easily. If I’m around (or living with) more than two people, I experience anxiety. Here’s some background.

For seven years, I lived with an in-house maid, with my working mum making appearances in the evening. Then, I dropped out of school and moved in with my dad in another city. Here, I had the house to myself every other day. He boarded at the construction site he managed thrice a week.

My paternal grandma also lives here six months out of the year, traveling to her home country every three months. When she’s here, my dad is away for even longer. My grandma and I have a language barrier and only talk superficially.

[Issues with my dad: He leaves me large amounts of money when he leaves, as a substitute for love. He apologizes by buying me Cheetos. I resent that I have never gotten a verbal apology from him. When home, he’s either on his work phone, watching reality TV or sleeping early. He’s also highly unaware of himself and escapes confrontation. Which is MUCH needed.]

So, I am left with no support;

My mum has been in another country for too long. (She’s the only one that understands things right.)

And somewhere along the way, I was depressed and cut off all my friends. I haven’t befriended anyone new because I have very strong opinions and am forced to pretend;be tactful;in social situations.

Now, the issue I’m currently (!) dealing with is my paternal extended family who’s visiting, including an aunt that invades my space, and an uncle that criticizes my weight and body in addition to sexualizing me. (My paternal family defends him.) Plus two cousins. For the last two days, my aunt has been entering my room without knocking and ignoring the visual sign on my door, which I resent. I also fear leaving my room and having my uncle look at me. Because of this, I locked my door earlier today and my aunt keeps calling for and haunting me. I haven’t replied.

I hate being around so many people.I am highly stressed and have been under my blanket for a couple of hours. I’m also considering staying here till they leave in a few days.

That’s about it. What label can I give to what I’m experiencing?

I don’t think there is a “label”. It sounds to me like you are feeling unloved, lonely and scared. That’s reason enough to be anxious and upset. It sounds like your dad doesn’t know how to be a father. Your mom can only mother from a distance. However well-intended your grandmother may be, there’s a language barrier. Now you are living with an uncle who makes you feel unsafe. Yikes! The result of all this is that you have almost no experience with how to live comfortably in a family or how to be relaxed in a social situation.

Sadly, I doubt very much that you will be able to change your family. I do wonder if you can change your situation. If your family can afford it, you might find it helpful to go to a boarding school. That would help you get used to living with other people. It would also provide you with an opportunity to learn how to make friends and get along with others. School mates often become “family” for each other.

If that isn’t possible, then I do suggest you get more involved in your present school. You are not going to learn how to be social by hiding under a blanket. You will only learn how to make friends and enjoy other people’s company by being with other people. A low key way to start is to join an activity, sport or volunteer group. Such groups are at least initially focused on getting a job done, not so much on each other. By joining, you increase the pool of people who share some of your interests and who can potentially become friends.

Yes. You will need to be tactful at times. Tact is what keeps the social wheels going. It isn’t being “fake”. It’s how people get along and develop trust in each other. Once there is trust, there will be room for your stronger opinions.

It’s sad but true that not every kid gets the family they deserve. The good news is that someday you can make one. In the meantime, you need to take care of yourself by learning how to create and keep a few good friends who can provide the support and love you need and deserve.

I wish you well.
Dr. Marie

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Obsessing Over Guys

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

Hi. I’m a senior in high school and going into this year I was highly motivated determined to be the best that I could be. I had a terrible year last school year with sickness, social drama (boys included and lost my best friends), and family and pet deaths. I went into this year a happier person but ever since I became friends with this new friend group I became more social towards everyone and have lost that motivation to do anything academically.

However at the same time I am still not happy with my friends. In one week of knowing them I had gotten so close to well at least the guys but one guy ended up leaving and I hooked up with the another one and now I just feel like I am the black sheep of the group therefore I have expanded my circle. However even when i was hooking up with the guy, i knew i did not like him. however, maybe due to the lack of any other potential crushes, i still think to myself that i may like him. But when i go to hang out i remember that I don’t. A similar thing happened last year except after I broke up with my best friends off limits ex boyfriend did I start to become obsessed about him. I also become constantly paranoid that they have other girls and distrust then. Because of all these guy issues I feel like I’ve started blaming my dad who I have never lived due to work with but is still married with my mom who I can talk to about everything but boys and drugs.

Recently I also randomly feel like crying (and I usually never cry) because i feel like there are so many emotions I’m trying to get out but can’t. Sometimes I even try to force myself to cry because it might relieve me of some of the emotions that are bottling up in my body. Sometimes I all of a sudden have this overwhelming feeling of being trapped and I just need to get out to anywhere and cry by myself when I’m not even sad. But then I wish I had someone that I could run to even though I hate when others see me cry. But other times I randomly become such a fun loving person and can laugh uncontrollably. But it’s just on the surface because I can go back into that weird mood very quickly.

I guess what I’m asking is if you think I have the very definition of daddy issues or am I just blaming it on my dad for the guy troubles (there are more problems than I have named)? And am I starting to have depression?

I can’t tell if you are starting to have a clinical diagnosis of depression. But you’ve shared enough for me to be concerned that you are feeling so mixed up and miserable. To lump everything into “daddy issues” is to make light of what may be a more serious problem. You seem to have a hole inside that is temporarily filled up with a boy or drama or both. All the hooking up and breaking up and questioning and trust issues certainly distract you from the business of doing well in school, figuring out what you’re going to do after graduation, keeping close with close friends and maybe finding a relationship that works — all things that are difficult but important parts of a teen’s senior year of high school.

I also don’t want to overlook the possibility that the emotional upheaval may be medical in origin. If you haven’t seen a doctor for a physical in awhile, that’s the first thing to do.

Medical or emotional, you’ve done what you know how to do to level off. Since all your good efforts haven’t worked, I do think it’s time for you to talk to a pro. Make an appointment with 1) your doctor for a checkup and 2) with a mental health professional for an evaluation. Once you know what you’re dealing with, you’ll be able to decide what to do about it.

Please don’t let more time go by before getting some help. Graduation is coming fast. I think you want to enjoy the last part of your senior year.

I wish you well.
Dr. Marie

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Hating Myself to the Point of Closing Myself Off

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

About 2 months ago, my grandpa passed away. I was really close to him and it was the first death I ever had to deal with. (I’m 15). At first my mother understood my depression, she allowed me to be late for school, and always tried her best to help me. But now that I should “Be over it” I’m not. I feel like I’m still in shock that he’s gone. I don’t know if it has anything to do with this… but I thought I’d mention it.

Lately, I’ve been getting really depressed stages at least once a day. It lasts about 1-2 hours depending on what triggered it. The triggers are stupid, and I KNOW they shouldn’t mean anything. But for some reason, It always hits me. For example, today my brother was joking around and said “Nobody likes you” And although I knew he was kidding, it made me look back on all the guys that made fun of me or that didn’t like me. I then start wondering why they didn’t like me… and I begin picking myself apart. My looks, personality; everything. Because of this I have very low self-esteem. I hate getting my picture taken. And when my friends are kidding around taking pictures, they always want me to join. I always cover my face, which leads to them saying “How are you going to be an actress if you don’t like getting your picture taken?” And then, another depressed stage will happen. I guess overall I feel pretty down about myself. Like I won’t amount to anything. I feel like my friends are better then me, and that my family would be better off without me ruining their moods. I’ve thought about suicide, but I would never really do it. Ever.

I just want to erase my existence from this life. I don’t want to exist; I don’t want to try. I don’t want to care, and I don’t want to feel this way anymore… Any advice or anything…?

You may be underestimating the grief and sadness associated with the death of your grandfather. It was a very recent passing. That event likely accounts for a major part of your depression. Losing a loved one is exceedingly difficult, especially when it is your first major loss. Many people would have a similar reaction to losing someone they love.

You feel that you “should be over it.” I would disagree. There is no identified period of time in which an individual “should” complete grieving the loss of a loved one. Generally, at a minimum, it can take six months to one year to come to terms with the loss of a loved one. Please don’t mistake the phrase “come to terms” with “getting over it.” No one “gets over” the loss of a loved one. It is a process of adjusting to the loss.

Grieving is a process. It takes time. Profound feelings of loss do not simply vanish. They usually diminish over time. In addition, healthy grieving often requires the assistance and support of others. Sometimes professional help is required and I believe that this may be one of those occasions. A therapist or a grief support group could be of tremendous benefit to you. I would recommend discussing those options with your parents. Symptoms of depression, regardless of their source, necessitate treatment.

Finally, when you feel ready, I would recommend finding ways to commemorate your grandfather. Celebrating his life could facilitate the healing process. Please take care.

Dr. Kristina Randle

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Lonely and Depressed. What Should I Do?

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

Q. I am lonely, depressed, have no friends and need help. I have gone through bouts of depression ever since the age of about 10.

Through high school I was reasonably happy and bubbly and had lots of friends until the last year when I lost every friend I had apart from one good friend who I have now lost nine months ago. Since then I just can not make new friends, I have ONE other friend, but this is not a real friend and he does not trust me and I don’t trust him.

My family are bad people. They do not love or respect me so I cannot turn to them. My mother is a good person, however I can not go to her for emotional support as she needs it herself from me as she has her own psychological problems.

People do not seem to like me. I try to be nice, I smile at people when I talk, I appear very confident on the outside. I pay people compliments, but for some reason people just don’t like me. It upsets me alot.

I have a boyfriend of about 8 months and love him very much. He loves me and I know this but because of how things have turned out for me in the past I am very scared of losing him and that the same thing will happen and he won’t like me anymore. I cannot bear to lose anybody else.
I am currently unemployed, I have been searching and searching for jobs, gone to interviews but nowhere has taken me. Everyday I basically do nothing. I stay in my house all day. I don’t know what to do. I have to get out of this but I don’t know how, it is making me a very bitter and unhappy person. It seems like I lose everybody who I trust and love in my life. Some helpful advice would be much appreciated.

You seem depressed. I do not know if it is temporary experience or more of a chronic depression. You did say that you have been depressed since you were about 10 years old and this may indicate more of a chronic-type depression, such as dysthymia. You may also be experiencing a general unhappiness with life, and not necessarily depression per se. It is difficult to tell from your short letter.

You said that people do not like you. This is your impression but the fact is that you do not know this to be true. Unless you surveyed these people about their opinions of you, you do not know this to be a fact. You could very easily be misjudging these situations. It is also possible that you are judging these relationships correctly but you’re trying to befriend the wrong people. Both of these circumstances are possible, therefore it’s best not to jump to the conclusion that it’s “you” that is the problem.

You take this same sort of self-blaming tone and attitude regarding your inability to find a job. Maybe you have not yet found the right employer or perhaps you are sending off a negative or depressive “vibe” to possible employers and that might be why you’re not able to find employment.

You said that your parents are “bad people.” I am not sure what you meant by that expression but I am taking it to mean that they are not people you can or could have gone to for support or advice. You mentioned that your mother has her own set of problems and she may not be emotionally available to deal with your issues.

It might be helpful for you to consider therapy. You said that you have few people to go to for advice. A therapist can help you objectively judge whether you need to alter the way in which you behave in situations regarding employment and relationships as well as help you with your depression. He or she can evaluate very thoroughly the way in which you interact with others and coach you on how to modify your behavior if it is deemed necessary. A good therapist can help you immensely with all of the issues that you’ve mentioned. I hope you will consider this advice. Thanks for writing. Take care.

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I Can’t Control My Behavior

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

From Vietnam: I am having a lot of problem in my relationship recently. And it seem to be the same problems that happened in my last relationships too. I had many broken heart relationships in the past too. I feel like I can’t handle a normal long term relationship. When things are normal and perfect, I tend to start ruining it and getting anxious. I start picking up a fight or being unreasonable and non sense to my girlfriend. Luckily I haven’t made any serious damage yet because I try to hold it up but it’s just escalate more and more in my action and behaviour until I brought us down together. Then I feel satisfy and guilty.

I don’t know how to stop all this. I don’t use any alcohol or drugs. I feel like every time thing doesn’t happen as my way, I started being grumpy and torture my girlfriend but not in a physical way. I tend to bring her mood down together with me. I had this problem too in my last relationships but I was young back then so I am not aware of my problems.

Now I am 28 and I started looking back in the past and realise how crazy I am and how frustrated people have to put up all with these things. I turn to be cold with my girlfriend to make her feel bad and think it’s all her fault even though it’s not. But then when she pissed off and start being cold with me. I started freaking out and worrying. I normally just try to hold up every time the other part of me strike up then let it go but I don’t see it’s the point. It ruins my life and chase all the people I love away from me. I can’t do anything to stop this. In the past I have seen many people I love left me in hopeless.

The first step to solving a problem is recognizing it. I applaud you for facing something that must be very difficult for you. I am very glad that you haven’t complicated things by getting addicted to drugs or alcohol.

It may be that something happened to you either while growing up or when you started having romantic relationships that made you pessimistic about whether someone can really love you. You very much want a relationship, but you fear that you will be rejected. One way to resolve that dilemma is to ruin a relationship before the rejection you imagine actually happens. That makes you feel more in control and preserves your self-esteem. You “fire” your girlfriend before she can “quit” on you (as you are sure she will do).

You are wrong that you cannot stop this. You are only in your 20s. You are not hopeless. Your letter shows that you are smart and insightful. Now you just need some help to overcome your pessimism. If you could do it on your own, you would have done it already.

Unfortunately, I’m not familiar with the services available in Vietnam. If there are counselors, I suggest you see one. If not, you might want to join one of the support groups here on LifeHelper.

You have a long life ahead of you. It’s wonderful that you want to solve this problem now so you can enjoy an intimate relationship with someone who loves you.

I wish you well.
Dr. Marie

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Wife can’t get along with my parents

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

I just got married in June. Before we got married my wife had troubles at home, she’d get into arguments and fits/fights with her parents sometimes. We all thought, including her parents that it was an issue that may be caused by her family. After marriage she moved in with my parents and I and now she’s been having terrible anxiety issues and troubles adapting to my parents. This is their house; we are going to live here for a year or two until we can afford our own home. She has bouts and fits about how she rarely gets alone time; she doesn’t get little things like a toaster (which we recently talked to my dad about, and he begrudgingly agreed to us getting one). She doesn’t talk to them about her troubles, just me. Also she’s recently gotten terribly upset about something my father said.

We were discussing a couple of days off that I was going to take off from work, one day to go to an amusement park with my wife, cousin, nephew, and the second day my wife said she might not be able to take it off, my father said something like oh good if you’re at work he can help me do stuff around the house. She got very upset about it.

Today she’s on the phone with me while I’m at work, complaining and angry and crying about how my father said oh you could just learn to use the toaster oven the way he (me) does. She’s crying and screaming about it. Also she was crying and yelling about not being able to come home from work and just turn on the TV and watch for a few minutes without someone coming over and talking to her, (nagging as she puts it).

I’ve told he that this is only temporary and we’ll be moving out once we have the money and the income. She doesn’t seem to care. She even goes as far as to say she doesn’t want to be married anymore and / or she wants to move back in with her parents. These are just some of the problems / issues she feels living with my parents. I’m afraid that even when we move out and get our own home, she may still feel/act this way. How can I help her, what can I do to keep her from this combustible anxiety/anger/unhappiness?

– Desperate for a fix

Thank you for asking about this and giving us an opportunity to respond. My advice is simple:

Move out.

A year or two of this will create more tension than a home of your own is worth. See this as an experiment that didn’t work out. Get your own place now and stop trying to make something work — and to be blunt, I don’t think this is an opportunity for an extended family therapy intervention. I could certainly be wrong about this, but my sense from what you’ve said is that your parents and your wife need to be separated. The better investment would be for couples therapy.

One of the presentations by Dr. Dan Gilbert at the APA convention this month in San Diego included a piece of research that parents are most unhappy when their children move back into the home. Chances are your parents are not happy about the arrangement, and I would strongly suggest you bite the bullet and get out while the relationships are still repairable.

On the other hand there may be more government help for you to purchase a home than you realize. Here is a link to the government site for housing and urban development with some information that might make your dream a reality sooner rather than later. If it can’t happen now, renting is the best choice for your mental health.

You may also want to have a session or two with a couples counselor as you go through the transition. You’ll want this experience to add to your relationship, not deteriorate it. You may find a referral in your area by clicking on the find help tab above.

Wishing you patience and peace,
Dr. Dan

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Urge to Harm Self, Others

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

I have severe depression…possibly bipolar, urge to severely hurt women. First I’d like to say thank you for answering my question!

Okay so, past these few years I haven’t felt ‘normal’, currently I’ve been told by a counselor I suffer from depression, social anxiety and possibly BPD but I don’t see her anymore, there were times I used to think she was amazing but there were times I wanted to hurt. My mother was emotionally abusive and I had been bullied throughout my childhood/early teens, I was never allowed to express myself as an individual and hid my feelings to the point I sometimes still don’t remember my complete childhood at a given time as in sometimes I would view it as good and at other times really bad etc. Also as a child I remember having a fantasy life detached from my own and still do, I constantly talk to myself (I sit alone everyday and don’t talk to others much at all) and every time I talk to myself I have different opinions about the same matter.
I have strong desires or you could say random impulses to hurt others (women), I have sudden urges to hurt these women, whether it is beating them to death or forcing myself onto then and these women are complete strangers, I have to tell myself no I cannot do this, but a part of me really wants to but I don’t allow myself. I wouldn’t ever hurt any of these women but I have considered it in the past when these urges take control, it can be compared to as an urge to urinate If you get what I mean. I remember as a child wanting to hurt other children sometimes and I would sit there for hours and hours on end thinking about the ways I could do this. I have an pet dog who I adore and would never hurt, its just women I have this desire towards.

In addition to this I have olfactory hallucinations, where I can smell and taste things that are not there, e.g. I can smell my counsellor and taste the smell even though I’ve never met her in person and I can feel her presence around me a lot of the time, sometimes I feel as I am being watched even sitting in a room by myself but that’s not often, and I sometimes see shadows from the corner of my eyes.

Sometimes I believe people are out to get me and can read my thoughts;that everyone is talking and making fun of my thoughts to the point I’ve been scared to leave my house for about two weeks earlier in my life and it still happens occasionally but not to that extent. I suffer form severe depression and contemplate suicide every other day but after lets says having being depressed for 6months, I always suddenly become happy to the point I think I’m an amazing person and become very confident and outgoing making several plans but never get round to do any of them, this last for a few weeks and then I am suddenly depressed again….I’ve also been told I may have bipolar disorder but I don’t know what to think as I feel as if I may be making half this stuff up when I’m not. I now realise I need help but, if I was to go to the doctors I wouldn’t know what to say to them as I am generally afraid of talking to people and they wouldn’t take what I say seriously. Thank You.

You are doing the right thing by asking for help. You recognize that you have a problem and want to change. That is very encouraging.

You had a difficult childhood. You experienced psychological and verbal abuse. I am sorry about what you had to endure. Undoubtedly, it was a painful time. Some of that pain likely is still affecting you.

Some people with histories of abuse might develop an impulse to want to hurt others. The helplessness that a child feels when he or she is abused or bullied can be immense and overwhelming. Lashing out at others might feel like a way for them to gain control over some aspect of their lives. It may be a way to cope with the psychological aftermath of abuse. It might also be an attempt to compensate for feelings of helplessness and a lack of power in the world.

Your impulse is focused on harming women. The abuse that you suffered as a child was from a woman, your mother.

It is important to understand that purposefully harming someone is immoral. It’s a maladaptive coping mechanism and it is an act of evil. In all likelihood, it would mean that you would be incarcerated.

You were in therapy at one time but for some reason, it ended. I would strongly encourage you to return to therapy. Be honest with your therapist about how you are feeling. At this point, you’re able to control your impulses but there may come a time when you cannot. By not seeking help, you may be putting yourself and others in danger.

If you cannot control your impulses, then seek emergency assistance. Call 911 or go to an emergency room. The staff can keep you safe and protect you from harming others.

Therapy could be immensely beneficial for you. If you don’t feel comfortable with a female therapist, then choose a male therapist. Therapy could help you to develop positive and healthy coping skills and it can improve the overall quality of your life. I wish you the best of luck. Please take care.

Dr. Kristina Randle

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Fear of the Social World

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

This might be one of the most hardest of questions because i am really hard to understand.

I am considered on the lowest part of the ladder, no one in my school hates me but at the same time dont love me, there not like ”hey wassup dude wanna hang or stuff?” with me, they also dont even say a word to me in class. Im always silent in class so that te teacher wont punish me plus i have one best friend and he is the only friend i hang out with. I never leave my house, i am always at home watching tv or playing videogames. Even when i go online on msn no one even says anything to me.

Now this is the main issue and i bet is the main cause of my dillema: i have no idea of social interaction: i dont even know what people talk about between each other. Let’s pretend i was with my school friend, what do we talk about becuse i have no idea, ill aways stay silent. There is this girl i met which is one of the teacher’s daughter in my dad’s university and when i sit with her, i dont say a word because i have no idea what to say or talk about. I am sooo depresed and im sure that no one understands me and i just want to know how can i become a social person? Thank you

I’m sorry that you are experiencing such a difficult time. Social interaction has been a challenge for you but it may not always be that way. It may be something that you’re struggling with now but you are not destined for a life of isolation and solitude. Social skills can be developed with practice.

You may be surprised to know that many people struggle with social interaction. You are not alone. It’s not something that comes naturally to everyone. I’m wondering if anyone has taught you effective social skills?

Some people are more extroverted than others and this trait may make it easier for them to be social. You may be shy and unsure of yourself and this inhibits your ability to interact with others.

One thing to keep in mind is that you may have inaccurately characterized your social skills. You mentioned that you are depressed. It’s possible that depression is clouding your judgment. It may be leading you to perceive many or all situations or self characteristics from a negative standpoint. It’s clear that you feel the struggle with social interaction but your skills may be better than you realize or give yourself credit for.

Below I list several ideas that you may want to try on your own to develop social skills but it is important to acquire an objective opinion. You need to know where you stand. You could ask a respected family member, your parents or a therapist for their opinion about your social skills. You may be pleasantly surprised by their answer.

  • Pay attention to the people around you. Instead of focusing on how you feel in a particular social situation focus on other people. This may serve to decrease or eliminate your nervousness because you’re less focused on yourself and how you are feeling in a particular situation. It moves the focus onto others and may force you to listen to what they’re saying.
  • Pay attention to details. Similar to the above suggestion, this involves focusing on the details of the people you are interacting with or the environment. For instance, pay attention to the clothes they’re wearing, the decorations in the room, or a person’s tone of voice, and so forth. Again, this focuses your attention on something else and not on you and your feelings. If you’re less focused on yourself then it may help to decrease your fear and anxiety.
  • Learn by observing others. If there is someone or a group of people who you believe have superior social interaction skills, try to watch and learn. Are they doing something that you don’t? What do they do that you wish you could do? Observing the interactions of others might help you develop the skills that you feel you lack.
  • Change your attitude. You do not think you are very good at social interaction but as I mention above, you may be incorrect about your perception of your skills. Realize that even if your social skills are not as good as you would like, they can be developed.
  • Put yourself in situations that increase the likelihood that you will have to interact with others. The more you practice the better your skills will be.
  • Take a public speaking class. Public speaking is the number one fear among many individuals. The good news is that after taking the course, many people are able to overcome their fears of public speaking. If you have the opportunity to take a public speaking course, you should.

As I remarked above, your social skills may be better than you think. If you feel that your social skills could be improved, then speak to your parents about enrolling you in a program or training course that could help you acquire the skills you desire. If there are no programs then ask your parents to take you to a therapist. A therapist could help you develop these skills. I wish you the best of luck. Thanks for writing.

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How do I help my husband?

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

My husband has recently discovered (with the help of his therapist) that he is severely depressed and suffers social anxiety. He realized that he has been “holding in” all of his emotional baggage for years and that all at once something triggered these feelings to surface causing what seems like a nervous breakdown in his life. He was always the gentle giant that “owned the room” without having to do much. He was always outgoing, a great conversationalist and loved by everyone.

Over the last few years I have watched him become more introverted, less willing to do things and overall just unhappy. We have two small children ages two and a half and 10 months. He has been to a therapist once and plans to go back again, but not for another month. Medication did not come up in their discussion, but he can hardly make it through the day without fits of rage, anger, sadness and/or hopelessness. I’m not sure that even if his therapist had suggested it, that he would take it – as he sees that as a weakness. In the meantime, he hardly speaks to me and has been travelling more to avoid being home. He says he needs some space, but it’s almost impossible to do that when I see him falling apart day after day. I feel like he is pushing me away and will eventually leave us. He has not been able to say to me that divorce is out of the question. I want to discuss his depression and what’s going on, but he literally starts to have (what seems to me) like anxiety attacks every time it comes up. I want to help him and I am trying my best to balance his illness, our children’s needs and my needs but I feel like I’m not going to be able to last much longer like this. To put it plainly, what do I do?
Thank you,

It must be very, very difficult to watch the man you love be in such emotional pain. I couldn’t help but notice that he started to decline somewhere around the birth of your first child. It makes me wonder if something about the responsibilities of fatherhood is overwhelming to him.

It’s unusual for someone in this much distress to have to wait a month to see his therapist again. Generally, I would want to see him at least weekly in order to help him open up about what is bothering him and help him learn some new ways to cope. Talk therapy has the most impact in the first month. Medication usually takes a month to reach therapeutic levels. That’s why weekly therapy during the first month is generally advised. If your husband refuses to consider medication, it is even more important that he get engaged in therapy.

Ideally, your husband would invite you to join him in a session or two with the therapist. You can help the therapist understand how your husband behaves at home. The therapist can help you learn new ways to support him – and can help your husband sort out how much of the problem is inside of him and how much of it has to do with how the two of you interact.

If your husband were seeing me, I would suggest to him that “having space” isn’t likely to be helpful. Wherever he goes, he’ll be there with himself. Talking about his feelings with you may make him feel hopeless because he doesn’t know how to do it in a way that gets him to a better place. A therapist can help him figure out ways to make changes that will help him feel less trapped and more able to manage the responsibilities of being a husband and a dad.

I hope he will consider calling the therapist to request another appointment soon and that he will be willing to have you join him for part or all of a session. The two of you loved each other enough to marry and have two children. If you are both willing to give it an honest try, the odds are you can find ways to be a family that is satisfying and happy.

I wish you well.
Dr. Marie

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I Am Losing My Emotion

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

From a teen in the U.S.: Over the last two years I’ve lost emotion and I live in a fog. When I think about what’s wrong with me I can’t think at all. Typing this out in struggling because I can’t even function. I can’t get it right.

I no longer feel empathy or sympathy. I don’t care for people older than 11, when something bad happens to them I feel like they deserve it. When someone dies I do not care, I actually hope for people to die if they’re guilty or bad (explained later). I often feel like people around me are also robots, like they aren’t real. I feel like the world around me is all a dream that I’m creating. As if past some area the world like a big white room because my brain hasn’t made that area yet.

When I’m irritated or angry, become very sadistic. I think and plan out ways I could torture that person. I imagine cutting them and watching the blood. But I only feel that way towards alcoholics, drug users, parents that abuse their children and killers. The main person I want to hurt being my mother. I only feel for my brother, best friend and uncles, no one else and animals. I often have to fake all of my emotions with people. I also feel death should be a happy moment, an escape from this hell hole earth.

Some background being: I was sexually abused at 5 and never told my mother until 14 which caused her to drink heavier. I got a concussion in 1st grade which caused stuttering and reoccurring headaches later having several other injuries some which were forced for attention. My stuttering has suddenly come back 9 months ago but it isn’t as bad. Before those nine months homicidal thoughts have increased and later found a steady pace only occurring when angry or with unliked people.

I’ve been to 7 schools and have no friends besides the few online. I’m good in school, I easily make friends. I have a history of depression as well as suicide attempts and self harm between ages 13 and 14. I was bullied in elementary and middle school.
And I’m vegan

I don’t want to hurt people, at all. But I need to know what may possibly be wrong so I can go seek help.

I can’t make a diagnosis on the basis of a letter. But I can give you some direction. First, it’s possible that you have unresolved trauma. You are distancing yourself from most feelings, the exception being extreme anger and homicidal thinking. You have a history of depression and self-harm. These thoughts and behaviors are typical of a kid who has a history of abuse.

You wrote that you tried to keep the abuse to yourself for years. When you shared the information, your mother started drinking more heavily, which certainly didn’t help you. You may have even felt guilty for bringing it up. You needed help, not another problem. If you didn’t get into therapy then, you owe it to yourself to find a therapist now who can help you work through the abuse so you can regain your trust and connection with more people.

You also mentioned that you had a concussion. Although most people recover within months, some people do develop post-concussion syndrome (PCS) with symptoms that last longer. Post-concussion syndrome can include physical, cognitive, and emotional problems. If you haven’t had a visit with a neurologist, I think it would be wise.

Changing schools so often hasn’t helped your stability either. You haven’t had the chance to develop the kind of long-term friends who can be there for each other when things are rough. You didn’t say why you’ve moved schools so often. I hope you are finally settled for awhile. The good news is that in only a couple of years, you may be able to leave for college and stay put for 4 years. I hope you are doing what you need to do to make that possible.

You haven’t had the adult support and direction you’ve needed. You are old enough now to seek it out for yourself. Talk to your guidance counselor about whether there are any free clinics for teens in your area. In the meantime, if you need to talk to someone, you can always call the Boys Town hotline. Don’t be put off by the name. Counselors there talk to girls too. Trained counselors are available 24/7 to talk by phone or chat online. It’s free and confidential. Here’s the website:
http://www.boystown.org/hotline/Pages/default.aspx.

I wish you well.
Dr. Marie

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If I Share with My Therapist, Will I Be Locked Up?

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

From the UK: i have this problem that i have been dealing with for 1 year now and it has not worsened and during times when i am occupied with my education or work it seems to get better (and basically stop). I see things in my peripheral vision for a split second and then they disappear. I dont know what it is that i actually see and its different every time and i am not saying this in the sense that i cant describe what i saw but in the sense that i actually do not know as it was my periphary or an area in my feild of vision where i was not focusing.

The problem is that whatever i see it doesnt appear as real as this laptop with which im typing this post so in essence i dont see it as real as reality and i know it isnt real. But at the same time it feels like this is more then just a figment of my imagination because in my periphery for a split second i did see something.

This internal conflict is eating away at me and i have been taking antidepressants for more than 6 months and have currently started getting therapy as well. I am afraid to bring up this topic to my therapist in detail because i feel like i will be locked up in a mental facility and i have no idea what to do about this. i went to my GP and described this only to be dismissed as having a vivid imagination and that if i really had schizophreina then i wouldnt have the insight to be having this conversation.

I suffer from anxiety and the antidepressnts have really helped but never the less i would like to know what would be the actual medical term for this phenomena that i am experiencing. this phenoma also happens when i switch my feild of vision such as blinking and turning my head. In most cases it seems like a shadow or somethng dark. I dont know how to actually describe it because i dont really know myself. All i know is that during this phenomena i do not see whatever i see as vividly as real objects around me but at the same time it feels too real than just my imagination and in my memory it does seem real.

Please do talk to your therapist about this. It’s not likely you’ll be “locked up”. You aren’t threatening to hurt yourself or others. You are functioning in your daily life. Your therapist is an important support and resource for you but a professional can only do their job if they know what is troubling you.

One of the first questions I would ask you if you were my patient is how much sleep you are getting. What you are describing is sometimes a consequence of disturbed sleep patterns or not getting enough hours of sleep. If that’s the case, the “fix” is to deal with that directly.

Then again, it may be a symptom of your depression or stress or something else. Your therapist will help you figure it out and what to do about it.

I wish you well.

Dr. Marie

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Fighting Hypothyroidism

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

From the UK: I’m a 28 year year old female suffering from Hypothyroidism. I am really down because I am really overweight and when I’m down like this, I just comfort eat. This causes me to feel even more down so then I just eat again. It’s like a vicious cycle. I’m single and I’ve had a string of bad relationships in the past — my last boyfriend always pushed me to be a size zero and never accepted me for who I was. I have no self-confidence, I hate looking in the mirror and I hate who I have become. I feel ugly. I carry my gym kit with me to work with the intention of working out but by the end of the day, I have depleted energy and I just want to sleep. I want to take control of my life and stop eating to fill my sorrow. Right now, I have no control. Please help me.

I hope you are being treated for the hypothyroidism. There is no need to “suffer” from it. There are medications that can bring it under control. Once you are taking the right medication, you are still going to have to confront the task of losing the weight you’ve gained. It’s not easy but it’s not impossible either.

If you wait until you have a healthier self-esteem to work on your goal of losing weight, you may never get there. Self esteem isn’t necessary to be successful. Rather, it comes from being successful at something you want to do.

If you want to take control, the best way to go about it is with others who are engaged in the same project. You need the support and practical help that can come from a group. Such programs as Weight Watchers and Over-eaters Anonymous are very successful because they provide both. (This is not to be understood as an endorsement of either program, only as examples. I’m sure there are other effective programs as well.)

Too shy for a group? Then find a “buddy” — someone else who has significant weight to lose and is willing to meet daily so you can monitor and encourage each other. You can do this in person or online. There’s nothing so supportive as talking with someone else who “gets it” and who is as committed to the project as you are.

Other hints I can offer:

  • Set reasonable intermediate goals. Rather than setting a goal to lose 50 pounds, aim for losing 1.5 pounds this week. Success tends to build on success.
  • Write down everything that goes in your mouth. There has been some research that shows that just writing a food diary helps people lose the weight. Writing it down before putting something in the mouth gives you time to think about what you are doing — so maybe you will change your mind.
  • Plan your menu for the next day the night before. Carefully write out what you plan to eat and when. Then you won’t be confronted with impulsive decisions.
  • Build snacking on healthy foods into your diet so you don’t feel hungry and deprived. Make sure you include plenty of fruit and veggies.
  • Make sure you get enough sleep. Often people who are tired eat to get an energy boost.
  • Make sure you are hydrated. Often people mistake thirst for hunger.

I wish you well.
Dr. Marie

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Is it normal to be depressed after sucess?

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

Q. Hi,I am an artist. I would say that I am pretty successful by most people’s standards and my work is received well. However, my profession is high stress, low on monetary security, and needs a strong ego. I worked a lot at my art. I gave it the time that it needed so I can be relatively secure in what I was doing and to get some kind of financial stability. The sad thing is that I have no real personal life, apart from a few really good friends which I cherish. I have been to therapists over the year to try and get some kind of balance but the reality is that my work cannot happen without 100% commitment and I don’t want to change my job. It gives a sense of who I am and that’s important to me. Anyway, the problem is this, and it may be a common problem for artists, I finish a successful art event and fall into a deep depression. I hide out at home, not answering the phone, letting laundry pile up, feeling … scared, overwhelmed, worthless. Is this weird? Or is this just the normal after effect of an intense involvement with something over a long period of time? Do other people get this? I have tangible proof that I am well-regarded but my life feels lonely after spending so much time intensely creating with a bunch of like-minded people. Any insight you might have would be appreciated.

Your life is out of balance. You have identified your weak areas. It is not enough to recognize a mistake and do nothing about correcting it. Many famous artists suffered from mental illness. The art became the outlet for their pain, a release for their emotions. Your art likely has acted as an escape from other problems or undeveloped areas. When immersed in your art you simply did not have time to dwell on other aspects of your life. You can have both and should have both, a good life and your love of art. I would suspect that you simply have not found a good therapist. The public tends to judge therapists by the degrees that they hold and the schools that they have attended. This would be like saying that the quality of art produced by any one artist, should be judged by the art degrees he holds and the status of the art school that he graduated from. I think we both know that the art itself stands apart from the degrees that an artist holds. I believe there is no correlation between art education and the art work itself. Likewise the quality of the therapist is based on more, much more than the degrees that he or she holds. A talented artist is indeed the talented therapist. Good luck. Keep trying therapists until you find the one who can help you. I really believe you will know this therapist after one meeting with him or her.

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Looking for LGBTQ Drug Rehab

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

Discharged from US Navy in 2001 “as a covenience to the government” and diagnosed with Borderline Personality Disorder w/Schizoid Features. Went home and started using meth on a regular basis, soon selling drugs to support my habit. Busted with two ounces of cocaine in 2001 and sentenced to 5 years intensive probation and a class 2 felony. After failing a number of drug tests, I was arrested for violation of the terms of my probation and stayed in jail for five months until a bed at a local state run drug treatment facility opened up. Stayed clean after graduating the program for 2 and a half years. The day I got off probation, I began using again like I had never stopped. In March of 2011 I was pulled over for driving on a suspended license and arrested. I had 1.75 grams of meth in my right pocket. On December 5th, I was sentenced to Drug Court Probation. I drop six times a week and go to alot of recovery related groups through my mental health care provider. I am waiting once again on a bed at the same state run drug treatment facility. I am pretty sure that you folks can’t help me, because to get quality drug treatment for the most part you must have lots of money.

I want to know why there are not more gay/lesbian oriented treatment centers in this country? If it’s the last thing I accomplish in life, I will complete treatment again, get my master’s in clinical psychology, and open a much needed drug treatment center targeted at the gay population and make it affordable or an option for anyone who wants the help.

In addition to BPD, I am diagnosed with PTSD and Severe Depressive Disorder and Bipolar NOS. The latter conditions developed most likely as a result of my substace abuse and failure to get help for BPD. When I was a child my dad’s girlfriend molested my brother and I and made us do horrible things to one another cause I guess it got her off. My mother got sole custody, married the Grand Dragon of the KKK in our city and we moved away.

My stepfather caught me with another little boy when I was maybe seven and decided he could cure me of my homosexuality type behaviour by making me take off all my clothing and throwing me outside the front door of our home in a suburban neighborhood as I cried and screamed and pounded on the front door to be let back in. Within a few minutes I had attracted the attention of some kids on bikes who began to throw rocks and laugh at me. It was bad..whenever I had a sexual thought about a boy after that I would punch myself in the head and hope it would go away. I never really accepted my sexuality until leaving the Navy at 23. And as much as I want to believe I was born gay, I will always wonder if that sick b who did that to me and my brother is the only reason I am gay. It just makes sense that gay themed treatment centers would be better for someone like myself to successfully recover.

You’re right that having a therapist who you feel understands you is key to successful treatment. I applaud you for wanting to use your own experiences to help others. Needless to say, you need to get yourself together before you can be successful.

The kind of center you wish for may not be available but there are certainly good therapists who can relate to you. Go to this link to find gay-friendly treatment.

Terrible things were done to you when you were a child. They undoubtedly had impact on your sense of self and your ability to deal with the world. It’s likely that your history of drug abuse is at least partly an attempt to self-medicate in order to get away from the pain. But as you’ve already found, it doesn’t really work. It may make you feel better for a time but it is getting in the way of longer-term peace of mind and success in life.

I hope you can find the inner strength and the outer supports to finally get substance abuse out of your life and to do the therapeutic work you need to do. Don’t let the lack of an LGBTQ center become the reason you don’t do it. There are good LGBTQ therapists in your city who can help you put together a comprehensive treatment program.

You still have well over half your life to go. With the right help and with personal commitment, you can make the next half better.

I wish you well.
Dr. Marie

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I Didn’t Marry My Soul Mate

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

Ok so I am 25 years old and have been married for 3 years however I have always felt like I’m married to someone who is just a friend. I love her but not in the romantic sense and unfortunately I know I’ve used her simply to combat my fear of being alone forever. We married young and have actually only been together for about 6 years. I thought I’d be able to live with my decision but I feel as though I have found my true soul mate. I know you may read this and say that I fall in and out of love easily but the truth is I’ve never fallen in love until now with a young woman who is not my wife. I don’t know what to do I have a wonderful life really a good job and a wife who loves me unconditionally but I’m just not happy with her and I feel by making a rash decision I have trapped myself. I can’t stop thinking of her though when I hug my wife I think of hugging the one. I should also add that the love of.my life feels the same way and we both felt the connection when we first met and we instantly became close. I don’t like controversy and I feel like I’m in a life time movie but I cant ignore my heart can I? It would be a lot easier to stay with my wife but isn’t love all abut conquering challenges and jumping obstacles to be together? I say it would be difficult because my soul mate lives in Germany but we met here in the US where I live and she was here about a year. I would have to move and I am more than willing to but is it the right choice or is there something else to explain it. These are just the ramblings of a love struck pup who needs guidance, do I stay and just live but always wonder and regret or do I take a chance and go to be with the one I truly love please advise.

I appreciate the depth of your feeling and the need to sort it though. I can offer you what I’ve learned.

Literally everyone I know who has gone through this has made the interpretation that finding a new love has stirred an internal conflict and they are now in a predicament. In this line of reasoning the solution, whatever it is, is ferociously complex and messy. This is because it looks like there are all these decisions that need to be made. But in truth there is really only one decision that you have to deal with. Do you want to stay with your wife or not? The fact that you are so powerfully drawn to someone else is only partly about that other person. It is primarily about the fact that your marriage isn’t what you hoped it would be. You soul mate is a symptom of your marriage first and foremost. If the marriage were fantastic you would not have been interested in pursuing your new love.

So the work is in looking at your marriage and deciding if it has enough left in it to make a go of it. If it does—then you do everything in your power to make it work. If it doesn’t, part as easily as possible, recognizing you both will need to have compassion for each other because it will be hard– but both deserve to be in a relationship where your partner is as committed and into you as you are to them.

Wishing you patience and peace,
Dr. Dan

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“You Don’t Have Any Problems, Just Bad Coping Skills”

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

3 weeks ago, I went to my very first psychiatrist appointment. It was a pretty big milestone for me as I haven’t been in contact with any mental health professional since I was 15, and I was really looking forward to finally getting the help I need. The whole experience was dissatisfactory overall, from filling out forms in the waiting room, to waiting for the doctor to actually come in for hours, I had switched from anxious but hopeful to frustrated and wishing I could just get it over with. Eventually, she (the psychiatrist) called me in and we talked for no more than 5 minutes. She asked me many questions but by the end she was completely dismissive about everything I confided in her about and ushered me out the door saying “I am a psychiatrist, I deal with people who have REAL problems, which you do not have, just bad coping skills.” Ah, yes, “bad coping skills”. I left with only one question in my mind: If I don’t have any problems, what do you think those bad coping skills come from? To say I was upset upon my arrival at home would be a massive understatement. It took everything within me to not express my rage. I wanted to scream, I wanted to cut, I wanted to burn my entire house down even if it meant death to my whole family just so I could die in it – but that’s not me. I hate bringing others into my personal problems. And so, I crashed into an extreme depressive episode in which I spent the evening crying for 7 hours, didn’t get out of bed for days, didn’t eat for more than a week (I’m only recently starting to eat at least one meal a day) and spent every waking moment feeling like I need to jump off a bridge because even the thought of my own existence makes me feel incurably sick to the stomach and pained in the head. Currently, I’m doing significantly better, and aim to contact a new therapist within the next week or so, but that initial experience is something I doubt I’ll ever forget, but honestly, I just wonder what’s the purpose of it all, as my desire for escape from existence runs its course, even when I’m not in any way depressed at all. (from the USA)

  I am terribly sorry this mental health professional treated you in a way that was dismissive. It sounds like the psychiatrist was only interested in prescribing medicine — not actually engaging you in therapy — and managed to insult you in the process. It also sounds like it took a tremendous amount of courage for you to bring yourself into the appointment, and I deeply admire your persistence and willingness to contact a new therapist. I highly recommend someone other than a psychiatrist so the emphasis will be on therapy, rather whether or not you are a candidate for medicine. This isn’t saying a consultation with a psychiatrist might be helpful downstream — there are plenty of magnificent, compassionate ones — but for now let’s put the emphasis on explaining your needs to someone who knows how to listen and isn’t necessarily looking to prescribe.

You asked about the purpose. The reason therapy can be very helpful in the hands of a skilled therapist is that often the safety and relationship in the therapy has a great deal to do with correcting the issue. You said it just right: “If I don’t have any problems, what do you think those bad coping skills come from?” The answer to that is often rooted in prior relationships, often in the family of origin. The relationship with the therapist combined with techniques, interventions, and the process of therapy often change the dynamics beneath the symptoms.

I hope you find someone who can honor you needs better, and help make the changes in your life you are looking for. The Find Help tab at the top of the page can help you find someone in your area.

Wishing you patience and peace,
Dr. Dan

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Dealing With The Aftermath of Psychosis

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

Hi, Please help. In October 2013, my Granny had passed away due to a long term battle with Cancer. Shortly after this (January 2014) my Girlfriend of 6 years had developed Psychosis and spent the next few months going in and out of hospital. I have stayed with her for the past year and a half dealing with it. throughout the past year, I have had two friends that were getting rather violent and angry towards me and stopped talking to me as a result in April. I had a friend commit Suicide in May. I have other friends whom I talk to and see every now and then, However I feel as if they are avoiding me.

I feel disconnected from the world and people. I recently broke up with my Girlfriend because I thought it was the relationship that was causing me to feel this way. She would have her ups and downs, days in which she was Happy and bubbly and other days in which she was down and upset. She would be in bed and sleeping after taking her tablets at 11 and would sleep until about 1 or 2 the following day.

I can’t help but feel down. I feel as if there is nobody here to help me. I feel like everyone I care about is going to leave me or die. Its obvious I love and care for my Girlfriend however I think i need time to sort my head out. Nothing interests me and I can’t concentrate. I’m constantly thinking about everyone leaving me and that all I am is a burden on my friends.

I often Question if breaking up with my Girlfriend was the right choice. I feel disconnected from her. The sex is at best just full of effort from both of us and If i continued down this route with my Girlfriend I would have gotten severe depression or worse, However I can’t help but feel I’ve made the wrong choice and I should stick it out with my Girlfriend because she’s the only one that has ever cared for me.

Please reply and Thanks for Reading.

You are dealing with a number of recent losses which understandably have made you upset. On top of that, you have noted possible symptoms of depression.

I don’t have enough information to know if you made the right decision regarding your girlfriend. You said that staying with her would’ve led to severe depression but did not say why. If you are correct, then it would seem that breaking up was the right decision.

She is also experiencing her own psychological difficulties. Neither of you sound healthy enough to maintain a flourishing relationship, at this time. After you both are more stable, maybe then consider reestablishing the relationship.

You should consider counseling. Depression and relationship problems are two of the most common reasons people enter counseling. Counseling can provide you with guidance about your relationship and teach you how to manage your possible depression symptoms.

Another option is a grief/bereavement support group. Many people benefit from talking about their losses. Sharing your loss often facilitates the healing process.

Once you are feeling more stable, you will be in a better position to make decisions about your future and with whom you want to spend it. Please take care.

Dr. Kristina Randle

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Very Insecure About Myself

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

In fact, I am insecure about almost everything. I can’t help but compare myself to other girls and I feel really ugly and fat. I never liked the way I looked or how my body shape is like. Whenever I see these really pretty girls, I feel horrible and jealous and I start wishing I was like them. Even though I’m not the skinniest girl, I know that I’m not fat but I can’t help but compare myself to other people. People say I’m beautiful and all that but I just don’t believe it. I would constantly look at myself at the mirror and I became more self-conscious. I started dieting a year ago and I continued starving myself so that I could be “thin” but I then realized that it wasn’t worth it and I worked hard to have a reasonably healthy body. However, I’m still insecure about my body and I admit that I still have trouble taking the right amount of food during lunch time. I’m also very insecure about how talented and intelligent other people are. Whenever I see my friends do better than me, I always put myself down by believing that I’m a failure and no matter how hard I try, I won’t be as good as them. Honestly, I try my very best to get really good grades but I always end up being disappointed with my results. For my first semester report, I got a total of 54/70. I know that it isn’t a bad score but when my best friend told me she got 61/70, I felt really dumb. I’m also very insecure about my ex boyfriend who I have very strong feelings for. I was his first girlfriend and he was my first boyfriend, so it was kind of special. I really don’t want to lose him. I’m scared about every possible things that would happen between us in the future. I’ve had constant mood swings after he sent me a message which shattered my heart into a billion pieces (this was in July). I kept feeling as if I was worthless and I felt really bad about myself. These mood swings won’t go away no matter how hard I try and I always end up feeling anxious/stressed/depressed whenever my insecurities and that day (when my ex sent me that message) come into my mind. I’m trying to change myself for the better now but I desperately need your help. I haven’t shared this with my parents because I have trouble opening up with them and I haven’t shared this with my friends. I admit that I cut myself when my ex boyfriend sent me that message and the reason I did this was that I thought it would be a distraction. I was wrong and it made things worse. I was depressed the entire summer and I kept having suicidal thoughts. These thoughts kept occurring over the last few months and I even had these urges to cut. Fortunately, I learned my mistake and I promised myself I’d never do this again. I don’t have suicidal thoughts as much as before but due to my insecurities, it is still there. I know that killing myself won’t solve anything and I know better. All I want is to figure out how to get rid of these insecurities and how to be happy with myself. I’m honestly trying my best to be a better person but no matter how much I try, these negative thoughts and feelings won’t go away. Before, I used to be positive and happy with everything around me but I don’t know what’s happening to me now. I’m trying to improve myself by distracting myself with doing things I enjoy but I need your help.

Self-assurance and self-esteem develop over time. It is quite normal for teenagers to lack confidence. Generally, people develop self-esteem as they accomplish more in life. The more accomplishments that one has, the more “proof” of one’s ability and thus the increase in self-confidence.

Though it may be normal for teenagers to lack self-confidence, your situation is concerning because of the cutting, depression and suicidal thoughts. These problems are serious and are degrading the quality of your life.

Like many people with depression, you seem to minimize your positive achievements and maximize negative aspects of your life. You also seem to be comparing yourself to others, which is problematic. Since each individual is so unique, any comparison to others will ultimately be an unfair and an unmatched comparison.

I don’t suspect that you have a mental health disorder per se but rather are misperceiving reality. In other words, you may be cognitively wrong about how you perceive yourself. You are a perfect candidate for psychotherapy. Psychotherapy is also recommended because you’ve “been trying to change yourself” but it’s been a struggle.

You have not informed your parents about these issues. Your parents need to be aware of your suicidal ideation, self-harm and depression. Your parents need to know so that they can assist you in receiving the appropriate treatment.

You seem to want help which is very encouraging. People who want help and who are willing to receive it have a very good prognosis with regard to resolving their psychological problems. The problems that you are describing are very, very common. When you look around you at school, many of the people that you are looking at are experiencing the same problems that you are. When they look at you, they might think, “why can’t I be happy and normal like her?” They don’t know what you are feeling on the inside and you don’t know how they feel on the inside.

Counseling can be a great help to you. It can make life much better. There is no reason to suffer, when help is so available to you. If you had a toothache, I would want you to see a dentist because they can easily take away your pain. Counseling can, likewise, easily take away your pain. Report your symptoms to your parents and ask if they could assist you in seeking professional mental health treatment. You will be glad that you did. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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