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Mood Disorder

I’m Not Good Enough to Keep My Mom from Being Depressed

by Holly Counts, Psy.D.
written by Holly Counts, Psy.D.

I’m 15 years old and I’m an only child. When I was 10 I found out that when I was two my mom had suffered from depression, my dad said it was because she was pregnant and then had a still born baby on Christmas Eve. However very soon after my parents talked to me about that my mom lost her job and was out of work for two years. She started changing, she was gaining a lot of weight and would cry all the time. All my life she had been able to sleep a lot but once she lost her job she wouldn’t get out of bed for days. Once she got a new job she seemed “happier” but then she became obsessed with work and likewise obsessed with my schoolwork. It was unacceptable if I got a B, it wasn’t “good enough.” However even though she had a job she would sleep all the time and would always be crying. It got to the point that between work and sleeping she didn’t have time for any of the normal mom things. She stopped doing laundry, cleaning, coming to my basketball games, and so I picked up her slack. Ever since I’ve been doing all my families laundry, cleaning the house, planning out what we need from the grocery store every week and if she ever offered to for example do the dishes so I could go to bed I’d wake up the next morning and they wouldn’t be done. Whenever I would talk to my dad about her he would say that that’s just how she is now because of her brain and that whenever she freaked out on me to not take it personally. Recently me and my mom were driving to Pennsylvania to visit family and she had a panic attack while driving she swore that the truck drivers were out to get her so she pulled over for an hour trying to “clear her head”. Also every time I try to talk to her about a problem with a guy or anything she turns it into her problem and I always end up holding her while she can’t stop crying. All of this started, because she lost the baby and after she lost the baby it was like I wasn’t good enough for her. I wasn’t a good enough reason for her to try to get better I wasn’t good enough to keep her happy I wasn’t good enough for her because I got a 92 in biology and “ruined my chances of going to a good college.” If I’ve never been good enough for her then how can I be good enough to help her? (age 15, from US)

Reading your question breaks my heart for all of you. Your mother’s depression is not your fault. It has nothing to do with whether or not you are good enough. Depression is a real issue that no one can cause someone else to have. Would you blame yourself if she was diagnosed with diabetes?

Losing a child is one of the hardest things people can go through and it sounds like what may have started as grief, or post partum depression, has turned into clinical depression and anxiety. These disorders can affect your not only your mood, but also sleep, thinking, energy level, and even how someone perceives the world. As hard as it may be, you have to not take the things your mother says or does (or doesn’t do) personally. It is about how badly she feels and she may be projecting this onto you without meaning to do it.

You should not be taking on adult responsibilities within the house. It’s one thing to do some chores and help out, but it’s another to run the household. You need to focus on school, friends, hobbies and age appropriate activities. It is not your job to take care of anyone else.

I strongly suggest that you ask to go to family therapy. This is all too much for you to handle without an ally and guide. A therapist can help rebalance the family and provide a safe place to talk about feelings. All of you would also benefit from seeing someone individually as well. Talk to your father about therapy soon, and if you need some extra help with this, you might consider speaking with your school counselor or doctor first.

You are a strong, caring person. You are good enough just the way you are. But, it’s time to be a kid.

All the best,

Dr. Holly Counts

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What’s Wrong with My Husband?

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

From the U.S.: I am so concerned about my husband & am wondering if maybe he is suffering from something more than a usual bout of depression. its pretty consistent nowadays. Usually, in the mornings he is the happy, optimistic, loving husband I fell in love with almost 30 yrs ago. but then come the late afternoon he does a 180 & gets grumpy, apathetic & is basically a real jerk & hard to be around! then he gets down, he’s sorry & keeps apologizing. And somehow I end up feeling like its all my fault when really I can’t get my head to stop spinning from trying to figure out what in the heck just happened!

Invariably he says things like, “Why do I get like that?” And keeps saying he’s sorry! I love him very much, as do our 2 daughters but we all walk around never knowing from one minute to the next how he will react to any given thing & usually whatever it is that has him upset at the moment is something that he blows out of proportion. Also, he is VERY passive-aggressive! Its like that nearly every day!

Both of our daughters have anxiety issues & take medication along with seeing a therapist, (which I believe is somewhat due to his behavior. He’s been like this to some degree for years now but this past year it seems to have gotten way worse!

Please understand, he really is a kind, loving soul…but something just isn’t right! And he gets so apathetic! I am an optimist, he says I’m the only one who can bring him back to earth with my happy attitude! I’m positive he could benefit from some kind of counseling but I doubt he’d go! This past summer he had a real bad cold & he wouldn’t go to the Dr. Then he started having chest pains & only after he had been having them all throughout the week & then on Friday he was hurting so bad it put him on the floor! I THREATENED TO CALL 911 & FINALLY HE AGREED TO GO!

So you can see how hard it will be to get him to see some kind of therapist for himself! If it was for one of us he would happily go, but not f or himself. is he just depressed or something worse?

I’m concerned that this is relatively new behavior. I’m also very concerned that he seems okay in the morning and things fall apart in the afternoon. That suggests that it is exhausting for him to hold it together for the whole day. It also suggests to me that this is a medical problem, not a psychological one.

I think you should start by insisting that he see his medical doctor. Go with him. Explain the changes in his behavior over the course of the day to the doctor. Your husband probably cannot report the changes in his behaviors and mood accurately. It’s possible that you are seeing a vitamin deficiency, thyroid imbalance or even the beginning of one of the dementias. Please don’t let the possibilities scare you into not seeking medical advice. It is better to find out early. It’s just true that early intervention often matters — a lot.

I wish you well.
Dr. Marie

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My Family All Hate Me Because of My Moods, It Seems that I Just Can’t Be Happy

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

Hi, Here is my issue, I seem to be able to go to work 5 days a week and function (for the most part) fine. However when I get home all I want to do is NOTHING. I have no pleasure in anything at home. Almost every weekend I lay on the couch and say very hurtful things to the people that love me (It’s like I want them to hurt like I hurt)!!! All I want is to be happy and NORMAL, my kids hate me and I don’t blame them. My husband sticks with me and I feel so bad for him because he deserves so much better.I am on wellbutrin at the moment, I have been on so many different drugs and nothing helps.I feel so empty and lost and can’t get motivated for anything. I have let my family down so many times and I just want to be HAPPY can you please help me, there have to be other people out there like me. My Dr. doesn’t know what to do with me, I think he thinks I’m nuts.When I get like this I just want to be alone…PLEASE,PLEASE can you help me so I can help myself?

I have helped many people with symptoms exactly like yours. I am not unique in my ability to help people. Somewhere, most likely within 25 miles of where you live now, there is a therapist who can help you. I can answer your questions over the Internet, but I can’t treat you over the Internet.

The most important thing for you to remember is that there is a therapist, close to where you are right now, ready and willing to help you. You need to open your phone book, do an Internet search, and begin your inquiries. Ask to speak to the therapist and read to him or her, a list of your symptoms. This should promote a dialogue between the two of you. Thank this person for his or her time and then call the next one on the list. When you have finished with all of your calls, you’ll find that there will be a few therapists that you did not like at all and there may be one or two that you seemed to “click with.” Studies show that it is this latter group of therapists who are the most likely to help you.

Carl Jung believed that depression was simply the conscious mind being forced into closer alignment with the unconscious mind, where the roots of consciousness and the beginning of the pathways of consciousness exist. This pathway of growth, he termed individuation. It is similar to Abraham Maslow’s concept of self-actualization. You may be interested in reading more about both topics.

You are able to function at work but do not feel emotionally well at home. Your specific circumstances would be highly suggestive to me of the need for talk therapy. Some people take the route of talk therapy others take the route of medication and some do both.

I hope you will take my advice and I wish you the best of luck.

Dr. Kristina Randle

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Do I Have Borderline Personality Disorder or Am I Just Overreacting?

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

From Sweden: I apologize in advance as I know this question has been asked, but I feel like I have not gotten the answer I’m looking for.

What leads me to suspect I have at least traits of BPD:

-Impulsivity: I have been impulsive since I was a child.I binge-eat, (purge), I’ve had unprotected sex, impulsive romantic interests, I chose what I wanted to work with on impulse, it’s hard to stop the impulsivity, etc.

-Fear of abandonment: If my friends are short with me; if they don’t pay attention to me; if they text without smileys; if my girlfriend doesn’t reply to my texts fast enough; if people don’t laugh at my jokes, I’ll be convinced they’re leaving me. I’ve pulled and clung to my friend so she wouldn’t “leave”.

-Identity crisis: I have no idea what I want to do with my life (granted, I am only 18 years old!) but one day I want to work with something, the next day it’s something completely different. One day I’ll say I believe in something, the next day my view is changed.

-Emotional instability: Sometimes I have intense mood swings where I am very frustrated/irritable and then laugh and cry hystercally without any warning. During those times, I talk too fast, and I make no sense. I say things I don’t mean. And I can be cruel. Other times, I feel empty.

-I idealize people when I first meet them and then after a while, without warning, I have this intense anger and hatred toward them. It’s over trivial things, too. I will “hate” my girlfriend for nothing and I’ll be moody/passive aggressive or quiet around her and then other times I will be completely in love with her and never want to break up with her.

-I took the tests on this site and both of them tell me BDP is [severely] likely.

Things that lead me to believe I do not have [traits of] BDP:

-My friends say I’m overreacting
-I am not paranoid
-My relationships have been intense and quick, but not unstable in the sense that we fight a lot.
-I have difficulty controlling my anger SOMETIMES, like most people I would think
-I perceive people with BPD to be more unstable than I am (perhaps this is ignorance on my part)

Does it look like I have traits of BPD or am I overreacting?

 Thank you for asking. It looks like you have done your homework on BPD. While it would be inappropriate for me to make a diagnosis, the important thing is that you have identified the symptoms that cause concern. It is important to remember that you have the same collection of indications whether or not you are overreacting on a regular basis — or meeting the criteria for BPD. A diagnosis can be helpful in finding the right treatment, but often a list of symptoms doesn’t fit neatly into a categorized diagnosis. I think the best way to move forward is to make an appointment with a psychologist or psychiatrist. He or she will be able to help put together a treatment plan for the symptoms, which is the main goal.

Wishing you patience and peace,
Dr. Dan

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Had Constant Mood Swings Since I Was Young

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

From the U.S.: Since young I had constant mood swings and extreme emotions. I said things that weren’t logical or had any sense at all. Most of the times I’ll get so mad I’ll hit someone or say horrible things to them. Had problems with self harm and people thinking that something was wrong inside my head.

My family always told me the same thing over and over. They said they didn’t know what was wrong with me and tried to take me to a psychologist, but it didn’t help at all. I’ve passed through depression too. My wise family said I never had nothing in between, never had a balance. It was either black or white they said. No in between. That’s why they thought and still think my emotions are extreme.

Personally I don’t notice when I’m acting this way, I just don’t notice it. Most of the time out of my head I apparently “see” things that aren’t there, but maybe it’s just my mind. I’m mostly bored all the time. Everything gets me bored easily.

I’m sorry if what I’m saying doesn’t have sense, I’m really sorry.

I guess this is due to a bad childhood. I didn’t really have any friends and used to bother other people a lot. Bother them in a physical way hitting them or anything else related, I can’t remember clearly. In elementary I didn’t have any friends, it seemed like there was one person, but they always backed of or left me aside.

During middle school it wasn’t the same, people ignored me even more and I didn’t have friends. As a result I talked with myself and responded like if I was with someone else. That was my way of not getting bored. I still enjoy taking to myself. My mother got scared every time I talked alone and claimed that I was “crazy”. I didn’t really notice my extreme emotions or mood swings until my family told me. I could go from being really happy and joyful to a crisis moment, and I’ll laugh when it wasn’t really meant to. Most of the times when I was crying I started to laugh and felt really happy, then went back to feeling awfull and continue crying. If I had to do a resume then it’s: Mood swings, extreme emotions, talking ilogic things, taking to myself and seeing things that aren’t there.

Although you’ve provided me with a description of your distressing feelings and behavior, you didn’t ask a question. All I can do is respond with what I think you need to know — which is this:

Just because therapy didn’t help at one time doesn’t mean that it isn’t helpful. You just didn’t find the right helper for you. Clearly you are troubled. Clearly you have difficulty making friends and relationships, dealing with your volatile emotions and idiosyncratic behaviors. You may be correct that this all started with the bullying in school, but you haven’t been able to end it. If you could have talked yourself out of the problems, you would have done so long ago.

Please. Listen to the people who love you. They are right to be concerned. They are doing their best to give you solid advice. But they can’t make you help yourself and they don’t have the skills to help you learn to control your moods or behavior.

Make an appointment with a therapist. If you don’t like what is happening in the first few sessions, talk about it. Maybe you and the therapist can adjust how your sessions are going. Maybe you need to look again for someone who is a better “fit” for you.

I wish you well.
Dr. Marie

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I Have Relationship Obsessive Compulsive Disorder

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

…I think I have it because I became obsessed if I love my girlfriend or not.

I performed also compulsions to check if i feel for her or not. During one month I had also one episode of anxiety because I dont wanted those thoughts and I fear my mental health. Intrusive thoughts are for my relationship and for my mental health.
While I was searching in internet for solutions about my problem , I came across with some sort of study that says that people with OCD can later be diagnosed with schizophrenia . Now above all my fears this is the biggest . I think I can avoid anxiety but I am very afraid for my mental health. Intrusive thoughts and this fear I am having is the worst thing that I have experienced so far . I want to overcome it , I will talk with a therapist and I am also practicing mindfulness ,but I didn’t needed another fear like schizophrenia. Can you help me please?

This is precisely the problem with untreated anxiety. It breeds more anxiety. Normally, research and information can be good for learning and understanding. With most any other problem, learning more is a good thing. However, that is not necessarily true for people with untreated anxiety. They tend to become more anxious as they learn more information about their condition. Perhaps that’s because anxious people tend to fear the worst-case scenarios. They tend to latch onto extreme ideas which then become a source of even more anxiety. In this case, perhaps less information is better than more information.

As I’ve said many times, in this column, one of the most common questions that I receive comes from persons with untreated anxiety, who research anxiety and come to believe that their symptoms are indicative of schizophrenia. It is one of the most common fears among people with anxiety. That is possibly because schizophrenia is a very severe and misunderstood disorder.

Schizophrenia and anxiety are two very different disorders. Schizophrenia is a thought disorder that involves having breaks with reality. Having a break with reality means that you can no longer determine the difference between reality and non-reality. It’s a very disconcerting and frightening experience. Only about 1% of the population has a diagnosis of schizophrenia.

Anxiety is a mood disorder. Individuals with generalized anxiety disorder (GAD), for instance, experience chronic worry about many issues. This can be an unpleasant state of being since the anxiety tends to be fairly broad and consistent. Uncontrolled anxiety tends to worsen over time. This out-of-control feeling can make people believe that they have a more extreme condition like schizophrenia.

People with schizophrenia hear voices and see things that aren’t there. The voices they hear are not their own. People with anxiety tend to hear their own voice. People with schizophrenia hear the voices of other people. That’s a major and important distinction. If you’re hearing a voice that is your own but it’s simply saying harsh things about you, that’s likely a sign of anxiety. If you’re hearing voices outside yourself, voices that you don’t recognize, who are saying mean things about you, that may be indicative of schizophrenia.

Nothing you’ve written in your letter would indicate schizophrenia. Please do not mistake that statement with a diagnosis. It is impossible to provide a diagnosis over the Internet which is why I always recommend an in-person evaluation. Much of what you’re concerned about has to do with whether or not you love your girlfriend. That type of worry is more consistent with anxiety than schizophrenia. If, you thought that your girlfriend was an alien from another planet, who was here to harm you, then you might be demonstrating ideas consistent with schizophrenia but that is not the nature of your issues. You are concerned about things that seem wholly in the realm of anxiety and not schizophrenia.

The best solution to this problem is to consult, in-person, a professional. That can make all the difference. Professionals receive training about how to treat mental health problems like the one you have described. Anxiety is something they know how to treat. They can help you. I hope that my response convinces you to seek professional help. There’s no reason to suffer with treatable problems. Please take care.

Dr. Kristina Randle

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How Do I Know If I Still Need Therapy?

by Julie Hanks, MSW, LCSW
written by Julie Hanks, MSW, LCSW

I am a married woman of 24 years with 3 grown children.  I have had a pretty rough past and struggled with mental illness most of my life.  I grew up in a very dysfunctional violent family with an alcoholic parent.  I was abused and neglected.  I attempted suicide at the age of 17.  Through the years I buried my past and attempted to live a normal life.  I did not have an identity, I did what everyone wanted of me, and even believed the beliefs of the people around me. I was an empty shell being filled up by other people.  I had another breakdown in 1999 and attempted suicide again.  That is when I began therapy.  It took me a realy long time to open up to my therapist.  It seemed I got much worse before I got better.  I began cutting and binge eating became  a huge problem.  I had always coped with food but now it brought my weight up to 322lbs.

As the years went by, and with medication I began to slowly deal with issues and start to rise out of my depression.  I trusted my therapist and told her things I would never tell another soul.  I was getting better and I decided to improve my life. I had gastric bypass to lose weight and in the past year I have lost over 120lbs.  I was using good coping skills and having more rational thoughts.   Unfortunately my bones suffered from the weight and degenerative bone desease.  This past October I had a total hip replacement and this past February I had a total knee replacement. It has not been 2 months yet and it has been a slow painful recovery.

My therapist retired this past December.  I do not have a regular one yet, although I did meet with one just one time to feel it out.  I am unsure if I need to stay in therapy.  I have been in it for a very long time and although I am better than ever before, I still have depression and dysfunctional thoughts.  I am still on medication, Wellbutrin, Lexapro and Neurontin for mood disorder.  I have been labeled as PTSD and BPD. I am starting to binge eat again and I am afraid the gastric bypass will be worthless to me someday.  I do not want to gain all that weight back as I could hardly move then.  I feel very sad that my therapist retired and I feel pretty lost right now. Is it normal to be in a therapy program for as long as I have been? Do some people stay in therapy all of their life?  I feel that I will never get out of this dysfunctional rut. Is there hope for me? I am very tired and very afraid to live this way.  I just want relief and to feel a bit of satisfaction in how I live.  I appreciated any input.
Thank you 🙂

What a brave women you are to have faced your past trauma and to have actively sought treatment to move toward a healthier and happier life. I can’t imagine how difficult it must be to have your therapist retire after working so hard to develop enough trust to open up and share things you’ve never shared with anyone else. It is very normal to feel lost, sad, and to grieve the loss of this therapeutic relationship, just as you would if you said goodbye to a close friend or family member. I imagine that finding a new therapist and developing that trust again is a scary thing to consider, but a necessary one.

Some health problems, like diabetes, are chronic and require lifelong attention, management, and treatment, while others are acute, like strep throat, and generally require one course of antibiotics. Mental illness can be conceptualized in a similar way. Your mental health history, your history of abuse and neglect, and your psychological symptoms seem to fall in the chronic category. It is common for individuals with severe childhood abuse and neglect to be in treatment on and off throughout life to help manage the emotional and psychological consequences of the early experiences.

Your continued struggles with dysfunctional thoughts, depressive symptoms, and binge eating suggest that you need to get back into therapy to maintain the progress you’ve made and to continue to develop coping skills and insight. You may in be in treatment throughout the rest of your life. If that’s what you need to continue to move forward, to manage your symptoms, and continue to create the life you want, then that is nothing to be ashamed of.  You deserve to have nurturing and support.

Take good care of yourself!

Julie Hanks, LCSW

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Moods swinging violently from hysterical to listless

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

I have very little memory of how I behave from day to day with no control of my mood swings.

As a background, I was made redundant almost 4 months ago, and have since been finding it very hard to find another job. At around 19 (I am now 25) I was diagnosed with depression, and placed on medication, the dose of which went up for some time. I attempted suicide twice, but seemed to be over this from around the age of 22, and have had little trouble with it since, and other difficult periods in my life (similar to the stage I am at now) have not caused my moods to change so. I live with my boyfriend of several years, who has tried quite hard to deal with my moods, but is understandably now suggesting that I get some kind of professional help.

Recently, I have found myself to spend much of my time feeling helpless, listless, unwilling to leave the house, finding it difficult to make simple phone calls etc. I spend a lot of time alone during the day, and understand from my previous episode of depression, that these are classic symptoms. However, unlike during my previous experiences with depression, my moods tend to vary dramatically between this “depression”, and hysteria, frightening anger, hyperactivity and fitful tears. None of this I have any control over. I have considered the possibility of a mood disorder, but my more “manic” episodes do not last for more than a few hours at a time, and I do not tend to spend wildly, or engage in outrageous behaviour with strangers- I am still quite insular. My hysteria is primarily aimed at my boyfriend and close friends and family. I also have prolonged periods of “normal” feeling and behaviour, thankfully, where I can look back at my actions, and see how irrationally I have behaved.

One major concern, and a huge cause of disharmony in our lives, is that I seem to have little or no lasting memory of how I have either felt or behaved. My boyfriend will suggest that I have been behaving hysterically for 5 of the last 7 days, and I will only remember perhaps one incident, and almost never remember what it was that caused the argument (which is the outcome of many of my irrational moments). I have been insisting for some time that my boyfriend must have been making up some of these arguments, or that he must be doing something, something I have been unable to put my finger on, in order to enrage me so. His constant insistence that he’d “done nothing wrong” seemed to upset me more, as I could not believe that I was reacting like this without provocation. Of course, my rational side realizes that he doesn’t have any reason to make me feel like I am insane by making this up.

When I am in one of these hysterical moods, I am always fully confident that I am right- that whatever wild point I’m making is correct.

I am still not sure whether I am depressed, but for some reason behaving like a spoiled, crazy toddler, or if there is something more wrong? I would like to get help, but it takes so long in the UK, and when hysterical, can’t organise myself to get to an appointment, and when miserable, am very reluctant to leave the house, or even call to make an appointment.

I am sorry that you are feeling so unsteady emotionally. The mood swings sound like they are very disregulating and I appreciate the opportunity to respond.

Three things jump out at me right away. The first is that you seem to have a boyfriend in your life that really cares about you and wants you to feel better. This is a very good thing, and I would draw on this relationship to help you get to a better place. I would ask him to help you by planning a time for him to be with you to make the call. I do know that in the UK the appointments can take time, but I also know that nothing will happen if we don’t get one nudged onto the menu. Ask him to help you make the call.

Secondly, I would make the call for a psychiatrist to do the evalation because my guess is that you want someone with experience in prescribing medicine for mood swings. Naturally I am a proponent of talk therapy, but my guess is that to make the kind of changes you want both medicine and therapy will be necessary.

Finally, I would start keeping a journal. A brief daily journal that would allow you to write down both what has happened (this will help with your memory,) and what your feelings are –so the psychiatrist might be able to discern if there is a cycle or a pattern to your mood swings.

I think if you take these steps you may be able to find out what is underneath all of this.

Wishing you patience and peace,
Dr. Dan

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