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i dont know what my problem is

by Dr. Marie Hartwell-Walker May 18th, 2024
written by Dr. Marie Hartwell-Walker

Q: Im not sure how to explain this but hopefully you can help me i dont feel comfortable talking to my close friends or family about this situation. I honestly feel that im a socially acceptable person but i dont understand why i can even motivate myself to go to work or class. im a very punctual and responsible person and everyone i know seems to trust me. I’ve always been a depressed person and i honestly believe its because of my inability to hold a relationship. I have some great friends and if it wasnt for them i would have probably committed suicide already. Im 22 years old and apparently girls see me as absolutely repulsive becuase no one wants to have a relationship with me. Im at a point where i don’t know how much better i can improve myself to others i mean i work all the time i do great in school. I know that its just my self esteem but no matter what i do i cant get a relationship started with anyone i talk to. Im starting to feel like maybe i should go ahead and commit suicide, maybe that would get me out of this hellous competition that im faced with. Everyday i get out of school, yet i do well, i like to drink to try and forget my stress. I kind of feel like im experiencing the adolescent form of self efficacy which i dont know how to change anyway. Im sorry im hoping that you might be able to analyze what im saying and help me out here because ive been taking psychology courses in school and i cant even figure out why i feel the way i do. Ive had a very caring family even though i feel some have taken advantage of me. This might be very confusing for you but if you could help me figure out how i could motivate myself to keep on living but yet i do anyway. I feel that if i can make it through the day with school and work the im one step closer to being a happy person otherwise right now if i got shot or hit by a car then God would be doing me a favor because i feel that the only reason i continute to work and go to school is to improve my self esteem which isnt working by the way so if you can analyze what i need to do to improve this let me know. But i honestly feel its because i cant get a relationship

Thank you for writing. What you are experiencing is pretty common at your age. I know that doesn’t make it better. But I’m hoping that knowing that other people go through times like this is a bit reassuring.

I think maybe you aren’t finding a partner because you’ve become too focused on yourself. You are so anxious about what is wrong that you are probably putting out a vibe that says to girls that you aren’t really available. To change that, you need to change your approach. You have a lot to work with. You are smart, sensitive, responsible, and trustworthy. Now put those characteristics to use. Find something you can do to make the world a better place. Do some community service or get involved with the presidential campaign, for example. Join up with other people who have similar interests and make something positive happen. If you do these things, the self-esteem issue will probably take care of itself. If you work side by side with other people to make a difference, you will get out of yourself and you’ll meet good people who will want to meet you. And, please, stop drinking. Alcohol is a depressant. It may be helping you avoid your feelings but it isn’t helping you solve your problems. Give all this 3 – 6 months of real effort and see where it takes you.

I wish you well.
Dr. Marie

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OCD vs. Phobia Problem?

by Kristina Randle, Ph.D., LCSW March 21st, 2024
written by Kristina Randle, Ph.D., LCSW

Hello, please help! I am a 48 year old male, married with kids. I have always had some degree of anxiety (a worrier), usually very minor but with all the stressors I’ve endured lately (double job loss, part time business failure), I believe it has accelerated to an OCD condition – I have a fear of hazardous material, and in particular asbestos and the diseases it causes. My fear is heightened when I think my family may be exposed as well. I’ve had this fear (to a much lesser extent) for quite some time since learning the horrors of contracting mesothelioma, but it has seemed to peak – I can take the thoughts to the extreme as described below.

I feel compelled to check every old / antique thing we own for it and everywhere I go, and have taken several samples from our home into a lab to get checked (drywall mud, paint, ceiling texture, etc.), although our home was built well after asbestos was banned for those uses. I also have had articles from the yard tested (old cooler insulation, concrete fireplace, antique painted fencing and lawn furniture, etc.). Everything has tested “no asbestos”. It seems that as soon as I get the good news of a negative test, my anxiety drops for a bit, but I soon find something else to obsess over. I even get paranoid in older buildings – is there asbestos above the drop ceiling? Have they remodeled recently, releasing fibers into the air? Is that sprayed on stuff on the ceiling support asbestos? I called the school system about the school where my wife works to ask about some vinyl tile, the city to ask about dust being raised from the dump by the road, and I email experts often when I have anxiety about certain objects or substances. My wife only knows a fraction of my activity for fear of her thinking I am completely nuts.

I always go through several layers of “what if”, and it is maddening. I feel that I need to find a way to retire from being the “asbestos police” – I know the odds of an illness are very remote, and exposure and illness are essentially out of my control. I feel that this may be my main issue – I have such a current lack of control over my life, I must need to control something. I have seen a therapist several times and it has helped to bring down my overall anxiety level, but the obsession to check for asbestos everywhere remains. I do have moments of clarity, when I see my obsession as a problem and have very low anxiety, but they are fleeting. Do I fit the description as having OCD, or am I just phobic and overly “cautious”? I really want to be back to my old self, virtually without a thought about asbestos.

Though I cannot provide a diagnosis over the Internet, your symptoms seem indicative of obsessive-compulsive disorder (OCD). OCD is an anxiety disorder that is characterized by unwanted, reoccurring thoughts and repetitive behaviors.

Among OCD sufferers, specifically among those with health-related anxieties such as yours, often no amount of reassurance is enough. In fact, the act of seeking reassurance can make OCD worse. It temporarily decreases anxiety but it reinforces the “seeking reassurance” behavior.

OCD sufferers should resist the urge to seek reassurance and instead endure their anxiety. If an individual habitually seeks reassurance when they feel anxious, then not doing so will increase their anxiety, possibly to very intense levels.

Those levels cannot be sustained. Anxiety always decreases. In that way, anxiety can be likened to the law of gravity: what goes up must come down. Individuals with OCD are unwilling to endure their anxiety. They do everything in their power to escape it. That is a mistake. Anxiety avoided in the short run is only intensified in the long run.

As you stated, “I know the odds of an illness are very remote, and exposure and illness are essentially out of my control.” It is generally believed that individuals with OCD, through their rituals, are attempting to establish control over events and situations that in reality they cannot control.

You can reduce or eliminate your anxiety by focusing on reality. If you force yourself to believe in reality, then your anxiety will diminish.

Beginning therapy was a very wise choice. I would strongly urge you to continue. Therapy can help you to understand and to be comfortable with things that are beyond your control. This wisdom has been shared by mankind since the beginning of recorded history and perhaps before. It is exemplified in the Serenity Prayer, (adopted by Alcoholics Anonymous) “God, grant us the Serenity to accept things we cannot change, Courage to change the things we can, and the Wisdom to know the difference…”

OCD tends to be a progressive disorder but this is not true for everyone. Symptoms may occur on certain occasions or on all, decrease over time or increase. There are effective treatments for OCD including cognitive-behavioral therapy and relaxation training. A specific form of cognitive-behavioral therapy, known as exposure and prevention response, has been shown to be a very effective treatment. Medication can help as well.

I wish you the best of luck. Please take care.

Dr. Kristina Randle

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Struggling With My Life

by Kristina Randle, Ph.D., LCSW January 28th, 2024
written by Kristina Randle, Ph.D., LCSW

This year has been very rough for me. In the summer I decided to tell my doctor that I am depressed. I have been depressed for the past six years due to my dad’s suicide. My doctor decided to refer me to a psychiatrist for psychotherapy.

The university I go to has had several problems making an already difficult experience worse. School has been very stressful and I am falling behind on the workload. Usually when I go to school I act happy or at least normal but I can’t do it anymore. I don’t even have the energy to fake a smile. People at school are constantly asking me what is wrong.

I also have issues at home because I live with my mom and her husband. They treat me like an object and my mom’s husband calls me “roommate” (which is actually one of the nicer things he calls me) because I am not part of the family. When I’m at home I get blamed for everything and if they’re having a bad day they yell and take it out on me because they know I can’t do anything about it. Whenever I argue back they threaten to kick me out and I can’t afford to move out because my tuition is very expensive. When I am at home I go straight to my room and stay there because I can’t handle them anymore. Every cut I have made on my body was because of them.

I have never been this depressed before. The only reason why I get out of bed every day is because of school even though it is stressful. It has been a dream of mine to get into this very competitive program at school. I am so confused because I love the program I am taking but I also want to give up because I am doing really badly in some of my courses. It seems like I have issues with school or personal problems every day, I feel like everything in my life gets screwed up and it is because of me.

This week I went to see my psychiatrist for psychotherapy for the first time. It was very awkward and I felt very uncomfortable. I was so nervous I didn’t take off my coat the entire time I was in there. I barely talked and stared out the window for most of the session as he typed away on his computer. He brought up some things I didn’t want to talk about like my dad’s suicide and said we could discuss them later. The thing is I don’t want to go back. I know I don’t talk a lot so this is going be an issue and even if I do talk I don’t get how this is going to help me. He said I have depression and I should continue talk therapy and take antidepressants. I told him I didn’t want to take antidepressants so he told me to think about it. By the end of the session I guess I looked a little unimpressed because he asked me if I was coming back and I replied I don’t know.

The next day I had class I just sat there staring at my binder. I couldn’t focus because I was so depressed. My friend noticed and I told her I was having a bad day but she didn’t buy it so she asked again in the hall and I told her about my depression. While we were in the hall the teacher walked by and asked if I was okay but I just brushed her off. Well, yesterday my teacher sent me an email saying “Are you ok? You are very quiet in class. If there is anything bothering you about the class please speak with me. I would like to speak with you anyhow Please make an appt for next Tues after class. I will be meeting with some Level 4 students and I can meet you right afterwards”. I don’t know what she wants and it is making me really anxious. I really hope I don’t have to explain to her what has been going on lately because it’s very personal.

I don’t know what to do anymore. I feel like I am failing university and all I want to do is give up. I use to have suicidal thoughts to escape my reality but now I have a very strong urge to do it. Every time something goes wrong I want to kill myself. I don’t think I want to die but it just seems like it would be easier and no one is going to miss me so who cares. I know I should phone the psychiatrist and make another appointment but I am scared that this is my last option to make things better and it isn’t going to help.

Please give me some advice because I am struggling with my life.

I think it is important that you try to talk about your issues with a therapist. I cannot tell if you are uncomfortable talking about your issues in general or if you do not like your particular therapist. If it is the latter, then consider making an appointment with another therapist. You do not have to keep the same therapist. If you find someone who you like and trust, then you may have an easier time discussing your issues. The right therapist can make all the difference.

As I alluded to above, a large part of being helped requires that you be willing to share your thoughts and feelings. The depression you are experiencing is understandable. It makes perfect sense. Many people would feel the same way. You lost your father to suicide. Losing a loved one, especially in such a tragic manner, is one of the most difficult experiences in a person’s life. I suspect that you have yet to properly grieve the loss of your father. In addition to your father’s death, your current living situation is stressful. The stress associated with your living situation is negatively impacting you at school. You are suffering emotionally and you are struggling to function day-to-day.

My biggest concern about your letter is that you are contemplating suicide. You need to know that there are many ways to handle the issues you are facing. Suicide is never the answer. People often feel suicidal when they feel there is nothing left for them to try. If you examined your situation logically, you would see that you have yet to try treatment. You went once and barely spoke. Help is available. Psychotherapy helps millions of people. You can be helped too, if you give treatment a chance.

What if you had a friend who was struggling with issues in her life? What advice would you give her? What if she wanted to end her life? You would probably beg and plead with her not to do it. Why? Probably because you would see that she could be helped and committing suicide would be an absolute tragedy. It is difficult to think clearly and logically when you are in the depths of depression. Thinking about it from the perspective of a concerned friend may help you to better understand why suicide is never the answer.

My advice is that you try to attend psychotherapy appointments and change therapists if needed. Force yourself to go if you have to. It might take a while to feel comfortable about opening up in therapy and that is okay. Not everyone comes into therapy ready and willing to share their life’s story in the first few sessions. It takes time to build trust between a client and therapist, just like it would in any other relationship.

If you are actively suicidal and strongly considering harming yourself then please call 911 or go the emergency room immediately. If you need someone to speak with or are feeling overwhelmed don’t hesitate to call the suicidal hotline. Their number is 800-273-8255.

Lastly, I must reiterate this to you: suicide is not the answer. Suicide is a human tragedy. People who have attempted suicide and lived often thank God that they did not die. Usually they see that life does improve for them. They see that help is available. Life can get better for you, just like it did for all those other people who like you were convinced that it would not. Learn from the people who nearly died from a suicide attempt and lived to witness an improvement in their lives.

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My parents are completely ridiculous

by Dr. Marie Hartwell-Walker January 24th, 2024
written by Dr. Marie Hartwell-Walker

I’m 15 and I have family issues. My Mom said she’s gonna call a psychiatrist on me and make me stay the night in a mental hospital or something. She wants me to change schools too and go to a Christian school.
This is completely ridiculous because:
A) I’m a nice person. They call me a mean person all the time and it just lowers my self esteem. I know I’m a nice person because I care more about other people than I do myself. I wanna adopt kids from Africa, my friends and I never ever ever get into arguments, nobody at school has anything against me, I help people (like if someone drops their books in the hallway I’ll help them pick them up and or if some girl is in wheelchair I’ll hold her lunch tray or pick something up that she drops or help someone with a question and give advice to people I don’t even know). Just stuff like that. They just think I’m a mean person because I don’t act all hyper and happy and friendly around them like I am when I’m with my friends. It isn’t my fault if I don’t wanna talk about boys and music (that they don’t even know) to them. That’s just stuff I do with my friends. That’s what friends are for.
B) They say I isolate myself. Everyone needs some private time just to themselves, right? I don’t see the problem with that. It’s not like I’m doing anything wrong. And yeah I’ll admit I don’t enjoy being in the same room with them because they always find something to argue with me about.
C) Sending me to another school is flat out dumb. I love my school and I love the people there. She wants me to change because too many pregnant girls are there and too many kids who do weed are there. I mean EVERY school is gonna be like that. Christian school or not- there will always be bad people everywhere and I think a normal public school would be good for me. If she doesn’t believe me she can get me drug tested. I told her that and that STILL isn’t enough to convince her. She’s impossible to please.
D) I got a cell phone about 6 months ago and they think that’s changing me. A cell phone can’t change somebody. I think I’m at the age where I’m finding out who I am and stuff and it’s just a coincidence I just got a phone at the same time.
E) They think I’m getting too serious with my boyfriend and that he’s causing a problem when I’ve only been going out with him for 3 months and they’ve said numerous time this has been going on for 6 months.
F) They’re also saying that me being a vegetarian is wrong. That’s a personal descision and they just have to learn to accept it like accepting somebody’s religion.

They’re both Christians and so am I, I have a relationship with God and all that jazz but she says that the Bible talks about eating animals. It also says don’t kill anything. The Bible says you need to take care of your body so if I don’t get all the protein I need then I’m sinning or something. I’m skinny. So I don’t see why I need to have the exact amounts of fat and protein everyday.

G) She says I need to bring more people to church. I bring two of my friends to church every week. What more can she ask for? Like no on else will fit in the car! And you can’t MAKE someone go to church with you. It’s their choice.

Do I have a problem? Do I need a psychiatrist? Or are my parents just overreacting?

You sound like a sensible, caring teen who any parent would be proud of. So — either you aren’t seeing and sharing the whole story – or your folks have never parented a teen before and don’t know what to expect. If you are on the level, then my guess is that your parents are terrified because of all the negative things they’ve heard about the teen years. In their efforts to protect you and themselves, they are going overboard. Let’s give them credit for how much they care.

Your best friends in this situation might be your school guidance counselor and the psychiatrist your mom wants you to see. Share your letter with the counselor and see if perhaps she or he can meet with your parents to reassure them that you are a normal kid behaving in normal ways around her family. If that doesn’t do it, go ahead and see a psychiatrist. If all is as you say, the doctor will most likely support you and will tell your folks that you are all going through a normal stage.

BTW: The doctor is also liable to tell your parents that there are lots and lots of parents who would be enormously grateful if they were only arguing with their kids about how much meat they eat. (And yes, you do need protein but research the web for ways you can get what you need in the vegetable world, ok?)

You all sound to me like good people. Your parents are doing their best. You are too. I hope you can find another adult who can give all of you some support so that your folks can relax and you can go about the business of growing up.

I wish you well.
Dr. Marie

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I need to help my brother

by Dr. Marie Hartwell-Walker October 18th, 2023
written by Dr. Marie Hartwell-Walker

From Lebanon: i dont know how to start and to tell u the truth im a little pessimistic now.im 22 my brother is 25 and he is diagnost with bipolar syndrom.but the problem nothing we do is helping,he dont get out of his room,hes afraid to do that,when hes out he thinks that evrybody’s pointing at him so he will get mad and start to yell,hes often saying that he hears voices or that somebody is whispering in his ear,he often wakes up scared or have bad dream.at one point he was very dangerous,5 years ago he used to scream indoors ,throw things in the house,threat me and my parents,he even started working with bad sporits,but now thank to god hes not doing it anymore.hes been to therapits,psychatrists,psychologs but no one seems to know what he has,they can all diagnos and give him pills.Well the pills helped to be calm and relaxed,but didnt help him to move on with his life,or let him think to have a job,ahd get a life.HES afraid to do that,and hes even not happy about it ,he wants help but i dont think were being able to do that,although my parents did their best and still doing it.,this last doc is going to give him seraquel,and hes even treating him with neadles…but till now no change,hes only been with him for like a 3 months maybe.MY brother needs help.We tried everyone,priests,elders,psycholigists,psychyatrits,,,, and still no use.HES 25 years old ,when is he going to h ave a normal life.he doesnt have a job,hes depending pn my parents till when,,,??? in shi condition he cant work.,I dont know if writting here is going to help me but franctly im kinda hoping u can help me even though im in the other way of the world.PLEASE HELP

Your brother is a lucky man to have a family that loves him and wants so much to help him. You already know that your brother is seriously mentally ill. He probably does need the medications that his psychiatrist is prescribing. Unfortunately, I don’t know anything about the services available in your country. All I can tell you is what I would suggest to someone in the U.S. and hope that it is somewhat useful to you.

My first concern would be whether your brother is accurately telling his psychiatrist about how he behaves and what he feels. If he will let you, I suggest you accompany him to his appointments and ask that you be allowed to share your observations with his doctor for at least part of his session. The remainder of the session is for his private conversation with the doctor. I also suggest that you and your family start some family therapy or get involved in a support group for family members of people with severe and persistent mental illness. Having a family member who is so ill is very, very stressful on any family. A therapist or a support group will give you all both support and some practical advice for how to handle your brother so his illness doesn’t tear up your family. A family therapist may want to include him in some of your sessions together to help him accept your help.

Finally, I don’t know if there are any community services available in your country for people like your brother. At least in some parts of the U.S., there are staffed group residences and work programs that serve those with severe mental illness. When someone doesn’t respond optimally to treatment, such programs can at least give the person a home, meaningful work, and the “safety net” of staff who make sure they get to their appointments and live a reasonably safe life.

I’m very sorry that I can’t be more specifically helpful. Perhaps your brother’s psychiatrist can give you and your family some guidance about what services are available in your own country.

I wish you well.
Dr. Marie

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Overwhelmed. Please Help.

by Kristina Randle, Ph.D., LCSW September 9th, 2023
written by Kristina Randle, Ph.D., LCSW

Q. Occasionally feel like I’m going “crazy” — like the world and life is not real and I’m about to black out. I have wondered on and off for several years now if I’m dealing with depression, but every time I take one of those online tests I’m never able to honestly check off enough of the boxes to be considered depressed. I go through periods of time that last several weeks where I feel completely immobilized. I don’t clean the house, or keep up with my calendars, or do anything except what absolutely has to be done like going to work and meeting my responsibilities to others. During these times the house gets disgusting and I get so overwhelmed that I feel like I can’t climb out of the hole I’ve dug for myself. Finally I’ll get my hands on a self-help book I haven’t read yet, and I’ll drag myself out of it and be fine for a couple of weeks. But it’s a struggle to be that way. It feels like it takes so much effort to live a normal life that there’s no way I can keep it up forever and I’ll finally give up and go back into my period of immobilization again.

I often feel like life is hard for everyone and I am just a spoiled baby who doesn’t want to deal with chores and hardships. A lazy worthless excuse for a woman. Then I start to feel like my family would be so much better off with someone else to care for them instead of me. A few times I’ve truly wished I was dead, but I wouldn’t consider this thoughts of suicide because I would never hurt myself no matter how bad things feel. It was more of a why was I ever born kind of feeling — as though I didn’t ask God to put me in the world so why did He have to put me here? Why would He have done that to my family when they deserve so much better than me. But more recently there have been a few times that I’ve felt like I’m literally going “crazy”. I don’t really know how to describe it. It makes me think of my psychology class I took last semester when I read about schizophrenia. I feel like my brain is trying to shut down or cut off or something. The world starts to look different — kind of jittery is the best I can describe it. Like you’ve had too much caffeine except without the energy rush. And it’s only behind my eyes; my body itself doesn’t feel jittery. I feel like I’m more inside of my head than normal, if that makes any sense. It almost seems like the world is going to go black. It’s always evening when this happens and I feel like a lot of it has to do with being really tired. Although I probably get just as much sleep as anyone else does. Anywhere from 5-10 hours per night just depending on what’s going on in the week. Probably an average of 7 hrs per night.

I’m embarrassed to tell you that I have children because I feel like someone in my condition has no right being a mother. But I do have two precious kids. The thing is that I have no problem forcing myself to care for them when I feel immobilized. I make sure that all of their needs are met and they are loved and adored and know how much they mean to myself and my husband. Anyone outside my life would probably be shocked to know that I was this way. My husband is really the only person that does know. This fact makes me feel like I must just be a lazy person because I know I have the ability to force myself to meet my responsibilities to others. My husband has said a couple of times that he thinks I may be depressed. I’m afraid to go to a clinic though because I somehow feel like if I do have something psychological going on it’s not depression, and I feel like a doctor would be quick to diagnose it as that and move on to the next patient. Any advice or ideas of what could be wrong with me will be greatly appreciated. Thank you so much, Overwhelmed.

You do not need to score a certain number or percentage on an Internet test to know if you are suffering from depression. It seems clear that you are, no matter what score you receive on those tests.

What do you know for sure? You know that you feel depressed seemingly more often than happy. You said that you have intermittent periods where you feel really lousy to the point where even the simplest task seems like an impossible chore. You often feel tired despite getting a healthy amount of sleep. You seem to have a negative or pessimistic view of yourself, harshly criticizing your behavior and referring to yourself as “lazy” and wondering why you were ever born. You seem generally unhappy with life.

You also mentioned that sometimes you feel that you are going “crazy” and experience that “[your] brain is trying to shut down or cut off or something. The world starts to look different – kind of jittery is the best I can describe it. Like you’ve had too much caffeine except without the energy rush. And it’s only behind my eyes – my body itself doesn’t feel jittery. I feel like I’m more inside of my head than normal, if that makes any sense. It almost seems like the world is going to go black.” I would need to ask you many more questions regarding the aforementioned symptoms to give a name to what you are experiencing.

I would suggest that you seek help from a professional. I know that you are worried about being diagnosed with something other than depression but without assistance you will continue to suffer. Life will continue to be unpleasant for you and the very prospect of that should seem objectionable to you. The symptoms you mentioned regarding the “craziness” that you feel may be related to your depression and if not, they may be related to a medical problem. But only a doctor who you met with in person could know for certain.

To counteract your other fear of getting to spend little time with a doctor, you should try to find a therapist who comes highly recommended. You can even do an Internet search for therapists in your area. Perhaps there are client reviews of therapists available to help you better choose a therapist. I would also recommend that you call many therapists before you meet them in person to get a sense of what they are like over the phone. You should call a minimum of 10 therapists. When you call, ask them many questions regarding how they might treat your issues and inquire about whether they have treated others with depression in the past.

I would encourage you to be brave and to stand up to your fear of getting help. Don’t let fear hold you back from becoming the strong woman, wife and mother you have the potential to be. If you don’t do it for yourself, then do it for your children. Know that even if you try to shelter your children from your bouts of depression it is still highly likely that it will have an impact on them.

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Going in circles

by Dr. Marie Hartwell-Walker June 20th, 2023
written by Dr. Marie Hartwell-Walker

Dear Dr. Marie,
I wrote back in July last year about my recurring depression and
suicidal thoughts. Thank you for your insightful and helpful response.

I did have counselling following my hospitalisation. I continued until
about September last year. I started to feel well about that time, my
energy picked up, I made new friends at work, and had a sense of
achievement and self worth.

I felt very clear about my decision to leave my husband. However it is
almost 2 years since I left him -the mandatory time before one can get
divorced in my country – and my husband is getting quite desperate to
get me back. I’ve become quite stressed by his turning up to see me,
visiting my family and friends, talking in church about me and to anyone
who will listen. He tells the children divorce is wrong, that the bible
says it’s wrong, that divorce means nothing and I’ll always be his wife.
He talks about “all these men” he says I am going out with.

At first it didn’t bother me as I am used to it and expected this but
just lately I’ve been feeling very stressed. My sleep, which has never
recovered since I initially became depressed, is worse, and I have that
terrible tiredness back. I really don’t want to go to work but I know I
need to both financially and for my psychological well being. However, I
do find shift work very tiring. I feel like I’m getting run down but I
don’t know how to manage my stress.

I’ve found myself doubting my perspective of how things were in the
marriage and going around the same circle again of should I give him
another chance. I really want to resolve this once and for all and his
telling the kids that the divorce means nothing has disheartened me. I
know I can’t go back but I’m not sure why I get confused from time to
time and have to go through a whole lot of turmoil to get to that
conclusion again.

Any ideas on what I can do to feel less stressed would be greatly
appreciated.

Thank you for writing. You’ve already taken an important first step by reaching out for some help. The next step is go back to the therapist who was helpful to you. He or she already knows your story and you’ll be able to pick up where you left off.

Therapy for a significant depression is rarely a one-time episode. Think of it as layers. You got through the most difficult one. Now it’s time to work on the next. You can draw comfort and hope from the fact that you did get better. You will again. This time you didn’t sink as low so it will probably be easier to find your strength again. Your therapist will also be in a position to help you figure out whether there is any reality to your husband’s position and whether the marriage is salvageable.

I do have my doubts. From what you wrote, your husband is not approaching you about what he can do better. Instead, he is blaming you and trying to isolate your from your family and community – and even your God. He’s also putting the children in the painful position of being in the middle of your divorce. If he were serious about making the marriage work, he would be taking some responsibility for the break down of your relationship (both to you and to others) and would be asking to join you in your therapy to do some couples counseling. Most important, he would be considering his children’s need to have two parents they respect instead of trying to get them to take his side.

Meanwhile, I hope you have talked with a lawyer about what your rights are. You may be able to limit your husband’s contact with you and what he can say to the children. I don’t know the laws of your country, though, so I caution you to seek out legal help.

Finally, ask your therapist for a referral to a local support group (or an online group) for women who are having similar difficulties. I think you will find it affirming and helpful to have the support of others who know what you are going through.

I wish you well.
Dr. Marie

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So Many Losses

by Dr. Marie Hartwell-Walker April 7th, 2023
written by Dr. Marie Hartwell-Walker

Q: 5 years ago, my Mother had a stroke paralyzing her left side, and passed away 5 months later. The day after her stroke my daughter began her Invitro procedures and became pregnant shortly afterward. A month after my Mother died, my daughter developed Preclampsia, was rushed to the hospital, and a few days later, my granddaughter was born 3-1/2 mos premature by caserian. Thank God, they were both ok and my granddaughter, after a few close calls, was released to go home 2 months later.

She had to be watched carefully by several different specialists for a year. My daughter was sick alot recovering from this…so I stayed with them alot to take care of her and my granddaughter off and on during that first year. After a year, my daughter had lost lots of weight and became quite thin after being quite overweight. She felt she had no life, was unhappy with her husband, and started staying away from home, leaving me with the baby, and met another man, not a nice one. I think he was a stalker and he saw her vulnerability and I shudder to think what he might’ve done to them. He was very wealthy and influenced her with his money. I think he had her drugged and for sure brain-washed. He still tries to tempt her with emails, even though he knew she’s back with her husband.

My daughter became increasingly verbally abusive to her husband and myself…I think she was on drugs of some kind. She was not focused and only thought of herself and what she felt was missing in her life. So my granddaughter and I had really bonded after all this time. I was afraid for my daughter, but, she wouldn’t talk to me….just stayed out and gone.

After awhile my daughter felt she couldn’t make it on her own as she was accustomed to a high end lifestyle, so she went back to her husband. She was still very abusive. She would make degrading remarks to me about my hair, my lipstick, my glasses, rarely a kind word nor appreciation or love. She treated her husband like he was dirt…telling him he was fat, etc. This has gone on now for about 3-1/2 years. She is better, but, now omits me from all the regular activities I used to share with she and my granddaughter, sometimes, telling my granddaughter I have other plans…which was not true.

Whenever I try to get her to talk to me about all of this, she screams and yells over my talking so she can’t hear me. I tell her I love her, I want a good relationship with her..I miss her.send her notes that I love her, I hug her anyway. She never responds..saying she doesn’t like hugs or affection and hates sex. She’s very cold, distant, artificially sweet at times. The only conversations we have are about my gdaughter or she talks about herself and how many guys try to pick her up, etc. If I try to have a conversation about something I’ve done or what I have to say, she cuts me off, yawns and has to go, and rarely asks me any questions about my life. Rarely compliments or has much good to say about me or what I do. Very critical of me and what I say and how I say it. If I say it’s black, she’ll say it’s white and act like she’s an expert on every subject. She’s just not interested in me as a person.

She is a good mother and has now been overcompensating, I believe, with her daughter as she feels guilty for ignoring her for about a year in there. She told me I was trying to get my granddaughter to want just me..and acts jealous many times that my gdaughter doesn’t want to leave me when we have to say goodbye. She will let me watch my granddaughter..I go and get her and take her home with me to spend the night or two. I take her to church if she’s here on Sundays..we have a great relationship. Her Mother knows we are very close. I feel left out of her life and she doesn’t want me in it except for her convenience. I never get invited to go places with them anymore…only to babysit.

So, it’s been bothering me for so long and I don’t know what to do. I feel so stressed over it and long for a family unit. It’s been so difficult since my Mother died…I was her caregiver also since my Dad had died 3 years prior to my Mother, and then all the problems with my daughter’s pregnancy and birth. I feel I’ve lost my Mother, Father and daughter. I have only my granddaughter. I couldn’t bare it if she weren’t in my life. She is 4-1/2 years old now. My daughter is 39.

What a difficult, difficult time you’ve had. This is a very complicated situation and won’t be solved by a few comments from me or in a short time. Maybe, though, I can give you some direction. It sounds to me like your daughter was traumatized by her birth experience. Terrified that her daughter might die, she distanced herself emotionally from her. To distract herself, she let herself get caught up in a self-destructive affair. At some point, something clicked back into place so that she wants to reclaim her daughter. But she also feels guilty for not being there for the first couple of years. She loves you for taking care of her child and feels terrible that you, not she, was mothering her. Sometimes the grateful part wins and you get to spend time with your granddaughter. Other times, the guilty part wins and she tries to distance you. She projects all her bad feelings about herself onto her husband and you. Unable to love herself, she won’t let you love her either.

You’ve done a wonderful job. You’ve tried to love your daughter through this instead of distancing from her. Your granddaughter has come through a hard beginning as an emotionally healthy little girl because you gave her the love and care a baby needs during the formative years. Now you all need help putting your family back together.

I strongly urge you to find a family therapist to help you. If your daughter won’t go at first, start with yourself. I hope your son-in-law will join you. Your therapist will help you find a way to invite your daughter into sessions. So much has happened that healing will take time. Please be patient. Enjoy your relationship with your grandchild and feel good about the stability you’ve managed to give her.

I wish you well.
Dr. Marie

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Big Problem with In-Laws

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP March 27th, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I have a big problem with dealing with my in laws. Actually, my boyfriend and me is getting along together for over 7years. There was no problem with my in laws at early years. But the problem began when I started studying abroad. Actually, my BF’ cousin, my sis in law, went to study BBA and she came back because she couldn’t study even the Foundation of Business English Class, not the Credit courses. But for me, I went to study MBA and I am OK with my studying. We went to the different countries and universities. At first I thought there was nothing concerning between my studying and hers. But unfortunately, she extremely jealous and gossiping about me in her relations. Although she is first cousin to my BF, their families lived together and they are like siblings. Especially, my BF’ mom love her like her own daughter. That’s the main point. My mother in law believe and accept whatever she and her own family said. Not only her, but also her mom hate me when I start studying abroad. She even talk and insult about my personality and character. For example, at the early months I went studying abroad, she and her family said ‘she cant study long coz she is not qualified’. But when I am ok with my studying, they said ‘she will become worse than a sexual worker and will cheat my bro cousin’ (yeah, they said even like that). But, when I am perfect with my personality, they (she and her family) said, ‘Ah! Nothing happened? Yeah. Because she is abnormal now coz she live alone without her family’. When my sis in law tried to study abroad, both and her family moved.
The main problem is that my BF’ mother believe and talked to me very very badly starts from over 1year ago.(She talked to me like a street dog). At the first time, I couldn’t even talk back a word to her because I was so surprise as we had a good relation. She did for twice but thanks for God, its a phone conversation and I drop the phone and never called her again. (But, now she pretend to be a good one whenever by boyfriend is with her and she said ‘I never said like that’ )
That jealous girl always tried to separate my BF and me with so many ways. I cant stand what they do. Coz they always talk about me badly to my BF, their relations and friends. As for me, I cant stand even a minute about that because my improving career is not like stealing her brain and her life. Hers is hers and mine is mine.
Start from there, I have been always angry with them. Like they stole my time by thinking about their nonsense gossip and insulting. Although my BF support me, I am not relieve of that. I often cried out suddenly and fight to my BF by telling about them but he never fight me back. He just say ‘Its not me Honey. Its them. Sorry for I cannot control them. But I will love you forever and will be more good to you’.
I don’t like this feeling. I had my peaceful life. I really miss my sound and peace past. I do hate them. But I also hate that feeling. I want to live without thinking them. I want to live peacefully whenever they have their family special occasions because I have to always worrying that whether they forced my BF to marry other girl (like they always do)or not and tell that how bad is my university and career and how bad is my personality.
I want to conquer them and my bad feeling. I do want to conquer them. On the other hand, I want to be in better place (education and personality)to make them more and more jealous. But this feeling drive me away and away from my peaceful life. I don’t know how to handle them and my feeling.
Please help me.

It is time to get your boyfriend involved more directly and have him deal with his family directly. He is too passive and you need more direct support from him. It is true he cannot control them, but he can explain how disappointed he is in them, how it is both disrespectful and unacceptable to treat you this way. Your accomplishments need to be a source of pride, not the target of jealousy. The only reason you have to put up with them is because of your relationship with your boyfriend. It is time for him to stand with you and support you and confront his family.

Wishing you patience and peace,
Dr. Dan

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Fiance Won’t Trust Me

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP February 21st, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I screwed up big time. My fiancée and I have been together for 5 years and have an 18-month-old daughter. For the past few months I’ve been feeling increasingly isolated (I’m an at home mom and he’s gone with work or projects). I’ve tried speaking with him and asked countless times to spend more time with him and let him know how sad I’ve felt. He’s always shrugged this off and noted that he has “to get things done” around the house and at our rental properties, etc.

After nagging him for some time I decided to seek emotional support from friends and began going out more often. In the past few weeks I’ve gone out three times and each time I drank too much to drive home. The first two times I stayed at my girlfriends house and he didn’t seem to mind much but the last time I went out with all guys. They were friends of mine but one, by my own assertion, “was a male whore”. I made a ridiculously stupid decision and decided to stay in a hotel room with the “male whore”. I also lied about where I was staying to protect myself and claimed I had stayed at friends. He called to friend and just about everyone else I knew and found out that wasn’t true (my phone had died). When I arrived home he was waiting for me and I continued to lie through my teeth to save myself when all I did was make it worse. I eventually admitted what had happened and have apologized profusely. I acted selfishly and have offered to end all communication with everyone and never go again if he would agree to work on things in the relationship but he’s flat out refused. He’s told his entire family and is making preparations to move me out of the house. I’ve begged for counseling but he says a counselor can’t get him to trust again. He just keeps reiterating what I said, what I did, what I should have done, what I could have done and I wish to God I had thought of those things before I made such stupid decisions. I’ve stopped eating in an effort to hurt myself the way I’ve hurt him and I really don’t think I can live with this guilt the rest of my life. I know I’ve screwed up and maybe there’s nothing I can do but I’m still willing to try. Any advice to save my relationship and my family would be greatly appreciated.

I deeply appreciate your question and concern. Bu this is an opportunity for a more nuanced evaluation, not simply having to “save the relationship.”

Your actions speak volumes about how poor of a partner he has been. You tried to talk with him and explain and the best he could do was shrug it off. The truth is you were massively dissatisfied in the relationship.

You chose a male whore for a reason. The only purpose was to create enough of a dysregulation in the relationship with your fiance so that resentment over the relationship issue would come to a peak; now it has.

Your fiancé didn’t get the message that you were not happy and that he needed to change, or talk, or something to preserve the relationship. While there might have been other, better choices in how you dealt with this, the truth is your fiancé was unresponsive and doesn’t realize his role in this.

His actions following this, which also leave him out of the formula for change, are also telling. My guess is that he wanted out of the relationship too, but did it passively, not wanting to deal with the dissatisfaction directly.

For you I would begin going to therapy to understand more about the reasons you deal with your dissatisfaction the way you do. Offer to go to couples therapy to work on the relationship, but this would be something he would want to fully engage in to be fruitful.

Finally let me recommend a book, After the Affair by Janis Abrahms Spring and Michael Spring. It is an excellent description of both sides of this coin.

But this is a learning opportunity above all else. Learn what your other options could’ve been, what allowed you to tolerate such an unfulfilling relationship, and what will happen when those feelings inevitably come up for you in the future.

Wishing you patience and peace,
Dr. Dan

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Overprotective Mother

by Kristina Randle, Ph.D., LCSW February 19th, 2023
written by Kristina Randle, Ph.D., LCSW

I am a 21 year old female who has always been controlled by her mother, even now as an adult living independently. When I lived at home, arguments always ensued if I asked for permission to go out with friends and God forbid if I were interested in someone. Now that I live out of State, she calls me a minimum of 10 times a day and constantly wants to know where I’m at, who I’m with, what I’m doing and her reasoning is that “I’m so far away and she does it for my safety.” I’ve had enough and want to know how I can get rid of this toxic relationship that is hindering me from forming any relationships here in Arizona out of fear of her intermeddling. I have dealt with this my entire life and I thought that once I moved out and no longer depended on her, this cycle would end but it seems to have only gotten worse. She constantly gives me guilt trips for leaving her back in my home state and she never gives me credit for being a responsible and independent female. I feel like I always need to be proving myself to her to demonstrate that I am independent and I feel like I’m always on attack. I am desperate for help and need advice on how to repair this situation. Thank You.

At this point in your life, you have the power to end your mother’s interference and control. I’m sure you know that. What you do not have the power to do is end your mother’s control and please her at the same time. You are uncomfortable with the idea of displeasing your mother. However, you will very likely never please her if you attempt to control your own life. Does she have the right to control her life? Do you have the right to control your life? Does she have the right to control her life and yours, while you don’t have the right to control your own life? Is it all right for her to control two lives while you control none?

Ultimately, changing the toxic dynamic means that you will have to change the way you interact with your mother. These changes will include imposing boundaries and rules regarding your interactions. You talk to your mother 10 times a day because you answer her calls 10 times a day. You apparently give in to her demands. As a young child, you had no choice; you had to follow her rules. As an adult, who no longer lives in her home, you no longer have to follow her rules.

When she calls, you don’t have to answer the phone. Nor do you have to provide the information that she is demanding. How often you speak to her should be your decision. That may mean only speaking to her once a day, once a week or not for months at a time. The choice should be yours.

She is not going to like your new changes. She will likely be upset and attempt to make you feel guilty. The guilt trip only works if you allow it to. You must resist her efforts.

Changing the way you interact with your mother will not be an easy transition. You will have to tolerate her being upset with you. You might think that giving in to her demands is more tolerable or easier than dealing with the unpleasantness of her being upset with you but that would be a mistake. Giving into your mother, and doing things her way, means that she retains control of your life.

I would recommend consulting a mental health professional who can guide you through this process. You may not need many therapy sessions but having professional guidance would be advantageous. You have an established dynamic with your mother that is going to require you to impose major changes. Understandably, you may need assistance in restructuring your relationship in a way that allows you to fully develop your independence. Please take care.

Dr. Kristina Randle

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Depressed & Confused About What Is Real

by Kristina Randle, Ph.D., LCSW August 3rd, 2022
written by Kristina Randle, Ph.D., LCSW

I don’t know how can I explain everything, I’ll try to be as clear as possible. I am diagnosed as bipolar. I am medicated and I tend to be like accelerated most of the time. I don’t think I get depressed as much as before, but is very deep and out of sudden. For example, yesterday I was fine in the morning, it was a good day (normal), when I got home to have lunch, I felt so empty, like my essence was drained, I stayed in bed all afternoon, couldn’t eat, speak, anything, not even drinking water, I just stared the ceiling in silence, and sometimes I cried, no real reason.

I wrote to my psychiatrist and she suggested me to go to the hospital, I didn’t. I won’t be hospitalized again, I mean, I have no money now, and if I do it my family would be so mad and then they don’t talk to me, and everything gets harder. So, today I just breathe and left the bed. I can’t talk, eat, or drink water yet. I am following my routine, but with sadness and feeling my lips sealed. I don’t think in suicide, not like I wan’t to die, ’cause I don’t, but I walk in the street and feel so much pain, and then I think if I shoot my head (or something there are many ideas) this pain will end, and never return. And then I try to think something else, my plans, something happy, but I can’t feel it, I just feel and see pain and confusion.

And then I think, that my psych says I am bipolar, but there are voices, I usually have voices, just I have learned how to live with them, like not answer to them in public, and mostly they are nice to me, and give me peace, but then they say I am not human, all this sh.. is because I’m not human, and I am like enlightened and I have to do stuff, to save other dimensions and help nature, and they are stuff that si nice, but now they talked to me again and put images on my head, of myself destroying cars, and streets. I said I could’t do it alone, and they say they’ll do their part, dunno, a lot of stuff. And is easy when you have images in your head about stuff is gonna happen, but you don’t have to do anything. ‘Cause then I just have to wait and see, but now I have to act. And when they are talking, when God talks to me, I don’t doubt, just know have to wait for the signal.

And later, I’m not sure what to believe, I don’t know if I am meant to help clean the world and do what God says, if I am enlightened and like a “special being,” with super perception and can talks to the universe. Or I am sick, I don’t feel sick, but I have read enough to know sometimes bipolars does’t feel they are sick. I never feel sick, I’m not sure I am sick, and i was diagnosed long time ago. like 10 years i believe. And is hard ’cause mi mom thinks I’m like a seer or a witch, and my med thinks I am sick, and my dad thinks I need to go to AA, ’cause is just my emotions in disorder, but I usually don’t have many emotions. And I never know what to believe, and I’m old enough to know, but I don’t.

Sometimes I think I should talk to someone, but I can’t, I can write it, I write to my psychiatrist but don’t see her cause she is out of the country for a year or so. And sometimes I used to talk to her, but nobody else. I really don’t trust in people I know, so I don’t talk about myself, or give my opinion, I mean I know I love my family, so I have a good relationship with them, but I don’t trust them. And is worse with people I don’t know, I can’t even say hi to them, i move my hand or smile, but it takes months of seeing a person, every day to say hi. So I don’t know how can I help myself if I can’t talk. And my head is getting so confusing I don’t know what to do.

I’m sorry for bothering, and I hope it wasn’t very confusing what I write, sorry again but I don’t feel very clear. I would really appreciate some advice, right now i am a little desperate.

Thank you very much for you time.

I am sorry that this is happening to you. It is very difficult to feel as though you have no one to trust, to confide in or to assist you with these issues. You mentioned that you have a psychiatrist but she’s out of the country. Being so far away, it would be very difficult for her to effectively help you.

At this point, your symptoms are unstable. You are hearing voices and are having difficulty distinguishing reality from non-reality. The voices are giving you messages, essentially commanding you to behave in a particular way. It is abnormal to believe that you are receiving such messages and commands. Those are signs of psychological instability.

As difficult as it may be, I would strongly advise you to see a mental health professional. I’m not familiar with the mental health system in Mexico so I cannot provide specific recommendations for how to access help. Generally, you should contact a mental health professional. Report your symptoms to the mental health professional. Even if the prospect of meeting with a mental health professional frightens you, do it anyway. Your feelings of fear may be very real but you can override that fear with action.

At this time, your judgment may be impaired. For that reason, you should not ignore your symptoms and assume that you are okay. Your symptoms may fluctuate in severity from day to day but generally they are not likely to improve on their own. Your symptoms require treatment which may include medication or psychotherapy. I hope that you are able to acquire the proper assistance. Please take care.

Dr. Kristina Randle

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Am I Crazy?

by Kristina Randle, Ph.D., LCSW June 10th, 2022
written by Kristina Randle, Ph.D., LCSW

When I was younger (middle school aged), I had what I think were hallucinations. I tried to tell my grandmother about them but she told me it ‘was the devil’ and that I should never tell people about it. So I didn’t. It happened three times and never again. Last year, I started believing crazy things such as thinking I was the Second Coming and could move things with my mind. I actually stared at objects trying to make them move and had a conversation with the sky (God?) asking why my powers weren’t activated yet. I sometimes think people can read my mind. I’m depressed, and have major anxiety issues… To the point that its hard for me to leave the house long enough just to get the mail.

I also lost all my friends and most of my family because I had an episode where I was overly happy and made horrible impulse decisions. I couldn’t understand why they didn’t think the way I did and why they were so upset… Long story short, I ended up in a cop car and moved in with a distant relative that I barely knew.

I sometimes have thoughts where I want to hurt people/things like my Nana’s dog. I tried to smother her last month just to see what it felt like. I’m confused about myself and am going to see a therapist in a few weeks about this but I’m nervous and wanted to get an opinion before I go. What could possibly be wrong with me? Even if it could be more than one thing, I’d just really like an opinion on the possibilities.

It is good that you have decided to seek professional help. Having an in-person evaluation by a mental health professional is typically how a diagnosis is determined. Diagnosis via the Internet is difficult, given the lack of personal details and psychosocial history. Based on the information provided, there are several possible explanations for what might be wrong but please remember that I have limited information.

Hallucinations and delusions are associated with psychotic disorders. Psychotic disorders include schizophrenia, schizoaffective disorder, psychotic disorder not otherwise specified (NOS), bipolar disorder, and several others. You stated that you had hallucinations but have never had them again. With regard to delusions, it is unclear if you currently have them or if they were something that only occurred years ago.

Having a history of hallucinations and delusions does not mean that you have a psychotic disorder but it does increase the likelihood. Whether or not you have a psychotic disorder depends on if you currently are experiencing symptoms of psychosis, how often those symptoms occur and their level of severity. Bipolar disorder may be the most likely possibility given your current symptoms which include (as you described them): being overly happy and making impulsive decisions which led to your involvement with law enforcement. Again, given the fact that I have limited psychosocial and personal information, a potential diagnosis of bipolar disorder can only be considered speculative.

Seeking professional mental health treatment is the wisest approach to addressing your psychological problems. When meeting with the mental health professional, inquire about the possibility of medication. Medication could significantly reduce your symptoms and improve your overall mood and emotional stability. I wish you the best of luck. Please take care.

Dr. Kristina Randle

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Should I Stay?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP October 17th, 2021
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I’ve been with my current boyfriend for almost 4 years; we had started the relationship as mostly sexual and then built a foundation afterwards. I really care about him and we have dropped the L bomb a couple years ago, but we cannot hold a meaningful conversation. We talk about food, sports etc. but the long conversations are one sided. He complains that I tell him the same stories over and over, but the thing is I’m just trying to hold a decent conversation. We are also in our second year of being in a long distance relationship. He does not like doing most things that I do, he thinks I’m silly, and sometimes I feel like he doesn’t take me seriously. But at the same time, he’s extremely handsome (way out of my league), he comes from old money, he really genuinely cares about me. His family is very important to me too. Recently, I’ve met this guy who I cannot get enough of hanging out with. He knows I have a boyfriend, but we just have to spend as much time together. We keep it innocent, but I am developing some feelings for him. He is not as good looking as my current boyfriend but the conversation is definitely my highlights of the day. We are also extremely honest with each other, we are aware of each other’s feelings toward each other but we both could not do anything to hurt my boyfriend. I continue to hang out with my new friend but I’m starting to get this feeling deep down that I need to make a decision between the safe route (with my current boyfriend) or take a risk and see what life has in store for me. I’m very confused, and have never thought I’d be put in this position. Even if I choose a path, what do I say to the other? How do I break it to them, while keeping a window of hope of remaining in good standing with them? I’m putting it in God’s hands, but I also need reassurance.

This is a particularly difficult situation since you can feel that you are on the cusp of a change.

Perhaps the best way to approach this is to recognize that fact: Something has to change. It is no longer viable to continue in the relationship you are in the way you are in it.

At this stage of the situation we know that you are not satisfied with in the relationship you are in, otherwise you would not need so much fulfillment. The man you are looking to spend more of your time with sounds much closer to someone who fills you up. Time with your boyfriend sounds depleting, demeaning and unfulfilling. The money and the looks are temptations, but how you feel when you are with him is better than a gorgeous bank account that leaves you emotionally bankrupt.

I would encourage you to be as honest with your boyfriend as you are with the new person. Tell your boyfriend that you feel less attracted to him because of how he treats you, and feel better when you are around other people. Let him deal with the fact that he is not in the relationship the way you would like. Honesty allows the truth to be used as a vehicle for change. Either he can make the shift toward improving the relationship with you, or you can make the decision that it is time to move on.

Wishing you patience and peace,
Dr. Dan

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Ex vs. Kids — Who to Believe?

by Kristina Randle, Ph.D., LCSW July 2nd, 2021
written by Kristina Randle, Ph.D., LCSW

I sent in a question about this issue a little over a year ago and have received a useful response that I thought was workable. However, the situation is still not resolved. I’ve been divorced from my ex over five years. He has two domestic violence felonies and has been incarcerated for domestic violence (against me). Since his release from jail more than five years ago, he has sought community based mental health counseling. He’s been diagnosed with bi-polar disorder, PTSD, and OCD. He’s on social security disability. I still love him. But there are a number of issues: 1) He claims he’s no longer mentally ill and only takes his psychotropic drugs shortly before he’s scheduled for his monthly appointment with his psychiatrist. The rest of the time he doesn’t take his meds. 2) He’s isolating himself in a very messy apartment, has grandiose ideas about rewriting the Bible, believes in all kinds of conspiracy theories, and engages in magical thinking; for example: he’s more enlightened than other humans because of his spirituality. 3) He is pushing me to let him come back to me again despite my three grown son’s objections. My youngest son (now 28) is in counseling also for PTSD because when he was a child (from the age of 10) he has witnessed his stepfather’s (my ex-husband) abuse toward me. My ex tells me if I really loved him I wouldn’t leave him, that in the eyes of God we will never be divorced, and if I did decide to move on without him I would betray him like everybody else in life. When I tell him about my sons’ objections he says they should get over it, and that I shouldn’t allow them to control my life. 4) I have forgiven my ex, but feel he might be playing on my emotions. I’m afraid if I allowed him to live with me again he might become abusive again. 5) Most importantly, I’m torn between loyalty to my sons and loyalty to my ex. I have a good and loving relationship with my grown sons. I feel my relationship with them will suffer if I go back to my ex who is diagnosed with mental illness but is noncompliant in taking his meds regularly because he feels he’s no longer sick. My sons want my ex out of their lives and out of my life. I feel torn between my family and my ex.

I would concur with your sons who contend that reconnecting with your ex is a bad idea. To paraphrase Maya Angelou: “people always show you early on who they are and if you don’t hear it, it is because you are just not listening.”

Your ex has a history of abuse. History of violence is the most reliable predictor of future violence. No one can predict for certain if he will abuse you again but the fact that he is noncompliant with his medications and is currently experiencing symptoms of psychosis significantly increases the likelihood of violence.

It is often difficult for an individual to control their behavior while they are actively psychotic. By definition psychosis is a break with reality. In other words, individuals who are psychotic have difficulty distinguishing what is real and what is not real. Their judgment is significantly impaired. His misinterpretation of reality could result in violence.

If you choose to reconnect with your ex, then you should do so slowly and with strict boundaries placed upon the relationship. For instance, don’t allow him to return to your home until he has at least at least six months of proven medication compliance and there is clear evidence that his symptoms are under control. He’d have to prove to you that he is taking his medication on a consistent and daily basis, not just in the period before his psychiatry appointment.

Given the information provided, I would not advise you to continue your relationship with your ex. He is not mentally stable, he is noncompliant with his much-needed psychiatric medication, he has a history of violence towards you, and you already suspect that he may be manipulating your emotions. However, I understand that my knowledge of your situation is limited. There are likely many more details about the relationship that were not included in your letter. It would be advantageous to meet with a therapist to discuss your situation in further detail. A therapist could gather the necessary information to objectively evaluate your situation, and assist you in making the best possible decision about how to proceed.

Please take care. I wish you the best of luck.

Dr. Kristina Randle

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Family Never Getting Along

by Kristina Randle, Ph.D., LCSW May 23rd, 2021
written by Kristina Randle, Ph.D., LCSW

I have been having a problem with my family for about the past few years. I am only 22 and maintain the house and vehicles more than anyone else in the home. I currently attend school so I can one day take over this house financially, I have put so much energy into this house. I mostly do everything besides pay all the bills, just some bills. The problem is that I am always getting talked down too as if what I do is never good enough. I do all of the driving in the house. My step father is 46 and has never had nor wanted a license, so that leaves everything on me for grocerices etc etc. I think my mother hates me she keeps putting me down saying how dissapointed she is in me, as If I am such a bad person. I have no kids or no student loan debt nothing the typical 22 year old would have. It seems like I can never win with my family no matter what I do. Nothing is making me happy anymore, I have alot of stuff but its no fun when you have to maintain it all on your own. I drive a fancy car and because of this it makes my step father seem less of a man. So she takes her anger out on me. About 6 years back it was just my mother and I in the home, so I sort of took over the maintence roll then. Now that my new step father is here he doesnt know anything about keeping a house in tact nor anything car related. So instead of thanking me for all of the energy and time I have put into this entire house, I get talked down too simply for doing more than my lazy stepfather does. Am I truly doing something wrong, because these constent put downs are annoying, it is almost like my mother has turned on me. My mother and I use to be closer but now its always fued, simply because of other peoples lack of masculine abilities. Is there something else I should be doing. I pay the car note at times, I cut the grass I have transformed this entire house with my bare hands and god given talent, but I just feel like its never enough.

Your parents seem never satisfied with what you have done. They don’t appreciate the help that you provide. That is a reflection of them and of their shortcomings and not a reflection of you. It is important that you understand this.

You cannot change the way your parents think. “They are who they are.” It is unfortunate that they do not appreciate you in the manner that you would like or that you may deserve but do not let their treatment of you dictate your self-perception.

In the course of normal human development, one needs to become an independent thinker. This means breaking free from your parents. Practically speaking, this means not necessarily or automatically sharing the thoughts, the opinions or the ideas of one’s parents. It is important to develop your own ideas about the world, who you are and what you should do with your life.

I would highly recommend counseling. You need an independent, objective review of your relationship with your parents. It’s very easy to simply continue the old existing relationship, the one that seemingly has always existed. However things are different now. You were a child but now you are beginning your adult life. This is a qualitatively different period of your life. It requires a shift. It is now your time to go forth into the world and begin your journey. It is time now to live your life and that is true for all persons at this stage of life. I could write a hundred pages on this topic but it would be far better for you to see a therapist who can relate this to your personal situation.

In many cases, breaking free from one’s parents also means no longer living with them. It may be time for you to move out and on with your life. I wish you the best.

Dr. Kristina Randle
@DrKRandle

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I’m Nothing without Him

by Dr. Marie Hartwell-Walker May 16th, 2021
written by Dr. Marie Hartwell-Walker

I’m 16. Almost a year ago today I met the person I fell in love with and wanted to be with for the rest of my life. When no one else cared, he was by my side. He came into the nurse’s office last year on my birthday and sat with me when the nurse saw my scars on my arm from cutting and called my mom.
This boy knows everything about me. I knew everything about him. We were always together. We, naively, planned out our future and everything. I lost my virginity to him as well. He’s a 10th grader at my school. I’ve never really had that many friends, and so with him i always had someone to sit with, someone to talk to, and someone who generally loved me for who i was.
I guess, over the next 6 months that we were together, i got to be too much for him. I’d get paranoid over other girls. And cry. I’d be afraid that i said or did something stupid. And cry. I’d get insecure about myself. and tell him about it, stupidly, because we were very open with each other. I cried all the time. It drove him insane.
It was a long extended period of breaking up, but sometime in March (2012) we were finally done. I had to take off the promise ring he gave me and we both cut off the rope bracelets we’d worn since the previous July- sailor bracelets that we shrunk in the water together that said we’d always be there for each other no matter what.
Now I’m all alone. It’s been two months, but I’m still crying myself to sleep every night. I have really low self-esteem too, so I look in the mirror and hate myself. Not only was I not good enough for him, I wasn’t good enough for any of my friends I’d gotten close too over the year. Now i stand alone every morning. Sit alone at lunch. My ex knows how I feel, and he doesn’t care anymore. He longs after all these other girls that don’t like him back. Not a lot of people liked him either, that’s why we got so close so fast i guess.
Now, I barely talk to any of my friends. I know i shouldn’t feel so bad about this “it’s just a stupid breakup, get over it” but I swore to God I’d found the one. No one else will ever be able to take that place. I still talk to him occasionally, but we’re not open with each other anymore. I want to tell him how I feel. I wish I could. I want to ask him what finally made him decide he doesn’t love me anymore. I have no desire to meet new boys. No desire to talk to anyone. I can’t get myself to do homework. It’s just not worth it. Every day without him in my life is a nightmare and I feel like nothing. I know “oh just grow up and you’ll forget all about him” But I’m stuck inside these memories and something needs to change. I’m not myself anymore. I’m empty. I have no strife for life. I just need some help.

You’re right. You do need help. You made a common mistake. You thought dependency was love. It’s not. You and your boyfriend both have trouble making friends, dealing with feelings, and liking yourselves. In each other, you each found a person who could understand and you clung together to make things seem okay. Things weren’t okay. You’re still not okay. I imagine neither is he.

I don’t have enough information to even guess why you got to 16 with so little sense of self and such low self-esteem. Something is lacking in your education about how to get along in the world. Somehow you didn’t develop the skills necessary to deal with the social scene or your own feelings.

The good news is that you are young. You haven’t wasted 40 years sitting in this pit of self-dislike. With some therapy, you can learn to love yourself — which is, after all, the first requirement for finding someone who can love you. Please talk to your parents, your school counselor, or doctor, or clergyperson to get help in finding a therapist who likes working with young people.

It was brave of you to write your letter and to ask for help. Now please do the next step and get the help you need. I suggest you take your letter with you to your first session. It will help jumpstart your work with your therapist.

I wish you well.
Dr. Marie

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Mother Still Tells Me What to Do

by Dr. Marie Hartwell-Walker March 16th, 2021
written by Dr. Marie Hartwell-Walker

“”You will take your father’s place, as the bread earner of the family”. This was told to me by my mother when I was in sixth grade. Repetition of this statement confirmed my aim for the future, to become a mechanical engineer, just like my father. NED University was my target. I let my mom take control of my life and did everything accordingly.

The gradual change began in ninth grade. My isolation had just started and went on for 4 years. Books were my friends now; with no one to talk to, I now have no speaking and social skills. My hard work got paid alright, got very good grades. But my parents, in a sense of greediness for perfection, they wanted me to be a perfect model child, crystal clear and scratch less. Unfortunately, I’m none of that. But I still kept my aim and strived towards it. With each of my result being announced, I noticed my parents did not have much enthusiasm and happiness that I had hoped for. In my 2nd year papers, my only thoughts were, If I get up and leave, no one will care. But I had my aim to live for.
My prayers and hard work got me into NED University. One day, my inside shouted at me, “Is this you really wanted? All you did was follow orders, now what?” I looked around the class of 43 guys 2 girls, coming from a religious family; my parents were disappointed in me, for choosing petroleum as my field instead of CIS, the one for girls. Eventually, my life got miserable. Taunts from my mother were a part of my progressing depression. Life looked meaningless. I couldn’t find my future anymore.

Then one day, my mother urges me to take IBAs test, since IBA graduates get jobs easily and get married soon. The irony of my life, I passed my test even though I didn’t prepare or study for it. Now, my life has become a joke, only understood by me. These changes left me quite insensitive and ungrateful. And IBA made my isolation, complete. Paying an enormous fees is a burden to them (my parents), but not paying my brothers expensive tuition fees. Life is now all about living in fantasy, as reality can shatter you. Not a day goes by when I feel that I’d wake up from this nightmare. Suicide was also in my mind, yet here I am writing about it.

Life is not a bed of roses, true. But when it’s all thorns and bushes, it makes you a person you never want to be. An introvert, insensitive, ungrateful and depressed person now sits in this world writing about it. Sometimes, inner peace is greater than basic needs.
Remarks by my teacher: I felt sad reading your essay. But believe me you’ll do very well in life. Just have faith in God and courage to live according to your convictions. I’m sure one day I’ll be talking to the CEO of a huge company!!
After reading this remark, I felt disgusted. I felt pitied, why?

Why? Because you are in such a negative spin that you can’t even hear a positive remark without turning it into something bad. You’ve been listening to orders, negativity, and criticism so long you have lost your perspective. However – writing to us is a positive step, even if you don’t think so. It’s a start. Grab onto that beginning, even if with only the barest of a grasp. It is something to build on.

Your biggest challenge right now is to decide what is good for you – regardless of whether your parents like it. As an adult, only you are responsible for your choices. Your parents can have their opinions. Some of those opinions may even be very good ones. But your job is to take enough distance from the emotional power of what they say so that you can independently evaluate the message. It’s not a matter of whether you “win” or “lose” in an old argument with your family. It’s about deciding what you, personally, want to do. You might even like IBA. (I don’t know what that is so please don’t take this as an opinion one way or another. It’s not.) The point is this: It’s your life. You can drop the argument with your parents and make your own choices about your profession.

The same is true for whether you stay an “introvert, insensitive, ungrateful and depressed person.” You can decide to give yourself a different approach to life. Yes, it will take some work. Yes, your parents may even take credit for it. But that shouldn’t matter. What matters is what kind of person you want to be and what you want to do with the life you’ve been given.

You may find it helpful to talk with a counselor to help you make new choices. It’s time to stop blaming your parents and to be an active architect of your life. A counselor can help you stay on track and give you the support you need while you build a different identity and a more healthy approach to life.

I wish you well.
Dr. Marie

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No One Measures Up to My Father’s Memory

by Kristina Randle, Ph.D., LCSW February 23rd, 2021
written by Kristina Randle, Ph.D., LCSW

My amazing father set the standard for what I think I relationship should be like. Everyone I’ve ever dated has been a disappointment for me. I’ve had to break up with some of the sweetest guys I’ve ever met because I got to the point where I realized I was spending most of my time antagonizing over their flaws and I made myself (and them) miserable. I just can’t get over the high standard set for whom ever I spend the rest of my life with.

See, I just don’t know how to stop comparing the guys to my dad! My dad tragically died when I was in 7th grade. His death was a harsh slap in the face by reality and it crippled my belief in God. I remember my father as a great man. Actually, I literately can not think of anything my father ever did wrong. The only memories I have of my father is of him being the most fantastic father, husband, and Christan he could be. My mother tries to tactfully remind me he was human too, but I can’t stand thinking of him doing anything wrong. I’m tried of breaking hearts! I’m making everyone miserable. I just don’t know how to separate my father’s memory from real life expectations.

You state in your letter “set the standard for what I think a relationship should be like.” You know what your relationship was like with your father. You are an expert on him as a father. You also state that he was the most fantastic husband. Only his wife would be able to knowledgeably comment on his ability to be a husband. You experienced your father, as a father, directly. Your mother experienced your father as her husband, directly. You were a onlooker into their relationship. Your mother has been just an onlooker into the relationships with the men that you have dated. I’m sure that you would agree, that she had been just looking in from the outside. The complexities of your relationships with the men that you have dated are not available to her. There is a public and personal side to virtually every relationship.

You mentioned how difficult it was for you to deal with your father’s death. It crippled your belief in God. You also said your father’s death was tragic. I think it is reasonable to conclude that you feel that your father’s death was very unfair. In your mind he is a victim. When you love someone very, very much, it is very natural to protect them at all costs. Many people would gladly give up their own life to protect someone that they love.

It appears to me that you are protecting your father by protecting his memory. It is your way of continuing to protect him. Your mother, who is trying to protect you, gently reminds you that your father was not perfect. I would have to trust your mother’s judgment as to your father’s abilities as a husband. I would trust your judgment as to your father’s ability to be a father.

The most important thing in life is to concur with reality. We must not see things as better than they are, nor worse. It is very natural for you to compare your boyfriends to your father. Sigmund Freud has long ago established this as fact.

I would like to ask you a question and I will respect and accept your answer. You have an impression of your father that is based on his only living until you were only in seventh grade. You presently possess that impression. What if he were alive today? What if you had all of those additional years with him? You did quite a bit of maturing after seventh grade; everyone does. You were much more knowledgeable in high school than you were in grade school. You saw the world in a much more complex way in high school and college. Now here’s my question: do you think that your impression of your father would be different if he were alive at this moment?

I have a few other questions that you might want to consider. Were you the perfect child? Do you think that your father would love you any less if you weren’t perfect? You know that your father loved you. You can feel it with every fiber of your being, even now. Those that you love, truly love, need not be perfect or even close.

You have pointed out that you’re having relationship problems. You stated that it’s time to do something about that. I would recommend counseling and I would focus that counseling on grief. In closing, I would like to assure you that no imperfection that you were to discover about your father would ever diminish the love that you feel for him.

You will find a list of therapists by clicking the “find help” tab at the topic of this page. Please take care.

Dr. Kristina Randle

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Is Schizophrenia Inheritable?

by Kristina Randle, Ph.D., LCSW February 14th, 2021
written by Kristina Randle, Ph.D., LCSW

I really need some advice. My fiancé and I are having a problem. His mom has come to visit us and she’s just not right.

He warned me before that his mom has bipolar but didn’t go into detail. For the first few days while here she was fine, it was wonderful! About five days in things began to change. It started with her not wanting to drink anything but sterilised water and no one else could open her water. That evening (the Friday) she woke us up in the night needing to make a phonecall. She phoned them while in our room and had an ordinary, 2 minute conversation and wondered out again. A few hours later she came in again saying she couldnt sleep in her room and wanted to sleep on the floor of ours. She slept without a mattress on the carpet.

The next day she was worse. She danced in the lounge for about an hour, staring out the window, changing all the lyrics of the beach boys to religious words (‘Help me God, help me get these things out of my head’). We took her to a wine farm and she brought a towel with her even though she didnt need it, and was confused about it later.

At the wine farm she kept getting frustrated if things didnt go her way (like she couldnt have the wine she wanted) and on the drive moaned constantly at my fiance for driving so fast (when he was driving so incredibly slowly) and made us listen to the same CD over and over. At one point she threatened to jump out the car and then cried for a while.

I can see in her face she is not herself. On Sunday we took her to the waterfront but before that she had to write a list of everything she had done since being in SA (my fiance’s sister believes this is because she thinks she is being poisoned as it went into great detail about food and drink and who had managed it – apparently the being poisoned fear is a common one with her). At the Waterfront she got quite mean, telling her daughter that she could see up her dress and it was disgusting and that her and I were going to get wrinkles cos we smile too much and that her daughter walks funny etc. Eventually she completely freaked out and shouted at us all to get away from her. You could see she was actually petrified of us.

In the car on the way home she eventually told me and my fiance that we sound just like his father and his new wife (who she doesnt like) and he got very irritated and we went home.

Apparently she has been diagnosed as bipolar and has medication, but she refuses to take it, saying it’s not her, it’s her kids.

I want to know, does this sound like bipolar behavior to you? Or is it more? Also, if someone won’t take their meds, how should we be behaving towards her and also, when she does go back, do you think it is safe for her to fly?

I’m also wondering, is this genetic, and if so, should we never have kids, or are there tests we can do?

It is difficult to know what her diagnosis may be but bipolar disorder or schizophrenia are realistic possibilities. Your fiancé’s mother does not seem well. She seems as though she is actively symptomatic. She seems paranoid and possibly is experiencing delusions or hallucinations. She may have those symptoms because she is not taking her medication.

Research has shown that approximately 50 percent of individuals with bipolar disorder or schizophrenia do not believe they have an illness and subsequently refuse treatment. If someone does not believe that they are ill, then refusing treatment seems logical to them. The problem is that they are clearly ill even if they aren’t aware. Unfortunately, individuals who are symptomatic suffer tremendously and so do their families who struggle with how to deal with a loved one who is clearly sick. It is a very difficult situation.

If someone isn’t taking their medication, then their family and friends should encourage them to do so. It can also be helpful to become actively involved in a loved one’s treatment, if possible. For instance, a close member of the family could offer to attend a doctor’s appointment with your fiancé’s mother, if she is agreeable.

You asked whether or not it is safe for her to fly alone. If she is actively symptomatic, then it would not be advisable. She might be okay but maybe not. I would not recommend it.

With regard to bipolar disorder and schizophrenia, scientists believe there is a genetic component. Scientists believe that there is a strong environmental component as well. Science has not determined the definitive causes of these mental illnesses.

Research shows that individuals who have relatives with schizophrenia or bipolar disorder are at a slight increased risk for developing one of these disorders. Having a relative with the disease in no way guarantees that other family members will develop it. Again, the risk is slight and its development depends on many factors.

Don’t hesitate to write again if you have additional questions. Please take care.

Dr. Kristina Randle

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