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Do I Need To Seek Help?

by Kristina Randle, Ph.D., LCSW November 24th, 2024
written by Kristina Randle, Ph.D., LCSW

Anxiety, racing thoughts, past trauma, etc. Hello and thank you for taking time to read (and hopefully answer) a few of my questions.
Around last October a number of troubling things happened to me: I got pregnant, broken up with, had an abortion, had my apartment broken into and everything of value stolen and had the transmission out of my car stolen. All of this happened within a span of five months.

Ever since all of this happened, I have been trying to cope as well as possible. I have noticed a few things about myself that worry me.

I used to read a lot, many books every month. Now, I struggle to focus on reading one book in a month and constantly put it down. My mind wanders and I constantly make plans but they fall through (this leaves me feeling hopeless).

I have nightmares when the lights are turned off so have to sleep with the light on. Even then, I have regular nightmares that I cannot get rid of.
I seek out sexual encounters with people I don’t know or meet on the Internet that be potentially dangerous to me. Later I feel worthless and terrible, but then I continue seeking out more people.

My mind feels like it is on fast forward and there are so many things to think and feel that sometimes I shut down and feel nothing. Every day is a struggle with myself. I am so very confused. I wanted to go to school this August, but had to move back to my parents (after living on my own for three years with a roommate) and now feel stuck.

Please, tell me what I can do. The problem is, I had issues before all of the troubling events happened and wonder if perhaps I have some underlying psychological condition. I was previously diagnosed with a mixture of depression/anxiety but this was not by a regular therapist (I only talked to him about two times).
I’m sorry for the long post and there is much I’ve left out but the main issues have been addressed.

In short, do I need to seek help? This is beginning to have a large impact on my life. I’m hoping to start school soon and do more with my life but with no help from family (and many friends in another state) I’m feeling unsure.

To answer your specific question of whether or not you should seek help, the answer is yes. As you noted in your letter, your symptoms are beginning to overwhelm your life. When you notice a problem developing you should not wait to seek help. It’s always best to seek treatment sooner rather than later.

You wonder whether you have an underlying psychological condition. It is a possibility but it is difficult to determine. Your symptoms are relatively understandable given the fact that you have recently experienced multiple difficult and traumatic experiences. Many individuals would have difficulty coping with the events you have experienced.

These traumatic events may have triggered or increased the intensity of your (possible) depression and anxiety. This would explain why you are having nightmares and why it is increasingly difficult for you to concentrate, but it does not explain your casual sexual behavior. This behavior may be your way of dealing with anxiety. One thing seems certain: it is a self-sabotaging type of behavior. You feel guilty after the sex act but it’s as though you cannot stop yourself from doing it. If this is true, it signifies a certain level of impulsivity and inability to control your behavior on those occasions. It might also be a sign of mania which is a symptom of bipolar disorder. Bipolar disorder is a mood disorder in which an individual sometimes feels very depressed and other times very happy and euphoric. Please keep in mind that these aforementioned ideas about a possible diagnosis are based on very limited information. It’s best to have a psychiatric evaluation before making a diagnosis.

As I said above, I believe you do need professional help. This is especially true for two reasons. One is because you have limited support from friends and family. The second is because the symptoms are increasingly becoming worse and negatively affecting your life. If you’d like to search for a therapist in your community, please click on the find help tab at the top of this page.

If you have additional questions, please do not hesitate to write again. I hope you’re able to find the help that you need. I wish you well. Please take care.

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Am I Difficult to Love or Like?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP November 16th, 2024
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I was diagnosed Bipolar II in 2007. My family and friends have had a hard time accepting this and most of my friends stopped talking to me and said I was faking it for attention and my mother told a family member that I could be different if I wanted to. I try so hard to be “normal” but sometimes it’s hard for me not to be overly anxious or very talkative.

When I’m around my family, I feel like they don’t like me very much and I don’t know if they love me anymore. Before my diagnosis and my “break down”, things were fine but after, things changed drastically. Even the way they speak to me has changed. There are times I feel anxious and I talk a lot and I try not to but my sister will admonish me in front of the entire family and tell me to calm down and stop cutting people off (my family is very boisterous and everyone speaks at the same time but she singles me out, even though every one is doing the same thing). My brother will shake his head and walk out on me and my father calls me a drama queen. I don’t know what to do anymore. I try to ignore it while I’m there because I don’t want to make a scene and ruin the evening but it makes me so sad and then later on, when I’ve had time to reflect, I get so angry and I want to cut them all out of my life. Last time I was there, I had such an awful time that once I got home, I had such an emotional melt down that affected me for hours just from the stress of the family get together. I don’t know what to do anymore and my family is one of those families that feels justified in their actions so no family therapy, no rational sit downs to tell them how I feel because they’ll turn it around on me and call me a “drama queen”. I know not all of this is because I’m bipolar II. I can usually recognize when I’m having issues but I get this treatment even on good days when I’m fine and quiet. Maybe it is me? Maybe I just don’t see it? I don’t know anymore but whatever the reason, being with my family makes me more miserable than any other time. Thanks for listening.

I am sorry you are having so much trouble with your family and friend relations. It was unclear from your email if you are in therapy and if you are being prescribed medicine for the bipolar II. If you are not in therapy and have not had a medication consultation I would strongly recommend finding a therapist and a psychiatrist who has experience in treating this condition. Being in the care of people who are trained to help can be an important step in coping with this.

On the good news side it sounds like you have some internal sense of when an episode is happening. This can give you options in dealing with your responses. I believe the strongest vehicle for learning what these options are is through group therapy. The find help tab at the top of this page can bring you to a person in your area that may be able to help. Often your local community mental health facility has an outpatient program where groups are available. In a group you will learn how to deal with your internal activation as well as how to come with feedback and confrontation from others. It can be a powerful source of support as you find your way.

Wishing you patience and peace,
Dr. Dan

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I need to find a therapist, but I’m scared to call

by Dr. Marie Hartwell-Walker October 23rd, 2024
written by Dr. Marie Hartwell-Walker

Back at the beginning of my sophomore year in college in 2009, I went into the counseling center at my college and started individual therapy with a therapist that was assigned to me. My sessions were fairly sporadic, and since I’m only allowed 10 per academic year, my therapist spaced them out so they would span more time. I had my final session with her back in February of this year, and I have been in group therapy this semester, but that’s an entirely different story.

I recently asked my therapist for referrals to an outside therapist where I could get more consistent and long-term treatment, rather than being so limited. She gave me several names and numbers, but I’m so scared to call anyone! I’m scared to call, but I’m also scared to ask questions. I know from researching some that I should ask some questions of a potential therapist to see if they are right for me. And I also read that it was best to do so on the phone so you don’t waste your time in an in-take session if they give cold answers. I just don’t think I’ll be able to ask questions on the phone or in person. So, my main, huge worry is that I’m not going to be able to be assertive enough to find what I need in a therapist, and I’ll get tired of jumping from one to the next, and I’ll probably end up not looking anymore.

While I was in individual therapy, I was slightly more capable of convincing myself that I was worthy of getting help for my low self-esteem and constant need for validation from everyone but myself. This feeling has lowered again, and I feel stuck, because I know I will be even more disheartened if I have a lot of trouble finding a good therapist. Nonetheless, the decision is up to me, but I have no clue how to make this work for myself. I’m just too scared, and I don’t know what to do.

I’m very proud of you for deciding to take charge of your problems and finding a therapist. As you’ve discovered, therapy really can help. I’m equally proud of you that you haven’t gotten so discouraged that you’ve given up. Instead you are asking for help, first from your therapist, then from us here at Psych Central.

Your therapist has already shown that she is willing to help you transfer. Since you like her and feel reasonably comfortable with her, I wonder if you could ask her if you could make the calls to the new therapists while in her office? She can coach you on what to say and be there as a support for you. Even if you just get to leave voicemail messages, you will have started to make contact. Yes – eventually your goal is to be able to do this for yourself. But you’re not there yet. There’s no shame in that. It’s something you know you have to work on. My guess is that if you could easily make those calls, your therapy would be close to being over. Instead, you are in the middle of the process. It’s fine to ask your current therapist to help you bridge to a new one.

Please do follow through. You’ve made such a good start. I really hope you will build on it by using the supports you have to help you transition to a new counselor.

I wish you well.
Dr. Marie

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Couple/family issue in relation to my bipolar & my meds

by Kristina Randle, Ph.D., LCSW October 12th, 2024
written by Kristina Randle, Ph.D., LCSW

Q. I know this is really lengthy, but I am in desperate need of help, my self-esteem is shot, and I am paralyzed with fear. I don’t know what to do. I wrote enough to set up the scenario and my history for you, to give you a better picture . I hope you *will* reply, I really need help.

I was diagnosed with BP1 in 2005. I have a long family history of bipolar disorder and depression as well. This is part of what led my dr. to this dx., along w/ other clues. I have worked with a good psychiatrist from the get-go to try to find a medication that works for me, and resolve some issues regarding the bipolar disorder.

Right now,I’ve been taking Lamictal for about a year, 200 mg. daily. It has taken a long time, but the dose I’m at now is helping more. It’s my opinion that I should try a higher level, since, while I don’t have the psychotic or manic symptoms as long, badly, or frequently, and the depressions are also not as long, frequent, or deep, I am still having “hiccups” so to speak. I am a rapid cycler who has mixed states as well. But it’s all starting to tone down a bit. With that established, here is my dilemma.

My husband of 20 years, who is a great skeptic of all things psychiatric, and believes meds are unnecessary, and that I am just looking to excuse my behavior with a diagnosis & medication, has recently began making snide comments and innuendos about my medications. He has repeatedly questioned, what is this? what does it do? This mostly began recently, when my gen. practitioner prescribed Darvocet for a herniated disc, and Relafen for my increasing arthritis (have had arthritis since age 36.) So, my side of the medicine cabinet has been filling up a bit. I was taking– Lamictal, Trazodone only as needed for insomnia & anxiety, Relafen, Darvocet on as needed basis, and two different antibiotics for gum disease and an infection. This began really bugging my husband, and the remarks began.

I have had trouble with bingeing on beer on occasion in the last three years, since my last breakdown (’04, before my diagnosis). I have been much better, allowing my meds to do their thing, and not running for a beer when stress hits me. It does feel better not to. I have a very low tolerance for stress, & we’ve had a LOT lately. Plus, I’ve been trying to find a job for two months, with no success, and feeling very low about this. I’ve been a stay-at-home mom for 16 years, and I think this is affecting my search.

T. and I had a blowout the other night, after I had finally had enough of his comments and his recent treating me like a five year old (to the point of even accusing me of *acting* like one.) Probably because of some financial issues I caused when manic and depressed two years ago (from which we are still recovering, & almost there), he has really been on my case about money & spending. Aside from some forgetfulness and my disorganized filing habits, I have let a bill or two escape payment, but I only spend what is needed for the household, the kids, or whatever unforeseen thing that may come up. I am not a “big spender” or an “impulse shopper,” I have no “shopping addiction.” However, he recently started questioning every penny I spend, and I then have to account for EVERY penny.

He took a loan out against his 401K last week, so we could — together — catch up the last few late bills. He called me immediately and told me sternly “DO NOT spend ANYTHING until we can sit down and work the budget out together. I do not want to blow this money. DO NOT go to the bank or the store!!” He repeated himself a couple more times, and I assured him I wouldn’t . He made such a big deal of it, and even when he got home. Well,I finally had reached the breaking point, and sent him a sarcastic email asking permission to buy these items, and saying he’s right, I’m a child and must be monitored at all times. I wasn’t very nice. Our blowout the night before had been a yelling match in which he had the upper hand, and shot down *anything* I tried to say with “Oh, here we go again — the ‘woe is me’ crap from you!” “Oh, THAT’s appropriate behavior for a five year old!” and similar things. I snapped, and went to bed crying myself to sleep.

I am tired of this. In my email, in my anger, I also said angrily, fine, I am quitting ALL my meds — the back pain meds, the psych meds, ALL of it — since he so disapproves of my “drug use.” Well, I realize, that’s stupid (although tempting) and now I want to just tell him, You know what? My search for stability is important to me AND to this family, and I have decided NOT to quit after all. I’m sorry if you disagree, but I feel this is what I need to do. The back pain med was prescribed to help me avoid surgery for as long as I can, since we have kids and horses, and financially, surgery and my layup would not be a good option for us.

So, I am not sure what to do now. There are also some issues he has with jealousy, and thinking I’m cheating or sneaking around — he checks our emails constantly, asks me “Who’s this? What’s that?” and gets really mad when I forget and leave my cell phone at home or in the car & he can’t call me. I’ve done nothing to warrant his behavior. I’m tired of being monitored like a child or a criminal. But that’s a whole other issue! Mainly, I am scared to stand my ground at this point, & take back what I said, and stay on my meds. My back is already hurting me *a lot* after three days, and I’m still on my Lamictal, only at a tapering off dose in spite of my p-doc’s recommendation.

I really want to talk to him, but i’m afraid he will turn it all around to make me feel bad about it. By the way, please don’t suggest marital counseling. We’ve already done it twice; he turned it all on me, saying everything was my fault, and thinks it’s all a crock anyway. He won’t go again. I am desperate, and feeling belittled, and have little self-esteem or confidence here. I really need some help or encouragement. I hope you will reply. Thanks for reading anyway.

Thanks for your detailed letter. Of course, you should stay on your medications. It sounds like you have finally found a regimen that works for you and you have done this in tandem with your doctor. Many people struggle for years to find a medication that helps regulate their symptoms. Also, many people find it difficult to find a doctor that they like to work with. You have both, a good doctor and medications that work for you; it would be foolish to forgo what is working.

If your husband does not understand why you are taking medications, or why you need them, perhaps you can inform him. Have the two of you sat down and had a real “heart-to-heart” about what it is like to live with bipolar disorder? Have you communicated with him precisely how the medications work for you? I know this seems like common sense, but maybe, being that we all seemingly live busy lives, these basic facts were never communicated to your husband in a way that makes sense to him.

Also understand that many people do not understand bipolar disorder and this can and often does include family members. Some family members find it difficult to believe that their loved one has the disorder, as in your case. This may be due to ignorance about bipolar disorder. Bipolar disorder is difficult to fully understand. Some family members, this may be true for you as well, are angry at their loved one for being “sick.” It is human nature for this to occur and very common. It does not make it right to be angry at a loved one for being ill, but it does happen. It is likely that your husband is at the very least not informed about the disorder.

I know that you do not want me to suggest marriage therapy and that’s fine, although it is necessary and with the right therapist, you could have had more success.

I am going to suggest individual counseling for you. It is also clear that your husband could benefit from individual therapy but it does not sound like your husband is open to the idea. Even if he is unwilling to get counseling, you still should.

I am suggesting individual counseling for several reasons. The first reason is because you could use some guidance in helping you build your self-esteem, and this can be done with a therapist. The second reason is that you (and your husband too) could benefit from working with a therapist on your relationship issues, and here are a few examples of why:

Your husband yells at you and you feel like a child. There is something clearly wrong with how he treats you. In this case, he is in the wrong.

He hounds you about taking medications; medications that seem to be helping you. Again, he is in the wrong.

In the last fight that you wrote about, he tells you that he wants to save money to pay the bills, asks that you not spend any money and you reply inappropriately, as you already know, with a sarcastic letter, egging him on, and a statement that you are going to quit taking your medications. In this specific case, you were in the wrong.

Your behavior (as well as his) within the relationship needs to be analyzed. A therapist can help you analyze how each of you behave within the relationship and help you correct your behavior and help you see how the both of you contribute to your “blow outs.” Every fight that occurs between the two of you hurts and damages the relationship. And that is why a therapist, even if it is only you that attends, is very important in your situation.

I hope this helps answer your question. Take care.

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Continuing Symptoms Despite Treatment

by Kristina Randle, Ph.D., LCSW April 27th, 2024
written by Kristina Randle, Ph.D., LCSW

Thank you. A month ago (or so) Dr. Kristina Randle helped me answering my question. (Misperceiving reality without medication). After reading the answer I decided to contact my former psychiatrist (the one I used to trust) and started a treatment with her.

I was feeling so much better and wanted to write just to say thank you, was not fine yet, but better, lot better. So thanks 😀 really.

I understand you answered my question, and don’t want to continue bothering you, but I’m in a little despair. My delusions diminished a lot, I think my official diagnosis is Bipolar Disorder with Psychotic features (or something like that), my mood was fluctuating, but was ok.

The thing is that 3 days ago I started to think of myself dead, uh… not sure how to say it. Like I see me killing myself in my mind (hope makes sense), was not feeling depressed or sad, actually I was fine, just this idea, and it started to invade my thoughts and now I just think in it. I don’t want to really kill myself, despite everything, I love my life, my plans. It has been hard to achieve certain stability, and I like being functional, but there’s this image that don’t leave me alone.

Then I started to listen other people’s thoughts (again), but I usually heard the thoughts of one person at a time, and now are a lot of thoughts of lot of people, so I can’t distinguish everything and my head is aching all the time because of the constant noise.

I wrote to my doctor explaining, I try not to call unless is a real emergency I don’t like when I am demanding, anyway I wrote to her, and she told me I have to give time to the med to kick in.

I know I have to be patient, but I can’t concentrate, or work, and I have datelines, and now I am starting to feel desperation, and don’t know how to deal with this until the med works fine, what if the meds don’t work? What if I’m not fine again?

And I ask myself if I really can’t control this or why am I doing it? Why a person would be like imagining things? Listening or seeing things that really are not there or happening? Am I just a freak? Should people be afraid of me? Should I stay away from people, to avoid hurting them?

And I feel so guilty and afraid for thinking of “me killing myself,” I know I like my life now (generally speaking), and was hard to get to this point. And people say that if you say it is just because you want attention, that people who wants to do it just do it. I don’t want to do anything like that, and also don’t want to have this images in my head, but don’t want to like to “call for attention.” How do I know if I have to say it to someone or not? How do I know if is real, and I should be worried or not? I used to want to die, I even try once and barely survived, and I am grateful I did, ’cause some years after my life improved and I liked it, but I feel ashamed as well (of feeling, saying and trying to kill myself and be alive) because it makes me feel like it was fake, that I was fake. Does that make sense? Should I ask for help or just wait until the meds work?

I’m sorry, I wanted to be just a thank you note, and I understand there are other people, and you have answered a question of mine before, so it’s OK if u don’t answer this time.

Thanks a lot for your time and previous advice.

I’m so glad to hear that you contacted your psychiatrist and have begun treatment again. I very much appreciate you writing back and letting me know how you’re doing. Thank you.

Please never feel that you are bothering me. I am glad to help you.

Your symptoms are obviously distressing but they are not your fault. No one would willingly choose to experience what you are experiencing. Those thoughts and images are essentially your brain playing tricks on you. It’s unfair, unpleasant, and frightening, and I’m sorry that this is happening to you. It will stop. It does take time. Be patient but also carefully monitor the suicidal thoughts that are occurring. If you feel that you might attempt suicide, you should call 911 or go to the emergency room. Keep your doctor informed about every change in your thinking.

You were wise to inform your doctor about your ongoing symptoms. Don’t feel like you’re a bother to your doctor. You are not. If you are a bother to your doctor, then she should find a new occupation. No good therapist would ever be upset with your providing the very information that they need to do their very best work. She needs you to keep her informed or she simply cannot do her job. What I am trying to say is you are being a responsible client. Without your self-reporting, she would not know how you are doing. As she noted, it may take time for the medication to “kick in.” Alternatively, your ongoing symptoms may be a sign that a dosage adjustment is needed. It’s important that you continue to inform her about your symptoms. It helps her to know whether your medication needs adjustment.

You may also want to consider the addition of psychotherapy. A therapist could help you to stay grounded in reality. For instance, he or she could help you to distinguish between what is real and what is not, teach you strategies for dealing with distressing hallucinations, voices, paranoia, and suicidal thoughts. During any distressing time, it’s important to surround yourself with a great deal of support. The more support you have, the better you will feel.

Thanks again for writing to let me know how you’re doing. Please consider writing back to keep me posted on your progress. I wish you continued success. Please take care.

Dr. Kristina Randle

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Boyfriend won’t talk about a future

by Dr. Marie Hartwell-Walker January 2nd, 2024
written by Dr. Marie Hartwell-Walker

I have been with my boyfriend since i was 14 and he was 16 it’ll be 6 years. in Nov.2010.In 2007, i had cheated on him and i told him about it. i felt he was never paying attention to me he was always with his friends literally everyday whether they came over or they went to go play basketball or something, I tried talking to him and he ignored m. i didn’t want to leave him because we had a 1 and a half year old daughter at the time who is now 4 yrs old. He forgave me and we had come along way but now i feel we are back to where we started if not worse. i feel he doesn’t want to be with me anymore but also doesn’t want to leave me.

For the past 4 years we have gotten into so many arguments about him not being romantic or showing me he loves me. I’ve only gotten flowers from him once for valentines day. ONCE. He barley says i love you unless i say it first and he says it back but it’s like it has no meaning to him. I tell him everyday that i love him but I’m starting to get to a point where i want to give up but i feel guilty. even though He has not been perfect he has done plenty of things that he shouldn’t have.

we don’t communicate at all. i feel like im his roommate who he has sex with occasionally about once every two weeks or so maybe more if i initiate it. he leave for work in the morning. i go to school. we come home eat take a shower and watch cartoons with our daughter and then go to sleep. He is always bringing up things about him having to support all 3 of us and how his co-workers wives do a lot with their lives and how i should be more productive. I feel i am doing all that i can but i am never enough for him.

also he doesn’t like talking about having more kids or getting married at all. he even gets mad sometimes when i would bring it up. it has gotten to the point where he has forced me not to want to get married or have anymore children with him because i feel like it’s a bad thing to want. I have tried talking to him about it and it always ends up being my fault because “i don’t do enough for this relationship”. don’t get me wrong he is a good man and a wonderful father i just don’t know what to do i need help I’m running out of options.

I think you and your partner are in two different relationships: You think you are in a love match that could be forever if he’d only see what he has. He thinks he is trapped in a relationship that he isn’t ready for and isn’t sure he wants. I give you both lots of credit for trying to make a go of this for the sake of your little girl. But from what you wrote, it seems that she is the only thing holding you two together.

Sadly, one person can’t make a marriage. It’s like you are trying to shake hands with a man who keeps both hands behind his back. No matter how much you want it; no matter how much you try; unless he extends his hand too, you can’t shake on anything.

It may be there is hope for this relationship but only if you both can get out of the argument and see if you can rekindle the love for each other. If not, the two of you need to talk about how to both be good parents for your daughter even if you can’t be good partners for each other. I hope the love you both have for your child will help motivate you to get to a counselor who can help you finally confront your differences and solve some of the problems. You all deserve better than this.

I wish you well.
Dr. Marie

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I’m Married and May Have Feelings For My Friend (same sex)

by Diane Walcutt, Ph.D. December 27th, 2023
written by Diane Walcutt, Ph.D.

I am 26 and married, I love my husband a lot but recently I have been hanging out with this girl, have only known her for about 2 yrs…I have been with my husband for almost 7 yrs and have never been interested in women before.

Now I’m starting to think I have feelings for her, I think shes beautiful and can never get her off my mind. I love talking to her. My biggest issue is that I know shes married and has no interest in women….plus i’m not used to it!

We hang out occasionally and every time we do I go home and i’m happy but a few hours later I get depressed and stressed because I wonder if these feelings are real or if they are something that will go away soon! At times I want to sit and just cry because I hate having these feelings. I have always heard its always good to tell the truth but should I tell her i have feelings for her? should i just lte it go and hope it goes away?

By the way on top of all this i have already had depression and this always seems to make it hundred times worse, and on top of it i have no job and with this economy its difficult to find one! Also i’d like to add that she does know i like her but i don’t think she knows i actually might have serious feelings going on. What should i do? its so depressing and i am so sick of hurting. I am going back to the drs soon to get back on antidepressants but i’m not sure if that will help enough so i need help! Please i need some advice, what should i do??

Hello and thank you for your question:

First of all, I don’t think you should tell your friend at this point. It sounds like you may have a “crush” on her because she understands you. Remember when you were younger and had strong friendships with girls? You dressed the same, talked about the same things? It sounds like this is a similar situation.

Just because you have these strong feelings doesn’t mean that you are gay. But if you want to explore this, I encourage you to find a therapist and talk with them about this. Women can develop very strong friendships because we understand how to communicate with each other, share similar feelings and often care deeply about the same things. Again, that doesn’t mean that we’re gay. 

I would not be able to tell you whether or not you’re gay over the Internet. Nobody can. You might be, or you might not. Check out our therapist directory for a therapist in your area. I would wait to tell your friend about your feelings until you consult with a professional. You might mess up a good friendship if you’re not careful.

As far as antidepressants, you should be going to a psychiatrist for these. They are the best doctors to get treatment for depression.

I hope all this helps,

Dr. Diana Walcutt

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Should I Take Antidepressants?

by Kristina Randle, Ph.D., LCSW October 25th, 2023
written by Kristina Randle, Ph.D., LCSW

I think I could write about my problems for days, however I’ll sum it up for you so that you hopefully can help me. I’ve felt depressed for so long that I have completely changed. I feel like I am two different people. Let me explain.

Before I started becoming depressed, I was so full of life, I was so energetic, and I had a lot of self esteem. I had so many friends and people wanted to hang out with me all the time! There was a friend who always asked my help for “social” stuff. I was always very optimistic. I rarely had a negative thought!

Now I’ll explain the “new” me. I’m by myself most of the day. I have only one friend that calls me, and that only happens occasionally. I have to always call people up to hang out, yet I can’t be in huge groups or I just break down. I’m very quiet now, and its hard to relate to people. There’s barely a point to go out anymore. I’m very pessimistic. I only see negative side to things! Even my teachers at school say I’m hard on myself!

I have to walk constantly! This is the way I’ve been able to cope with (what I think is) depression. I don’t get happy after walking, but it helps me get through the day. I took all my friends for granted, and now I know exactly what it feels like to be a complete loner.

I can act happy at any given time. I don’t want to be a downer around people, so I’ve learned how to do it. However, this isn’t how I want the rest of my life to be. I need help! At this time, I will do anything to get back how I used to be!

I was wondering if you think I should take antidepressants. I’ve tried so many different options. I want to be happy. I can’t take this anymore. Please help me find my old self. Thanks!

If I had the opportunity to talk to you in person, I would inquire about what has happened in your life. You were happy before and now are depressed. At some point, apparently there was a change. Did something negative happen? Did something recently change in your life? Answers to these and similar questions might help to uncover the source of your depression.

Your question is whether or not you should try antidepressants. The answer will depend on many variables. It would be advantageous to be evaluated by a mental health professional. The purpose of an evaluation would be to assess your symptoms and to determine if you do in fact have depression. Once you had received objective feedback about your situation, you would be in a better position to choose the most appropriate treatment.

It is currently believed that a combination of psychotherapy and antidepressant medication is the most comprehensive treatment for depression. This combination, however, is not effective for everyone. Some individuals respond better to medication only. Some prefer psychotherapy. If you had tried psychotherapy and found it to be ineffective, I would encourage you to keep trying. Oftentimes it can some time to find the right therapist but finding one could make a major, positive difference in your life. If you decide to try medication, I would recommend working with a child/adolescent psychiatrist who is specially trained to treat depression in adolescents.

You exercise to feel better. Although it does not eliminate your feelings of depression it to some degree improves your mood. For the time being, it is a good coping mechanism. It provides emotional relief and it is a healthy activity. You may also want to try walking with a friend or family member. I understand that you are struggling with social interaction but you should resist the urge to isolate yourself. Social isolation might make your depression symptoms worse.

I would also recommend consulting your parents about the possibility of taking antidepressants. They may have important feedback or advice for you. They may be able to help you with this problem. It might also be helpful if you read more about antidepressants and their side effects. Knowing more information about a potential treatment can help you to make the most informed decision.

Thanks for your question. I wish you well.

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Acquiring a counselor

by Dr. Marie Hartwell-Walker October 24th, 2023
written by Dr. Marie Hartwell-Walker

The year 2009 was a very traumatic one for me and my family. I started school in September and I was working very well. Early October I started to get depressed, and I was not coping with the work. I was very open about it, which helped me. I remember being in the computer room at school with my friends talking about wanting to die and my having no direction educationally. I had a very bad headache that day and I was jittery and conveyed the view that I wasn’t serious and was just having a bad day. That is true yet not true. Me and my friends talked about it, for some reason we are very open and tend to be able to articulate problems in a very direct conversation. *I am not like this at present, but I am generally like this as a person* In the end I went to sleep at school, skipped a class to do so and felt much better after. Skipping classes can sometimes add to my problems. I tend to pick and choose… For example, I never attend gym class or participate. I may have come into school an hour late on occasions so I can miss the morning class. However, I always make sure to find out the work I’ve missed and study. In fact, I love to learn. In classwork and homework I get A’s and A+’s but exams are a straight fail… Especially recently, I couldn’t revise because I was with my family constantly, I was required to shop, clean, be hospitable to guests and I had family staying over. In all honesty my attempt to study for my exams scored me 10 minutes of swearing in a car by my mother as she drove me home. On my birthday.

I have been depressed for many years, and also failing exams for the same amount of time. I believe I am smart, and for some reason all my endeavours are vocational and I don’t do the normal teenage things. I enjoy studying and being in the library. Probably because I can’t deal with a lot of noise and I like silence. But it’s hard. Everyone seems to be on a different level to me, they are normal. I am not. I do blame it on the depression. I am a bit of an introvert and have poor verbal communiction skills. I would like to talk to people but I can’t, maybe because whenever my mother shouted at me she would never listen or would only hear what she wanted to hear. I told her I was depressed and she has acknowledged this verbally to me, but only once. This was when she got mad at me last. I don’t talk to her or anyone because I don’t have anything good to say or anything to say that somebody can’t think for themselves. I give great advice and have been told I should be “a motivational speaker” but that’s about it.

Reasons why I am depressed vary. Sometimes it’s because nobody *teachers, family* tries to help me, or if they do they try to cheer me up, which leaves me empty because you’re trying to make everything okay on the spot. It doesn’t work like that. In early October my grandmother was brutally murdered in another country. We didn’t know until early December, I didn’t see my father for 2+ months while he did the police’s work along with other family members. They found her and they did all the work, right up to December 24th. This situation hurts me… I’ve seen what was to be seen and that does not affect me, but the sheer destruction of the situation gets me. My family is a big one and eveybody has been strained emotionally, financially and everything… And even so, only one person has truley acknowledged that this is hard for me. What I find hard is the life of my grandmother being taken, my mother telling everybody *I mean that* like it’s good to be linked to tragedy ; that my family needs counselling to this day. I had to leave the country right after I was given some stupid swine flu pill from the government, technically speaking, and it nearly killed me. I ended up missing almost a month, maybe just 2 and a bit weeks, of school. When I came back I felt ‘out of the loop’. So I skipped my math class to do some other work, I didn’t want to go because I knew I wouldn’t learn anything. Also, I was upset that my homeroom teacher told the class that my grandmother ‘died’ *she did this when I was late, in other words behind my back*. When to me it was much more than that! Some teachers and pupils didn’t know, including my math teacher and people were asking me how my holiday was. Really??

The math teacher told me to go and see her, I did, she asked me why I missed my class etc etc then a lady came in who I’d never seen before. They started talking to me about school and where I’d been schooled before and my math teacher informed the lady about me cutting her class. In my defence I said I had work to do, I know it wasn’t called for but I hadn’t been in school for a while. My math teacher agreed that I hadn’t been at school and she said she would look into it. This was the first time I realised not everyone knew, I didn’t want people to know initially but it just goes to show that the people who needed to know didn’t and the people who didn’t did.

Apparently I had told my math teacher that I needed help with organising my papers so the lady then told me to go and see her in the next period. I did. My math teacher met the lady by the door of her office and passed her a note. My math teacher looked at me either sad or disappointed. So I could tell she had found out about my loss. During the organising session she asked me questions which I half answered and she asked me one particular one that got on my nerves, “so do you have family in another country that you go and visit often?” I immediately said “no” and she backed off. I asked where the bin was, and she answered me with curiosity and as I went to the bin she covered the note with her hand. So I knew the content of the note was based on my grandmother. I was upset. I hate my business being circulated as it is.

Also, the fact I don’t remember telling my teacher I need help with organisation brought to my attention that my memory is going. I often don’t remember what I’ve done, some experiences, what I’ve said, other peoples reactions, things I recently learnt. I need help. Teachers don’t help me which is fine because they are not counsellors, but I can’t take it. I don’t even think I can verbally tell someone, a counsellor what’s wrong. But I can’t move forward unless I get help. I’m depressed, I have mood swings, I no longer get angry which is worrying to me because it shows I have no emotion left, I talk to myself about a bad situation rather than the person I want to say it to, I constantly need isolation, I have no trust in anyone, I can’t talk, I cant say what’s wrong…

I just want someone to talk to, that will help me. I really dislike school but love to learn, I can’t deal with noises, I am anaemic which is getting on my nerves, I am always tired, once I slept for 20 hours. I just want to succeed in life. I know what I want but I get so low sometimes. I fear my family members death sometimes, and I invision it and how I would feel. So I constantly feel that I have to be nice. Which I don’t have a problem with but it’s just………………..

I don’t want to harm myself, I want to stay alive, I want to stay true to myself and succeed. But to find a counsellor I have no approach and I need confidentiality, I dont want anyone to even know I’m going… I hope you understand what I’ve written, I have a hard time explaining things.

What a hard, hard year you and your family had. You explained things just fine. It makes sense to me that you are feeling down and overwhelmed. The events of the past year would be overwhelming for everyone. I have to wonder if your parents may be having as tough a time as you are. They too suffered a shocking loss. They too are dealing with what it means to bridge two cultures. They too didn’t have each other’s support since your father had to be away to work with the police. It just could be that your mother isn’t able to help you because she is too stressed herself. It sounds like your teachers tried to help you but did it so awkwardly that their help wasn’t helpful. Whatever good reasons there may be that the adults around you couldn’t help, it has left you feeling alone and scared.

Your letter shows you to be intelligent and sensitive. I think you may be grieving your grandmother and the family that you used to have even more than you think you are. Grief makes people do many things that may seem unusual. In your case, you withdraw from other people and even from yourself. You feel you can’t trust anyone. You are disorganized and have trouble with memory. And you get scared that other members of your family will die. On top of all that, you also report that you are anemic and that you get headaches. It may be that medical issues are contributing to your depressed feelings. It makes sense to me that you are depressed and immobilized.

I’m very glad you found the library and books as retreats from a world that at times feels very painful. The library is your sanctuary where there are no demands and plenty of interesting things to distract you from a daily life that seems much too hard. It has given you a much-needed rest. As helpful as that may be, though, you also need to take more charge of your life if things are to improve.

I encourage you to follow your own good instincts. Find a counselor to help you, preferably one who understands cross-cultural issues. Yes, it’s hard to find just the right person but please believe me: It’s worth the effort. You should see your doctor for the medical problems anyway. While you are there, ask your doctor for some names of counselors. Take your letter with you to your first appointment. It is an articulate and thoughtful description of your problems. Sharing it will help you get started. Finally, please understand that counselors do respect confidentiality. What you and your counselor talk about is strictly between the two of you.

I wish you well.
Dr. Marie

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Eating disorder?

by Dr. Marie Hartwell-Walker August 3rd, 2023
written by Dr. Marie Hartwell-Walker

I’ve been in treatment for an eating disorder for almost 3 years now. It started when I was 17, and now that I’m 21 i’ve been better, but i’m not completely recovered yet. I used to go to weekly appointments with my psychiatrist, now I see him once every 3-4 months, i also went to equine therapy twice a week and then left it a year ago, plus i went to individual psychotherapy and nutritionist once-twice a week. This has been my life for the past 3 years and I’m also a psychology student and will be graduating nexo year.

I was diagnosed first with anorexia, purging subtype, and then my treatment team changed the diagnosis for ednos (eating disorder not otherwise specified). I used to starve myself, restrict my food intake and i tried to induce vomiting a lot, even though i only succeded 2 times but felt relieved and guilty at the same time, so i stopped trying. Instead, i restricted and when i felt i had eaten too much and felt guilty, i skipped meals or excercised.

But recently (like a year or less from now) i’m not using a lot of eating disordered behaviors, i restrict sometimes and skip meals, but not as bad as before. I left one of my treatment team therapists like 5 months ago, and on our last session she told me she didn’t really think i had an eating disorder (this came out after 2 and a half years of treatment with her), and she said it was because i wasn’t as bad as other girls with ed’s.

When i told her 2 different psychiatrists had diagnosed me with an ed (eating disorder), she said,well, ok, you do have an ed. Now that i’m going twice a week with my other therapist, last session she told me i was more functioning than most people with ed’s and that she didn’t think i really had one, cause i wasn’t that sick.

I don’t really know what to think or believe about this whole situation, it’s just making me more angry at them, cause i feel decieved by them cause then they lied to me all these years, and it also makes me mad at me for not being “sick enough” to deserve treatment, and i thought that phase was over.

Hope you can tell me what do u think or what should I do. Thanks!!

There is no sweepstakes on trouble. It doesn’t matter in the least whether your problems with eating are better or worse than other people’s. You were diagnosed with an eating disorder 3 years ago. Period. To your credit, you had the courage and the perseverence to get treatment. It sounds like it was largely successful. You still don’t have an absolutely healthy relationship with food but you are getting there. You are not endangering your life or health anymore and you’ve developed other ways to handle anxiety. Good for you!

Rather than being in an argument about diagnosis, I think it would be more helpful for you to give yourself credit for how far you’ve come and then refocus your treatment. i worry that your identity has become somewhat tied up with having the diagnosis. I’d like you to instead be redefining yourself as a person who has done good therapeutic work and who has developed positive ways to manage stress. Can treatment now focus on building your self-esteem and self-confidence so that you can truly put the eating disorder behind you?

I suggest that you talk to your therapist about setting treatment goals for the present and near future and that you leave the past where it belongs — in the past. Of course you deserve treatment. But at this point treatment may take a new direction so that you can eventually terminate therapy.

I wish you well.
Dr. Marie

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7 yr old daughter has become out of control

by Dr. Marie Hartwell-Walker July 11th, 2023
written by Dr. Marie Hartwell-Walker

I have a 7 yr old daughter, a 7 yr old stepdaughter ( who I have had full custody of since she was 1) and a 2 yr old daughter. My step daughter is a doll. She has always been very well behaved, My biological 7 yr old for some reason is very defiant, very angry when she doesn’t get her way, and becomes violent with her sister at times. She fights w/ her sister anytime things dont go her way, she will reach out and hit, scream, say “I hate you”, she’s also very defiant with me. She gives me dirty looks, slams doors, talks back, yells at me, and she cries all the time over everything. It’s been going on since she was about 4. I thought I could handle it, that she was just a dificult child and eventually she will grow out of it, but it just seems to be getting worst. What makes it harder is that at the same time, she can also be the most helpful, loving, wonderful little girl when she wants to. It hurts me a lot to see her like this, and my 2 yr old looks up to her sisters and I’m afraid she’s going to end up the same way. I can’t afford therapy right now so I’m hoping anyone can give me some suggestions or new things to try. I have tried sending her to her room, taking things away, spanking her, and sitting down and talking to her about how much it hurts me, which seems to work at the time but then an hour later something else doesn’t go her way and were right back where it started. She seems to not be able to control herself, and the other major thing is she lies so much that I never believe anything she says anymore. I’m worried because lately I have been almost unable to control myself and I find myself saying really mean things you shouldn’t say to a child, and screaming very loud at her, I’m afraid if she doesn’t calm down that I might not be able to keep controlling myself. I love her so much. Please help me.

I’m so very glad you wrote. It takes courage to face it when a family is spinning out of control. I have a lot of respect for any parent who takes steps to stop the confusion and anger and find a better way to handle her children. You didn’t share with me the role your husband plays in the family. I hope you can look to him for support, especially when you feel you are in danger of losing your temper.

It sounds to me like your biological daughter perhaps doesn’t feel that she can be as good as her stepsister. In order to still have a unique place in the family, she’s become the “bad kid.” She hasn’t done this consciously. Kids find a niche for themselves by trial and error. Sometimes they get stuck in a role that even they don’t like.

Meanwhile, it doesn’t surprise me that your methods of disciplining your daughter aren’t working. In your desperation to find something that works, you keep changing your parenting style. From her point of view, she doesn’t know what you really expect. On top of that, you are now acting much like she is: screaming and being out of control. She needs the adults to be in control and to be confident about what they expect.

Theory doesn’t help you know what to do. For that you need some practical help from someone who knows your family. I suggest you check the website for Parents Anonymous (PA) to see if there is a group meeting near you. These groups are run by volunteers or by nonprofit agencies for parents who want to be better parents. Usually there is little or no fee. Ask your pediatrician or the school guidance counselor for advice on where to find a PA group or another type of parenting group that would teach you effective ways to set limits and give you the support you need.

I wish you well.
Dr. Marie

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No self-esteem following a betrayal

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP March 1st, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I am 21 years old, and lately I’ve been experienced a lot of anxiety. My childhood was a normal childhood, I am the oldest of four children, my parents are married, and both work and I grew up in a small town and had a really happy normal childhood. Since I was little (about 12) I lacked self confidence, but then I started gained it, and by the time I was 15 I was in a pretty good place in my life, I loved it, I had many friends a happy and great life, and that year I met my current boyfriend. After a year of being together, he cheated on me with another girl, that killed me he was the first person I had ever truly loved and he did that to me, he apologized and begged for me to take him back so I did; and we’ve been together since then. A year or so after that, he moved out of the country and we broke up, I was devastated, because I felt like after all the years spent with him nothing counted, and it was when this whole paranoia and lack of self confidence started. Not so long ago he asked me to get back together, I was really happy but then again my situation of low self-confidence and self-esteem got worse each day. Currently I feel like I have no control over my actions, I feel like in my past I was really outgoing and could make friends easily, now I can’t, I feel as if I am boring and I rethink a million times everything I want to say or do, which as a result brings having a difficult time meeting new people. I feel paranoid all the time thinking people are going to talk bad about me behind my back or will think I look bad or I’m fat or ugly, I feel as if I have lost all of my personality. I get really furious at myself almost everyday when I see pictures of other girls my same age or even younger than me that I know partying, traveling and having a great time, while I’m sitting at my house not enjoying my youth, because my paranoia of not being good enough won’t let me. These problems have affected my relationship with my boyfriend and my family. My boyfriend constantly tells me that I have changed, that I am not as fun and adventurous as I used to be, that I acted as if I had lost my personality, the one which he fell in love with, and I feel he is right, I also feel scared all the time that he will leave me any time and find a girl that is happier and more fun than me. Rewarding my family, I’m always moody I treat my brothers and sisters very bad, by getting easily irritated by them and I find myself screaming and yelling at them all the time, as if I had no patience with them and could not stand their site. Not only has my personal life has been going down the drain I have also been getting bad academic reports, in the past year I have failed 2 classes, and my grades have decreased incredibly. I mentioned the fact that my boyfriend cheated on me before, because I feel that in a way this has to do with everything that I am going through right now, after that happened my life started going down the drain and it hasn’t stopped. Every single aspect of my life was affected by the fact that the person I loved and trusted the most betrayed me, cheated on me, with a girl I even knew! I forgave him because he demonstrated he cared, and he showed me in so many ways he loves me and he was so extremely sorry. What makes me more mad it is not the fact that he cheated on me, but the fact that this girl with who cheated on me with had everything going for her, even though she is a horrible mean person she seems to have everything in a perfect way, perfect hair, perfect car, perfect body, perfect friends, perfect everything and I don’t. I feel like myself is in ruins, literally. Another thing that makes me so uncomfortable is my boyfriend’s family; because of my low self esteem and the fact that I am so different in every way from them, I feel as if they hate me; I’m paranoid about what they might think of me, when I’m with them I’m afraid to speak or say something, because of the fear of making a fool out of myself, so I come off as rude and shy, so I have no idea what to do. I feel so alone because I have no one to talk to, no one to express myself with, I have no friends, I have gotten FAT I have gained more than 10 pounds from eating so much (anxiety), my boyfriend lives in another country and currently reminds me of how much he’s noticed that I have changed, my academic has been awful, I am depressed, I cry every single night hoping my attitude will change. Please help me, I have tried to change but I feel lost, I feel as if something is missing, I am not satisfied with my life, I feel as if my best years are going by and I’m in my room crying and eating. Please help me I feel as if I have no control over my life, what do you think I should do?

I am glad you are taking care of yourself by reaching out to us here. Your self-esteem has taken a hit because you are too dependent on your boyfriend as a barometer for your own emotional wellbeing. This isn’t a very functional relationship, from what you are telling me, and I can understand why you would feel insecure and anxious. Your trust in him is shaky (at best). He is living in another country, and his criticism of your changes doesn’t help. It is time to reclaim yourself and become more self-reliant and resilient.

I am not suggesting you end the relationship, but I am asking you to put it in perspective. It sounds like you are drawn to his potential rather than his reality. Obviously you get something out of the relationship, but don’t confuse what you want him to be with who he is.

I would begin reclaiming your life and work on getting yourself back. Start a program of taking care of your body, your intellectual development and your emotional wellbeing. Your boyfriend cannot do these things for you. You have to take care of yourself. If you do this it is a win-win situation. If the relationship survives then you will be less needy and more capable and happier in it. If the relationship doesn’t survive you will be able to move on with confidence.

A therapist during this time is a good idea. If you don’t already have one you may want to begin and create some emotional support. The college you are going to will have a counselling center with a number of qualified therapists.

Wishing you patience and peace,
Dr. Dan

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Might I Have A Mental Problem?

by Kristina Randle, Ph.D., LCSW February 24th, 2023
written by Kristina Randle, Ph.D., LCSW

I was wondering if i might have a mental disorder. people have described me as being cold hearted, and socially retard. I dont have friends and i havent had one for years, I have a group of friends when i was in elementary school, and then when i went to middle school that group shrank and then in high school i had no friends just a couple of people i just talked to, I get anxious when im in public ( walking fast), I always get paranoid when people just start laughing or giggling around me, i think that they are talking about me. Iv thought of suicide before and tried it once but couldnt go through with it that was a few years ago i still think about suicide on a weekly basis’s it seems. I used to be really quite around people and kind of forced my self out of my shell but it seems that i still cant form any form of meaningful connection with anyone, when ever i talk with someone i have trouble collecting my thoughts and at times people have trouble seeing my logic, when ever i talk with someone i always lose get bored and lose interest with the person, and what bothers me is not the fact that i dont have friends but that i cant seem to “fit” in. I went to college for a year but droped out, i was bored and uninterested, then i joined the military, i dont hate my job but i also dont enjoy it, i feel as if i should be doing something greater with my life i want to do something with my life, that very few people can say they have done. The only time i feel happy is when I’m in the ring fighting someone. Theres a lot more i could write but the question is might there be something mentally wrong with me or am i just being paranoid?

Diagnosis over the Internet is difficult. I cannot say with certainty whether or not you have a particular diagnosis but there are several symptoms that would be indicative of a problem, including: anxiety, believing that others are talking about you, difficulty making a connection with others, and suicidal thinking. Those may be symptoms of a specific mental health diagnosis including, though not limited to, depression, anxiety disorder, or personality disorder.

Another possibility exists. You may not have a diagnosable mental health disorder but rather are feeling an overall dissatisfaction with your life. You feel that you “should be doing something greater” with your life. That statement supports the assertion that you are experiencing a general dissatisfaction with your life. At some level, you may feel that you are capable of more than you currently have achieved.

My recommendation is to have a psychological evaluation. An evaluation would be advantageous for several reasons. One reason is that the clinician can gather many more details about your life and history and make an objective determination regarding a mental health diagnosis. Secondly, he or she could provide a referral to the appropriate treatment provider, if necessary. Finally, the clinician can answer any specific questions that you have regarding your symptoms. The find help tab, the top of this page, can help you to locate a mental health professional in your community. Please take care.

Dr. Kristina Randle
@DrKRandle

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Boyfriend Can’t Get Over My Past Relationship

by Dr. Marie Hartwell-Walker February 22nd, 2023
written by Dr. Marie Hartwell-Walker

I’ve currently been dating a man for 8 months. He’s 45, never been married and has no kids. I’m 1 month away from a finalized divorce and share 2 little boys with my ex. My married relationship has been over for years and I’ve dated a bit before I got into my current relationship.

My current relationship has been fast, but fantastic. We laugh a lot together, we can communicate really well, have been able to very successfully work through and resolve conflict, our sexlife is great, we share the same goals for life and we continue to share and build a trust and a bond which we both haven’t felt with anyone else.

The problem is, he feels like he’s living in the shadow of my ex and feels like he’ll always be standing on the outside looking in. THe only thing we fight about is my ex. I have not much contact with my ex except when it involves my kids. There has been a bit of drama going through the divorce but not much. My boyfriend has been very supportive but obsesses about my past life. I want to reassure him and make him feel like he is number 1 in my life, because he is. He just can’t get over me having an ex and says that will bother him always.

My boyfriend suffers from extreme depression and I know that the stress from my impending divorce must be brutal for him to deal with at times. But we love each other and we have put 8 months into this relationship, which in my eyes and I believe in his, a relationship that holds so much promise. What should I do?

What you should do is slow down. Eight months is a very short time to make a lifetime decision. You may think your marriage was over long ago but you haven’t been divorced. Please take the time to make sense of your prior relationship and what went wrong. You’ll be sharing parenting even if you aren’t sharing a life together so it’s important to gain perspective and, hopefully, a positive working relationship with your ex.

Your boyfriend seems to want you to have no past. That’s unrealistic and unfair. To be with you is to be with someone who has had a life that was different from his own. He’s right that he will always be on the outside to some extent. That’s not the problem. The problem is that he can’t accept that fact as your reality. You have two little boys who ideally should have a relationship with their father. They can also have a relationship with a stepdad, of course. But it’s unfair of your boyfriend to ask you and the boys to act as if the other man isn’t still an important person in the life of your family.

I very much hope your boyfriend is in active treatment for his depression. He needs to be doing the hard work involved in learning to manage a mental illness, not asking you to change your history to make it easier for him.

I wish you well.
Dr. Marie

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Want to Feel Normal

by Dr. Marie Hartwell-Walker January 10th, 2023
written by Dr. Marie Hartwell-Walker

My problems started when I got a job in November on night shift. It killed me I had such a difficult time with it. I was already on an anti psychotic and an anti depressant. But having such issues the doctor put me on another anti depressant. I was feeling better for a while until I lost my job. Losing the job was a relief but now my life is falling apart.

Almost everyone in my family is bipolar including me. My son has ADHD and picks up everything people say. my brother is 35 lives at home and pays no bills. He is disrespectful and my son is picking it up. I confronted my parents and now my mother is so upset she can’t talk to me, My husband yells at me when I get upset instead of helping me. I just want to be able to control my emotions. I want to feel normal. I do not have insurance so I cannot go to see anyone. I really need help but can’t get it. I have thought about what it would be like to end my life but could not do that to my son or family. I watched my in laws go through it when my brother in law killed himself. I could not put people through that. But I do want to just go somewhere and never have to deal with anyone I know. I want to disappear and have no feelings at all. People just keep telling me to get over it and it is not that easy. I need help but cannot get it so maybe you could give me some advice.

I’m so sorry you are having such a miserable time. I’m glad you wrote.

All the medicine in the world is not going to help you out of what is a toxic situation. No one in your family appears to know how to handle emotions and conflict constructively. They get upset and yell instead of solving problems. And there are a lot of problems to solve. Being diagnosed with bipolar doesn’t excuse people from treating each other with compassion and doing what needs to be done to have a healthy family.

I think you do need to see someone to help you figure out where you may have more power to change things than you think you do. A resource for free services for women is often found in programs for domestic violence. Although you don’t describe a situation where you are battered physically, you are certainly being emotionally abused. I suggest you see what the program near you has to offer in terms of counseling services. The closest program to you is in Wilkes-Barre. The phone number is 866-206-9050. Why don’t you give them a call and see if they can offer you free help or if they can refer you to another appropriate service?

I wish you well.
Dr. Marie

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Two-Month-Old Marriage is Failing

by Dr. Marie Hartwell-Walker December 19th, 2022
written by Dr. Marie Hartwell-Walker

I’m writing in desperate need as a last resort before divorce. My husband and I were married two months from yesterday, however, our short marriage has been anything but a fairy tale. It’s like he’s two totally different people. One minute he’s really sweet to me and the next he does and says unthinkable things to me. I don’t profess to be anywhere close to perfect, however, I don’t deserve his treatment. Here are some examples:

He’s told me a lot that I am lazy and fat and puts me down a lot.

About a month ago, I thought I might be pregnant so I told him. He punched me in the stomach and said that he wasn’t having a baby and that if I did, he would always be angry about it because it would ruin his life. Luckily, I wasn’t pregnant.

One Saturday, we were out shopping and he got mad about me not wanting to do something he wanted to do and told me he’d cheated on me. He later said he didn’t cheat on me, however, he frequently tells me about all the girls who are attracted to him at work.) He also said he hoped every day that I would die on my way home from or way to work so he wouldn’t have to deal with me anymore. He told me he wanted a divorce but then the next day he acted like nothing had happened. Sometimes when I ask him why he said or did something to me, he’ll say he didn’t know and other times he’ll act like he didn’t do or say what I’m asking about.

Last night we had a terrible fight and he told me I’m just like my family and it’s not in my DNA to be successful. I’m always going to be JUST a legal assistant. He yelled profanity at me and told me again he wants a divorce. This morning he came into where I slept (we frequently don’t sleep together) and kissed me and told me he loves me.

He likes for me to go with him to see his family, however, he never wants to go with me to see mine.

One day he got so mad that he pushed me and another time he threw my purse across the room so hard that it broke the case my glasses were in.

He never wants to have sex with me anymore and says he’s not attracted to me anymore.

He gives me one answer and then a few days later he’ll give me a completely different answer and act like I’m crazy for believing the first answer he gave or that he never even gave the first answer.

He usually gets mad when I ask him to clean up after himself, however, I work full-time just like he does and I refuse to be his mother or maid.

He’s very self-centered (always tells me how good-looking he is and flexes in front of the mirror a lot) and considers HIS money HIS (He’s always wanted to have separate accounts for our money.) He expects me to pay him every penny I “owe” him for my part of our rent and bills or if I have to borrow money from him, however, if he owes me money, he gets mad when I ask him for it. He has even told me I am sad and deserve nothing and he was embarrassed for me.

He tells me how much smarter and better he is than me.

He drinks beer every day and sometimes even before I wake up in the morning on the weekends. He’s also addicted to tobacco which I can’t stand. I don’t know if the alcohol makes him act the way he does sometimes or not.

I want to stay with him, but I just don’t feel like it’s ever going to get any better. I’ve begged and pleaded with him to go to therapy with me, however, he isn’t willing. Do you have any idea why he might act the way he does? Do you believe we have a chance?

I’m sorry to have to tell you that I don’t think you have a prayer of saving this marriage without sacrificing yourself. I don’t know why your husband is this way. Frankly, I don’t care. What I care about is that you are being treated so badly. This guy doesn’t want a partner, he wants someone he can subjugate and control. Don’t believe the apologies. Don’t believe the times he is sweet. He is manipulating you and gradually taking away your self-respect. The time he punched you when you thought you were pregnant should have been the last straw for you.

Get out. Get out now. Check out this website for information about where help is available near you.

I wish you well.
Dr. Marie

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I Just Don’t Care

by Kristina Randle, Ph.D., LCSW November 20th, 2022
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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Boyfriend won’t Communicate

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP November 3rd, 2022
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

About 5-6 months ago I noticed my boyfriend’s behavior changing and it never went back to the way he used to me around me. A little background: we have been together for 2 years now, both 26, and do not live together. We spent a year apart while I was across the country in a training program. We skyped every night and saw each other every 2 months during that time, and it was a great way to get to know each other well without having the physical distraction. We have many things in common, but a few things differ on an ideological scale, and I think it plays an important role in our current issues. He is a virgin, and believes a person should have loved another enough before even meeting them to save themselves. I am not, though each person I have had sex with I was in a serious relationship. That really bothers him, and he used to bring up my past relationships a lot but doesn’t anymore. Things were perfect the first year, then he started to get less affectionate, which I think is natural as time wears on. Starting 5-6 months ago with no catalyst, he would refuse to kiss me, even duck out of the way, and would just stand there if I hugged him, he stopped holding my hand and cuddling but at least once a week we still have a passionate few hours. He stopped saying he loved me 3 months ago. Things were pretty normal besides that, with random bouts brought on by seemingly nothing where he’d be disrespectful and irritable. He never explained what brought it on even when asked. I have tried everything I can to get him to communicate what is bothering him. Most of the time he just responds with silence. He won’t tell me specifically what I do (if it’s me) that bothers him no matter how I ask. On many occasions when he get upset and withdrawn, I can’t even imagine what caused it, because everything seemed fine to me. I love him with every fiber of my being, but I don’t know what to do anymore. I am a great girlfriend, never raised my voice at him in frustration, take very good care, and am very patient.

I can appreciate how difficult it is to love someone who has become less emotionally available to you. While you are right that some loss of affection is natural, the pattern of behavior you’ve described sounds more deliberate. You may be at a crossroads and I would highly recommend a few sessions of couples therapy to bring in a learned third party. The find help tab at the top of the page can help you locate someone in your area.

But if your boyfriend doesn’t want to go the talking route, then you may want to initiate a trial cooling-off period. The relationship flourished when you were very distant, and perhaps distance is needed to rekindle it. Relationships are like violin strings. Some of them need great tension to be in tune, and others need much, much less to be in harmony. Yours may be more like the second type. If it is –the two of you can go on to find the right balance. If his silence is trying to communicate something else you’ll find out during the cooling-off period.

Wishing you patience and peace,
Dr. Dan

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Hearing Voices and Losing Focus

by Kristina Randle, Ph.D., LCSW September 5th, 2022
written by Kristina Randle, Ph.D., LCSW

I can’t function when this happens. I recently failed out of college, and ever since, I am not sure I am okay. I keep “checking out”, as in I suddenly will lose my ability to focus on anything, my brain gets very foggy/tired, and I will lose a lot of muscle tension and not be able to hold anything or stand up very straight. A couple nights ago, I was crying very hard and in a lot of pain, when I heard Hound speak up. (Hound is an internal voice in my head. He started as an imaginary friend and just took on a life of his own. I don’t mind him; he never threatens me, makes demands of me, etc.) He said “Shhhh. You’re okay. I’m going to take care of it.” and I “checked out” into that foggy state; I stopped feeling anything and went limp. This isn’t the first time Hound has told me that he is the reason behind my dissociation (if that’s the right word).

This morning, after I woke up, I closed my eyes again and relaxed. I wasn’t quite awake, but I wasn’t asleep either. I heard another voice, a very cranky old woman who was berating me. Then another one, a little kid. Then another kid, and a teenager, all talking about different things. I saw myself in a room full of silhouettes, the voices. Then I heard a familiar English accent; it was Hound. I called out to him, and he picked me up and carried me out of the room, locking the door behind us. He apologized, saying he was sorry and that I wasn’t supposed to see that yet. The impression I got was that the voices lived in my head, and he was hiding them from me.

Between that and my constant checking out, I’m beginning to worry about myself. I feel like I am losing my mind one piece at a time, and it’s starting to greatly interfere with daily life. If I check out, I can no longer even hold a conversation. I would really like to seek some help, but I don’t want to ask my parents to pay for therapy if I don’t really need it. That is especially since I failed out of school; they are not exactly happy with me.

You did not detail what led to your problems at school. I suspect that your failing at school and your latest symptoms might be related. Both are signs of a potential problem. To address your question directly, you need to be evaluated by a mental health professional.

It is unusual to hear voices and to be “checking out.” Hearing voices might be indicative of psychosis. Psychosis is a break from reality. Psychotic breaks can be stopped if caught early. Medication can disrupt psychosis and restore the mind to healthy psychological functioning. The importance of early treatment of psychosis cannot be overstated.

Psychosis is a possibility but so might be a neurological problem. Brain tumors, cysts, drug usage, alcohol withdrawal, and so forth, can cause psychosis-like symptoms.

Your mental health and perhaps your physical health are being compromised. Don’t ignore your symptoms. As you noted, they are greatly interfering with your life. It is imperative that you undergo a psychiatric evaluation as soon as possible. Please take care.

Dr. Kristina Randle

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Disgusted by People

by Kristina Randle, Ph.D., LCSW August 23rd, 2022
written by Kristina Randle, Ph.D., LCSW

I’m 18 years old. I believe in taking care of my body. I workout, have a balanced diet and great skin. I don’t smoke and I don’t take drugs. I strive for perfection in everything i do, which i obviously always end up with. I have a family that loves me.

I love me and my body over everything, people often ask me if i have a god complex. “No”, i reply. It feels like I’m meant for something great. But behind my exterior of perfection I feel a lot of hate and anger over those who don’t agree with me, those who are fat, those who doesn’t look good, those who doesn’t take care of their body, those who don’t care how they look and so on. I feel A LOT of hate against them. I while ago i saw the movie “American Psycho”. I recognized myself in him, though he actually killed people which i have never done and will never do. It seems like we share the same feelings. I have been seeing a lot of psychologists but it doesn’t seem to help at all. The reason i write to you is because of this: I now feel hate towards my friends that I’ve loved all my life. This disturbs me. I want this to end before it gets out of control. Thanks beforehand.

You said that you strive for perfection “which I obviously end up with.” Perhaps you were trying to communicate your desire for perfection but did not mean to imply that you had achieved it.

Striving for perfection is a worthy and admirable goal but no one is perfect. In fact, nothing in life is perfect. There is no perfect science, no perfect experiment, no perfect painting, no perfect body, and so forth. To believe that you are perfect, or that anything or anyone else is perfect, is a matter of opinion and not a matter of fact.

You feel anger and hate toward your family and friends without any reason for those feelings. You should feel love and admiration for those you care about, not hate. Feelings of hate are a problem and they are abnormal.

Christian Bale’s character committed heinous acts of murder. The fact that you identified with a murderous character is unusual. The movie character’s personality could be described as psychopathic. Psychopathic individuals are characteristically shallow, superficial, grandiose, are unable to feel empathy and have little to no regard for others. Those are not the traits of a psychologically healthy individual.

You asked for advice about how to handle this situation before “it gets out of control.” It is good that you recognize this as a problem and want to correct it. Seeking professional help is the proper way to address this situation. Ignoring the problem would be irresponsible, especially in light of your concern that this problem has the potential to become “out of control.”

You have been to “a lot of psychologists” but I would encourage you to continue to search for a therapist who can assist you. It is not uncommon to have to try many therapists to find one who can truly help. Giving up your search now would be premature, inadvisable and out of sync with your desire to strive for perfection. Please take care.

Dr. Kristina Randle

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