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Very Insecure About Myself

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

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

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

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

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

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

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

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

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

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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How Can I Help My Schizophrenic Friend?

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

I have a friend with paranoid schizophrenia. He suffers from it for 10 years and is on meds all the time. He lives with his sister and her family with few social contacts, more or less isolated. His mother died and his father doesn’t want to see him much due to the fact he’s so ill.

Ever since I’ve met him I saw the relationships in the family are rather bad. He’s subjected to mockery and is getting scolded fairly often. I’ve never felt much – if any – support from them. He usually does nothing at all just to minimise the possibility of spoiling something. He’s unkempt, not able to keep his room clean, doesn’t care about his grooming and neither do his family. He only keeps painting all the time. But I know he’s capable of a difference as he e.g. shaves when I’m about to visit. He can talk about many things just fine, at least with me, and it is clear that behind the disease there’s a very clever person.

It pains me to see he could possibly get better if treated differently or living in a better environment that would support him and lead him to being more independent. But what can I do? He’s legally competent and adult. Talking about changes frightens him. And I can’t take him to my house and I can’t talk to his family members. I’m not a part of his family and they wouldn’t listen anyway.

Should I really try to let it be as it’s not in my capacity to change it? Sometimes it gets so painful to watch and the helplessness is the worst part…Thanks so much for any advice!

You said that he takes medication which means that he sees a mental health professional. You can encourage him to speak to his doctor about independent living arrangements; however, if he’s not ready, then you must respect his wishes.

As you suspect, your power is limited in this situation. You’ve tried to talk to him about moving and the idea of change frightens him. His family won’t listen. You’ve really done all that you can.

Many people with schizophrenia are frightened of change. In some cases, too much change, too quickly can lead to a psychotic episode. Even knowing that he is not living in the ideal set of circumstances, it may be in his best interest to simply leave him be. He may someday be ready to move out but now doesn’t seem like the right time.

You are his friend when no one else seems to be. You care about him even when it seems that no one else does. You may think that you are not doing enough for him but your friendship undoubtedly means a great deal. Perhaps in time, he will lean on your caring and support to become independent. Research has consistently shown that having strong social support significantly improves the outcomes of people with schizophrenia. Your relationship with him has the potential to create strong positive change.

Continue to be a friend and an advocate and maybe in the future, he will be ready for independence. He may never be ready but should he be, your relationship will have served as an important lifeline. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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How Do I Help My Daughter?

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

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

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

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

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

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

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

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Is My Girlfriend Disassociating?

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

I have been with my partner for over 6 years. In times of high stress, she will “go to her box” as she calls it, and another personality will take her place in the world for a while.

She says she “goes to her box” to get away from the stress and that there is a faceless young girl in the box with her each time. This is NOT the person who takes over for her in the real world. This is a third person who makes her punish herself at times (I’ve seen her hitting herself) but will normally just sit with her.

Her latest episode, however, has lasted almost 2 months. Until now, I’d never seen it last more than a few hours.

Due to work, I had the leave the state and we would be apart for 8 months. Within a week of my leaving, she started spending inordinate amounts of time in her box. She is saying that the girl in the box is making many of her decisions for her ever since. And, when I offered to come back, she said no, that she afraid to see me.

She is a different person from when I left and I am scared for her. She has mentioned hurting herself, but says if I tell anyone in her family about this (I am the only one who knows about “the box”) she will never speak to me again.

Is this some sort of Schizophrenia? I’m not sure if it is, though, because unless she goes to her box, she doesn’t hear voices or anything like that. She has complete control of when she goes to the box. But, she is saying that she’s confused because of what the girl in the box is telling her. She will not tell me what the girls says, however, as she says she is not allowed to.

Can you help me help her? Thank you.

It is difficult to determine what is happening to your partner. It doesn’t appear consistent with schizophrenia but only an in-depth, in-person clinical interview could determine a diagnosis.

She may be experiencing a form of disassociation or potentially dissociative identity disorder (DID). DID used to be called multiple personality disorder. It is a diagnosis contained in the Diagnostic and Statistical Manual of Mental Health Disorders, however some mental health professionals are skeptical about whether DID is a valid diagnosis and thus it remains controversial.

Dissociative disorders are real and can be debilitating. She probably utilizes “the box” when she is feeling stressed or unsafe in the world. It seems as though “the box” is a form of protection for her that makes her feel safe. “The box” is a defense mechanism, however she is using it more often and for longer periods of time. She is now confused and apparently believes that she is interacting with other people while in “the box.” These are all concerning symptoms.

She needs to be evaluated by a mental health professional. She should see a specialist who is trained to deal with dissociative disorders or trauma. You may be able to find a therapist by visiting the International Society for the Study of Trauma and Disassociation, an organization of therapists who focus on assessing and treating dissociative disorders. Click on the “find a therapist” tab to locate a specialist in your community. Do your best to convince her to seek treatment. It is highly recommended that she seek professional help. She’s not well and intervention is needed. Please take care.

Dr. Kristina Randle

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Intentional Forgetfulness

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

The question I have today has bothered me for a long time. While I was normal for most of my life, the past few years have been evolving many problems for me.

For example, I have had numerous problems with skills such as driving. Once it had been an easy, low-attention activity but now I notice things are changing. Now, instead of driving being second nature, I am starting to overly concentrate on things such as whether I am correctly positioned in a lane. Furthermore, even with all the concentration on a very small skill, I fail to perform this skill effectively (for example, staying in the lane). The worst thing, however, is that I have not found a way to stop concentrating on one thing for my own safety. I feel like I am a deadly risk on the road because of this and I am often very scared to continue driving.

Furthermore, the situation in other areas of my life is not very good. For example, I’m studying to become a chemist, and I consider chemistry and studying skills to be the bulk of what I know. However, as I try to think about these subjects, I often feel the irresistible urge to forget these subjects. It sounds stupid, but my mind will sometimes say to me, “forget chemistry” or “forget how to study”. I always have to harshly resist the urge to do so. However, when I think I have the problems solved, my mind often finds other ways to incite the same urge. Or my mind will cajole me to “try to forget something”. I feel like if this goes on for much longer, my knowledge of topics like these (and others) may start to be lost. I don’t know what may happen and I am in the dark about this topic. As I write, my day is completely occupied by trying to resist the urge.

The scariest feeling is that, as each day passes, these problems seem to be getting worse. Two Around 2 and a half years ago, when these problems started, they barely got my attention. Now, however, they are so much worse. I feel in the dark and don’t know what to do. I’m scared to tell people because I’m afraid there may be repercussions on relationships and my life. Any advice would be greatly appreciated. Also, may I remain anonymous? Thank you in advance for you advice.

It’s possible that you are not forgetting intentionally. It may be that something is physically wrong. It would be wise to have a medical evaluation to determine what might be wrong. Discuss all of your concerns with the physician and be certain to mention that this problem is increasingly interfering with your life.

If medical problems are ruled out, then a psychological origin can be explored. A mental health evaluation will determine what may be wrong. Being evaluated by both medical and mental health professionals can assist you uncovering what may be wrong.

Have you recently experienced a life change? Trauma? Are you experiencing a great deal of stress? Recent life changes, trauma or stress might be contributing to the problem. It may also be related to obsessive-compulsive disorder or generalized anxiety disorder.

In the meantime, you may want to read about the concept of hyper-intention. The basic premise of hyper-intention is that a person’s fears or problems are made worse by their intense focus on them. Frankl says that the solution to hyper-intention is paradoxical intention. Paradoxical intention means that you do the opposite of what you would normally do in response to something that you fear. You can read more about these concepts in a book called Man’s Search for Meaning by Viktor Frankl.

Medical and mental health evaluations might uncover the source of your problems. Subsequently, consider psychotherapy if it has been indicated. I hope that you are able to find the help that you desire. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Depressed and Refusing Help

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

Hello, I am a 4th year psychology student getting my bachelor’s in the spring. I am hoping to go to grad school and become a clinical psychologist, but I would like some help with my current situation.

My fiancé and I have been living together for the past 2 years now and everything has been going well for the most part. About a year and a half ago she began seeing a psychologist for depression and bouts of rage.

In high school, she had been put on Prozac by a psychiatrist but found that it made her much more apathetic than feeling better, by the way. Now she swears that no medication will ever make her feel better and refuses any doctor who tells her that what she needs is an anti-depressant.

The problem is, lately things have been getting much worse for her. This spring, she dropped out of college, after struggling for 3 years (great grades but “can’t find anything that [she] likes at all” in her art school). Since then, she has been working as a bartender at a restaurant that treats her horribly, but she seems to have developed learned hopelessness and refuses to leave thinking that there are no other opportunities (they work her over 40 hours a week, void her checks because she “makes enough in tips to cover minimum wage”, make her work off the clock or threaten to fire her, keep her on longer than her scheduled times, etc.). In addition, she no longer feels comfortable in our home that we have been refinishing and tells me that “we need to move somewhere else where [she] is more comfortable,” but her expectations are unrealistic for our price capabilities. Also, the last month or so, our sex life has become nearly nonexistent. She claims that she really wants to be physical, but when it comes to it, she feels that “[her] body just shudders and says that it needs to stop.” I can hardly touch her now. She assures me that she loves me still and wants to be with me, but things are becoming incredibly strained because of all of this.

In addition, she has told me that she is never happy anymore, as well as stating that she wishes she weren’t here several times (to which I discussed with her that if she was suicidal that I would have to seek help, and she assures me that she could never commit suicide). She is hopeless most of the time, tired most days, feels that she cannot make any friends or keep any real friendships. She has great difficulty going out in public and avoids almost all social settings unless it is with her only 2 friends, or completely private (e.g. a movie with me). Even at times like this, she will find something that upsets her and sulk and demand to leave.

I am incredibly worried about her and feel that I have no options to help her. I have suggested finding a psychologist who will work with her on cognitive behavioral therapy, but she refuses. Also, she has told me that she will not take any sort of medication for depression, so I have no idea what other options there are left.

Is there anything that I can do at all, or is this completely up to her? I have told her that I am willing to go to counseling with her, whether it be couples, group, individual, or anything else, but she has never followed through on any of it.

Please help me to show my fiance that she can be happy!

You’ve modified your lifestyle to accommodate her evolving needs. You’re supportive and loving. You’re even willing to attend treatment with her. You are clearly doing everything you can to help your fiancé. You’re doing what every loving partner should do when presented with such a situation but at this point she’s unwilling to accept help.

You’re in a predicament. She didn’t cause herself to be depressed but it is up to her to decide that she wants help. You can’t force someone to do something they don’t want to do.

You’re not left with many options but there is something else you can try. Give her an ultimatum: agree to participate in therapy for at least six months or you are not getting married. That may seem like a harsh tactic but your options are limited. It may be necessary to save the relationship and her well-being.

If her ultimate decision is that she’s unwilling to seek help, you then have to decide whether you want to stay in this relationship. It would be difficult to maintain a relationship with someone who is emotionally unstable and who is unwilling to attempt to help themselves. It won’t be easy for you to stay and you may begin to resent her. Her unwillingness to seek help undoubtedly affects the relationship and your happiness.

If you’re ensure about how to proceed, then consider consulting a therapist. I am suggesting that you see a therapist when it’s your fiancée who is depressed because it’s a delicate situation and a difficult dilemma, especially if your fiancée continues to refuse help. You’d feel much better if you had objective, sound clinical advice about how to navigate this most important relationship. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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My husband gave me an STD

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

I have been married for almost two years in June of this year. I am currently seperated and waiting to file for divorce because my husband was unfaithful and gave me an STD. He has a history of lying to my face impulsively until finally I ask over and over again until he eventually tells me the truth. We were seperated for 7 months until we recently tried to work it out when I again asked him if he had any sexual relationships with any women during our seperation.I asked him this before we had unprotected sex, he said I did not. The reason we had unprotected sex was because we were going to try for another child…which we already have a 2 year old daughter. He informed me that NO I DIDNT HAVE ANYTHING TO WORRY ABOUT…a week later I sat down and asked him point blank if I had anything to worry about and for him to tell me if he cared about my health, that I wouldn’t get mad, and that I needed to know so I could get screen for STDS. It was then that he admitted to having sex with a woman…more than once..and unprotected. I need to know if I should give him time to work out his inner demons? I need to know if it’s worth keeping this family together if all he does is lie to my face? I just feel like he can never be trusted. We are seperated again and I do plan on filing for divorce because I feel like our marriage vows have already been broken.

It sounds like you’ve already made your decision but want to double-check your own thinking. I’m reluctant to make a judgment because I don’t have enough information about the whole of your relationship. Yes, your husband lies and cheats. But you didn’t say if there is anything positive about this marriage or if he is doing anything to take charge of himself to be a better man.

I do know two things: First: You can’t make a marriage on your own. It takes two people who are willing to be worthy of each other’s love and trust. If you have to constantly monitor him, you don’t have a partner, you have a fellow who doesn’t want to grow up and be a responsible husband and father. Nothing you can do will change that unless he sincerely wants to change himself. Second: You two shouldn’t even be thinking about another child until you have a solid marriage. Another child won’t bring you closer. It will put more stress on an already stressed relationship. Another child won’t give you the love you need from an adult partner. Children need us to love them without expectations that they fill a hole left by a grownup.

I’m very, very sorry that at only 20 you are having to face even the possibility of a divorce. I’m sure this situation is disappointing and heartbreaking and frightening. If you need someone to help you think things through, I hope you will seek out a counselor to help you feel good about whatever decision you make and to help you figure out how to take care of yourself and your little daughter. You are fortunate to live in a city where there are many qualified therapists. Ask your pediatrician for a referral. If you have the kind of family that can be there for you during this difficult time, I hope you will let them love you and help you. You deserve to have some support and practical advice.

I wish you well.
Dr. Marie

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Problems with My Family

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

Hi, I am one of four sisters and have four brothers. We are a total of eight siblings. My father past away almost six years ago and so did my grandmother from my mother’s side. My mother was left to care for us all. She has never responsible to pay the bills in the house her responsibility was cook, clean and take care of her children. She has diabetes. After my father past away it has been horrible. Since my mother doesn’t work she received benefits for the 3 younger children. Social security and disability she also received Medicaid, food stamps and Section 8 Housing. She now lives with my four younger siblings. Without this help I don’t know where my mother would be. She has always struggled paying her bills on time and having enough food in the house. Me and my oldest sister are renting an apartment therefore we are not living there anymore. My oldest sister and I have helped her with everything talking to her, giving her advice; also financially we have helped her. My mother allows my little brother to miss school he hasn’t gone in like two weeks or more and he’s only in sixth grade. He doesn’t like to go and has had problems with bullying. I am afraid something bad may happen. Also my little sister that is eighteen dropped out at the age of sixteen and is now working part time. The seventeen year old is doing really bad in school with bad grades. Me and my older sister have given her a lot of advice and have tried helping everyone but it’s only so much we can do. My oldest sister and I are now working full time and currently attending college. I don’t want my family separated. I really want to help her but I have exhausted all my efforts. My sister and I have tried asking her to give us the checks she received so we can manage all her bills but she does not want to. No one else in the family wants to help. My two oldest brothers have their families and they are low income as well. My mother has an inspection coming up soon and it doesn’t seem like she’s taking it seriously. If she doesn’t pass this second time she is in jeopardy in losing the house. Please help me.

I’m sorry that you are faced with these problems. There are no easy solutions. As you noted on several occasions in your letter, there’s only so much that you can do. You cannot force your mother to be more responsible. You can’t change who she is. You also can’t force someone to do things that they refuse to do. Unfortunately, your mother’s unwillingness to change may lead to her losing the house and putting other family members in jeopardy. It is also possible that children and youth services will intervene in the case of your brother not attending school. The reality is that your power to effect change in this situation is limited.

You are doing all that you can do. The idea that you are doing everything within your power and yet problems still arise is a very helpless feeling but that is the reality of the situation.

Despite your very difficult upbringing, you managed to move out of your home and begin college. This is evidence of your resiliency.

I hope that your family situation improves but the reality is it might not. It’s important that you brace for this very real possibility. It’s never easy to be faced with these types of situations. It’s akin to watching a car wreck in slow motion. It’s unbearable to watch, especially when you realize that no matter how much you want to help your loved ones, there’s little or nothing you can do. For those reasons, I would encourage you to begin counseling. Counseling could assist you in determining your role in the family. It could also provide much-needed emotional support. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice

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Love or Obsession?

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

When I was in fifth grade, there was this boy whom i usually pick fights with. I never understood why but the boy pissed me off for no reasons. I will always start something so that I can argue with him. After fifth grade, our family moved away from that town and I have never seen him since. However when I was in eighth grade, I started to have dreams about him and then I realized that I am in love with him. I assumed that it was because he was the complete opposite of me and that was just a crush. The feelings unfortunately did not fade with time like I hope. I found that my ‘love’ towards him grew stronger by the day, if that could be called love. I keep track on his Facebook and twitter accounts, so that i am kept updated about his daily activities. I fantasize about him all day long, however I did not pay that any mind as I assumed that it was normal. For your information, I have never been in a relationship as I am unable to scrape off my feelings for him. I have never been attracted to men apart from him. I tried to get rid of this feeling in every way that I could but I could not. Recently, I found my self hating every single of his female friends for being close to him. I am unable to sleep nowadays as I keep thinking of him, I fantasize killing his female friends as I want to keep him all to myself. The thing is I know that he might not even remember me anymore, but subconsciously, I always include him in my plans, for example, the other day I was at this furniture shop and there was this cabinet that got my attention, and I start imagining buying it for our,me and the guy’s, house. I also like to start a conversation with my own mind, so at that time, my mind reminded me that he does not even aware of my existence, and that got me really upset. For your information, i have thought of killing the guy so that nobody can have him. What should I do? I have not seen him for so long and yet I am like this. I cannot forget about him at all. I do not want to be a stalker.

You seem obsessed with this man. Per your own admission, you fantasize about him day and night. You track his cyber interactions. You don’t sleep because you can’t stop thinking about him. You’ve considered killing his female friends. You are now contemplating murder because in your mind if you can’t have him no one can.

Those are dangerous thoughts. You can’t control your feelings and the concern is that you’ll be unable to control your behavior.

If you were to hurt this man or his female friends, you could lose your freedom. You could spend the rest of your life in prison. You might even be sentenced to die, which in your country of Malaysia is execution by hanging. Virtually all religions believe murder is a sin. Should you carry out your deadly desires you would destroy your life and the lives of many people. Are you really willing sacrifice your life for someone who is not even aware of your existence?

He was your first love, even if you didn’t know it was love at first. Firsts, of any kind, can be hard to forget. In your case, it was not only a first but an “only.” New relationships will help you forget past relationships. If you had experienced more relationships, you might barely remember your first love.

The responsible course of action is to seek professional help. Psychotherapy can assist you in controlling your feelings and behavior. It could prevent a tragedy that would undoubtedly ruin your life and the lives of many others. I hope you make the responsible choice and seek professional help. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice

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Can Therapists Have Mental Health Issues?

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

Q. I have struggled with depression and anxiety for much of my life. When I was four, my mother entered me into therapy and I was later diagnosed with dsythymia and generalized anxiety disorder. I stopped therapy at the age of 14, and later attended family sessions to benefit my younger sister (focused on her). At age 19 I began having inexplicable panic attacks whenever I tried to attend my college courses and had to withdraw. I entered counseling briefly and the therapist declared me healthy and ended our sessions. By age 23, I had been struggling with severe highs and lows coupled with intense anxiety and the insomnia that had been with me from my youngest days (I said I was unable to sleep as young as 2 years old!) Recently, after I reluctantly agreed to try medication for my depression, I was given a tentative diagnosis of bipolar disorder (ultra-radian cycling) by my primary care physician (not a psychiatrist.) I am currently being treated with a low dose of sertraline and feel pretty steady the majority of the time. I have not received counseling since the bit when I was 19.

My question, after all this lead-up, is this: I am interested in art therapy as a career. Will having this history or being on medication prevent me from working as a counselor? Should I strive to be off medication? Are employers or certification boards permitted legally to ask me about my mental health history? I have often helped others with emotional or relationship issues, and I feel I could really make a positive impact. I hope I can pursue this career path. Thank you.

You have asked some very good questions. It is not uncommon for individuals with past or current mental health problems to be attracted to a career in psychology. While this is not uncommon, it is important that if you are going to enter this field that you do the work (in therapy if needed) to correct, or at least become aware of, to the best of your ability, your psychological or emotional issues before you seriously consider helping others. You do not have to be “perfect” to enter the field of psychotherapy, none of us are but you do have an ethical and moral obligation to be as psychologically healthy as you can be. In addition, if you are suffering with major psychological issues, it will be extremely difficult to help others and to give good advice. Giving bad advice could certainly harm a client and cause further emotional distress or trauma.

Regarding your own mental health, your personal experience with mental health issues and your experience taking different medications can provide you with unique insights that can assist you in helping clients. Having these experiences can better help you empathize with others with similar issues. As a therapist, the ability to empathize, or to put yourself in someone else’s shoes is an invaluable and necessary skill. Also, in your journey through your own mental health issues, you probably learned skills or specific techniques about how to deal with certain issues. You could pass these learned skills onto your clients.

To answer your specific questions, to the best of my knowledge, there is no law that prevents individuals who have had therapy from being able to obtain a degree or license to help others. If you committed a felony, in most states, you may be barred from helping certain groups of people (children, etc.) but having therapy will not bar you from pursuing a career art therapy.

With regard to medications, whether or not to stay on medications is a personal decision. Again, to the best of my knowledge, taking medications as a therapist is not against the law in any state. As far as future employers, it would be against the law for them to obtain your personal mental health history without your signed consent.

If you feel that you can be helpful to others then your instincts are probably correct. Take care.

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Boyfriend Hearing Voices

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

So, this all started when my boyfriend mentioned to me that our roommate and the girl he’s seeing gossip about him.He says that the girl asks our roommate all sorts of questions regarding him the entire night and have been doing so for over a week, therefore making it impossible for him to sleep. I was never able to hear anything at night even when he says they’re talking at that very moment and he was even 100% sure the neighbors heard it too, saying the neighbors would also talk about the girl gossiping so late at night. A few days ago, he had enough and confronted our roommate, telling him she needs to leave and not to bring her anymore. Our roommate completely denies it and even the neighbors told us, they never hear anything through the walls. Ever since then, my boyfriend has gotten worse saying that he feels like he can read the neighbors thoughts and will be so focused on the voices that only he hears, that he’ll completely ignore any conversation I’m having with him. He smoked pot every day for almost the last 10 years but since his paranoia and behavior, I’ve asked him to stop. It’s only been 2 days since he’s stopped completely and still hears these voices constantly. He’s planned to stop for a month minimum but I don’t know what else I should do. He refused to see a therapist and only confides in me about these things he hears so I don’t want to break his trust. Could it be the pot or something else entirely? Was telling him to stop smoking the right thing to do and what can we do in the meantime to help him make the voices go away…

It’s difficult to know what is causing the voices. Marijuana use has been linked to psychosis. Research has indicated that our brains are not fully developed until around the age of 25. Drug use before the age of 25 could significantly alter the brain chemistry and potentially lead to mental health problems.

The decision to stop using marijuana seems appropriate. The longer that he can abstain from using drugs, the more likely it is that the voices will decrease. However, the damage might have already been done. Only time will tell.

He has refused professional help but that is what he needs the most. The voices might be indicative of the beginning stages of a psychotic episode. If so, then therapeutic intervention could prevent the development of a full-scale psychotic episode.

The best way you can help him is to continue to encourage him to seek professional assistance. He is unwilling to see a therapist but perhaps he would be willing to see a primary care physician. Offer to attend the appointment with him. He might change his mind.

You stated that you do not want to break his trust but it might be necessary. If revealing his symptoms would convince him to seek treatment, then do it. Prompt treatment is imminently important. It could prevent the development of a lifelong, severe mental illness.

You can’t force him to seek treatment but you should do everything within your power to convince him to seek professional help, even if it means breaking his trust. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Bipolar Daughter Out of Control

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

Our daughter is 8 years old and has recently been diagnosed with bipolar depression. Her biological father is bipolar, as well as her grandfather on her mother’s side. We have been taking her to regular therapy sessions with a psychologist, and she has seen an actual psychiatrist once. He prescribed Risperidone to treat her illness. The medication has helped, but her behaviors have still not toned down enough to make her manageable. She constantly lies about even the smallest things. She threatens to stab or kill people, she always says she wants to kill or harm herself, she is very self centered and inconsiderate of others and their feelings, has no respect for anyone or anything, She sometimes hurts her three year old sister, and has extreme mood swings. She cannot bear to be away from her mother and always needs to know where she is and what she is doing, and will have a tantrum if she can’t be included. She cannot occupy herself at all. She absolutely has to be doing things with someone else and cannot play or read or color or do anything by herself. She will not listen when she is told to do something by her mother or me, and will throw a fit when she is made to do the task. We are at our wits end and have no answers. We are scheduling her an appointment with a different psychiatrist who can see her immediately. This little girl brings so much drama and turmoil into this family and we just don’t know what to do because we love her and we want to help her. She will not talk to us or share her feelings with us, and when we ask her questions the only answer we ever get is “I don’t know” or a lie. What can we do? What advice do you have for how to manage her?

I’m sorry you’re having so much difficulty with your daughter. It is painful to feel that there is little you can to do to help, especially when someone is so much in need of help.

I’m familiar with cases like yours. This is a very, very difficult situation. It is especially concerning that your daughter is violent and has access to a younger sibling in the home. Her threats to harm others should be taken seriously. This means, as you noted, that she needs to be constantly supervised. Among the cases I am familiar with, the parents were forced to quit their jobs and to stay at home with the child. It was necessary because of the risk to the other family members, as well as the risk to the child in question. In other cases, parents were forced to place the child in impatient residential treatment. I understand that these options may not be ideal but they may be necessary.

It is essential that you get the very best help for your daughter. I would recommend contacting local universities, treatment centers or taking your daughter to various physicians and specialists until you find the proper help. You may be able to locate a specialist by searching on national mental health websites or through bipolar blogs. Below are links to a few that may be helpful:

The Child and Adolescent Bipolar Foundation

The National Federation of Families for Children’s Mental Health

I would also recommend contacting the National Alliance on Mental Illness, a large organization whose goal is to help the family members of individuals with mental illnesses.

Medication may be helpful to your daughter but it often requires finding the right combination of drugs. She is currently on a drug that does not seem to be fully effective. Other drugs or combinations could be. Perhaps she could benefit from a higher or lower dose of her current medication or an adjunct medication. Finding the right medication is usually not an easy process. It takes time and requires patience, on the parts of the physician, the client and the family.

Unfortunately, there is no easy solution to this problem. I would recommend trying to utilize all the resources of the mental health system. I would also encourage you to contact other families who are dealing with similar situations. Family members who have experienced similar circumstances would likely serve as a valuable resource and support network. I would also encourage you to explore the possibility of a residential treatment facility, where your daughter would live outside the home and receive constant supervision by psychiatric staff. While living in the inpatient facility, she will have access to daily psychiatric treatment, she will be supervised 100 percent of the time and the staff can keep her safe. Of course, this is not the ideal situation but knowing that she will be safe may bring you peace of mind. Given the circumstances, it may be the best option at this time.

Please take care. I wish you well.

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Both Homicidal and Suicidal

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

I have been intrigued by murder and serial killers, it borderlines on obsession. For over 7 years I have been having vivid fantasies about plunging knives into my sisters chest and throat and poisoning my dad. Then it progressed to complete strangers. I have each one planed out from picking my victim, to the actual act, then the disposal of the body and any evidence, even my alibi should I need it. These fantasies moved to urges, so strong that I have to hold myself back from actually doing it. This should sicken me but it Intrigues me, fascinates me, excites me. In my fantasies I’m doing it out of boredom because it’s fun. Most recently I have included myself in them. Making me the victim as well.

The fact that you have most recently included yourself as a victim in your fantasies indicates that you have a desire to die. It means that you are both homicidal and suicidal. In many cases, they seem to go hand-in-hand.

You did not provide details about your life circumstances but I suspect that you are experiencing a great deal of psychological pain and are in a position in which you feel a lack of power. Often, individuals who feel as though they have insufficient power in the world will fantasize about what they perceive to be the ultimate power, which is taking the life of another.

There’s nothing glamorous about murder or those who commit it. It’s an act of grave destruction. Every religion considers it a sin. It’s an act of evil, plain and simple.

You are on the verge of being unable to control your behavior. In addition, it seems as though you continually expose yourself to your obsession which increases the likelihood that you may act out your fantasies. I would consider your risk for potential violence as being high.

I strongly urge you to seek emergency assistance. If you feel that you cannot control your behavior, then go to the emergency room immediately. The staff at the emergency room can keep you safe and can ensure that you receive treatment. Treatment would also address why you feel compelled to hurt others and help you to control your impulses.

Fantasizing about wanting to harm others and yourself are clear indicators of mental instability and potentially severe depression. At this point in time, you have not harmed anyone. Should you act on your fantasies, you will lose your freedom and potentially your life. You might spend the rest of your life in prison or face the death penalty.

If you’re looking for other ways to handle boredom, I have some ideas that may be helpful.

  • Engage in physical activity: Going for a walk, run, workout or playing a sport can help you release energy and improve your mood.
  • Learn a new skill or hobby: Taking up a new hobby or learning a new skill can keep your mind occupied and give you a sense of purpose.
  • Seek therapy or counseling: Seeking professional help to deal with negative thoughts and emotions can provide the protagonist with the tools and support needed to cope.
  • Turn to creative outlets: Engaging in creative pursuits such as writing, drawing, or music can channel the protagonist’s energy and emotions into something positive.
  • Find a new purpose or goal: Setting a new goal or finding a new purpose can give the protagonist direction and motivation, and help shift their focus away from negative thoughts and behaviors.
  • Connect with friends and loved ones: Building and maintaining strong relationships with friends, family, and loved ones can provide a sense of support and fulfillment, and help combat feelings of boredom and loneliness.

Please seek help immediately before you do something that you will regret and could ruin your life. Please take care.

Dr. Kristina Randle

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Can’t Explain Problems

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

I am starting to have some grave concerns that there is something fundamentally wrong with me. I have a long history of an eating disorder (30 years), a little bit of mild self harm, depression and dissociation issues. More recently I have started acknowledging that trauma is a part of my history and probable post traumatic stress a factor.

I have now recovered from the ED, have control of the depression and have greatly increased self awareness and as a result have identified the following problems:

  • I struggle to have a cohesive sense of who I am and have quite extreme changes in who I am when with others. More than would be considered normal and it includes abilities. This despite much work on developing a sense of self. I often feel I don’t recognise myself at all. The level of my paradoxical reactions to just about everything is truly extreme and sometimes happens simultaneously which creates great internal conflict. Sometimes this even manifests in physical ways.
  • Regardless of improving my paranoia about criticism and attack I am still intensely affected by perceived criticism or if I am not understood. I may not show it but it is a big problem.
  • A seeming almost total inability to have a narrative of my life on a day to day level. It’s as if both my life and I are made up of pockets of time. All disconnected.

There are certain things I have thought preclude it but I am no longer sure:

  • I do not rage at people. I am always in tight control of my anger and until a few years ago I thought I did not get angry. My anger is turned inwards. I may be impulsive in other areas of my life but I have both an intense need to avoid hurting others at all times and a need to appear rational. Both are more powerful than anything else.
  • I am impulsive but only in some parts of my life. In others I am super controlled and use it to create a buffer between the world and my internal problems.
  • I have huge problems with relationships but in some ways am able to give the appearance of not by keeping my self hidden and keeping things superficial.
  • I am very private and had thought that those with BPD are normally open. I give the impression that I am open and am quite expressive and entertaining but in reality I am not.

Therapy literally feels intolerable to me. The interactions required seems to immediately send me into a downward spiral of paranoia and distress. In other words I would certainly not be the type of person people would think would have BPD. But I wonder if a lot of these problems can still be a factor but hidden. Or I wonder what else could explain these struggles. It seems to impair my life in so many ways and stop me from getting help that does not simultaneously damage me.

The interpersonal sensitivities and the and the seeming inability to have any sense of cohesion in my life is the foundation of most of my problems.

You have provided a long description of what you think is wrong but you did not provide any specific examples. For instance, you stated that you struggle to have a cohesive sense of self and have quite extreme changes in who you are with others but did not describe these changes. What do you consider extreme? What do you mean by the phrase cohesive sense of self? Without more information, it’s difficult for me to determine if you have correctly assessed your problems. People with depression tend to inaccurately judge their own abilities. They often incorrectly assume that something is wrong with them. That might be what is happening in your case.

You also mentioned that therapy feels intolerable. It makes you feel paranoid and distressed. What about it makes you feel this way? It shouldn’t cause that reaction. It is an inappropriate emotional reaction. Logic dictates that therapy is designed to benefit you. Some people are hypersensitive, to the point where even constructive criticism is perceived as being a personal attack, an attack on the very essence of who they are. Your hypersensitivity might be why you are reacting with such strong, negative emotion to therapy.

I would recommend therapy even if it feels intolerable. It might feel intolerable but in reality it’s not intolerable. You have successfully overcome many issues in your life and for that you should be proud but at this point professional help is required. Therapy might be difficult but it’s necessary to overcome the issues that are plaguing your life.

You asked whether or not you have borderline personality disorder. That’s not something I can answer based upon your short letter. An in-person therapist, after collecting an extensive psychosocial history, can determine if you have a diagnosable mental health disorder. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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I Just Don’t Care

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

It’s not like I’m depressed or anything, I’m not suicidal or self-harming, thats why I haven’t really sought out any help until now. I’m not sad in any way. I’m usually either really happy, or neutral. I used to do well in school. I’d try to ace all my courses, but recently I just really stopped caring. I feel almost like I’ve experienced everything but dying. I’ve been in most cliques at school, I’ve had major and minor surgeries, and I have a lot of medical conditions (that I was forced by my parent to visit the doctor and take care of). I still ,obviously, haven’t experienced everything though. I hardly pay attention to the actions I carry out and how they affect others , the way they react doesn’t bother me. Even though I should care about how they feel,I can’t and I realize it’s hurting my family and the people I’m around and I wish I could care. When my grandfather died a few months ago, I couldn’t even cry. I attended to my grandmother, but I didn’t feel like I lost anything; even though I was close with him. Late February, I adopted a pet, hoping it would pave the way to caring, it doesn’t feel like I’m cherishing the time with it though. It just feels like a responsibility that I must attend to regardless if I want to or not. I have no idea if theres something wrong with me, I just don’t want to live the rest of my life in this grey void. I’m not looking for a diagnosis, just advice.

You may be having a normal reaction to difficult life events.

You had both major and minor surgeries, “a lot” of medical conditions and recently lost your grandfather. These are all major life events and all seem to have occurred in close temporal proximity. Virtually anyone would struggle with these issues.

Your medical problems and surgeries could be affecting your mood. Your medical problems may require you to take certain medications, which may also be affecting the way you feel. Virtually all medications have side effects which could produce changes in your thinking and behavior and feelings.

Losing your grandfather may also be affecting your mood. Sadness after the death of a loved one is normal.

Medical problems, surgeries and losing a close family relative will undoubtedly have an effect on your mood and behavior. Therefore, it’s possible that these events are the reason why you are feeling the way you do.

It’s highly unlikely that you will “live the rest of your life in this grey void.” You’re experiencing a difficult time in your life but you will not always feel this way. I would encourage you to share your feelings with your parents. Ask if there’s anything they can do to help. They may offer advice or perhaps suggest counseling. During this difficult time, be open with your feelings and make it your goal to gain as much support as possible. The more support you have, the better you will feel. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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What’s Wrong with Me?

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

I was just wondering if somebody could possibly give me an idea of what an official diagnosis would be like for me. I’ve been raped, abused, etc… My mother was an alcoholic my entire childhood and she was never there. She exchanged alcohol for pills and now uses those instead. My father randomly had a stroke and a seizure last August and it caused an aneurysm to burst, so he passed away two days later. I feel rejection with even the slightest thing (like, “I need to get off the phone” or “I’m talking to my friend”), I get extremely paranoid that somebody (especially people I know) watch me in odd ways (through my phone screen or my computer screen), I don’t love any member of my family nor do I want to, I am very antisocial, I get angry easy and just about anything can cause me to feel bad or depress me. I try to do anything I can to make people happy with me. I never say no to anybody and always try to agree with anything peolpe say. Unless I know them personally, then I generally have issues with arguing way too much and thinking I am always right or should always be right.I have problems maintaining friends. I can just see somebody and immediately want to be with them and try to be with them. Then something as simple as them not saying much the first time I talk to them makes me feel like they hate me and don’t want me and I get upset. I could go on and on…Do you have any idea?

It’s always difficult to provide a diagnosis over the Internet since I don’t have the ability to interview you and ask follow-up questions. You named a number of symptoms that don’t necessarily seem to fall into any one particular diagnosis.

You may be experiencing some of the elements of schizotypal personality disorder. Individuals with this personality disorder are described as odd or eccentric. They have difficulty maintaining close relationships. They tend to misinterpret the motivations and behaviors of others and become distrustful of them. Paranoia-associated social anxiety is linked with this particular personality disorder.

You may have elements of schizotypal PD but not everything matches. You described never being able to say no to friends and always agreeing with what people say. Those characteristics are not necessarily associated with schizotypal PD or with any particular disorder which again makes diagnosis, especially over the Internet, quite difficult.

Having difficulty saying no and being agreeable may mean that you are a people pleaser. People pleasers go along with the crowd to avoid confrontation. They also want people to like them and feel that being agreeable helps to accomplish that goal.

You had a difficult childhood. You experienced trauma multiple times over. Your mother was unavailable and you lost your father. Those seminal events could be and likely are contributing to your psychological problems. The most efficient way to deal with psychological problems and to receive an official diagnosis would be to see a mental health professional. The problems with which you are struggling are correctable. Therapy could greatly assist in the process of correcting psychological problems. Click on the “find help” tab at the top of this page to locate a mental health professional in your community. I wish you the best of luck. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice

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Wife’s Issues Harming Children

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

I am fairly convinced that my wife has some degree of bi-polar disorder. She goes into fits of rage over any question about her, her parents or upbringing. She constantly belittles me and talks bad about my family to the children.

It has escalated in recent years with her attempting to push me, going into 20 minute tirades where she brings up everything that I had done over the last 12 years and her drinking has increased. She drinks to the point that she is carried out of neighborhood parties with the children crying out of embarrassment then blames me. Those who dont tolerate it are ‘fake people’ but the others are ‘true friends’ and she has been going out and staying out all night this past month.

What is of greatest concern is that her explosions have increasingly come in front of the children resulting in them crying hysterically and her threatening to ‘kick me out’. She yells at them and then goes into a dialog of how much she does for them and how lucky they are.

It is very stressful but I need confirmation that this is what I am dealing with and how do I proceed?

It’s unclear whether your wife has bipolar disorder. Emotionally she is unstable but it might be due to her drinking. The fact that she is drinking makes it difficult to determine if a mental health disorder is present or if her drinking is the main problem. It may be a combination of both but I cannot make that determination based on this short letter.

What is clear is that your wife’s drinking is excessive and is causing a great deal of distress for your marriage and for your children. Both you and the children are subjected to her tirades. It’s abusive, unacceptable and something needs to change.

Encourage her to seek psychological treatment or inpatient rehabilitation if necessary. If she is unwilling to seek treatment, then you must take action. This might include seeking psychological help for yourself so that you know how best to deal with your wife or temporarily moving out of the home. Your children should not be subjected to your wife’s tirades. It most certainly frightens them and it’s abusive.

You may also want to consider an intervention. By this I mean you and members of your family come together as a group and ask your wife to seek help. During the intervention, members of the group describe how her behavior is affecting them and ask her to receive help. Perhaps she would be willing to seek help if she knew how her behavior was negatively affecting friends and family.

I can confirm the fact that there is a problem but I cannot determine the precise problem that is causing your wife to behave in such an unstable manner. Utilize the help of mental health professionals to assist you in dealing with your wife and children. I firmly believe that trained mental health professionals can give you the best advice about how to proceed. I wish you the best of luck. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Crying and Anger

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

Often I find myself more sad than happy. I don’t feel good enough to anyone, and when I try to say it to my family of a friend they always tell me to get over it. They tell me that I think the worlds out to get me when it really isn’t and I should stop acting the way I do. Sometimes I go to my room and regret even trying to talk to them. I can’t really get my way across to my family and it’s hard to talk to anyone else because they either don’t get it and get angry with me or I overreact and burst into tears, not being able to breathe. I often cry myself to sleep and sometimes sleeping is getting difficult right now. I keep waking up every hour or so to use the bathroom and my family members who have shared a room with me say that I always toss and turn in bed and grit my teeth often.

Lately I’ve been getting angry or sad over little things. Sometime my mother or father has said usually make me cry or I start yelling. I retaliate more at my mother than my father. I have put my hands on my mother but it was just a push. Sometimes my inner thoughts about myself get to me and I think worse than it really is; if I can’t win in something I think of myself as a failure, if I do bad on a test I think I’m stupid rather than thinking the test was hard. I call myself ugly and fat 24/7 and I don’t believe when other people tell me otherwise.

My family calls me lazy and it gets me angry. I don’t really do anything during the day but sleep and being on my phone or computer. I have been going to the doctor often for my obesity. I’m only 16 and weigh 350 lbs. this discourages me so much because I feel like I’m doing everything and I have done everything to loose it but it’s not working. I have been to behavior specialists and i have taken anti-depressants but i stopped doing so last year. Also, Last year have been diagnosed with poly cystic ovarian syndrome.

You have a lot going on and not much support. Your recent medical diagnosis is most likely contributing to your emotional distress.

I’m wondering why you stopped psychological treatment? Was it not working? If one therapist is not helpful, then try another. The same is true with medication. It often takes a great deal of trial and error before you will find the right therapist and the right medication. You shouldn’t give up.

Summer might be a particularly stressful time for teenagers because there’s less structured time. When school is in session, you’re not home all day. When people have extra time, they may focus more on their problems, which in turn causes them to feel more depressed than usual.

The excessive weight is also likely contributing to your depression.

I would recommend resuming therapy and trying to find a medication that could relieve your depression. With the assistance of your parents and your pediatrician or primary care doctor, choose a therapist who specializes in behavioral weight loss. There are many good behavioral treatment specialists who can assist with weight loss.

You should also consider joining a gym or an exercise group. Try checking with your local YMCA or your school. It would ensure that you’re physically active and also get you out of the house. It would also be a nice respite from your family.

You should also consider inviting your family to participate in family therapy. It might help to address the negativity coming from your family. They may not be aware of how their negative words are affecting you. Therapy might provide a safe haven for making them aware of this problem.

Don’t be discouraged. It is a difficult time in your life but it won’t always be this way. Time will pass, you will grow and things will change. You can accelerate positive, psychological change by resuming your mental health treatment. You will be glad you did. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Boyfriend’s Job Affects Our Relationship

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

I’ve been dating my boyfriend for almost a year known him 10 yrs. He lives in Cleveland, I live in Columbus. He is a workaholic. He travels for his job, I rarely get to see him because all he does is work. His job is in the medical field, he makes a great deal of money which is great because he can have nice things for himself but never can have a social life. The problem is the communication. It is so bad. Yesterday on facebook he commented on his friends status that he is in Vegas for a medical convention. He didn’t even tell me he was going to Vegas. I asked him about it and he told me it was last minute. He apologized and I told him you need to prove to me that you want to be with me and want to move forward. Also, he is wanting me to move in with him, since he is never home I’m not sure if this will work out. He is fighting for me hard considering I have told him maybe we shouldn’t be together and he has said no I will improve. He said he does care and blah blah blah. My friends think he is a flake but I truly do care for this man and do see a future with him regardless of him working all the time or not. Please help!

This seems to be more serious than just a communication problem. You and he are not close. You may officially be a couple but you interact more as acquaintances than close companions. His friends know more about his whereabouts than you do.

I’m concerned about the fact that you “see a future with him regardless of him working all the time or not.” It’s like saying “I don’t care if he changes or not, I’m pursuing this relationship anyway.” You shouldn’t be so willing to stay in a relationship, regardless of the circumstances.

Moving in with him will not solve this problem. It could make it worse and create feelings of resentment and disappointment.

It’s important that you see the relationship as it is and not how you wish it would be or hope it would be. “Workaholics” prioritize work over all aspects of their lives. It is a choice that he has made. Your boyfriend has chosen to pay more attention to his career than to your relationship. His actions speak volumes. If he is committed to ensuring the success of your relationship, then it must take priority over his work.

Until he sorts out his priorities, I would strongly advise against moving in with him. You should only move in with him if you’re satisfied with the direction of the relationship. If you continue to struggle with the relationship and how to proceed, consider psychotherapy. Relationship issues are one of the most common reasons people begin therapy. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Loving Someone who Can’t Love Back

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

I’ve formulated a friendship with a man who has admitted to me he has a personality disorder (the name of which I do not know). He has told me he is incapable of love. He is, however, empathetic and charismatic. He loves people and surrounds himself with them at all waking moments. When you’re with him he is 100% in the moment, and will focus on whomever is in his presence entirely. However, when you leave his presence, it’s like you no longer exist to him. I tease that it’s “if a tree falls in the forest syndrome” He experiences horrible migraines, and treats himself with diet, and Effexor. He also sees a therapist.

My problem is this: we’ve kept our relationship strictly as a friendship so far. We have an intense chemistry, but have not acted upon it. I feel madly in love with this person, even though I know he has told me he’s incapable of love. I’ve tried to distract myself with other men, and with work, but nothing seems to stop me from wanting to be with this man. I know it’s my brain’s chemistry telling me this, but what can a person in my situation do? Is the only option to run? How can a healthy person love someone incapable of ever returning love to them? Can someone in their 40 some odd years of existence, whose never loved, one day love? Is it possible to have any kind of healthy relationship with someone that has a disorder like this?

I am not aware of any personality disorders in which one of the symptoms is the inability to love. It would have been helpful to know more about his understanding of the inability to love. That phrase may have many different meanings.

It’s odd that he is capable of forming friendships but doesn’t believe he’s capable of love. He apparently makes a distinction between friendships and romantic love relationships. If he is capable of engaging in friendship-type relationships, then he should be capable of other types of interpersonal relationships.

You have very strong feelings for him. You can’t help how you feel. It will be difficult for you to continue your friendship without sharing your true feelings. You should tell him how you feel.

Until you better understand what his psychological problems may be, you cannot determine whether a deeper relationship with him is viable. You need to explore his “inability to love” in more depth. Ask him to expound upon what he means by that phrase. Does he have examples? Did he try to love someone and it was a struggle? Where did the idea of incapacity of love originate? Don’t rule out the possibility that his “inability to love” is his polite way of saying that he is not interested in a romantic relationship.

Ultimately, you need to gather more information about whether he’s capable of being in a romantic relationship and whether he’s interested in doing so. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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