Tag:

Tiredness

Going in circles

by Dr. Marie Hartwell-Walker June 20, 2023

written by Dr. Marie Hartwell-Walker

Dear Dr. Marie,
I wrote back in July last year about my recurring depression and
suicidal thoughts. Thank you for your insightful and helpful response.

I did have counselling following my hospitalisation. I continued until
about September last year. I started to feel well about that time, my
energy picked up, I made new friends at work, and had a sense of
achievement and self worth.

I felt very clear about my decision to leave my husband. However it is
almost 2 years since I left him -the mandatory time before one can get
divorced in my country – and my husband is getting quite desperate to
get me back. I’ve become quite stressed by his turning up to see me,
visiting my family and friends, talking in church about me and to anyone
who will listen. He tells the children divorce is wrong, that the bible
says it’s wrong, that divorce means nothing and I’ll always be his wife.
He talks about “all these men” he says I am going out with.

At first it didn’t bother me as I am used to it and expected this but
just lately I’ve been feeling very stressed. My sleep, which has never
recovered since I initially became depressed, is worse, and I have that
terrible tiredness back. I really don’t want to go to work but I know I
need to both financially and for my psychological well being. However, I
do find shift work very tiring. I feel like I’m getting run down but I
don’t know how to manage my stress.

I’ve found myself doubting my perspective of how things were in the
marriage and going around the same circle again of should I give him
another chance. I really want to resolve this once and for all and his
telling the kids that the divorce means nothing has disheartened me. I
know I can’t go back but I’m not sure why I get confused from time to
time and have to go through a whole lot of turmoil to get to that
conclusion again.

Any ideas on what I can do to feel less stressed would be greatly
appreciated.

Thank you for writing. You’ve already taken an important first step by reaching out for some help. The next step is go back to the therapist who was helpful to you. He or she already knows your story and you’ll be able to pick up where you left off.

Therapy for a significant depression is rarely a one-time episode. Think of it as layers. You got through the most difficult one. Now it’s time to work on the next. You can draw comfort and hope from the fact that you did get better. You will again. This time you didn’t sink as low so it will probably be easier to find your strength again. Your therapist will also be in a position to help you figure out whether there is any reality to your husband’s position and whether the marriage is salvageable.

I do have my doubts. From what you wrote, your husband is not approaching you about what he can do better. Instead, he is blaming you and trying to isolate your from your family and community – and even your God. He’s also putting the children in the painful position of being in the middle of your divorce. If he were serious about making the marriage work, he would be taking some responsibility for the break down of your relationship (both to you and to others) and would be asking to join you in your therapy to do some couples counseling. Most important, he would be considering his children’s need to have two parents they respect instead of trying to get them to take his side.

Meanwhile, I hope you have talked with a lawyer about what your rights are. You may be able to limit your husband’s contact with you and what he can say to the children. I don’t know the laws of your country, though, so I caution you to seek out legal help.

Finally, ask your therapist for a referral to a local support group (or an online group) for women who are having similar difficulties. I think you will find it affirming and helpful to have the support of others who know what you are going through.

I wish you well.
Dr. Marie

June 20, 2023 0 comments

Tired, Very Very Tired

by Kristina Randle, Ph.D., LCSW May 8, 2021

written by Kristina Randle, Ph.D., LCSW

I dislike me. Currently teaching at the university, regularly teach at the high school full-time; so I’m just part timing at the moment. Working keeps me slightly “busy,” but not enough to distract me from my thoughts; every once in a while I have this thoughts of complete unsatisfaction. Last year I taught without a break (all summer + all year round school) and I felt very exhausted towards the end of teaching at the high school, I even had a couple of break points. I see a psychiatrist, she says I’m bipolar (2). I’ve tried so many many many meds that at this point, it’s pointless to continue taking them, I really want to get off them; be it uncomfortable side effects like lactating or gaining so MUCH MUCH weight — I just got off Zyprexa and lost about 6 or 7 pounds; plus, I’m not sure if it clouds my thinking, as I’ve felt that I’m just not as quick as I once was — which is the strongest reason to come off them. I also see a psychologist, but I don’t get to see her very often, mostly once a month, if not every two weeks; she says I have GAD and not bipolar. I’m just so tired that I just go by without a will or purpose to continue. It is such a dull time consuming annoyance dislike to continue; but I know there’s no reason to “off” me. I probably am too hard on myself, but I just see so many “excuses” to come up with that don’t lead me to something productive and prosperous set of achievements. I’m just SO TIRED, VERY TIRED; this is never ending. When I go see my primary physician, he will include the bipolar diagnosis, I HATE IT!!! The psychiatrist tells me she will look up for something else I can take, but I just don’t feel any relief. My primary doctor tells me he is glad that I seem to manage my work/career good enough considering, but I don’t even feel/think I’m bipolar to begin with.I guess every once in a while it seems so much more pointless that the psychiatrist recommended ECT; I know I don’t want to take lithium; even the ticks I feel, I dislike; seems as if I were to have a stroke. I don’t know what to do.

Your dissatisfaction with life is propelling you to search for something better. This may sound counterintuitive, but that’s a good thing. You’re unwilling to tolerate unhappiness. That is a necessary prerequisite for a happy life.

Your current therapy arrangement does not seem to be meeting your needs. You should either see your therapist more often or make a concerted effort to find the most competent and best therapist in your community.

Begin your search by making a list of five to 10 highly-rated therapists. Call each one and inquire about how they conduct therapy, which problems they have had the most success in solving, how much they charge per hour, and so forth. When you find several with whom you connect with over the phone, go meet them in person. Choose the one with whom you have the strongest connection.

In the meantime, consider group therapy. It could help to stabilize your mood between your one-on-one sessions.

Your letter touched upon some potential thinking errors. For instance, you have achieved success in your career but you downplay your achievements. When someone is depressed, they tend to minimize their successes. You might be guilty of minimization.

Incorrect thinking can lead to incorrect decisions. It’s no small thing. Your thoughts and behavior are correlative. It’s important that your thoughts are consistent with reality so as to avoid making mistakes in life.

One of your biggest complaints is your being tired. I’m not certain if you meant tired of life in a more general sense or if you are quite literally fatigued. In the latter case, medications often cause fatigue. Tiredness increases irritability which affects mood. Medication changes an individual’s personality, even if ever so slightly. Many people have reported that they do not feel quite like themselves when taking medication.

Reading is not an official treatment for depression but there are some great books that just might improve your mindset and help move you in the right direction. Some of my favorites include: The Road Less Traveled by M. Scott Peck; Many Lives, Many Masters by Dr. Brian Weiss; and Man’s Search for Meaning by Dr. Viktor Frankl.

I have also recently came across a great blog called Barking Up The Wrong Tree by Eric Barker. Some of his work has been featured in the New York Times, the Wall Street Journal, Time Magazine, among others. It’s filled with evidence-based insights about happiness. You might want to check it out.

I hope that my advice has helped you in some small way. If your current therapy regimen isn’t working, then search for something better and don’t stop until you are satisfied. Yes, it might take some work but it is well worth your time and effort. The right treatment can make all the difference. Please take care.

Dr. Kristina Randle

May 8, 2021 0 comments

Incredibly Angry and Sensitive With PMS

by Kristina Randle, Ph.D., LCSW May 4, 2011

written by Kristina Randle, Ph.D., LCSW

Hi. I had terrible problems with depression through high school and in my first year of college, most of which have gone away now that I’ve started medication (about 6 months ago). The only thing that hasn’t gone away is how I feel when I’m premenstrual. The smallest things make me incredibly angry–angry enough to want to scream and break things (although I don’t). Any strong stimuli, like smells or noises, feel like a violation and make me feel really anxious and agitated. I also am just really sensitive and cry at things that wouldn’t normally make me cry. I just want to be left alone and get upset when I’m at all disturbed. It’s for three-four days every month, and it consistently comes and goes with PMS, but I was wondering what would cause this and how you deal with it? It’s pretty disruptive, especially since I live on a college campus where I’m surrounded by people and noise. Thanks!

The severity of your symptoms may suggest premenstrual dysphoric disorder (PMDD). PMDD is a more severe and debilitating form of premenstrual syndrome (PMS). It affects approximately 3 to 8 percent of women and it is more prevalent among younger women.

I would recommend reporting the symptoms to your gynecologist or family physician. He or she may be able to better evaluate whether PMDD is the cause. In addition, if you are taking birth control pills they also may be contributing to the problem. An adjustment might decrease the severity of your premenstrual symptoms.

In some ways, PMS can be likened to being very tired. When someone is tired, they tend to be irritable. They may be “short” with others or “snap” at their friends or family. They may have trouble concentrating or experience difficulty making clear decisions. The tiredness clearly affects their mood. The same is often true of PMS. It is a temporary condition but it significantly affects how a woman feels.

One of the biggest challenges is recognizing the symptoms of PMS. It may seem counterintuitive but some women experience the symptoms of PMS and don’t attribute those symptoms to PMS. Instead, they may believe that something else is wrong. It’s not until the symptoms begin to diminish that they realize that it was the PMS causing the shift in mood.

When you notice the symptoms, you are going to have to work hard to force yourself to be as logical as possible. This can be difficult. It may help if you have someone to consult with during that time period. This enhanced objectivity can help to ensure that you’re thinking as clearly and as logically as possible.

What is good about your situation is that you can fairly accurately predict when the mood swings will occur. This means you have time to mentally prepare yourself to utilize the above mentioned measures, in an attempt to decrease the severity of your symptoms.

In addition to consulting with your gynecologist and family physician, you may also want to discuss the possibility of antidepressant medication. Antidepressant medication may help to decrease your mood swings. You may also want to consider seeing a therapist. You may only need to see a therapist for short time but the goal could be your developing coping skills to effectively deal with your monthly emotional dysregulation.

I wish you the best. Please take care.

Dr. Kristina Randle

May 4, 2011 0 comments

Headache, tiredness and worries

by Dr. Marie Hartwell-Walker October 6, 2010

written by Dr. Marie Hartwell-Walker

i’m a fresh graduate, 25 and male, looking for a job in Hong Cong. I have been suffering from depression and anxiety. i took medicine, sertraline because my student counselor asked me to see the doctor in May. After a few days, i had a mild headache. Then after 2 months, i saw the doctor again to tell him the problems of headache. He thought i had no need to take the medicine and should focus on seeking a job. Then, after half a month, i still had a bad headache so i saw him the third time and i took the medicine again. Now, my headache happens every day, but it’s very terrible in some period of time.

Besides, i have felt extremely exhausted like i have done a ton of things or jobs in a day. i feel extremely extremely tired and didn’t want to do anything. in fact, it’s okay to do something like watching tvs or listening to music. in particular, i feel completely tired when waking up in the morning. it’s too hard for me to be like a normal person who feels good and can do cleaning at least once every day. I usually need to sit down and thought what’s wrong with me and how i can overcome this, but this makes me upset and sad.

by the way, i think at this moment i can’t do a job although i can find a job. it’s because of the tiredness. in addition, i have stomach problems and some illnesses too.

Thus, I am worrying too much that i quite often check my body or go to see a doctor. That wastes time and money. i think i feel sick, but it almost had no problems and i am just fine. in fact, i know this problem but i should make sure that’s ok when i feel just a little bit uncomfortable or sick.

in addition to health problems, i am quite anxious of my daily life, even trivial things, like what i need to do next hour or something. i always want to finish my jobs quickly and perfectly, so that i am not worried. However, this doesn’t work and even makes me worst. Actually, i feel a bit tired of this pattern of thinking because it makes me anxious and gives me some pressure. And i can tell you that it’s not normal.
thank you so much.

You’re right. It’s not normal for a young person to have so much anxiety and depression that he is unable to function. That doesn’t mean that it is that unusual. Many recent graduates have a difficult time for a while. They have been in the rhythm of school and focused on getting their degree for years. Once they get it, they aren’t quite sure how to move to the next stage of life. Some, like you, develop symptoms.

I”m very glad you’re under a doctor’s care. It is always important to make sure that your symptoms aren’t caused by a medical condition. You and your doctor seem to have ruled that out. That being the case, your symptoms do seem to suggest anxiety and depression.

Studies show that anxiety is underdiagnosed in Asians. It may be that your treaters underestimate how serious the problem has become. If you feel this is the case, it may be important for you to emphasize how much you are suffering.

Medication alone isn’t working for you so it might be helpful to add other elements to your treatment. In the States, I would suggest you seek out a cognitive behavioral therapist. Cognitive behavioral therapy (CBT) has been shown to be one of the most effective for dealing with anxiety and depression. If you would like to learn more about it, go to this link.

In addition, it’s particularly important that you pay attention to your physical health. That means eating right and getting some exercise every day – even if you don’t particularly feel like it. Some mindfulness strategies like meditation or self-hypnosis or yoga often help to lower the intensity of anxiety. Finally, you might find it helpful to join one of our online support groups. Members of the community can offer both emotional support and practical help.

I strongly suggest you find a mental health professional to help you develop a comprehensive treatment plan and to provide you with support. If you could pull yourself out of this on your own, you would have done so already. With a more intensive treatment strategy, I have every reason to believe that you will get through this.

I wish you well.
Dr. Marie

October 6, 2010 0 comments