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Mental Health

Overachiever But Emotionally Exhausted

by Kristina Randle, Ph.D., LCSW June 12th, 2019

I’ve been working for the same company for over 3 years. I’m good at what I do, my bosses often call me a “star” Due to my

sales performance. I often make half of my stores turnover by myself, and consistently have kept up with my high targets and expectations until now. Recently I have been promoted to Assistant Manager, and I’m finding myself exhausted from not only keeping up with my own personal targets, but also trying to lift my co worker’s performances.
I do recognize that i could be a workaholic and an overachiever.

I feel like something needs to change as lately I have had depressive and emotional outbursts at work. I have recently struggled with personal home issues, and when this happens I tend to put my all into my working life, it’s like I feel that work identifies my success and self worth, only now I feel I have lifted the bar too high, I cant keep up with what is expected of me. Because of all this self doubt and internal struggles there have been clashes with me and my co workers, and my manager.

I feel like they don’t understand how emotionally exhausting it is to be the company’s “topseller” and to be an asst manager at the same time, I love my job but recently i just don’t feel like I can cope with the pressures of sales and targets.

I sometimes feel like it’s my fault I’m like this, that I cant relax, that I keep pushing, pushing, pushing myself to breaking point. I’m the only driven person in my store, so I feel like if the store suffers it is because of me.

I would tell all of this to my boss and manager, but like I said I feel like they don’t understand my nature. I feel stuck, hopeless, lost and confused. I feel like i’m only good at my job because i put literally everything into it to the point where it effects my mental health. Unfortunately now that the results are there and the bar has been lifted i feel like i cant go anywhere but forward, i have to keep pushing to make the higher targets, to make more sales.

Maybe I have depression? I really do not know.

The funny thing is I don’t even get paid well for what I do, I don’t know why I care so much, but I do.

You may have depression but it is difficult to determine. What may be driving your overachieving behavior is low self-esteem. You may feel the need to outperform your colleagues in order to feel good about yourself. Overachieving ensures that you are at least “good enough.”

I had a client who was a workaholic. His focus was on making money. He invested a great deal of time in his work but his career and money were not of equal importance to his wife. His marriage was damaged and he was facing divorce. His imbalance led to a great deal of suffering for both parties.

Your focus on work takes away from other areas in your life that need attention. By your own admission you are not happy. You’re putting more into your job than the good it is returning. It has become a detriment to your mental health. There has to be a balance. Something has to change.

Therapy is a great avenue to help you explore this problem in more depth. The therapist can also help you achieve a more balanced life and assist you in scaling back your overachieving tendencies. Click the help tab at the top of this page to review therapists in your community. I wish you the best. Please take care.

Dr. Kristina Randle

April 21, 2011 0 comment

Do I Have Adult ADD?

by Julie Hanks, MSW, LCSW August 1st, 2019

written by Julie Hanks, MSW, LCSW

I’m a student receiving my Masters degree. Within the past two years I’ve felt my body and mind change significantly in many ways. I feel extremely anxious when doing tasks (even small ones like packing/unpacking a suitcase). This is the same with grocery shopping or attempting my homework. I then push everything aside and get nothing done. My habits of cleanliness such as my apartment have declined because I refuse to motivate myself to clean. I’ll find myself in the kitchen then in the bedroom for some reason the randomly in the bathroom, ultimately accomplishing nothing. I get distracted by TV a lot and it impedes my homework. I also feel pressured on what to do when I finish my masters and feel like I’m too lackadaisical to even search for jobs. My relationship with my boyfriend is also affected by this in that I’ll freak out on him, refuse sex, and find him at the mercy of which high or low I’ll be on. I’ll also find myself drinking and smoking cigarettes more often to avoid doing work or tasks. I feel like I have adult ADD due to these symptoms and have spoken with my mother, who revealed she believes she has it as well but was never properly diagnosed. I would like to know what to do and what would happen if I see a psychiatrist.

Next time you talk with your mom ask her if she recalls you having similar attention problems in elementary school. While your symptoms do sound a lot like adult ADD, it’s important to determine whether you experienced these symptoms during childhood or whether they are new. If all of your symptoms are recent, it’s very unlikely that you have ADD. If they’ve been going on for years, it’s more likely that you have have ADD.

There are other possible explanations for your recent changes in your behavior and emotions. Depression or anxiety disorders often emerge in young adulthood and symptoms are similar to what you’re describing – difficulty concentrating, irritability, lack of motivation. ADD is often associated with other mental health conditions as well, so there may be a combination of issues that you’re struggling with.

Your idea about getting an evaluation by a psychiatrist is right on target! An evaluation will provide a clear diagnosis and suggest course of treatment to help you manage your symptoms. Your doctor will likely recommend medication or psychotherapy, or a combination of both.

If you’ve never had a psychiatric or mental health evaluation, it’s natural to be a little nervous because you have no idea what to expect. When you set up an appointment with a psychiatrist, he or she might give you some questionnaires to fill out before the appointment. During your appointment he or she will perform an in-depth interview with you. Medical or psychological testing may also be recommended. In addition to your evaluation and psychotherapy, you and your boyfriend may want to consider couples counseling to help repair any damage to your relationship.

You are in a stressful time of life full of transitions and important decisions – graduate school, serious relationships, career choices. These can be exciting and incredibly stressful. Make sure you’re taking care of your basic needs by getting adequate sleep, eating well, and engaging in regular recreation and exercise. No matter what your diagnosis, all of these lifestyle choices will help you manage your symptoms and will contribute to your overall health and happiness.

Take good care of yourself.

Julie Hanks, LCSW

February 24, 2011 0 comment

My Brother and His New Medication

by Kristina Randle, Ph.D., LCSW March 21st, 2019

written by Kristina Randle, Ph.D., LCSW

My brother is diagnosed paranoid schizophrenic. He has been in and out of prison and mental hospitals since he was 13. He was recently released from Warm springs and came to live with my mom, he has been doing great for the past several months, he came early last summer and all through this winter it has been great having my big brother around. He was having a problem with sleeping all the time and his mental health doctor kept promising to prescribe him something that they had him on while he was still in warm springs, however he never did. He became convinced that Ritalin would resolve his problem, his mental health doctor refused flat out to prescribe him Ritalin advising him that it was not a good idea and if my brother started taking it he would have to find himself another doctor, not I’m not sure this is exactly what is said as I have never had the opportunity to talk to his doctor this is just what he has told me and through conversations my mom has had. He recently convinced his regular doctor to prescribe him the Ritalin and since he has begun taking it things have turned for the worse. He is far more absent minded, the other day he was out watering the horses and he was carrying the water in buckets instead of using the garden hose and then when he was out there he just stopped and stared at the ground, he often pauses to think but I checked out the window about 20 minutes later and he was still rooted to that exact spot staring. Now am even more worried as he says that his hallucinations are getting worse and he has become convinced that they are demons of the devil, he will not recognize that they are just hallucinations and now he is starting to talk about how these demons are messing with his car and hurting our horses. He is getting more difficult to communicate with and is becoming increasingly despondent and irritable. I’m so worried that I am going to loose my big brother again. My mom already tried talking to him about how he is getting worse but he believes so strongly that the Ritalin will work he refuses to listen to the fact that he is getting worse. How do I convince him to stop taking the Ritalin or get him a new mental health doctor that will work with the sleeping all the time quickly and get him stable again?

There is no easy solution to this problem. Unfortunately, your brother, who is not thinking clearly, has decided the manner in which he wants to treat his illness and it is making his situation worse. Most likely because of his decision to take Ritalin, he is decompensating. Decompensation is a clinical term that essentially means that an individual is psychologically deteriorating. In addition, he is not receptive to anyone’s input. He was not willing to listen to his doctor or his family.

The signs and symptoms you have described are worrisome. He is having delusions. He believes that demons are attempting to harm the horses. Other troublesome symptoms include difficulty communicating, despondency and irritability. You have also described instances of what seem like staring spells or immobility. I’m not certain if this is related to the Ritalin or if it is indicative of catatonia. Individuals displaying catatonic behavior may remain motionless in an odd or rigid position sometimes for hours.

You asked about how you can convince your brother to stop taking the Ritalin and how to get a new doctor in an attempt to stabilize him. I’m not certain if that is possible. Since the episode seems to have already begun it may be difficult to stop it without emergency intervention from mental health professionals.

Given the situation, below are my recommendations for you.

Call his prescribing physician. HIPPA (privacy) laws may prevent his doctor from giving you specific information about his case but there is no law preventing you from calling and detailing your concerns. His prescribing physician needs to be aware of his current symptoms and your concerns. Also, his doctor may be unaware of his psychiatric history. You can and should provide that information.

My second recommendation is that you and your mother be vigilant. At this point it seems as though your brother is actively psychotic. He may still be in the early phase of a psychotic episode but I cannot tell with certainty because the nature of psychotic episodes can vary from individual to individual. Why should you be vigilant? Because individuals who are experiencing psychosis and paranoia may be at risk for harming themselves or others. For instance, if your brother believed that demons were attempting to harm him or the horses then he may do something to protect himself against the perceived threat that may endanger himself or the horses.

It’s also important to monitor whether he is caring for himself appropriately. Is he eating or drinking fluids? Is he bathing? If you see a change in this type of behavior then it may mean that he should be admitted to a hospital. In some states, individuals who are not able to care for themselves (eating, bathing, etc.) would be eligible for inpatient hospitalization.

Another complication in this matter is that it is unclear what has caused this psychotic episode. It may have been the Ritalin in combination with another drug. Maybe there was a negative drug interaction. Perhaps he takes the Ritalin on an irregular basis, not as prescribed (i.e. takes too much at once or doesn’t take it when supposed to). It may also be that he suddenly stopped taking the Ritalin and that has caused his symptoms. In some cases, an abrupt discontinuation of medication can cause a relapse. Those are some possible triggers for a relapse. There may be many others but at this point it’s too difficult to tell what exactly is causing your brother symptoms. All that you may be able to discern with any certainty at this time is that his behavior seems to indicate that a psychotic episode has begun and emergency intervention in the near future is likely going to be necessary.

As indicated above, vigilance is important at this time. If the decompensation continues then please strongly consider taking him to an emergency room or calling a local mental health crisis team. Be certain to call his prescribing physician and ask for his or her advice.

I wish that I could give you an easier answer about how to deal with this difficult situation. The fact is that dealing with schizophrenia and other related psychotic disorders can be very difficult, especially for the family. If you have any further questions, please do not hesitate to ask. Thank you for your question. I wish you and your family the best of luck.

March 4, 2010 0 comment

Was This Marriage Necessary?

by Diane Walcutt, Ph.D. January 13th, 2020

written by Diane Walcutt, Ph.D.

Please I need a professional reply in this matter. I am married for 2 years.I have a 14 month old baby. This marriage was settled by my parents. They chose the girl and I agreed. Before marriage I had some psychological problems. I was studying Masters in IT in Dhaka, Bangladesh in 2007.

Both my parents were abroad in Saudi Arabia. I was in dhaka with my younger brother. There was a lot of pressure of courses. There was also the challenge of making a good result set by my father. I also felt loneliness. I could not handle the pressure. I was partly responsible since I was irregular in my studies and wasted my time in games etc.

During my exam in february,2007 I became arrogant, misbehaving, used to break things out of anger,used to brag and give foul lectures, became proudy and felt all knowing. I hardly slept 3 to 4 hours a day and took food irregularly. There was also a feeling that everyone around is observing me and criticising me. My friends noticed the change and took me to a psychologist.

I failed in two subjects. In disgrace and humiliation my condition deteriorated. I had palpitition and could not sleep at night. My mother returned in March. She took me to the same psychologist. He prescribed some medicines for three months and suggested my mother to arrange a marriage for me. He also asked to put me in complete relaxation. He told that if I get a friend such as a wife my condition will improve.

In the next two months, my condition improved. I was married in June, 2007 with the expense of my father.
Both I and my wife were unaware at that time that the intention of my parents was to improve my mental health. Although I told my wife that I was mentally sick before marriage, she took me as a normal person as my condition was lot better. By the end of July, I became completely well. I love my wife and she loves me dearly and she is happy with me.

I am also happy but still there is a feeling that disturbs me that I don’t worth all of these. Once my father was angry with me for a certain matter and told me that I don’t worth any girl, had they not arranged the marriage for me I could not marry anyone by myself. This came as a shock for me. Ever since I cannot comfortably enjoy my family life. My father holds me responsible for the mental illness I suffered.

I have all the rights but I feel them granted, like I don’t deserve them! I am in debt for all of these to my parents! All my pleasures of my family life are permitted, not personal!

I make love with my wife, I adore my kids, still I feel the lack of personal freedom and right in it. Was a marriage absolutely necessary for my cure of mental illness? Could it be healed through medicines and other therapy? How much responsible was I for my mental illness?

Hello and thank you for your question:

I must confess, I don’t know a lot about your culture, only what my patients from your country have told me. I do know that mental health is looked upon as a weakness, but here in America, we have done a lot of research that has proven that it is NOT a weakness, but a real chemical problem.

It is NOT true that you don’t deserve your wife and children. It is also NOT true that your illness is your fault. However, it could be true that you were very stressed and staying up too many hours studying that you became exhausted. If you were drinking a lot of coffee and playing video games as well, that will make you lose sleep, become agitated and very difficult to live with. You can have a physical collapse, which will affect your mental health.

Your doctor may have been right in recommending that you get married. It may not have “cured” your mental illness, but you certainly did get a lot better, didn’t you? It would seem that not only did you get your health back, but got a wonderful family in the process.

Be thankful for your loving family. Your parents obviously wanted what was best for you.

Was the marriage necessary? Maybe not, but with all honesty, there is no reason for you to feel guilty about how your life changed for the better. Be happy with what you have been blessed with. You are a fortunate man.

I hope this helps,

Dr. Diana Walcutt

July 1, 2009 0 comment

Grieving BF can’t love new baby

by Dr. Marie Hartwell-Walker March 12th, 2019

written by Dr. Marie Hartwell-Walker

I’m a 26 year old female i have been with my fiancee for about 14 months we now have a baby boy who is a month old about 2months ago i found out that he had been seeing some one on the side whom he worked with. He told me that he was not happy anymore with me and he couldn’t tell me why just that he wasn’t happy. About 2 weeks ago we separated he didn’t want to see his son and had really nothing to say to me.

last week i took the baby to see him and we talked and decided that i was going to move back in and that he was done seeing the other woman and he said she would get over it he was even talking about changing shifts at the job to avoid anymore problem he told me that he loved me and our baby and that was what he wanted, things were going well we were acting as if nothing had happend and it was wonderful

2 nights ago he went crazy and i had to call a family member of his to come help me he had locked his self in our bathroom and was threatening to kill himself and he got very physically violent in ways i had never seen him act. I will add that he is 37 and he lost his first and only child before ours 12 years ago tomarrow in a car accident.

Last night he wakes up from a nap and tells me he is tired of living with a headache and that he can’t force his self to be happy and askes me to take my boys and leave, told me he wasn’t asking me to move out just to give him time and space to himself to think and decide what he wants.

I will add that this is a man that is a alcoholic in the first 3 days i was gone from the home i found 5 empty beer cases on my porch and i believe that he needs help for that along with mental help am i wrong for thinking that?

Do you think it would be wrong for a family member to have him commited for mental health help even tho he is going to get extremely upset with everyone. And do you think i am wasting my time waiting for him to decide what he wants or could it be he knows he mad the mistake and don’t how to deal with it and could it be that he still hasn’t found the right way of dealing with the anniversary of his sons death.

I love this man with everything in me and i want us to make things work but how do you do that when the other person won’t try and get help all they say is there not going to help me it would be a waste of time.

What a painful and difficult situation for both of you. It certainly sounds like having a child has triggered unresolved grief and pain in your fiance. He is casting about for a way to dull the pain. Alcohol, an affair, and even suicide all look like options to him. Sadly, he is missing out on the baby he has while he mourns the child he lost.

Sometimes people who have lost a child are terrified to love another. They know how vulnerable being a parent makes us. They never want to feel that kind of loss again so don’t let themselves get close.

Some people believe (consciously or unconsciously) that moving on means disrespect for the child they lost. They don’t want “help” because they feel that it would be in some way abandoning the child.

No. I don’t think you are wasting your time to try to support a man who is in this much pain. Your baby is only a month old. Standing by him now may mean that you can yet make a family. If you love him, you need to be patient and you need to get some practical advice. Please consider finding a therapist, not because I think you are ill but because I think this situation would be difficult for anyone. A therapist can give you the support you need and can help you figure out what to do. Once the therapist knows you and your story, she or he can also invite your boyfriend to join you in a few sessions. Sometimes this is a way to show someone that help is actually helpful.

It’s unlikely that you can commit your boyfriend unless he is actively suicidal. It would be far, far better for him to face his pain and accept some help. I hope you can talk with him lovingly and gently. I hope you can let him know that you understand how overwhelmed he is feeling and that you want to be with him in his grief. And I hope the two of you will seek out some counseling to help you through this difficult, difficult time.

I wish you well.
Dr. Marie

June 6, 2009 0 comment

Husband in military wants a divorce

by Dr. Marie Hartwell-Walker December 30th, 2019

written by Dr. Marie Hartwell-Walker

My husband is in the military and under a lot of stress right now, and I fear it may be having a very negative impact on him. For years now he’s been really detached from everything. He has no friends, he doesn’t do much with his life. He works and he plays World of Warcraft and that’s about it. He was a completely different person when we first got married. He hadn’t been in the military very long, and he was very full of life. He had hobbies and friends. He enjoyed getting out and doing things, but the more time he spent in the service, the worse he became.

Eventually he just stopped doing much of anything. He stopped talking to friends, didn’t spend as much time with his family, even his hobbies seemed to be slipping. I didn’t think anything of it at first, but maybe I should have. I figured it was just stress and it would go away eventually.

He’s seeing a therapist, but I’m not sure how often. I remember him saying once that they’d said he had OCD and had suggested that he might be schizotypal. He’s told me several times that he feels like his mind is splitting and thats why he has mood swings. One minute he’s friendly and caring, and the next hes very cold and distant. Naturally I was concerned, but I have no idea what to do.

We’ve been married five years (just had our 5th anniversary yesterday). We haven’t seen each other in two years due to him being in the service, though I did see him for two weeks over Xmas break. During that two weeks things seemed fine. We spent time together and we had fun and he seemed very in love with me. A few weeks ago he called me out of the blue to say he wanted a divorce.

His reason for this has changed several times. First he didn’t love me anymore, which I just can’t believe. Then he felt trapped and wanted to be free. Then he wanted the chance for us to start over fresh and correct past mistakes. Then I wasn’t the kind of person he wanted to be married to. He wants someone with a good work ethic, and I admit that mine is severely lacking, but I’m making up for that now. I’m fixing my mistakes, but I’m still concerned for him.

He won’t talk to me because he says talking to me hurts him. When he thinks about the good times and leaving it all behind, he feels hurt. To me, and I may be wrong, that says that he’s not sure that leaving is the right choice. But he’s avoiding his feelings. He’s cutting himself off from everything. I feel like he’s trying to shove the issue and his feelings under a rug, in hopes that they will just go away. As long as he avoids talking to me or talking about our relationship, he doesn’t have to face the fact that he may not be making the right choice.

I believe his detachment from everything is one of the (if not THE) key factor in the downfall of our relationship. So now I don’t know what to do. Do I just sit here and let him deteriorate even more and let what’s left of our marriage (as well as our friendship) fall apart completely. Or do I do something about it? I realize I can’t force him to stay with me, I’m just worried about his detachment. Not just from me, but everything. I don’t know who to voice my concerns to about it. I have no idea who he’s seeing, and there’s no way for me to find out. He wouldn’t tell me, and due to confidentiality, I can’t find out anywhere else.
What should I do? He doesn’t want to talk to me, and if I tell him I’m concerned, it may just push him further away.

Your husband sounds significantly depressed and perhaps at risk for hurting himself. He may be pushing you away in the mistaken idea that it then won’t matter to you. Military life takes its toll on people whether or not they are in active combat.

I strongly urge you to call the chaplain connected to his unit and share what has been going on. Please don’t be concerned about your husband being mad at you for interfering. Better to live with “interfering” in a way that might help him than to live with not doing so and having something happen to him. The rules of confidentiality allow for you to share information even if the person you are talking to can’t give you details in response.

You may also find some help for both of you at this website:

National Military Family Assn

Military life can be hard on the whole family. If you haven’t done so already, I hope you will reach out to a military family support group in your area. Your problem is not unique. Other spouses left behind can help you feel less alone and give your you practical advice.

I wish you well.
Dr. Marie

March 2, 2009 0 comment

How Does Pregnancy Affect Women with Schizoaffective Disorder?

by Kristina Randle, Ph.D., LCSW January 30th, 2020

written by Kristina Randle, Ph.D., LCSW

Q. A year and a half ago my sister was hospitalized because she suffered from a mental break down. The doctors never gave her an exact diagnosis. They said that it appeared that she was suffering from schizoaffective disorder. She was released from the hospital and sent home with medication that was supposed to help her condition. 2 weeks later she stopped taking them and she was sent back to the hospital.

Home again just a few weeks later she seemed to be more clear, not 100% but a huge improvement of how she was only weeks before. She began going to a Community Mental Health Center and was seeing therapists. She decided that she no longer wanted to take the meds that had stopped the hallucinations and voices because she was better and meds made her sick. She stayed on an anti-depressant.

Months later she is better. Clearer than ever and going to school. She still makes irrational choices, never understanding consequences and seems to lack sympathy for anyone but that is how she has always been. Then, last August she found out that she was pregnant and the baby is due any time now.

Thru her pregnancy she has been extraordinarily clear. I feel like I got my sister back for the most part. The father of the baby is not in the picture but she seems generally happy about life. She reacts to stress better now and she is more caring of others.

My question is, is she only better because of the pregnancy? I heard that sometimes because of the hormones, that it can help a person with mental disorders but as soon as the hormones are gone and the stress of having the baby sets in the person gets worse than ever. Is that possible? Is it possible that she does not have schizoaffective disorder and it was just a mental break down? How can I tell the difference and what can I do to help her? I truly appreciate all of you advice!

Thanks for your question. It is possible that a woman can feel or act differently (in this case, better) while pregnant. It could be just as you mentioned; the hormones contribute to the change in personality or behavior.

Generally, people with schizoaffective disorder have difficulty handling stress. Pregnant females with a schizoaffective diagnosis are at a greater risk for psychiatric complications during and after pregnancy. How well your sister will handle the stress associated with pregnancy is difficult to know. The truth is only time will tell.

There are plenty of cases in which women diagnosed with schizoaffective disorder remain stable during pregnancy. But there are also mothers-to-be heavily impacted by the stress of a baby, to the point where psychosis during pregnancy develops, or a postpartum depression or psychosis erupts after the baby is born.

The fact that your sister has already had a psychotic break does mean she is at an increased risk for a future break. You said she also stops taking her medication because she thinks she is better. Medication noncompliance can and often does lead to future psychotic breaks. It is very common for people with schizoaffective disorder or schizophrenia to stop their medication because they “feel” better. It is important, however, that she’s encouraged to take the medication because taking it consistently is one of the most effective methods of preventing future psychotic episodes.

I also want to point out the fact that your sister was diagnosed with schizoaffective disorder and this likely means that she has had other psychotic episodes. A schizoaffective/schizophrenia diagnosis can technically only be given if there has been more than one psychotic break.

You asked whether your sister really has schizoaffective disorder. I cannot know for sure but the fact that she was diagnosed means that it’s at least a likely possibility. Also, you wrote that she “makes irrational choices, never understanding consequences and seems to lack sympathy for anyone but that is how she has always been.” These are some of the hallmarks of schizoaffective/schizophrenia disorder.

Please keep in mind, however, that I could never make an accurate diagnosis over the Internet.

As for your role, try to be very supportive and also encourage your sister to stay in contact with her doctors and therapists. Most critically, and a point that I cannot stress enough, she needs to take her medication consistently, not just when she feels like it. Medication is essential in the prevention of future psychotic breaks. If she has help and support from you and other family members, and stays on her medications, there is a very good chance she can remain stable. Please write back if you have any further questions.

May 5, 2008 0 comment

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