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Is it normal to be depressed after sucess?

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

Q. Hi,I am an artist. I would say that I am pretty successful by most people’s standards and my work is received well. However, my profession is high stress, low on monetary security, and needs a strong ego. I worked a lot at my art. I gave it the time that it needed so I can be relatively secure in what I was doing and to get some kind of financial stability. The sad thing is that I have no real personal life, apart from a few really good friends which I cherish. I have been to therapists over the year to try and get some kind of balance but the reality is that my work cannot happen without 100% commitment and I don’t want to change my job. It gives a sense of who I am and that’s important to me. Anyway, the problem is this, and it may be a common problem for artists, I finish a successful art event and fall into a deep depression. I hide out at home, not answering the phone, letting laundry pile up, feeling … scared, overwhelmed, worthless. Is this weird? Or is this just the normal after effect of an intense involvement with something over a long period of time? Do other people get this? I have tangible proof that I am well-regarded but my life feels lonely after spending so much time intensely creating with a bunch of like-minded people. Any insight you might have would be appreciated.

Your life is out of balance. You have identified your weak areas. It is not enough to recognize a mistake and do nothing about correcting it. Many famous artists suffered from mental illness. The art became the outlet for their pain, a release for their emotions. Your art likely has acted as an escape from other problems or undeveloped areas. When immersed in your art you simply did not have time to dwell on other aspects of your life. You can have both and should have both, a good life and your love of art. I would suspect that you simply have not found a good therapist. The public tends to judge therapists by the degrees that they hold and the schools that they have attended. This would be like saying that the quality of art produced by any one artist, should be judged by the art degrees he holds and the status of the art school that he graduated from. I think we both know that the art itself stands apart from the degrees that an artist holds. I believe there is no correlation between art education and the art work itself. Likewise the quality of the therapist is based on more, much more than the degrees that he or she holds. A talented artist is indeed the talented therapist. Good luck. Keep trying therapists until you find the one who can help you. I really believe you will know this therapist after one meeting with him or her.

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Looking for LGBTQ Drug Rehab

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

Discharged from US Navy in 2001 “as a covenience to the government” and diagnosed with Borderline Personality Disorder w/Schizoid Features. Went home and started using meth on a regular basis, soon selling drugs to support my habit. Busted with two ounces of cocaine in 2001 and sentenced to 5 years intensive probation and a class 2 felony. After failing a number of drug tests, I was arrested for violation of the terms of my probation and stayed in jail for five months until a bed at a local state run drug treatment facility opened up. Stayed clean after graduating the program for 2 and a half years. The day I got off probation, I began using again like I had never stopped. In March of 2011 I was pulled over for driving on a suspended license and arrested. I had 1.75 grams of meth in my right pocket. On December 5th, I was sentenced to Drug Court Probation. I drop six times a week and go to alot of recovery related groups through my mental health care provider. I am waiting once again on a bed at the same state run drug treatment facility. I am pretty sure that you folks can’t help me, because to get quality drug treatment for the most part you must have lots of money.

I want to know why there are not more gay/lesbian oriented treatment centers in this country? If it’s the last thing I accomplish in life, I will complete treatment again, get my master’s in clinical psychology, and open a much needed drug treatment center targeted at the gay population and make it affordable or an option for anyone who wants the help.

In addition to BPD, I am diagnosed with PTSD and Severe Depressive Disorder and Bipolar NOS. The latter conditions developed most likely as a result of my substace abuse and failure to get help for BPD. When I was a child my dad’s girlfriend molested my brother and I and made us do horrible things to one another cause I guess it got her off. My mother got sole custody, married the Grand Dragon of the KKK in our city and we moved away.

My stepfather caught me with another little boy when I was maybe seven and decided he could cure me of my homosexuality type behaviour by making me take off all my clothing and throwing me outside the front door of our home in a suburban neighborhood as I cried and screamed and pounded on the front door to be let back in. Within a few minutes I had attracted the attention of some kids on bikes who began to throw rocks and laugh at me. It was bad..whenever I had a sexual thought about a boy after that I would punch myself in the head and hope it would go away. I never really accepted my sexuality until leaving the Navy at 23. And as much as I want to believe I was born gay, I will always wonder if that sick b who did that to me and my brother is the only reason I am gay. It just makes sense that gay themed treatment centers would be better for someone like myself to successfully recover.

You’re right that having a therapist who you feel understands you is key to successful treatment. I applaud you for wanting to use your own experiences to help others. Needless to say, you need to get yourself together before you can be successful.

The kind of center you wish for may not be available but there are certainly good therapists who can relate to you. Go to this link to find gay-friendly treatment.

Terrible things were done to you when you were a child. They undoubtedly had impact on your sense of self and your ability to deal with the world. It’s likely that your history of drug abuse is at least partly an attempt to self-medicate in order to get away from the pain. But as you’ve already found, it doesn’t really work. It may make you feel better for a time but it is getting in the way of longer-term peace of mind and success in life.

I hope you can find the inner strength and the outer supports to finally get substance abuse out of your life and to do the therapeutic work you need to do. Don’t let the lack of an LGBTQ center become the reason you don’t do it. There are good LGBTQ therapists in your city who can help you put together a comprehensive treatment program.

You still have well over half your life to go. With the right help and with personal commitment, you can make the next half better.

I wish you well.
Dr. Marie

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Losing my pastors; losing my anchors

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

This is probably a stupid question, so thank you so much for being willing to use your time to read it if you do. I used to hurt myself. I mainly bit or pinched myself until I started trying to stop and found way more ways to hurt myself. It almost never drew blood, but bruising or picking off skin was not uncommon. Anyway, I did it to take away stress, and to drown out physical and emotional pain. I also did it to punish myself for mistakes.

It has been almost a year since I started trying to stop, and it will be one year on April 10 since I hurt myself, but the desire to hurt myself is still really strong sometimes. It has especially been bad recently because my grades are not very good, and I had been denying the reality that the youth pastors at both my churches are leaving at the end of the year, and I got reminded of it.

It scares me because one of the churches I have been going to since I was about 3 years old, and I probably will not get to go back when the pastor leaves so I will lose all those friends. The other one is the first person who I told about hurting myself, and also the first person who made me feel like I belong at the other church.

I am afraid that this stuff will be ‘too much’ and I will hurt myself again. How can I make these desires go away? (I guess I should probably say that because I was not doing anything really harmful that there are barely any people who know that I ever hurt myself, so I do not see more than a couple times a week the people who know about it.)

First, there are no stupid questions. You were right to reach out for some help on this. Teen years can be confusing and emotionally really hard. The kids who seem to manage the turmoil the best are those who either have a very stable and loving family or those who have found a “second family” in a group activity that means a lot to them. Some kids are lucky enough to have both.

It sounds to me like your pastors and your churches are central anchors in your life right now. Thinking about losing them frightens you because you’re not sure you can manage on your own. But pastors (and other significant people) move on. Loss is part of life. Treasuring the time we have with important people and keeping what they’ve taught us in our hearts is one of the things that makes us stronger.

I don’t understand why you would lose the church when your pastor leaves. Your friends there are your friends. It’s only fair to give the new pastor a chance. New people give us new opportunities to expand our support network and to learn new things about ourselves. As for the other pastor, he or she helped you face a problem. The best way to honor that relationship is to maintain your resolve not to hurt yourself.

My best advice is to keep attending the youth groups. Focus on doing whatever activities happen there. If you haven’t yet made friends, give it time. Doing things together without pressuring for more can help friendships just naturally evolve. Since you have a life of faith, practice prayer and meditation when you are stressed. Research shows that self-harm may release stress in the moment but it also teaches a person to do more self-harm. Quieter forms of destressing such as prayer and conscious breathing have longer-lasting effects with no shame or self-blame attached.

I wish you well.
Dr. Marie

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Is my wife a sociopath?

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

I have been married to a woman for thirty two years and I have been persevering with what I consider to be some very serious problems. She has a very unusual lack of and often times a total absence of empathy, sympathy and understanding for even her friends and those closest to her including myself. She is a fair weather friend. She’s your buddy until you need her help and she stands her friends up without so much as a phone call. I have seen two friends of hers at different times become temporarily bed ridden and ask for her aid at which time she completely abandoned them and never saw them again. I was ill for 9 mo’s and unable to work, She consulted a lawyer and tried to have me thrown out of the house, sick with no job. When trying to discuss a marital issue she cannot bear the suggestion that she is doing something wrong and becomes defensive, angry and sometimes vicious, so when there’s a problem then I just have to live with it. She has a very unusual lack of remorse and was very cruel to the little dog we once had.

She is attractive, fun-loving, friendly, laughs and smiles alot and I’m one of the few who really knows what she’s like. Lying is a very common thing for her also. I wish none of these things were true and would love to say I’m a lucky guy to have such a wonderful wife but I can’t. I have re-read this several times and there honestly and truthfully are no exaggerations. Does it sound like she’s a sociopath? I will be much better able to cope with all these things if i can understand. Please help me.

There must be much about her that is compelling to you to manage this for 32 years. As you know, I can’t make a diagnosis on the basis of a letter. I can only tell you that the behaviors you describe are not sufficient to diagnose someone as having an antisocial personality disorder (sociopathy) or mental illness. Of course, I may not have a complete picture so I suggest you research this more on the web. However, your wife does show some antisocial behaviors that must be very hard for the people around her to understand since they are so much in contrast to her friendly and fun-loving personality.

According to Encyclopedia.com website, “Antisocial behaviors are disruptive acts characterized by covert and overt hostility and intentional aggression toward others. Antisocial behaviors exist along a severity continuum and include repeated violations of social rules, defiance of authority and of the rights of others, deceitfulness, theft, and reckless disregard for self and others. Antisocial behavior can be identified in children as young as three or four years of age. If left unchecked these coercive behavior patterns will persist and escalate in severity over time, becoming a chronic behavioral disorder.”

One guess about her apparent lack of empathy and unwillingness to be wrong is that she is terrified of loss or loss of control and distances herself whenever either becomes a possibility. It’s a “you can’t fire me, I quit” approach to life that does fend off some kinds of pain but also costs her the closeness and intimacy that comes when people are there for each other in the hard times. Not willing to be wrong prevents a fight but also deprives her of the opportunity to grow. You’ve both adapted to her “rules” in order to stay married but your marriage is unlikely to be as intimate as it might otherwise be. I’m sad for both of you.

I wish you well.
Dr. Marie

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Boy is an old man in a boy’s body.

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

I am writing to get an opinion or suggestion. I know a 10-year-old boy who lives with his mother and little sister all the time. His parents got a divorce within the last two years.

The problem:
“E” is a 10-year-old boy with a very high IQ. He is in some special classes for smart kids. He reads a lot and enjoys science shows on TV. He analyzes everything—he cannot answer a simple question, What is your favorite color?, without thinking and analyzing the question and answer.

Word association does not work either. He does not laugh and smile like most 10-year-olds. He says the kids at school act “stupid or silly” but what he describes is being kids. He is a “what if” person, worrying about things kids and sometimes adults don’t need to worry about.

Example: he won’t play video games because he is worried about the electric bill increasing. Shouldn’t he be worrying about high scores? He told me that he read if a boy rides his bike too much he might be unable to have children. What 10-year-old thinks about stuff like that? He only plays outside or with his sister every now and then. Even if his mom is acting silly he won’t join in—having a water fight with friends and sister, he would not even go outside to watch.

I know that when he is with his dad they work on the farm, and watch the news and news shows all the time. He reads consumer reports and news magazines instead of comics. He is an old man in a 10-year-old’s body. Does this sound familiar to anyone? Any suggestions? His mother and I are very worried about his behavior. Please reply with any help. Thanks a lot.

Of course, I can’t make a diagnosis on the basis of a letter. But I really, really hope your friend will take her son for an evaluation. Much of what you say is consistent with Asperger Syndrome.

AS is a neurobiological disorder that is on the autism spectrum. People with AS have normal to high intelligence but often have significant difficulty with social skills and communication skills. Often they have a highly developed interest and expertise in one or more narrow and unusual topics. Sometimes they are overly sensitive to sensory stimulation. Changes in sounds, light, tastes, smells, etc can be experienced as painful.

Paradoxically, they often have a high tolerance for pain. Because these people are neurologically different, they often appear odd or eccentric to others. It’s very important for those around them to remember that their behavior is not intentional rudeness or craziness. They really do see the world differently.

There are certain parts of the world that are referred to as “Aspie colonies” by those who know and love these people. You will find a higher than expected concentration of “Aspies” in companies that develop computer programs or that involve highly technical skills, in certain departments on college campuses, among teenagers who are involved with gaming, etc.

AS is more difficult in childhood than adulthood since children can be very cruel to those they perceive as different. Aspie kids are often teased and bullied by their peers and seen as odd by adults. It is helpful to get a diagnosis because it gives the behaviors a name and provides parents and teachers with a direction for providing help and support. Please do a web search for more information and see if any of this fits the situation you described in your letter.

An important caution: I am only making a guess based on a letter. It is also possible that the boy is reacting to his parents’ divorce by trying to be his idea of the “man of the family” for his mom. Then again, it could be something else.

Of most importance is that you have a legitimate concern that this little boy is overburdened by something. Trust your instincts and encourage his mom to take him to a licensed child psychologist for an evaluation.

I wish you well,
Dr. Marie

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Lexapro Withdrawal. Please Help.

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

Q. I am having horrible withdrawals from Lexapro. Is there anything to help? I am a borderline personality and in a relationship for 5 years that has many ups n downs. I was taking Lexapro for about 5 months when I decided it wasn’t helping so I stopped taking it. I did my research after the fact about withdrawals. Well, I’m having them and they are HORRIBLE. I feel faint and winded when walking fast (I am in shape so thats not normal for me). Worst of all though, every little thing is annoying me to such an extent that I cried in my boyfriends car and I didn’t know why. I just felt annoyed. We tend to have stupid little fights but lately I have been so impossible. Everything is a fight. It’s made him think everything I argue about isn’t important now. I cannot stand how I’m feeling. I hate myself. I feel out of control. I have been self medicating with pain killers to make me feel elated and not miserable. Nothing makes me happy. Everything is just to the absolute extreme. Is there anything at all I can do or take to calm these withdrawal symptoms? I stopped taking them about 3 weeks ago and they haven’t calmed down much. I don’t know how much longer I can take this and I KNOW self medicating is not the answer but I’m so desperate to feel good. I don’t know what to do. If you have any advise I would really appreciate the help. Thank you!!

It might be helpful if you called your prescribing doctor about this matter. You should ask him or her whether it is normal to experience the withdrawal effects of Lexapro for three or more weeks. You should also ask about the effect of suddenly discontinuing the medication without slowly being titrated off of it and if a new medication would be helpful to you while you are experiencing withdrawal symptoms (if that is what is occurring). You need to be asking your doctors these sorts of questions.

It is difficult to know if what you are experiencing are “withdrawal symptoms” or if they are, at least in part, elements of your borderline personality disorder. You also said that you are taking pain killers as a method to manage your symptoms, “self medicating” as you referred to it. The pain killers have their own side effects that could be interacting with your withdrawal from the antidepressant. Pain medication can cause extreme mood swings and depression, much like what you have described. It is very plausible that the three issues that I mentioned, sudden discontinuation of Lexapro, the possible reemergence of your borderline symptoms and your consumption of pain killers, are all affecting or contributing to the way in which you’re currently feeling.

In addition to contacting your doctor to inquire about your specific concerns regarding your current withdrawal symptoms, you might want to also consider trying therapy. If you found a good therapist, he or she could help you deal with the many “ups and downs” of your relationship. Therapy could also help you develop better emotion management skills, help you feel more in control and may decrease your need to take a medication or rely on pain medication as a way to feel better. Pain medication is not only unhelpful and most likely contributing to your mood swings but it is extremely addictive. I understand you are desperate to feel better but pain pills as a form of “managing” day-to-day life is not working and it’s dangerous.

Borderline personality disorder is treatable with therapy and if you have not considered it you should, especially if you do not want to return to a medication-only form of treatment. Be sure to either contact your doctor, find another doctor you like or consider therapy. Any one of these options would be infinitely more beneficial to you than relying on pain pills that are dangerous and addictive. Please take care.

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Very Insecure About Myself

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

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

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

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

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

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

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

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

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

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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How Can I Overcome Depression on My Own?

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

I’ve never been to a psychologist, though i really wish to. Atleast for another year i will be unable to seek professional help since I have issues with my parents who are more bothered about their reputation since they are in the medical field and we live in a small town. From the time I was eight I’ve been having depressive issues. I used to try and supress it. i’ve been suicidal and tried to take my life more than 15 times in the last 10 years. I have all the symptoms of depression. the problem is that from the last one year i have been so miserable that it is effecting my social life(which is as good as non-existent now) and my studies. I have been molested when i was 12 and have always had relationship problems with my parents. they are fed up with me and the mess i create. i have been promiscuous and can’t stay faithful in any of my relationships with the opposite sex. im unstable and can’t stay in a relationship for long. my longest has been a year and a half. i also can’t seem to stay single at any point of time. i’ve had casual sex. though i have stopped that now. i lost my virginity at 15… i was a victim of date rape and that has left an irreversible effect on me. 6 months back i was blackmailed and then forced to sleep with three guys. my then boyfriend helped me out of it. after that i am unable to have a normal sex life…with almost no interest in sex. i really want to lead a normal life. please help me. i cry for no apparent reason and i get angry for even the slightest provocation. i was a college topper but after what happened six months back i am unable to study….i keep thinking about it.

I know that you are interested in helping yourself out of depression but I am not sure that is a wise decision. My main concern with you helping yourself is your many suicide attempts. When you have tried to help yourself out of depression in the past it seems that you turned to suicide. Because of this I would strongly advise that you see a professional.

Is there any way that you can see a professional without your parents finding out? And if they did find out, what would be the outcome? Would it be that bad? Isn’t your well-being more important than their reputation? It would be unfortunate if your parents cared more about their reputation than about the psychological health of their daughter.

Have you talked with them about how much you are suffering? Do they know about your many previous suicide attempts? It could be that they are not aware of your depression and maybe if they knew, they’d try to assist you into treatment.

Try to steer your thoughts away from thoughts of suicide. I have written about suicide often and I always tell people the same thing: it is never the answer.

People with depression often think that suicide is a good way to end their emotional pain. People suffer so much at times that for them, dying would be better than having to live with the psychological pain they have to endure. Because they cannot think of any other way to feel better, they mistakenly believe that ending their life is their best way to solve their problem.

But what if they are wrong? People assume that suicide brings relief but no one really knows this. It’s an assumption often based on desperation and impulsivity and not based on any facts or evidence. In fact, people who have had near death experiences (NDEs) after attempting suicide report having hellish experiences in the “afterlife.” What if suicide brings more pain and suffering and not less?

There are many people who have attempted suicide and lived and eventually find a way to decrease their depression. Viktor Frankl explains this idea in his popular book Man’s Search for Meaning. He recalls interviewing over twelve thousand people who had attempted suicide during his time as a doctor in an Austria hospital. The common theme he discovered among his patients who had attempted suicide was that they were happy they had lived because they eventually did find a solution to their problem. He used this knowledge to help other distressed patients as way to prevent suicide. Speaking to patients who had yet to find an answer to their problem, he stated the following: “…who can guarantee that in your case, it will not happen one day, sooner or later? But…you have to live to see the day on which it may happen, so you have to survive in order to see that day dawn, and from now on the responsibility for survival does not leave you.”

What he means is that a terrible situation can improve but you’d have to be living to know and to experience that improvement. For you, this means that because your situation might get better, as it does for so many other people, it’s your responsibility to live to see that day come.

You need to know that you can recover from depression. There is an excellent chance that you will be able to overcome your depression, with the right help.

Do you have any friends to talk to? Do you have a person in your life that you trust or who you can spend time with that can keep your mind occupied and way from suicidal thoughts? Try to find others to spend time with but as I mentioned above, I would strongly recommend that you seek help immediately.

In summary, I would suggest that you talk with your parents, consider going to a therapist even if your parents would not approve and try to keep it a secret if you have to. You have to do whatever is necessary to get better. You need help from a professional and you need it now, not a year from now. Your well-being is paramount and you need to make yourself a priority, even if that means “embarrassing” your parents. This is a matter of life or death and getting help now is more important than preserving the reputation of your parents. Please believe this because it’s true. Get help now.

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

by Kristina Randle, Ph.D., LCSW
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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Is it More Than Stress?

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

Q. Are there key signs in a persons behavior or thought process that would help determine if their issue is something more than stress? This is the issue: I have a lot of stressful things going on in my life right now, the biggest being a painful physical condition left over from an injury 5 years ago. I do understand that chronic pain almost always breeds depression, but like to think that I have kept this minimized, with the exception of one or two weekly pity parties that I allow myself as an outlet for my frustrations. Otherwise, meditation, breathing exercises, visualization and yoga keep the pain and emotional aspects as under control as I believe medications would. But I’m worried something else might be going on now.

Being unable to work and unable to get out much, I am bored out of my mind. This might also add to the problem I’m having. The problem being, I can’t seem to turn off my brain these days. I wake up thinking about something and it just runs all day if I let it. There is nothing disturbing about my thoughts…they just don’t stop. I watch TV, read a book, or do internet searches about random subjects just to give my brain something to focus on to calm it down. It seems like the strangest thing to me sometimes. Reading some of the information on your website, I thought that OCD sounded a bit familiar, but I don’t do any of the other behaviors…just the constant thinking. I’m seriously stressed about my future with this pain issue, bored with my limited life and have a serious case of cabin fever…but can these things alone make your brain run like this? Or is there something wrong with me. Can these conditions disturb a persons mental state? Or, do I just suffer from chronic boredom that my brain is trying to battle with it’s own entertainment?

It is difficult to say whether or not you are suffering from depression, OCD or from “cabin fever”. You did not mention if you had a history of depression or OCD. If you had I may be inclined to say that your current issues may be related to these two disorders. Since, however, there was no mention of this I am assuming that you have no history of either of these two disorders. Also, you did not mention any other symptoms of depression or OCD, with the exception of rumination.

Without many other symptoms of depression and OCD it would seem that you may be suffering from “cabin fever” or boredom. You’re probably not used to having so much free time. I know many people who complain of the very same problems that you mention, when they are sick; having to lie in bed suffering and feeling miserable. Many people in these situations, even after a few days, are bored “out of their minds”, feel irritated and cannot wait to return to their “normal” lives.

I cannot say with any certainly that you are not suffering with any of the disorders you mentioned. As you said, depression is not uncommon among those dealing with pain issues. It is advisable to see a doctor who can meet with you in person to determine if you indeed have either depression or OCD. My sense of your situation is you are at home, not working, are in pain and after a while, this temporary way of life has gotten “old.”

I have worked with clients who were in a similar situation with regard to not being able to work due to an accident or illness. Like you, they often found themselves having to spend the majority of time at home, not working. At first, they admitted they liked the idea of not having to work and getting to stay home. Over time, however, they started to feel not only bored but would become angry at themselves for not being able to do more. Some people remarked that they felt useless or unproductive having to be home. They felt this way even though they were forced into their situation because of something out of their control and there was little else they could do. It was helpful to remind them of the truth of their situation. That is, the reality was that for the time being, until they recovered and it was time to return to work, they had to make the best of their situation. This was their temporary reality.

As I mentioned before, you should consider seeing a doctor to verify if you are suffering from OCD or depression. Also, it may be helpful if you had a therapist or at least a friend to talk to about all of the things you are constantly thinking about. You could also try joining an online pain discussion group.

Another idea may be to try journaling. Studies have shown that people who journal feel better psychologically. Journaling also gives you a written record of your thoughts. This could be helpful in determining whether you have OCD or depression-like trends or patterns in your thinking. I hope you feel better soon. Thanks for writing.

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“Teen Thing” or Real Issues?

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

Q. I think i may have mental health issues i’m not sure. Well i’m asking this because for about a year now i haven’t felt… well right. At first i thought it was just a teen thing it’ll pass but it hasn’t and i’m scared that i may have mental health issues. I’ll go into more detail; Well alot of things have happened in my life i’ve felt alot of pain, Relatives have died, my dad had cancer, my parents got divorced and many other painful events. I hate showing my feelings so tend to keep everything inside but i really don’t think this is the best way to cope. Lately things have really got bad; death seems to dwell on my mind alot whether it’s my own, others or just the thought of death, and i have been thinking about suicide and i did attempt it once but couldn’t bring myself to do it. I live with my mum and she hates me she said she wanted nothing to do with me, she even says there’s something wrong with me. I can’t talk to her and my dad who i no longer live with has recently got a girlfriend and isn’t interested in me anymore. I tried to tell a friend once i was feeling suicidal but he just said seek professional help, but i can’t i don’t want to they’ll just ruin my life even more send me away i don’t want to go away. I just feel i have no future that my life isn’t worth living. I cry every day. I get hardly any sleep. I’ve completely lost my appetite. I don’t socialize. I just sit in my bedroom all day unless i have to go to school which i have begun to hate. I know something isn’t right but my question is what? I’m just really worried I’ll do something I’ll regret. I have an uncontrollable temper and have hurt many people in the past with it. I can really lose it sometimes. I just feel my life is on a downward spiral please help me? Do you know what could be wrong with me?

Your emotional instability and depression are understandable. You’re living with your mother who you said “hates” you and “wants nothing to do with you” and who tells you there is “something wrong with you.” You said that your father has a girlfriend and no longer has “interest in you.” You also wrote that some of your relatives have died, your father had cancer, your parents were recently divorced and that there are other painful events that have occurred in your life that you did not include in your letter. Any one of these situations or events would be extremely difficult to handle and you’re dealing with them all, simultaneously and seemingly without any help or support. This cannot be easy.

I believe that all of the abovementioned events and situations may be contributing to how you are feeling. It does not seem that there is anything “mentally” wrong with you meaning that you probably don’t have a mental health disorder. I say this because you’re living through a very challenging family situation in which you have no help and you’re reacting to what you are faced with. You are in a situation that is truly difficult to handle and you’re trying to manage it alone.

Please know, however, that there is help for you. You should go to a trusted clergyman, a teacher, a family friend or to the school counselor immediately. Tell them how you have been feeling and that you want their help. It is imperative that you stop trying to handle these matters on your own and that you go for help immediately.

You also said that your friend suggested getting professional help. This would also be a good idea. If you had a person in your life that you could go to for help, support or advice you would have an easier time knowing how to manage your emotions. You need someone like this in your life. Unfortunately, your parents do not seem to be fulfilling this role for you as they should. This is extremely regrettable because it is their job to provide you with advice and support. Because you do not have a person that you can go to for advice, you need to find someone who can help you. Remember, this person may be a therapist, a teacher, the school counselor, a family friend, a member of the church, etc. Please reach out for help. You deserve help and you need it. Please consider writing back and letting me know how you are doing and please find someone to help you.

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I want a better relationship with my mother

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

My life was so enjoyable years ago. I was a straight A student, I made friends with anyone, and I was the most favored throughout the family. Years later it is the exact opposite. My grades aren’t straight A’s but it is nothing lower than a B and I have a tutor that is helping me. I can never shut my mouth and I always talk back to my parents. I don’t understand why I do this because I live in a beautiful home and I get anything I want.

I always feel ignored and I feel like my mom favors my siblings rather than myself. I take no interest in doing activities anymore except for track and band and it may be because I am not well at most things except for skiing and running but that is very expensive to do all the time. I’m a great runner if I push myself but other than that I fail at other things.I’m so sick at looking at other people’s lives and not understanding why I can’t have a life that they do.

I have a horrible relationship with my mother, I have VERY low self esteem ( I have dealt with anorexia) and everything else is just falling apart. All day I focus on what I eat because I get so worried for ending up being fat. I have all the signs of depression and bipolar disorder. I’m not sure if this has to do with anything but sometimes when I lay down for a while and when I go to get up I fall and everything goes black for a few seconds and everything is dizzy. I’m tired almost everyday but I get at least 7 hours of sleep. I’m always concerned about my looks and I ocasionally check myself in the bathroom throughout the day.

Anyways, I have dealt with many things such as physical and mental abuse from my mom. There’s not a day that goes by that I don’t get called selfish,lazy,unappreciative,horrible,terrible,and self-centered. I try to call out to her, discuss our problems, and she tells me that if I say one more thing about her she will leave. I don’t know if I act this way from my past. On certain accounts, I have told my mother I wanted to kill myself and she just mainly laughed at me and said there is something mentally wrong with you and then I said well if there is then it wouldn’t be my fault and I need help.I don’t know I always tell my mother that I appreciate what she does for me and she says things like yeah yeah.

My mom talks about me to other adults, making me sound like a horrible child and all the other words that I have mentioned already. She expects me to do every chore there is in the house if I do a chore. For example, my siblings and I washed all of the dishes and did other things and my mom comes home and says, “Why didn’t you wash the dishes in the other kitchen?” and that made us all disappointed because when we try to do something for her she points out what we didn’t do or what we did wrong. I’m just so sick of dealing with all of this and I don’t know why I do things that I do.

I’m starting to go to church more often and I pray everynight for me and my mom to have a better relationship but nothing works and if it does it only lasts a few days then it’s a full circle again. I feel very bad for my mother because she lived a HORRIBLE life as a kid. Her mother physically abused her, she was raped, she was always made fun of, and her dad didn’t want anything to do with her and now she is dealing with a a lot of pain . she lays in bed and cries and throws up. And here I am, while my mother is giving me this wonderful life that she never had, I have to act like a spoiled brat and be hurtful. I really need some help. I don’t want this to continue. When she is gone one day I do not want to look back and regret what I have done. I want to have a good relationship with her until the day she dies. I really hope you can help me and tell me what I need to do. Thank you very much.

What a mess of troubles! I’m so, so sorry you are feeling so terrible. I’m impressed that in spite of it all, you are motivated to change things. Good for you.

I suspect that what happened two years ago is that you became an adolescent. School got harder. And you started to develop your own opinions about how life should be. Part of what is going on for you are the physical changes and emotional upheavals that come with the teen years. And part of what is going on for your mom is that you are emerging as a young adult. A lot of parents have trouble with that transition. In your mother’s case, her own upbringing didn’t prepare her to deal with the natural conflicts between mother and daughter in a way that is helpful.

If that were not enough, you are both struggling with physical problems. Your mom must feel crummy most of the time. You have struggled with anorexia. It may well be that the lightheadedness you feel is a result of not eating regularly or not eating enough.

I deleted some of your letter because I wanted to protect you from being recognized by people who know you. If you really want things to be better, I can think of a few things you can do:

First, stop focusing on how wonderful the lives of your friends are in comparison to your own. It may not be true. It does nothing to help you. Instead of focusing on your deficits, work on your considerable gifts. You belong to band and track. You’re a good runner. You have friends. You have a tutor to help you figure out how to do better in school. You have a grandmother you like to see. You do manage to have the relationship you want with your mom for a few days now and then. When you are feeling down, recite the good in your life instead of the bad.

Secondly, start taking better care of yourself. Eat right. Go for a reasonable run several times a week. Continue to turn to prayer. All will give you the strength to deal with the hard stuff.

You are fighting with yourself about how to see your mother. On the one hand, you are grateful that she has given you a life she never had. On the other hand, you are furious with her for the way she sometimes treats you. Both can be true. Appreciate the good times. Forgive her the others. She has had a very hard road of her own.

Finally, talk with your school counselor or minister about how to get some family therapy for you and your mother. A therapist will help you both understand and talk to each other. Your mom needs to learn some new ways to manage a daughter. You need to learn how to respond to your mom in ways that don’t make a bad day worse. If your mom won’t go with you, please consider going for a few sessions by yourself. A counselor will get to know the specifics of your situation and will be able to give you more helpful advice than I can on the basis of only a letter.

One more thing: If you ever think about hurting yourself, please call the Boys and Girls Town Hotline. People are available 24/7 to talk to teens and to give you needed support. Their number is 800-448-3000. You can read up on what they do at their website.

I wish you and your mother well.
Dr. Marie

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Got Hurt And Now Depressed

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

I basically hate my life right now, because my entire life i have had huge issues trusting anyone at all, and more recently in the past years i have been burnt by any woman that i ever cared about or trusted, and just recently a girl that i cared about a great deal and who i considered one of my best friends, and who said she considered me her best friend as well, the only girl i have let close to me in years, and she played me for a couple weeks then hooked up with my friend right in front of me….now i just am completely lost and dont know what i can or should do, the only thing i can think to do now is just numb the pain through heavy drinking….i have tried talking to the very few friends that i am willing to talk to, however i am not very good at opening up to people either, even worse after how this girl treated me.

You may have problems understanding the dynamics of relationships. Early relationships (during the teenage years) tend to end. During this time, people are testing out new relationships and searching for a match but generally speaking, most relationships during this time period do not last.

Dating is a social contract in which two people agree that they will date and get to know each other but that contract does not include “a never break up” clause. Generally, people date each other to see how the relationship will go. In most cases the relationship will end and both people will move on to another relationship. The ultimate goal is to find the right life partner. This is the nature of relationships, especially during the teenage years when individuals are just beginning to learn who they are and what they want.

You are seeing breakups as a betrayal. With each breakup, you are acting as though you have been cheated. You are assuming that the girls you have dated have essentially made a promise of never breaking up with you. From your perspective, if a woman dates 10 men before she is married, she has betrayed nine of them. It is a mistake in judgment to believe that. When people are dating there is no promise that each partner will stay with one another. Dating does not imply permanent commitment. Breakups should not be unexpected or translate into mistrust in your mind. It’s a mistake to believe that being in a relationship equates to some guarantee that the relationship will continue forever.

Your reaction to breaking up is more common than you think. Some people do bond quickly and think that if they feel love, the relationship will be a lifelong commitment. This is an illusion. Both people make talk about how in love they are, how many children they will have, where they will move to when married, what they will name their future dog, how many children they will have, etc. A week later they receive a “we need to talk” message. Both people may have sincerely meant what they said, when they said it, but they no longer feel that way, not now. Until both parties are fairly mature, until both parties have enough life experience to know what they really want, until the relationship has stood the test of time, don’t ever feel that the relationship is a forever thing.

I would highly recommend counseling. It can help you to better understand the dynamics of relationships. It can also help you to understand why you may be misinterpreting breakups as betrayals and how to change your reaction to such events. Please click on the find help tab at the top of this page to search for a therapist in your community. Please take care. I wish you well.

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How Can I End The Pain?

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

My name is irrelevant much like my life. It’s hard to find a place to start, so I guess I will start with my childhood. My parents were extremely overprotective of me. In other words, I was “hidden” from most of my childhood. I was in a small school with no friends. The kids would always mock me and beat me up. When I came home from school bloody, my parents would ask what happened. I would always tell them that it was sports or that I fell. When I came of age, (highschool) I rebelled against everything and everyone and I think this is where my actually depression begain. As highschool went on I got involved with drugs (nothing hardcore) like weed. I was never liked by any girls in highschool and was liked by a select group that was just as messed up as I was. Anyway moving along after I graduated highschool I went to college and was living with my aunt on my mom’s side of the family. She had said that I could stay there until I found someone to room with out at school. She ended up kicking me out of her house for no reason 2nd semester. I then moved in with one friend that I had 150 miles from my school. Since I lost my job from the move I couldn’t stay in college and dropped out. I found a job at a gas station eventually and met some people that were into cocaine. It’s a long story but to make it short, I was 19 years old and shot in the knee with a .38 special. I then went back home and got heavially involved with drugs. I was doing weed all the time cocaine, any pills you can think of. I was diagnosed with serious depression in which the doctor gave me more pills. I abused them and he said that he could not help me. It is also important to note that I have tried to kill myself by hanging, cutting, shooting, and ODing. I realized that I had to try to help myself so I quit all the drugs and started drinking. My depression lightened a bit. I thought I had finally beat it. But recently I moved to a new state and it keeps resurfacing. I just want to find love and a reason to be here. I’m also a virgin and at 23 longing to find someone that won’t judge you negativally because of that is extremely hard. I’m just so tired. So sick. So distant. So lonely. So hurt. So angry. I had these things well but you can only bury so much before it explodes. I’m afraid that I’m going to either kill myself or go on a killing spree. PLEASE HELP ME! Tell me how to make the pain end finally so I can have rest and peace.

I am sorry you are suffering. Realize there is help for you. It is not clear from your letter whether you have help or support from family, friends or mental health professionals. My assumption is that you do not. If so, this is what is lacking. You are dealing with a multitude of complicated issues and you need support. Research shows that people who have a support system have an easier time managing psychological distress than those who don’t. People who have the support of others are also less likely to commit suicide.

Your issues began as a young child. Your parents were overprotective. This may have led to problems in your development. You felt like an outcast in high school. Ultimately, you wound up with legal trouble and using drugs and alcohol. Usually people who use drugs and alcohol do so to bury their problems. You were briefly successful in stopping your drug use and dealing with your depression. That success was short-lived, perhaps because you lacked a support system and because it is simply difficult to stop drugs and alcohol “cold turkey.”

You must be suffering tremendously to believe that harming yourself or other people is the solution to your problems. You must realize that it isn’t. When people cannot think of an alternative way to relieve their suffering they oftentimes decide to kill themselves, or worse, kill others. Usually these decisions are made impulsively in the midst of great emotional turmoil. They’re not well thought out. It’s difficult to think logically when you’re driven by strong emotions. Those who have attempted suicide and lived, usually find they can be helped and can get better.

You did not mention anywhere in your letter whether you have tried counseling. There are millions of people who feel like you and were able to be helped with counseling. In fact, many people are in counseling because of an issue stemming from their childhood. We cannot control what happened in our youth but we have the potential to alter the course of our lives as adults. As adults, we have a responsibility to correct the mistakes made by our parents. You have the power to do this. Your parents no longer control you or your behavior. You are free to do what you want. Overcoming depression is not going to be easy and it’s going to take a lot of work but counseling is the ideal place to deal with your problems. I strongly suggest you consider this approach. Choose life over death.

If you feel that you want to harm yourself or others go immediately to the emergency room. It is important to go to an emergency room if you’re having thoughts of harming yourself or somebody else. The emergency room can protect you from destroying your life or the life of others.

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Diagnosed With MDD But Am I Borderline?

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

I have treated for major depressive episodes but think i should have been found to have borderline personality disorder. Even as a child i always felt different from my family & friends and so when as a teenager i had to see a psychiatrist no-one was really surprised. i had my finger on the self-destruct button for most of my teenage years (and for many other periods in my life) my self-harm took on many forms. taking too many drugs, alcohol, picking up men for sex that i never enjoyed, making rash dangerous decisions then being scared of the dark or a tiny insect. my sister called me a freak of nature and it is true. I was sexually abused by a family friend and also bullied by an older brother who loved seeing me in pain (it was his friend who abused me)i got in trouble with the police on several occassions i have been on various medications over the years from anti-depressents, anti-psychotics and mood stabelisers and although for some of the time i felt ‘better’ i never felt normal and still dont. i have now stopped all medication and seeing the psychiatrist but see my G.P. who is a good man. I tried explaining to him that the medication and the ECT may have stopped me committing suicide they never stopped me self-harming or make me feel normal. he suggested i may have been born this way, and that it might be part of my personality. is this possible. would this explain me being as i am. I am currently married and this relationship started in my early 30s, this was my 1st real relationship, as i went between picking up men and kissing women. i get very angry for no reason and my moods are very intense and passionate often within the same day and all of this was when i was still taking the medication and was one of the reasons i stopped. after speaking to my GP i went online and i quickly discovered that my symtoms may well be a personality disorder that has been plagued by depression. is this possible. i eagerly await your reply.

If I understand your question correctly, you want to know whether you have borderline personality disorder vs. major depressive disorder (MDD). You seem to meet some of the criteria for borderline personality disorder and depression. It’s also possible that you have bipolar disorder (vs. your current diagnosis of MDD, not in addition to). Some of your symptoms match that disorder as well. Please keep in mind that I can’t be certain of your diagnosis. I would need to meet with you in person and review your extended personal history, but based on the information provided, borderline personality disorder or bipolar disorder are plausible diagnoses. These are possibilities, not definitive diagnoses.

You also want to know if it’s possible to be born with certain problematic traits or personality characteristics. This is a matter of long historical debate. It is a question of nature vs. nurture. In essence, you want to know if you were born this way or if your environment shaped your personality and led to a mental illness. Science has not determined the answer to this question. Some believe mental illness is purely a brain disorder and the problem is caused by a chemical imbalance. Some believe that behaviors are learned or that our parents and the way we are raised shape our personality. Many theories exist but none have been definitively proved. Many scientists believe that mental illness is a result of a complex combination of biological or genetic risk factors and environmental stimuli.

I usually try to discourage people from focusing on gaining an exact diagnosis. There are two basic “schools of thought” on whether a mental health diagnosis is helpful. On one hand, if an individual suffers from a series of symptoms and then learns there’s a name for this specific set of experiences, it can be a relief. It can also be a validation. On the other hand, learning of a specific diagnosis is not always very informative. Nor is it easy to know whether the diagnosis received is accurate. Mental health diagnosis is not an exact science. In addition, getting a diagnosis may make an individual feel upset, overwhelmed, hopeless, and even stigmatized.

What’s most important is that you find a way to relieve your symptoms and live a happy and fulfilled life. Troublesome symptoms make it difficult to function. It can make life miserable and you unhappy. You may not need medication but at the very least, consider individual therapy. You mentioned that you have problems managing your mood. Therapy can help with this. You also said that you are struggling with relationship/marriage problems. Again, this is the type of issue for which therapy could be very helpful. Try asking your general practitioner (I’m assuming this is what you meant by GP) or your psychiatrist about referral to counseling. You may also want to try searching this therapist directory. Thank you for your question and I wish you the best of luck.

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Tell Family About Suicide Attempt?

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

Back in December I hit a really bad depressive episode. My relationship with my girlfriend of 3 years wasn’t going well and work was highly stressful. I went into work that morning and got into a verbal altercation with a co-worker who never liked me. That was it, I was fed up with the world. I couldn’t take it anymore. So I went home and around 9pm locked myself in my room and attempted to overdose on my medication for diabetes and depression.

No one in my immediate family knows except my roommate, a friend, and two of my sisters. I’ve asked them all to keep it a secret. It’s been four months since I’ve attempted to take my own life. But unfortunately it was not the first. I’ve had a history of one previous attempt when I was 16. Since then I’ve battled to with my past and brought a lot of ghosts to rest. However, depression still haunts me. I suspect it will for the rest of my life. I’m on medication now. It helps for sure other than the occasional blues. But I recently lost my job and so the search for survival is on. (I haven’t told my family this as well) I feel ashamed and embarrassed and a failure. I’m 38 and still single and I rent. I’m educated and skilled. Just completed my MBA. But I feel like I only bring concern and worry to my family. I also feel conflicted because they always say I never let them in.

The problem is I don’t want to let them into this. I don’t want to drag them through what I did before.

Should you tell your family? That is a difficult question to answer. Will they understand? How will they react? Will they take it personally? One or several of your family members may blame themselves for your actions. They’re not likely at fault but sometimes family members lay the blame on themselves. Other questions to consider include do you have any expectations about their reaction? How would you feel if they began asking you questions about the incident? Would it bother you if they did? Would you feel comfortable answering those questions? How much are you willing to share? What is your relationship like with your family? You say you “never let them in.” Is this true and if so, is there a reason why not? These are all questions (and probably many others) that you may need to consider before you decide whether or not you should tell your family about the incident.

The issue of whether to tell your family is an important one but it’s secondary to the fact that you attempted suicide. You were stressed to the point where you actually took steps to end your life. This is a very serious matter. Life can be difficult but why did you turn to suicide as a way to deal with your problems? My concern is that you lack the necessary skills for coping and handling stress.

I am also concerned with the fact that you may be engaging in cognitive distortions. Cognitive distortions are essentially lies people believe about themselves that are not true. They are usually based on conventional wisdom. Unfortunately conventional wisdom is often wrong. People also tend to compare themselves to other people and come to a conclusion, usually negative, about themselves based on where they believe they “should” be in life. For instance, I suspect that you may subscribe to the idea that because you are 38, you should be married to the “woman of your dreams”, you should own a big, beautiful home and should have children by now. Because you have not achieved these things you may have concluded that there is something wrong with you thus leading you to feel depressed. You may even also believe that a person graduating with an MBA “should” be able to find a job and because you just lost yours, this is tantamount to being a “loser.”

My point is that maybe you’d like to have a job, own a home, be married, and so forth but because these things are not currently true it does not equate to you being a failure. Nor does it mean there is something fundamentally wrong with you. Maybe there are other explanations, beyond your control, as to why you’re not where you want to be in life.

For instance, with regard to being unemployed, the truth is that many people are losing their jobs through no fault of their own. The country is in a recession. Some political pundits suggest that we are practically in a Depression, much like during the late 1920’s and 1930’s. Furthermore, it’s been reported that college graduates are having an especially difficult time finding work because many companies are cutting back on hiring. My point here is that you should consider the very realistic possibility that unexpected economic conditions outside of your control make it difficult for you to find work.

You also mentioned that you are taking medication for depression but still have symptoms occasionally. In the very recent past you attempted suicide and that was not your first time. You did not mention whether or not you are in therapy. If you are not seeing a counselor please consider it. As I wrote earlier, my concern is that you lack basic problem solving skills. If you lack these skills you may be more likely to attempt suicide in the future. Suicide is not an effective problem solving skill. Studies show that most people who attempt suicide do not actually want to die. They want their psychological suffering to end and they don’t possess effective ways to deal with their pain. Counseling can greatly improve your coping skills. It can prevent you from resorting to the extreme measure of attempting suicide when you get stressed.

One last thing. It’s difficult to judge from your letter whether or not you are engaging in the kind of cognitive distortions I wrote about. If you are please know that you do not have to be “like” everyone else. Stop believing in the idea that you “should” be doing things at a certain age or time in your life. Be your own person. Live the way you want to live and try not to compare yourself to other people. You’ll be much happier in life if you focused on what’s appropriate for you and not what other people are doing. Please keep me posted on your progress.

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Why Do I Feel Like Everyone Has a Sexual Partner But Me?

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

At an early age, I’ve always disliked people my own age. I thought that they were immature compared to me. As I got older, however, I started getting used to my ever-changing body, and so did everyone else. My opinion of them has not changed over the years, but it appears that everyone is “growing up faster” than I am on the sexual side of things.

Of all the stories I hear in locker rooms and restrooms and of the many things I’ve seen, it appears that everyone has a sexual partner except me. I’ve also felt a greater hatred for them because they have a sexual partner, even greater than before. Not only have I become more irritable, but I feel constant emotional pain. I want to cry almost every night but I am unable to.

I don’t think I’m that hard to look at on the eyes. I may be a little obese but I’m starting to exercise and take men’s multivitamins. I feel livelier but not happier. I think the only solution to all of this is to find a partner and get laid immediately. I know this is wrong but it’s something in the back of my head that says “this is the answer.”

I’ve been looking around and trying to socialize, but nothing seems to work. What should I do?

You may feel as though you are the only one without a sexual partner but is this accurate? Statistics show otherwise. Recent surveys of teenage sexual activity show that only 46 to 55 percent of males have ever had sex. That means roughly 50 percent of males in your age range have not had intercourse. I point this out to demonstrate that just because one feels something to be true does not mean that it is.

It’s also important to keep in mind that people do not always tell the truth. People may lie about the activities they are engaged in. They may brag about things they haven’t done. They may also embellish a story. They typically do this as a way to enhance their self-esteem. They may also do it to increase their popularity, make others feel jealous or to fit in with their peer group. A recent online survey conducted by Seventeen magazine, featured in USA Today, surveyed 1,200 teen and young adult males between the ages of 15 and 22. Several intriguing statistics were found:

  • 60 percent of the males admitted to lying about something related to sex;
  • 30 percent lied about how far those sexual activities had gone;
  • 24 percent lied about the number of sexual partners they had; and
  • 23 percent claimed they were not virgins when they were.

Another interesting statistic was that approximately 78 percent of the teens surveyed said that there was “way too much pressure” from society to have sex. You may be feeling this societal pressure.

These statistics do not support your assumption that everyone is having sex. It’s important to focus on facts. It is imperative to be factually correct in your thinking.

You wanted to know why you hate other people, particularly those who seem like they’re having more sex than you. If you believe that everyone is having sex but you then this may signify in your mind that there is something wrong with you. You might assume that others will also think the same thing. If you don’t hold this opinion of yourself yet feel others do, you could be angry at them for misjudging you. This could explain the anger you feel.

You also believe that everyone is “growing up faster” sexually than you. Again, this assumption may be inaccurate. As I pointed out above males, according to the Seventeen survey, tend to exaggerate how often they have sex or even if they’ve ever had sex. In the survey, 45 percent of the males said they were virgins and those are the ones who “admitted” to being virgins. Because people do not always tell the truth in surveys, that figure may be conservative.

I’m also curious about your dating and social life. You did not provide those details in your letter. Are you able to make friends? Do you have both male and female friends? I wonder if you have trouble dating? Do you have difficulty securing a second date? Having answers to these questions may have shed light on how well you socialize with others. If you have difficulty socializing you might benefit from social skills training.

I want to compliment you on the fact that you are able to see yourself objectively, at least with regard to your physical appearance. You describe yourself as being slightly obese. To combat this problem you began to exercise. I understand that exercise is not making you happy but look on the bright side, it has made you feel livelier. It seems that exercise has improved your overall well-being. This is very positive.

Your solution to this problem is to have sex. It’s important to keep in mind that sex is not something that should be done casually and with just anyone. Sex has consequences. It can include unintended pregnancy and being infected with a sexually transmitted disease. The purpose of a relationship is not just to have sex. Sex is part of relationships but if it’s the sole purpose, that relationship won’t last long.

You describe feeling intense emotional pain. Because of this I would recommend counseling. Counseling may also help you develop better socializing skills, if needed. It can also help you develop relationship and interpersonal skills. A therapist can also help you to better understand the nature of relationships. I believe you could benefit from therapy.

I hope I have adequately answered your questions. If you’d like to search for a therapist in your community, try searching this website. Thank you for your question. Please take care.

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Depressed, Suicidal & No One to Talk to

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

hi. im 14. and to be honest, im really depressed. im suicidal almost every night, and sometimes in the daytime. im really mature for my age. i self harm a lot. i suffered for 2 years, stopped, then picked it up again. i have severe depression, bpd, and anxiety. i think im bipolar and ive talked to my mom about it but she doesnt believe me. my parents are extremely harsh on me and i feel i have no reason to live. i just wish somebody out there would listen to me and take me seriously. i think i have some anger issues too, and ive punched walls and taken out my anger on people and my pet cat, which i feel guilty about immediatly afterwards. i dont abuse my friends or pet but i yell and say mean things. i just hate myself and im too scared and depressed and too much of a failure to complete life. i have a therapist but shes stupid and doesnt even listen to me. whatever. i guess this is goodbye to the world sine i want to commit suicide within the next 3 mmonths. i have many plans, i just need some anthehistamines to make sure i dont puke up the pills if i choose that way. i hope someone here listens and doesnt take me for granted and think im kidding. i mean it.

I am sorry for what you’re experiencing. It is difficult to feel that you have no options and no one to talk to but realize that suicide is never the answer. It is always the wrong choice. The problems you are facing can be resolved. Your life can get better. It has for many people and it can for you too.

People may contemplate suicide for many reasons but fundamentally it’s due to the pain that they feel and because they have not yet developed the appropriate coping skills. There are many good ways to deal with the issues that are causing you distress.

You have a therapist but you don’t feel that she’s helpful. Have you told her about your suicidal feelings? If not, you should do so immediately. It is possible that she isn’t helping because you are concealing important personal information from her. It is also possible that she’s providing ineffective therapy. Without more details about your situation, I can’t say with certainty what the problems are.

The fact that you have a therapist shows that your parents understand that you need help. It shows that they care. I would encourage you to tell your parents about your ineffective therapy sessions and your suicidal thoughts. They may be able to assist you in receiving more effective treatment.

You are clearly suffering and you need to make that known to those around you. It also important to realize that at this point in time you are not thinking clearly. The proof is demonstrated by your belief that your situation cannot improve. It can and it has for millions of people before you.

I don’t underestimate your pain. It can feel overwhelming but the truth is, it just feels that way. In reality it is not overwhelming. It hurts but that pain will end and much more quickly with the help of a good therapist. Do not mistakenly believe that the only way to help yourself is to end your life. There are good ways to deal with life problems and those skills can be learned. Please get help now.

If you feel that you cannot protect yourself, go to the hospital or call 911. Please take care.

Dr. Kristina Randle

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Does my brother have a mental disorder?

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

Q: My brother wont stop lying and stealing from family. He even steals when he has everything. He has his own RX for pain meds and he takes my grandmothers, knowing she is in need of them as well. His response to her is that she knows she cant trust him with med’s or money. If he knows he has a problem why does he continue this behavior? He was recently homeless and my grandmother took him in. She took him to the dr. cause he said he had alot of pain, sleeping problems, etcs. He doesnt have to pay for anything and she is not pressing him to get a job. She pays for all the bills. He has had several jobs and exlaims he is the best at everyone of them. Soon after, he quits or gets fired for various reasons. His reasons always change. Whenever he is in a relationship he will tell the girl lies about having money and college degrees. I have paid for a college corse online and he gives me excuses why he hasnt been doing his school. I gave him money for his bills i.e. cell phone. He didnt pay it but lied and said he did. The phone was shut off and he still insisted that he paid it until i asked for the reciept. Then he told the truth. He never tells the truth unless he knows he has been caught. He has threaten to kill himself more than once. My mother had Paranoid Schizophrena Disorder and she attempted suicide as well. Is this a pattern he is following? He has substance abuse problem with narcotics, street drugs, and alcohol. When he takes pain pills or when he drinks he will do so until he takes too much. He doesnt know his own physical limits. He has lived with family off an on. The family cant trust him and are in need of help. He knows my grandmother wont throw him out on the streets so he keeps taking for her for granted.

This is heart-breaking. Your brother is a mess! He takes no responsibility for himself and manipulates the family into giving him a place to live and taking care of his bills. He’s acting like an out of control 15-year-old. Either there is something charming about him that you all continue to fall for his lies or you are all so terrified he will hurt himself that you will let him take advantage of you to try to keep him off the streets and safe. I’m sure the situation is hard on everyone.

You all need some help. You can’t make him straighten out. But you can learn some ways to change how you respond to him that may be more helpful. I suggest you and your grandmother start with a visit to an Al-anon meeting. Al-anon helps families of people who are alcohol- or drug-addicted. The program will teach your family how to stay in a loving relationship with your brother but not inadvertently support his addictions and general bad behavior. It is unclear whether there is a mental illness at work here as well. But the addictive behavior is at least a place to start. If you are uncomfortable with a meeting, then please consider seeing a family therapist to help you sort out what might help this situation. Even if your brother won’t go, the rest of the family can talk about the situation and get some practical help and support.

I wish you well.
Dr. Marie

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Will this man ever grow up?

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

I have been dating this guy for about six years now. The first two years were great(keep in mind that he is a flirt, he justifies that by saying he’s a little on the heavy side so he flirts to see if he stills has it). He enlisted himself in the US Army, got sent to basic training and in the process I was giving birth to a baby boy. While away in training we discussed how we were going to move our relationship in another direction. We needed to get a place of our own because I had moved in with him and his mother.

When he graduated from the training and returned home, instead of us getting an apartment he decided to get a new car, new jewerly, and new clothes. I felt that he did not have his prioties in order. I left and moved in with my mother then later found my own place.

At this point our relationship is being challenged. I feel now that he has a little bit money he doesn’t know how to act. I distance myself from him. I feel like I’m raising this child on my own, going to work and trying to keep a roof over our heads while he’s out with girls, friends having a good time.

I don’t know what was going on with his mother’s situation but they got evicted out of their apartment. The mother moved into a room leaving her son to find his own place. I took him in until he found himself a place. The mother couldn’t get along with her roommates and the son did’t want to stay where he was. My boyfriend wanted us to move in together but I wasn’t sure that was the right thing to do. I didn’t want him to move in because I new he couldn’t afford to do his share. Somehow he convinced me that all three of us should move in together. By three I mean him, me and his mother. I know its wasn’t the smartest thing to do but he was the only child and his mother wanted him around in case something happened to her.

We all moved in and in less than four months things becomes ugly. We are fighting over petty things. Its gets to the point where the mothers changed the locks on us and by law that is unjust. The cops get involved we
(me my boyfriend and the baby) are now sleeping in hotels because the mother doesn’t want us in the house anymore. She went to the extreme by inflicting pain to herself then calling the cops explaining to them that her son had done that to her. Now he is being arrested for a crime that he didn’t commit.

All of this is taking a toll on me and I don’t know what to do. What I am asking for is help on how to move on past the pain. There is alot that I havn’t mention because I knew it would be too much to read. I used to keep a journal but I don’t anymore because my boyfriend found it and read it.

I go through my boyfriends phone and emails because I dont trust him. I know that he is talking to other girls because of what I read on the e-mails and on the text message. I have even found pitures of naked girls on his phone. When I comfront him about it he says its just talk. When it comes with the pictures he says that he doesn’t ask them to send it, but he also doesn’t ask them to stop sending them either. I feel like I’m being played in this relationship. I stop telling him how I feel about things and our sex life has gone downhill tremdously.

A part of me knows that he loves me and wants to be with me but I dont want to nor do I want to feel like I have to be a detective in this relationship. Right now as of today, I do see a change in him as far as his responsibilities are concern. Keep in mind that he didn’t have a father figure in his life growing up. With that in mind, when does a person takes accountability for their actions and stop making excuses.

I want to thank you for taking the time to read what I had to say. If possible I would like to continue to discuss with you in greater details what is going on with me inside and with my relationship. I have invested alot of time, money and patience in this relationship and I want to know if it is worth saving. I don’t want my son growing up thinking want he is seeing is normal.

Please read your last sentence to yourself over and over and over again. It’s the smartest thing you said. You’ve been living a Jerry Springer life. It’s full of drama. It may even have moments of love in it. But it isn’t a stable and loving environment for a little boy to grow up in. As you present it, you’re the only one in this situation who has enough responsibility and maturity to make a better life for your son and for you. You made a good start at it once. It’s well past time to do it again.

Stop making excuses for the bf and get on with your life. Get a place of your own and get on your feet. Your mom helped you once. Maybe she will again. Get a job. Find good care for your boy while you work and make an adult life for yourself. If your bf wakes up and starts doing the same thing, then maybe you can consider dating him to see where it would lead. But please don’t base your decision on promises. Wait for him to actually do the things he needs to do to be a worthy husband and father.

You have done your best to help your bf and his mother. In return, they abused your kindness. Focus on yourself and your son where your efforts will pay off. It’s not possible for me to be your coach in this. But there are good therapists in your area who can. Give yourself the gift of having a professional in your corner who can both give you some practical advice and some emotional support.

I wish you well.
Dr. Marie

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