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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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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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Boyfriend Has Schizoaffective Disorder

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

I have been in a relationship for five years with a man who was diagnosed with schizoaffective disorder, depression with psychotic features. For the most part, his disorder does not have a negative impact on our relationship. He has trouble keeping his place clean and he is slow to take actions that move his life forward in positive directions. But he is on the right track now, returning to school and looking for a better job.

He was in the military for six years. Two of these years we were in a relationship. He told me about some episodes he had before we were together, which included months he could not remember. He moved to my town almost two years ago. He has some auditory hallucinations, but he has learned to ignore them. Since he was discharged from the military, his symptoms did not extend beyond that.

This weekend, I left town for the weekend and I asked him to check my cat. I realized halfway through the weekend I had not given him my spare key. I called to ask him if he checked my cat and he said yes, saying he got in with my spare key. I thought he was lying, which did not make sense because it was a strange thing to lie about and I have never caught him in a lie before. Today I came back and saw he definitely was not here. My cat’s water bowl was completely dry and her litter box was filthy. I talked to him about it, still thinking he was lying, and came to realize he sincerely believed he was here. I gave him evidence to the contrary and he was visibly concerned. I told him I was scared and he said he was too. He said he does not think this has happened in years, but I suppose there’s no way to be certain. Of course I love him and I want to help him. For the most part, our relationship is very good and I would hate to end it. But I am very concerned how things could go in the future. If I can’t trust him to check my cat, how could I trust him with a child? I don’t know how to move forward.

Also, he has not been on medication since he was in the military. When he was, I think it was for depression only. He does not have insurance for psychiatric help right now or the money to pay out of pocket.

You are correct to be concerned. Dating is about attempting to determine if your partner is someone with whom you could spend your life. If you continue in this relationship, his mental illness is a reality that you must face.

People with psychotic disorders can have successful relationships, but they are not without their challenges. The success of those relationships is often dependent upon receiving effective treatment. The concern is that your boyfriend is not participating in treatment. The cat feeding incident is evidence that his cognitive state is a problem and may be the result of his not participating in treatment. The extent of his symptoms and how this impacts your relationship is apparently not able to be determined at this time.

Whether he needs to be on medication or could benefit from other mental health interventions, should be evaluated by a psychiatrist. Even though he doesn’t have health insurance, most community mental health centers offer free or low-cost treatment. Having been in the military means that he has access to government treatment through the Veterans Administration (VA). He should be eligible to receive free treatment through the VA.

Untreated symptoms will impact the quality of your relationship. If he is unwilling to participate in treatment despite having symptoms, then you may want to rethink this relationship. You may also want to consider consulting a psychotherapist for short-term counseling about this issue. It could help you objectively evaluate whether or not this relationship is healthy and sustainable. It could help you to navigate the relationship, should you decide to stay. Please take care.

Dr. Kristina Randle

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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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I Never Enjoy Things, and Right Now I Think It’s Because I Don’t Feel Like I’m Living “In the Moment”

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

I’m having a hard time putting my finger on it, but for as long as I can remember I haven’t been enjoying pretty much anything. At all. I can’t bring myself to watch a movie or work on a project I should theoretically be excited about, because I always feel like I should be doing something else, and this always ends up with me doing nothing at all. I live by a daily schedule where I give myself different task for different times of the day (eg. doing chores from 4 – 6pm), but times constantly roll over and I could never keep up, and I don’t give myself reasonable time to complete tasks anyway.
Just today, I was listening to music on a friend’s vinyl set, and I just could not bring myself to relax and enjoy it. I felt like I had to be in 10 other places, whether it was finishing up old chores, or finishing off another project.
Ordinarily this wouldn’t mean much to me, but recently I tried marijuana while watching a movie and I couldn’t feel more into it. I felt focused, and like I could really process the stimuli right in front of me. I fear developing some sort of addiction, because it was the best feeling ever and I feel as though it would do me good to have that same feeling all the time.
I send this message out because I initially thought this was some sort of disassociation disorder phenomenon. As in not feeling like I’m “in the present” enough to carry out immediate activities. But I look up the symptoms and it’s just a whole lot of not what I thought it was. So I’m having trouble identifying this. Depression? Anxiety?

A couple of things could be going on here. Abraham Maslow, a famous psychologist who is most known for his work on self-actualization, writes about one characteristic of individuals who are self-actualizing which is their continued freshness of appreciation. He notes that these individuals have a “wonderful capacity to appreciate again and again… the basic goods of life, with awe, pleasure, wonder and even ecstasy, however, stale these experiences may have become to others.”

Essentially, it’s the idea that people get used to their blessings and take them for granted. He believes that people, for instance, are more apt to be loved and appreciated after they have died than while they are still here. He notes a similar thing is true for physical health, political freedoms, and economic well-being. We don’t recognize their value until they’re gone.

Perhaps part of the problem is that you are not appreciating or valuing what you have. You may be taking aspects of your life for granted. To change this, you might try keeping a gratitude journal which would help to focus your attention on that which you have. Focusing your attention may increase your appreciation for what you have and what you are doing.

Meditation might also be useful. It likewise forces you to focus your attention inward. The science of meditation suggests that it is highly effective not only for the mind but also for the body. It is been shown to reduce the symptoms of irritable bowel syndrome, ulcerative colitis, anxiety, depression, high blood pressure, and other conditions. In general, it helps with calmness and relaxation, and positively enhances one’s overall well-being.

It makes sense that you would feel better when you’re on drugs. That’s why people do drugs. Getting high feels good but there are severe consequences for using drugs. One is, as you mentioned, the potential for addiction. You shouldn’t need to use drugs to feel better. It’s a sign that something is wrong. Keeping a gratitude journal or trying meditation are both good alternatives to drugs. You want to do everything in your power to avoid doing drugs to feel better.

My recommendation is to undergo an evaluation with a mental health professional. They will review your symptoms and determine if a diagnosis is warranted. Most importantly, they will recommend a specific treatment. You might benefit from cognitive behavioral therapy (CBT) which is a highly effective psychological treatment that can help with a range of problems including depression, anxiety, alcohol, drug use problems, eating disorders, among others. At its core, it assists with faulty thinking, learned patterns of unhelpful behavior, and changing thinking patterns. CBT also helps with problem-solving, increasing one’s confidence, and learning better ways to cope with the stresses of life. Studies have shown that CBT can positively change one’s thinking, and decrease problematic emotions and behavior. You could benefit from this type of treatment.

Good luck with your efforts. Please take care.

Dr. Kristina Randle

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Please, Please Help with My Depression

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

From India: hello sir/mam, I am an engineering student, it all started from diploma final year, now I have completed my diploma. I was a very funny and enjoying person, I studied very well and scored good marks. When I was in the last year of diploma, that is in 6th sem, I failed in a subject due to overconfidence, and then after everything changed, my one year was wasted and I couldn’t join engineering, in this one year I kept on thinking of my year back, I was depressed all the time, feeling lonely.

After this one year, when I came to engineering, I thought everything will change again, but because of strict college rules that I had never faced at all, I started fearing to go to college itself, I couldn’t even find any friends to support me.

I am very depressed all the time. I cry a lot day and night. I get some type of fear when I go to college. My studies pressure is killing me day by day. The anxiety is going on increasing.

I can’t tell this problem to my parents. When I said that am not able to concentrate, they said to try, but I am not able to try, I am confused the whole day, some kind of confusion keeps on going in my mind which I am not able to tolerate. When I am in a silent place where there are no sounds and just cool air, I feel calm, but when I get into public — say just in my home, just a small family talk — I can’t handle the pressure which I don’t know how to explain.

plz help me, I am done with this life. I am hating it now. I was a very good student, I got good grades in my school and even in college, now I am dying thinking what has happened to me. I am confused, I am not able to concentrate in study. I am sad the whole day from the time I wake up till I sleep. I cry a lot day and night, depressed, bottled up myself with anxiety. I am not abel to handle this plz help me. plz plz plz help me.

The pressure you are under to excel must be terrible indeed for you to be so anxious. Whether that pressure comes from yourself or your family, it is not at all helpful. It is immobilizing you. It’s no wonder that you want to isolate yourself. I’m very glad you wrote to us.

Your crisis of confidence is not at all unusual when a student who is accustomed to being the best and the brightest has a set back like the one you described. As a college professor, I’ve seen it often among students who were at the top of their class in secondary school. When they come to university they have to compete with other people who were also at the top of their classes. If the student’s self-esteem is tied too firmly to being the best, he or she is in trouble. Not everyone can be the best of the best.

One common but not at all helpful strategy for dealing with the problem is avoidance. The student preserves idea that he is the “best,” but develops depression and anxiety so he doesn’t have to prove it. Claims of “trying” are a substitute for doing.

You — and students like you — need to come to terms with the fact that you won’t always be the best. Sure, you’ll excel at some things. But if you associate with other bright people, chances are they will sometimes do better than you do. If you try new things, chances are that you will fail now and then.

It may comfort you to know that many famous people have experienced failure and have gleaned wisdom from it. Albert Einstein once said, “Anyone who has never made a mistake has never tried anything new.” And educator John Dewey said, “Failure is instructive. The person who really thinks learns quite as much from his failures as from his successes.”

You’ve tried to manage this crisis on your own without success. I suggest you make an appointment with a counselor. Good counseling can provide you with the support you need while reconsidering your sense of yourself and re-establishing your self-esteem.

I wish you well.
Dr. Marie

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In Love with Two Men, Causing Me Depression. I Can’t Make the Right Choice.

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

I will try and be as brief as possible: 3.5 yrs ago I fell deeply in love with a man who is 13 years my senior. I had never felt this way and neither had he. We were together full time for 1.5 yrs however it was a long distance relationship taking up to 10 hours each way to see each other. We adored each other and wanted to make it work so made an effort to meet up every 2 weeks. The distance took its toll and when I felt ready to move in with him, he suddenly became very scared (his mum committed suicide 3 yrs before I met him and was quite abusive to him when he was a child) and took a step back which caused no end of heart ache. I knew he still loved me however it was simply impossible to continue as we were. Eventually the frustration of being apart caused us to separate. We decided to take a break- not to break up. But he went into denial and although we were in touch most days during the break, he said that he wanted to stay single. I was dying of heartache and 6 months after our so called break met another man who for the first few months became just a lovely friend, consoling me about my break and helping me, eventually the new chap and I started having a relationship although I had mentioned nothing to the first man (love of  my life) as in my head I thought he no longer wished to be together. After some time he found out and told me that he wanted to get back together by which time my trust had flown out the window. The new man was so lovely and kind and fun and all the rest of it but we lacked much sexual intimacy. Fast forward nearly 2 yrs and they are still both in my life, I am in love with both and both are in love with me. I live with the new one but I am dying inside being away from the first.  I have seen him and we both don’t understand what’s going on. Its so painful and I feel so guilty. Sex is still an issue with new man- I love him dearly rather than passionately. Help me please if you can. (From the UK)

I would like to offer a perspective that may be helpful in these types of situations. Of course, it is hard for me to know all the particulars, but there is something happening, which involves a lack of intimacy that seems important to highlight.

In different ways both men were available and unavailable simultaneously. Your first love was emotionally and physically intimate, but was distanced geographically. When it was possible for that to change — he changed. The second man is available geographically, but not sexually. The red thread is that neither is fully available and, by your descriptions, never have been.

This leaves you in the constant position of wanting and not having love. You are living with one and want the other, but you no longer trust the other enough to leave. The constant in all of this is you are drawn to each man’s potential, but not to their reality. By staying in love with both, you keep yourself from being fully intimate with either.

The situation is not meant to be resolved, which is what is most likely causing you depression. The illusion is that there is a right choice to be made, but the situation has evolved so that there is no right choice — only more of the same wanting and not having.

The way out of this is to understand more about your own process of being with unavailable men. For this I recommend individual therapy. A good relationship therapist will be able to help you sort through both the origin and ways to correct this process.

Wishing you patience and peace,
Dr. Dan

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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

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How Can I Overcome Depression on My Own?

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

I’ve never been to a psychologist, though i really wish to. Atleast for another year i will be unable to seek professional help since I have issues with my parents who are more bothered about their reputation since they are in the medical field and we live in a small town. From the time I was eight I’ve been having depressive issues. I used to try and supress it. i’ve been suicidal and tried to take my life more than 15 times in the last 10 years. I have all the symptoms of depression. the problem is that from the last one year i have been so miserable that it is effecting my social life(which is as good as non-existent now) and my studies. I have been molested when i was 12 and have always had relationship problems with my parents. they are fed up with me and the mess i create. i have been promiscuous and can’t stay faithful in any of my relationships with the opposite sex. im unstable and can’t stay in a relationship for long. my longest has been a year and a half. i also can’t seem to stay single at any point of time. i’ve had casual sex. though i have stopped that now. i lost my virginity at 15… i was a victim of date rape and that has left an irreversible effect on me. 6 months back i was blackmailed and then forced to sleep with three guys. my then boyfriend helped me out of it. after that i am unable to have a normal sex life…with almost no interest in sex. i really want to lead a normal life. please help me. i cry for no apparent reason and i get angry for even the slightest provocation. i was a college topper but after what happened six months back i am unable to study….i keep thinking about it.

I know that you are interested in helping yourself out of depression but I am not sure that is a wise decision. My main concern with you helping yourself is your many suicide attempts. When you have tried to help yourself out of depression in the past it seems that you turned to suicide. Because of this I would strongly advise that you see a professional.

Is there any way that you can see a professional without your parents finding out? And if they did find out, what would be the outcome? Would it be that bad? Isn’t your well-being more important than their reputation? It would be unfortunate if your parents cared more about their reputation than about the psychological health of their daughter.

Have you talked with them about how much you are suffering? Do they know about your many previous suicide attempts? It could be that they are not aware of your depression and maybe if they knew, they’d try to assist you into treatment.

Try to steer your thoughts away from thoughts of suicide. I have written about suicide often and I always tell people the same thing: it is never the answer.

People with depression often think that suicide is a good way to end their emotional pain. People suffer so much at times that for them, dying would be better than having to live with the psychological pain they have to endure. Because they cannot think of any other way to feel better, they mistakenly believe that ending their life is their best way to solve their problem.

But what if they are wrong? People assume that suicide brings relief but no one really knows this. It’s an assumption often based on desperation and impulsivity and not based on any facts or evidence. In fact, people who have had near death experiences (NDEs) after attempting suicide report having hellish experiences in the “afterlife.” What if suicide brings more pain and suffering and not less?

There are many people who have attempted suicide and lived and eventually find a way to decrease their depression. Viktor Frankl explains this idea in his popular book Man’s Search for Meaning. He recalls interviewing over twelve thousand people who had attempted suicide during his time as a doctor in an Austria hospital. The common theme he discovered among his patients who had attempted suicide was that they were happy they had lived because they eventually did find a solution to their problem. He used this knowledge to help other distressed patients as way to prevent suicide. Speaking to patients who had yet to find an answer to their problem, he stated the following: “…who can guarantee that in your case, it will not happen one day, sooner or later? But…you have to live to see the day on which it may happen, so you have to survive in order to see that day dawn, and from now on the responsibility for survival does not leave you.”

What he means is that a terrible situation can improve but you’d have to be living to know and to experience that improvement. For you, this means that because your situation might get better, as it does for so many other people, it’s your responsibility to live to see that day come.

You need to know that you can recover from depression. There is an excellent chance that you will be able to overcome your depression, with the right help.

Do you have any friends to talk to? Do you have a person in your life that you trust or who you can spend time with that can keep your mind occupied and way from suicidal thoughts? Try to find others to spend time with but as I mentioned above, I would strongly recommend that you seek help immediately.

In summary, I would suggest that you talk with your parents, consider going to a therapist even if your parents would not approve and try to keep it a secret if you have to. You have to do whatever is necessary to get better. You need help from a professional and you need it now, not a year from now. Your well-being is paramount and you need to make yourself a priority, even if that means “embarrassing” your parents. This is a matter of life or death and getting help now is more important than preserving the reputation of your parents. Please believe this because it’s true. Get help now.

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Family, Depression, and Feeling Trapped

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

Hi. To start off, a couple of months ago my grandpa died from cancer, and I was really close to him, and loved him a lot. A little bit before that, I was diagnosed with depression, but my parents didn’t tell me. Then, under false pretenses, I had to take another long series of tests, which, again had the same result. They still didn’t tell me, and I found out from my therapist, who I have to see for parents issues. I am adopted. The parent problems have been going on just about forever. My mom especially. She also treats me like I’m worthless, and I’m starting to think I am. She hits me, leaves bruises, scratches me, and hurts me, inside, and out. She has broken fingers, and scarred arms and faces. My dad sees, and does nothing about it. She never does anything to my sister, she just hates me I think. There are only two people I’ve told, two close friends. Recently it’s been getting worse. She has been screaming at me about what an idiot I am, how stupid, fat, and ugly I am, and how I don’t mean anything to the family. She says she wouldn’t care if I was there or not. I’m starting to agree. On top of that, my grades are sinking low, to the C range, which she considers unacceptable, to say the least. Also, I have been feeling extremely down, with the depression I mentioned above. This year it has gotten really bad, fast. I have started cutting and drinking, and even doing some drugs. It makes me feel better for about 5 minutes. Then I feel like crap again. I’ve thought about killing myself many times, and I’ve even tried once or twice. I don’t know what to do. I am sort of thinking maybe I should just run away from it all and kill myself. Or just run away and stay with a friend or something. I just know one thing. I can’t live with this anymore. I’m scared. I’m lost. And I’m trapped. What do I do?

I’m sorry about your situation. It must be difficult to feel trapped, frightened and all alone. You mentioned that you have a therapist. Is your therapist aware of your issues? Does he or she know that your mother physically harms you, that you’re thinking about running away or committing suicide? If not, then you are withholding important information. He or she needs to know that information to help you.

Once you have your therapist involved you may want to discuss two possible strategies that may improve your situation. One is a possible move to a residential living facility and the other is family therapy. Temporarily moving to a residential living facility would allow you a break from your stressful environment. You would also likely have access to mental health professionals who can assist you with your family and emotional problems. If a residential living facility is not an option, then what about temporarily staying with a close relative? I am not certain if moving would be an option for you but it is something to be considered.

I also mentioned family therapy. This type of therapy generally consists of you and other members of your family working together to resolve family issues. Many of your interactions with your family are upsetting. Family therapy could help with this.

Ideally, your therapist should be the one making suggestions about how to improve your life. Generally, that is their job, at least in part. Since that does not seem to be the case for you, you may want to bring these suggestions to his or her attention.

I understand why you are turning to drugs and alcohol, running away or contemplating suicide; those are the type of solutions individuals may choose when they are confused. You are on the wrong track but you can change this by asking for help. Talk to your therapist or another mental health professional immediately so you can access the help you need and deserve.

One last thing, be certain to call 911 or go to an emergency room if you believe you are going to harm yourself or someone else. The hospital can keep you safe.

I wish you well. Thank you for your question.

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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

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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

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Lost and clueless

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

I have trouble focusing on anything I do. I’ve ALWAYS been like this. Ive also ALWAYS had social issues. I remember when I was very young and would see someone from school at the grocery store or whatever, they would say hello, and I would look at my feet and get embarassed. My mom would tell me I was rude, but I didnt know how to change. I HATE talking to people now. I have tried to learn body language, listening, and observational skills, with minimal success. I KNOW I am being misinterpreted. I KNOW that when I think people are talking about my social inadequacies, they ARE. The worst part about it is I KNOW that I am a social retard. I am completely aware of it, yet nothing seems to change. I have tried to find a root, as if there is some singular problem that can be fixed that will solve my social problems, but there isnt. I have tried to diagnose myself as having autism, asperger’s syndrome, depression, social anxiety, ADD, and others, but NONE of them really fit. Aspergers is the closest, but I have no OCD or anything similar.
I also have a speech problem. This, along with my social retardation, has encouraged people to think that I’m homosexual. I know that I’m not, but I still try to convince people that I’m not, even thought I know that this is probably affirming their convictions.

I know I shouldnt care what people think, but I dont understand how to be social if I dont at least consider it.

My girlfriend continues to ask me when we’re going to get married. I love her, but I dont know why. And I dont trust her. I cant prove that she cheats, but I know she does. I can see it in her eyes and hear it when she speaks. I also see it when we are in social situations. She will never admit it, and I cant talk about my feelings anymore or she will leave. Should I cheat too, and just be cool? I dont want to feel like this all the time AND be married. All I want out of life is to feel like a man, be a man, and have a woman that is as faithfull as I am. I dont have any of these. I dont even have anyone to talk to about anything, and I solve anything on my own.

These are just tips of icebergs, and may possibly be side effects of other problems that I am unaware of. Im not sure what kind of advice you can lend me, if at all, but Im pissed off that I have to deal with this stuff. At times, I would rather be oblivious to all of this, than be aware that Im retarded.

Thank you for writing. I have a guess that it wasn’t easy to lay out all of your troubles so starkly. It must be very, very painful to live with so many doubts about yourself and the woman you love. I don’t blame you for being angry and sad. I give you lots of credit for not getting married until you settle at least some of these issues. No, you shouldn’t cheat to keep things even. That would set a divorce in motion before you were even married. You should get some help that will get to the root of the problem.

You describe symptoms that are consistent with a number of different diagnoses. Without talking to you, I can’t narrow it down. What I can do is suggest to you that you make an appointment with a psychologist for a thorough evaluation. You’re a complicated guy. You want to find a psychologist who has the skills to do some psychological testing if she or he deems it necessary to go beyond the usual interview in order to understand you. Ask you doctor for a referral or contact your local community mental health center.

I think you will find that naming your problems will give you some relief. Once you know what you are dealing with, you and the therapist will be able to develop a plan of action that will help settle your anxiety and build your skills for dealing with the social world.

I wish you well.
Dr. Marie

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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

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Depression, Bipolar or Anxiety?

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

My mind feels as though it is being constantly battered and weakened. I used to be anorexic, but that was four years ago, and I do not feel that it was a pure anorexia, but a manifestation of some sort of depression. I simply did not want to eat because I did not want to prolong my life. Since recovery I have spent months feeling stable, months feeling out of control and months feeling as though my only option was to hide/run away/die. My moods can change so fast that I hardly know myself, or trust myself sometimes…I used to regularly self-harm, but now it only happens if I let my mind be overcome by an intense rage/dizziness/distress…As the years go by I have less faith in myself to maintain stability…I eat nutritious organic food, exercise regularly and don’t often drink anymore. I take supplements. But I still have chronic insomnia and am at the point of being completely overwhelmed.

I am not certain of your exact question but I think it is about whether anorexia could have been, in your case, a manifestation of depression. It may have been. The lack of eating was directly related to not wanting to live anymore. If that were the only reason for why you did not eat then depression may have been at the root of the problem. On the other hand, anorexia really isn’t about food per se and most individuals with the disorder likely suffer with depression, at least to some degree. It is a difficult question to answer because I have so little information about you and your history.

You state that you are currently in recovery and I’m assuming you mean recovery from an eating disorder. Usually followup care is suggested following eating disorder treatment. I’m wondering if you are in treatment. I suspect that you are not. If you are not then you should be. As time passes you admittedly become less stable. It should be the other way around, where you become more stable over time.

Another important area to address is the self-harm. You currently engage in self-harming behavior when you feel overwhelmed but not as much as you used to. It is important to highlight your progress in this area but you shouldn’t ignore the fact that you still occasionally harm yourself. The fact that you do it less often is good but it brings up another concern: when you do self-harm is it more severe?

It seems as though you have overcome anorexia and that is true, it is a major, major achievement. But there are still other issues to deal with that may require professional help. I would suggest that you consider psychotherapy. You have been able to decrease the frequency of self-harm but it still has not been eliminated from your life. The fact that you feel less stable over time is another indication that professional help may be needed. With the advent of the Internet it is easier to find therapists in your community. Here is a directory that you may want to consult. Another idea is to ask for a referral from the mental health professionals associated with your eating disorder recovery program. They may know of a good therapist. I hope you will consider it. Thank you for your question. I wish you best of luck.

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MDD Is Worsening. What Else Can I Try?

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

From the U.S.: I’ve been in therapy and taken many different medications for close to 30 years. In the last 8-9 months my MDD has become medication resistant and is worse than I ever thought possible. I’ve tried ECT (3 treatments) and it did not help at all. I’m doing a litany of self-help wellness things that have taken over my entire life and I’m just getting worse. I take Effexor, Adderal & Clonapin. I do yoga, meditate daily, swim 2-3 times a week, see a therapist weekly, eat very nutritionally, get plenty of sleep but not too much,

I don’t work, and my life situation outside of this debilitating depression is very good. Happy marriage, great kids, generally financially stable, few good friends, mostly good relationships with family although there are a few estrangements that haunt me. My therapist did the Minnesota assessment on me and the high levels included major depression, anxiety and PTSD. I had a very unhappy and unstable childhood.

I am at the point now where I feel like I am a tremendous burden on my family and have completely isolated myself within my own home. I feel like a completely different person than I was before and I miss myself and my old life. What else can I do?

I cannot live like this any longer. Nothing is working and I feel very alone even though my family is very supportive. Right now i’m just pushing them away for their own good. I’m so sick of myself and of being me. I attempted suicide via OD in 2014 but it was a compulsive act at the time based on a situation. I have the means to do it again, successfully this time, but I genuinely don’t want to do it.

I simply don’t know what to do and cannot plan anything more than 5 minutes in advance because I’m completely unmotivated. I spend most of my day reading. I don’t cook or clean and I have a very enviable life all things considered. But if this is what I have to look forward to for 20 more years, I’m just ready to go right now. I’m exhausted and I’m just done.

I do sympathize. This is what an intractable depression looks like. You are doing everything you’ve been asked to do and nothing seems to help. You say you are sick of being you. But it sounds like your family isn’t. They love and support you. To me, that means that there is much more to you than your depression. I’m very glad for their sake and yours that you are resisting the thoughts of suicide.

If your therapist is truly out of ideas, it may be time for the two of you to call in another therapist as a “consultant”. Sometimes new eyes on a situation can make a huge difference.

This is not to be understood as a negative comment on your therapist. He or she may be excellent. But each of us therapists has our own training and has our own unique history of experience with many different people and situations. A new therapist just might have had experience with a former client that would be helpful to you. Ask your therapist to consider inviting a colleague or two to some of your sessions.

I also suggest that you join a forum here at LifeHelper. People from all over the world offer help and support to each other. Click on the “find help” tab on the homepage. Then click on “forums and support groups”.

I wish you well.
Dr. Marie

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Does My Partner Have Schizophrenia?

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

I think my partner may be experiencing Schizophrenia or something similar. Before I met my girlfriend she had been diagnosed with depression and general anxiety disorder. Within the last year she has stopped taking her medication (Paxil) because she felt it was no longer helping her. In fact her episodes of depression seemed to be worse. A month and a half ago we moved to Toronto and since that time she has been complaining about people we don’t know (customers at a local restaurant behind our house) are laughing at her and know what she’s been writing about in her journal. Furthermore she has, for the last four weeks, been complaing about people sending her sexually perverse images and sounds into her head. She can hear moaning, animals screaming, children begging not to do something, and a man with a deep voice bitching at a woman to stop. During this time she has been even more sexually insatiable than normal. She complains of being constantly sexually stimulated or abused by people who are just not here. At one point she claimed that it was people using magic (a cult of satanists, or pagans). She complains of feeling that she is not complete, that some part of her is where these practioners of magic (or whoever is responsible for this stimulation) are. She has on a few occasions asked, no begged, me to help her kill herself because of this unending torture. I have found her with a cable wrapped around her neck several times as if she had just tried to strangle herself. At first she believed that the people responsible were here in the neighborhood but now believes that they are further away and taking that part of her that is missing with them. Could you shed some light on this for me?

Thank you,
A concerned boyfriend

Dear concerned boyfriend, I can understand why you’re worried. Your girlfriend’s symptoms are severe. The most concerning aspect of her behavior is that on several occasions you found her with a cable wrapped around her neck ready to end her life. It does not seem as if she’s depressed. It’s as if she’s being driven to behave in such a manner by her delusions, paranoia and hallucinations.

Her symptoms may be indicative of a schizophrenia or bipolar-like disorder. It may also be a generalized psychosis. It’s difficult to diagnose an individual over the Internet so I can’t know with certainty.

If I could ask you followup questions I would want to know what, if anything precipitated her symptoms. Was there a stressful event that had recently occurred? Was there a recent trauma in her life? Did something in her life recently change? Was there a death in the family, loss of a job, or a move to a new town or city? Does she use illegal drugs or alcohol? Has she had a recent head injury? If I knew this information I might be better able to determine what is causing her abnormal behavior.

You also mentioned that she has recently stopped taking Paxil. Though it is rare, there are some occasions when abruptly stopping a medication causes a negative reaction. Usually these negative reactions are more commonly associated with other medications such as antipsychotics and not necessarily antidepressants. As I’ve mentioned, it’s rare but it’s possible that her behavior is the result of the discontinuation of Paxil.

Has she been to a doctor? It is unsafe for her to be left alone while she is in the condition you have described. This is evidenced by the fact that she has made multiple attempts to end her life.

Please do not ignore or avoid this problem. My advice is to bring her to an emergency room or to make an immediate appointment with a mental health clinician. She needs to be evaluated as soon as possible. Do not leave her unsupervised. Please let me know if there are any other questions I can answer for you.

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How Do I Help My Daughter?

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

About 6 months ago I found out my husband had been having suicidal ideation for about a year. I thought he was having a lot of work related stress and had no idea how bad he was because he managed to be highly functional despite his depression. Depression and suicide runs in his family. Shortly after that I found my 16 yr old weeping and stressed a few times. A year ago one of her acquaintances committed suicide and two of her friends have been depressed and are now being treated for it. She was in constant fear that someone else was going to die. Fearing she was also in trouble I got her into therapy. As her father and friends have improved with medication and therapy, it seemed like my daughter had improved, but neither her and I have felt like her therapy sessions have had much impact. She is very shy still with her therapist. Tonight she broke down and was crying again. She is very imaginative and says that she wishes she lived in the fantasies she imagines and is disappointed that she can’t. But sometimes it feels like they are real. Real life is boring. She can’t stand being around most people and large groups of people make her feel very anxious. She feels irritable around her family and feels like being mean to her siblings and harps on them. She hates feeling like she is a mean person, but can’t help it. She is often disrespectful to my husband and I and doesn’t care and feels guilty that she doesn’t. A couple weeks ago she was mad at us because we wanted her to do her chores and she stormed out of the house and was gone for a couple hours before returning. It scared me, but we just treated it like she retreated to her room for a bit, because we didn’t want her to using running away as an attention getting thing. She was interested in writing but no longer wants to because she is discouraged that she can’t write out what she can imagine much better. She knows she is being too perfectionistic about it but can’t get past it. I also think she feels low self esteem because although she is very bright, imaginative and enjoyable to be around she compares herself to others, including her siblings, who have talents that are more easily seen such as being in the gifted program, music or athletics. She was a very outgoing, fun child but is much more reserved and insecure as a teen, at least outside of the family. She says she thinks something is wrong with her. She sleeps fine, no weight or diet changes and had straight A’s. She doesn’t want to go to her therapist anymore or start over with anyone else. I don’t know if she is just going through normal growing pains or if she really needs more intervention. And my recent failure to see my husband’s needs makes me not trust my own judgment on the matter. I just want all my family to all be happy again. What can/should I do to help her?

Between your husband’s recent suicidal ideation and the suicide of one of your daughter’s acquaintances, the fact that she is reacting to these circumstances is normal, but professional intervention is required. Some research suggests that suicide can be contagious, especially among teenagers. One person’s suicide or suicidal ideation can trigger another person’s thoughts or behaviors. Though she has never directly expressed suicidal thoughts, her risk of suicide is elevated.

You felt that her therapy was not helping but was it given a fair chance? Your daughter improved but you allowed her to quit because she was “very shy with her therapist.” Shyness is not uncommon in the beginning of therapy. It takes time to build a trusting relationship. She should return to therapy. Try another therapist. We are not all the same.

If resuming therapy is not an option, then you should contact the therapist, report that your daughter refuses treatment but clearly needs it and ask for help. The therapist is familiar with her case and can advise you about how to proceed.

Given your daughter’s exposure to suicide, she may be more susceptible to suicidal thoughts or behaviors than someone without exposure. Your daughter should be in treatment.

If you continue to struggle to help your daughter, then you should consider entering individual therapy. Family therapy is also a wise option, especially given your husband’s suicidal ideation. If you attended therapy, you would serve as a great role model for your daughter. If she sees that you are willing to engage in treatment, then she might follow in your footsteps. Do whatever is necessary to ensure that she receives help. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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