I fantasize about killing people in extreme detail. My most recent “fantasy” (I don’t prefer saying fantasize because I feel that people assume I like it.) was of me going to school with a gun and a camera and I would go to my home room class and close and lock the door behind me. I have everyone get into a corner and ask them what they think their problems are (I am recording from this point on). When they get done telling me I go through and tell them their problems. I kill them one by one and then point the camera at myself. I go about talking about my own problems and then kill myself. I don’t feel that I would ever do this I’m just wondering if this much detail is normal.

A. Your fantasies are abnormal and potentially dangerous. The most dangerous aspect of fantasies is that they allow the preplanning of an event. At this time, you have not carried out this plan but it is concerning that you are preoccupied with such violence. I would highly recommend that you report these fantasies to your parents or the school administrators so that you could receive the proper mental health treatment.

Having a fantasy is not illegal. You have done nothing wrong but your fantasy is indicative of the fact that something is troubling you. Often, people who fantasize about harming others feel out of control or powerless. Their fantasies often involve a situation in which they are in complete power. These fantasies might be a way to compensate for a perceived lack of power.

By telling your parents or school administrators, they can assist you in gaining access to mental health treatment. Counseling would allow you to uncover what is wrong and why you would want to hurt people. It can also help you to correct your thinking and feel better about yourself and your abilities. Please do not ignore my advice. Seek help immediately. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

I’ve always been self-conscious about my body. When I was 13 I gained a lot of weight and I realized I was getting stretch marks. I didn’t really care back then, but when I turned 17 I noticed that I had stretch marks everywhere. I developed bulimia and anorexia at age 17.I believes I didn’t want to lose weight but I wanted to get rid of my stretch marks. Well, when I turned 18 I started self-harming to cope with all the hate I felt for myself.
I quit studying 2 years ago. I no longer have a social life or even get out of my room. When I do go out, I feel like a freak. I see all those beautiful girls with their gorgeous bodies, and how men turn their necks to see them. I feel awful, Inferior, useless and worthless. I have made my mind that no man will ever love me and I don’t allow myself to be happy.

It has come to a point where I’ve tried to commit suicide and do drugs because I’ve stopped caring about myself. Coming to realize that I’ll die alone. I have no propose, dreams or plans for the future cause I feel useless. Some people may think that it’s not serious and that I shouldn’t worry about it, but I can’t. I have no control over this. It’s too much hate on myself. I quit studying; I have literally no friends at all. I’ve been to a psychiatrist before, but my mom says I don’t need one. No one in my family knows about this body issue I have and how it ruins my life.

I don’t know how to deal with this anymore. I need help, but my mom refuses to get help for me cause she says I’m normal. I hate it when people compliment me cause I feel bad for myself.

I am exhausted. Mentally and physically, I feel old, tired and depressed. I no longer sleep at night and I rarely eat.

A: I am sorry you are having so much trouble with your self-image. But I do think that there are several things that you can do to gain support and feel better. The first thing I would do is look for an Overeaters Anonymous meeting in your area. These meetings are free and meet following 12-step principles on managing your food. Beyond the education you get at such meetings, you get a strong sense of fellowship of the members who attend. I think this gives you the best first place to begin.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

I spent last winter in an apathetic state where I completely lost interest in things that were important to me and I avoided interacting with friends at all costs. I spent my days distracting myself with videos and mindless things. At the start of this year I started to feel better. My writer’s block wore off and I felt like I could relate to others again. Mid February I broke down into tears one night for no reason, alone in my room. Nothing had triggered it, but on and off after that I had more cry spells and I felt terrible some days. I couldn’t sleep.

Lately these feelings have been building up more frequently, and sometimes I become very sad in public, and I feel as if I can’t hold it in. My health has also suffered. I get sick easily when I get no sleep, I’ve had migraines lasting several hours to a couple days and muscle cramps randomly during the day. I don’t feel like I can trust anyone enough to tell them about how I’ve been feeling. I have no close friends; I’d reduced contact with all of them when university started because I didn’t like being around other people. I know that even if I were close to any of them, I still couldn’t tell them. I’m able to socialize easily with others, but I can’t trust easily.

All the things that didn’t bother me before are affecting me now, and I feel like I’m alienating myself around strangers. Lately I’ve been having thoughts about suicide, even though I know I would never act upon them. I’m distracted at school and at work, and I think of myself as a lost cause that’s not worth the motivation. I really want to beat this on my own and am hesitant about approaching a school counselor, even though I’ve felt bad enough to have thought about it. I want to believe that this is a short term, temporary thing, but I have no idea

A. You are not a “lost cause.” You, in all likelihood, have depression. It’s reoccurring and it seems that your episodes are worse with each reoccurrence. The fact that you’re considering suicide is evidence of the seriousness of your condition.

You have been suffering with this condition for at least a year. It is degrading your life to a significant degree. You’ve been hesitant about seeking help but you should not be. You should not have waited this long to seek help. You should have sought help when you first began to notice the depression. I’ve noticed that sometimes people believe that they have to wait until their symptoms are severe “enough” before they receive help. Ideally, one should receive help upon the emergence of troublesome symptoms. The sooner the better.

Sometimes people also believe, like you, that is important to solve one’s own problems. Perhaps it’s due to pride. It may be due to the fact that some people feel stigmatized by seeking psychological treatment. In their view, the fact that they sought professional help is a sign that they are a failure. Nothing could be further from the truth. There shouldn’t be any hesitancy to seek professional help. Mental health professionals specialize in the very problems with which you suffer. Depression is also very treatable. Don’t wait any longer to receive help. Approach the school counselor immediately and report all of your symptoms. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice

I am 21 years old girl and I’ve got much interest in psychology. So sometimes I doubt that I’m assuming all problems and in real I’m OK. Summarizing all issues, I have trust problem so I’m very reserved. I am survivor of suicide and also committed self injury many times. Many people who claimed to love me, betrayed me so I don’t trust anybody now. My close ones never value me the way I do. I recently broke up with my best friend and also ignoring my other friends. I think it’s the only way to protect myself from being triggered for self injury and suicide. But I am still feeling abandoned and worthless. I don’t know I fixed it or made it even worse…

A: The best thing for you to do is to see a psychologist or a mental health counselor for an evaluation. I often tell my students that if they are interested in psychology, it’s important that they experience what it is to be a client. We all have issues. If we’re going to be helpful to others, it’s very important we understand ourselves and know how to keep those issues from intruding on our understanding and helpfulness to others. Being a client for awhile also teaches us in a profound way what it feels like to be on the receiving end of therapy.

You have some important things to work out. It sounds like you have a difficult time tolerating big feelings and trusting others. You’ve been so hurt in your life that your only solution for dealing with pain is to distract yourself with pain you control (self-injury and suicidal actions). In therapy, you would identify your strengths and use them to gain self-confidence and improve your self-esteem so that you can risk connecting with others again. You would learn how to cope with your feelings and how to transform them.

I think you made an important first step by putting your thoughts into this email. Now take the next one and make an appointment with a counselor. You have important personal work to do.

I wish you well.
Dr. Marie

Hello, my name is Jane and I’m from Germany, I have already been in therapy for depression because I used to want to kill myself. Well, now I just want to kill people around me. I get really excited when I think about getting a gun and just killing people. I’m not interested in killing one person at a time in a slow and painful way but more in school shooting. Sometimes I just want to slit people’s neck or just stab them all over and dispose of the body as soon as possible. I actually do have friends now and I like them and I’m glad I do, but when I was a child I used to have none at all and I had a very bad relationship with my parents, I never felt like they actually loved me, now it’s different but I stil can’t get the pictures out of my head. I really just want to KILL for the pleasure but I can stop myself, my thoughts belong to myself and I want to pretend it’s alright and have others believe that and maybe these thoughts will go away.. Well, I just feel like everybody always leaves me and nobody truly loves me for who I am and I’m so sorry I’m such a f-up, I wish I was normal but I just.. am not.

A. Hello, Jane. I’m concerned about your letter. You began experiencing severe depression that led you to want to end your life. You’ve now become fixated on the idea of killing others. The desire to want to kill or harm others is very unusual. It’s a sign of someone who is unwell, truly suffering and in need of intervention. Sometimes when people are suffering and perceive that they are being ignored, it angers them. They may want to seek revenge or punish the people who they think should be helping them.

You must understand that killing is wrong. It certainly will not solve your problems. Killing involves the destruction of human life. Every religion considers murder a sin. It would ruin the lives of many people. You would also very likely spend the rest of your life in prison.

It is important that you receive help immediately. Go to a hospital if you feel as though you cannot control your behavior. Call emergency services if necessary. You should immediately report your feelings to your parents or the school administrators. Once they are aware of your thoughts, they can assist you in receiving the appropriate psychological help. Counseling could assist you in developing coping skills to deal with your very strong emotions. Please seek help immediately. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice

I grew up with a younger sibling with autism, and I deeply love and care for her. As I grew up, my parents always told me that I had to be successful so I could care for her when they died. I was perfectly okay with this at first, but as I entered grade 7 I started thinking life and my reasons for living.

My father wanted me to become a doctor and I grew up with that goal for a while. However one day, I thought long and hard about it and I realized that I really couldn’t see myself in that kind of role. I hated the sciences, and I could never see myself studying it for the rest of my life. Even after realizing this, I still decided to study medicine to please my parents.

I adopted a rather lazy attitude entering the seventh grade, and as my marks dropped to the 70′s and 60′s, my parents constantly reprimanded me. For whatever reason, I was unable to break out of my streak of laziness. My parents became angrier with each mark I showed to them and began reacting as if I had just committed a crime. Sometimes they would cry and yell at me. Sometimes they would blame the marks on my friends and sometimes they blamed the fact that I played video games. What really hurt me, though, was what they said about my role as my sister’s brother. They told me that I wasn’t just failing them, I was also failing her and by getting bad marks I was showing them I didn’t really love her. Through all of this, I never retaliated or told them how I felt. I just stood there and endured everything. Around this time I was very sensitive and prone to crying and I spent that whole year crying myself to sleep every night because of how worthless I felt. I soon realized that these emotions were going to eat me from the inside if I let them go on. I decided it would be much better if I just shut down my emotions.

I trained myself to stop crying and in order to make my ability to control my emotions stronger, I watched some gruesome horror movies and tried my best to feel nothing while watching them. I was dead set on becoming stronger and eventually I was able to endure any kind of emotional trauma and feel nothing. After that, I was a lot more emotionally stable. When my parents yelled at me, I simply listened and moved on as if nothing happened. I still loved my sister, and only let down my emotionless persona when I was around her. Eventually I realized that even though I had become stronger, I felt empty and unfulfilled… I questioned my reason for living and realized I didn’t have one anymore.

I came close to committing suicide at one point but realized that if I was gone, there would be no one left to take care of my sister. I decided that my life did not matter as long as I could make my sister happy. I have friends but I never feel close enough to them to tell them this story. I think about killing myself from time to time but I never feel sad or depressed while doing so. I just feel like it would be better to have everything disappear in an instant.

Do I have some sort of psychological problem? or am I just a pathetic human being?

A. I don’t think you have a psychological problem per se nor are you a “pathetic human being.” Your parents placed a heavy burden on you. Even as a young child, you were told that you were going to be the lifelong caretaker of your sister. What your parents did to you was unfair. You never had the opportunity to be who you wanted to be. Your parents saw you as an extension of themselves. They chose your sister over you. They should have had two children, who for each they wanted the best possible life. Instead they have joined you together to form “children.” They want the best for their children, not what’s best for each child.

As a response to this heavy burden, you developed a coping strategy. It’s evidence of your resiliency and resourcefulness. This strategy protected you from experiencing a great deal of psychological pain but it was temporary. Your true feelings eventually reemerged.

You are in essence sacrificing your life for that of your sister’s. While that sacrifice might be noble, it is unhealthy and it will lead to a great deal of dissatisfaction in your life.

Your sister requires the assistance of health and mental health professionals who can properly care for her. There are many social service agencies and independent caregivers that can assist your family. Your sister is best served by trained mental health professionals who have years of experience dealing with autism. Call your local social service agency and inquire about what services are available for your family.

Your reaction to this situation is logical given when you have faced. Of course you love your sister and want what’s best for her but this should not come at the expense of your life. You have the right to be happy and to live an independent life. You can help your sister as much as you chose to when you have developed your own life. You must seek meaning and happiness in your life.

This burden has led to your contemplating suicide. Nothing, no plan, that leads you to suicidal thoughts can be the correct plan. Erroneously, the plan that your parents had assigned to you was the plan that led to suicidal thoughts. I’m sure that wasn’t their intention. They have a problem because they have a daughter who has special needs and they don’t know how to care for her after they are gone. They would benefit from counseling, to help them assess their choices.

You could also benefit from counseling. It can help you to understand the burden that has been placed upon you and assist you in becoming more independent of your family. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

I hospitalized three times for attempted suicide. said bipolar 2 disorder, on meds for schizophrenia: I had what i term to be some sort of break down four years ago. I believed that the school system, my friends and family were trying to take my children from me. I would see random things like book titles that were laying around the house that led me to believe this to be true. I believed that songs that came on the radio were trying to warn me also. I quit showering, grooming and everything because I believed that there were video cameras that were placed throughout my house, in my car, and that i could be monitored throught the tv in my home or where ever i was by the police.Everytime i would see a police cruiser, i thought they were following me. I was seeing someone at the time,we were engaged to be married. I started believing my fiancee and my sister were secretly seeing each other and along with everyone I know and ever knew were trying to kill me by poisoning my food, drinks, or by doing/saying things to make me feel as is if I was loosing my mind. This lead me to barely eat anything for a period of three months. I tried talking to a few people as to what was going on, but only to have them think i was blowing it out of proportion, even my family doctor.I sat in my mothers living room at one time screaming and crying while home alone because i was surrounded by fire. I was convinced that my family was going to lock me in the basement and burn the house down to get my kids away from me. I would go outside and sit crouched facing the corner with a hood over my head just to smoke because i was so terrified. I tried to talk to my mom and aunt to tell them what was happening with me, to no avail. This lead me to try suicide on three seperate occassions within a year. I was hospitalzed on all three occassions being told i had bipolar 2 disorder. But one thing about that is, they had no clue of the things i was seeing/hearing. They never asked. Not one time. I have been placed on several different medications (9 at one time). we have tried depekote, and geodon but they just zombify me to the point where i can not function at all, just sleep. I fight insomnia but at the same time have days where i can not get to sleep. I have rapid thoughts that lead into anger and just break down and cry, even at work. My doctor has placed me on latuda to try and control the symptoms. But the research i have done says that this medication is for schizophrenia and is not approved for bipolar disorder. I dont really know much about schizophrenia and when i try to talk to my doctor about my diagnosis whether it be the bipolar or schizophrenia, he has just asked me why i would want to label myself. I don’t, i want to know more about the conditions so as to educate myself and how to control and recognize what the symptoms are to get a handle so i know what to do and how to recognize when im coming into a crisis situation, i do not have a support group, im on my own with this. My question is, does the bipolar 2 disorder have this sort of symptomology, or is this more leaning toward the paranoid schizophrenia? the Latuda does help control the delusional thinking to a point, but the paranoia is very hard to keep at bay. I just need a better understanding of what is going on with me. Thyroid has been ruled out, but the seratonin levels are all out of whack. Thank you ahead of time for your time and understanding.

A. It is difficult to know precisely which disorder you may have. It’s possible that you have schizophrenia but another possibility is schizoaffective disorder. Schizoaffective disorder is loosely a combination of bipolar disorder and schizophrenia. In many cases, finding the right treatment is more important than pinning down a diagnosis.

What may be happening in your case is that you withheld information from your prescribing doctor, and were given an ineffective medication. To the best of your ability, it’s important to report all of your symptoms so that you can receive the most appropriate treatment. My advice is to contact the prescribing physician, report every symptom and be as honest as possible. Given new information, your doctor may prescribe a different medication which could significantly reduce your symptoms. Having the right medication could be the difference between having controlled and uncontrolled symptoms.

You also stated that you have no support. Is there a support group in your local community? Are friends and family willing to assist you? At this point in time, you need as much support as possible.

You’ve been through a lot. You have been battling significant mental health symptoms for at least four years and you refuse to give up the fight. I admire your determination and persistence. Having the proper medication could greatly assist you in reducing or potentially eliminating your symptoms. Talk to your doctor and hopefully, a change can be made immediately that would bring you relief. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice

I’m not happy I guess. I can’t go to school anymore, too many goddamn people staring at me and thinking about me, judging me ALL the time. I can’t even leave my own house, and when I do I either stay in the car or go to my brothers house, which is horrible. I know what people think of me, I’m a bad person. I deserve to be treated badly and ignoring, I deserve to be miserable for the rest of my life. No one will ever like me, let alone love me. Once they get to know me, they’re off like the wind. I have no one to talk to, my sister is in just as bad shape as me so she hates me. My mother doesn’t care, my Father is a crack head and hates me too. I’m at home everyday, crying and wishing I could go outside. I can’t do outside!!! There’s too many people, I’ll start to shake and and sweat, my heart starts pumping hard and I can’t breathe. These people do it to me!!! I hate people, I can’t stand them, they don’t understand me, no one ever understands me… Makes me want to end it, I carry around a bag full of pills just in case if I feel like how I did when I over dosed before. Makes me feel in control, I feel like I can’t do the things I want to do. I hear something telling me I’m a loser and there’s no point in trying. I can never do anything at all…. My reflection is my only friend, I have no one else, so I just sit in my room talking to her. I always think she’s not me, that shes someone else, I always try and make her move or say something when I’m doing nothing. It keeps me busy throughout the days. No one believes me, no one cares enough to see why I can’t go outside. I wish I would get taken away or something, I want to be locked up forever so I don’t have to worry about being near people. I always fantasize that something will take me away from here, that there’s another world I can go to, somewhere I can be happy. Life is pointless and meaningless, I don’t care anymore,,,,,i cant cry anymore,,,,,,,,,,this is no longer nicole, shes gone now.

A. I’m sorry that you’re suffering. The fact that you believe “no one likes you” might be a sign of depression. You are convinced that other people don’t like you but you may be wrong. People with depression often misjudge reality. In the absence of any objective evidence, individuals with low self-esteem often believe that other people perceive them as being unlikeable or a “loser.” That type of faulty thinking leads to inaccurate conclusions.

Anxiety also seems to be an issue for you. You don’t like to go outside. When you do, you “shake and sweat,” your heart beats rapidly and you can’t breathe. You may be experiencing a panic attack. People have panic attacks when their anxiety has become out of control. In general, people suffer tremendously when their psychological symptoms are not well controlled.

It’s also concerning that you have suicidal thoughts. You’re prepared to overdose on a moment’s notice and are constantly fantasizing about dying. Those are worrying signs and clear evidence that professional help is required.

When an individual has difficulty seeing reality clearly, then it is in his or her best interest to seek the help of a trained professional who can correct their view of reality. Psychotherapy could be immensely beneficial to you. Anxiety disorders are highly treatable, as is depression. Medication might help, especially with your anxiety symptoms. You deserve to live a psychologically symptom-free life but you first must be willing to seek the appropriate professional help. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

I am 48, divorced with two grown boys and a granddaughter. One might think what a wonder life. Its not. I have been in medical chronic pain for over 8 years now. My medically issues continue to grow causing a now total of three chronic pain issues. All are different, all three are extremely painful. My life is in my bedroom. there is no cure for what I have.

I love my kids, and I have a boyfriend who supports and helps me. But I am not myself. Being in pain every single day has finally gotten me to the point of considering my quality of life. I spend hours in a day dream or something thinking about how I could take my life without it hurting my family or rather not having my boyfriends or kids walk in on my death.. this is crazy right?

Let me explain. I thought about going into the back yard leaving my dogs in the house, and cutting my wrists allowing the blood to go into buckets so there is no mess for my family to see. I think about taking my car and going super fast and ramming it into those cement things holding up the over pass. Quick, fast instant death that would not only releive my pain, but total the car so my boyfriend doesn’t have to worry about the payment anymore.

I honestly do not want to die, but with no cure, I can’t bare thr thought of living like this for the rest of my life. I can not take the pain anymore. Its always on the high end of the pain scale. Yes I am given pain medication but only just enough to barely take the edge off, its not enough! I’ve cried, screamed, spoken rational to my doctors but its like I am invisable. Wy can’t they hear me that I can’t take it anymore. Doctors are so afraid to give me proper pain control because of the crack down on drug abusers. If I didn’t have pain, I wouldn’t even consider taking this stuff. So I am suffering because a doctor is worried about his license? What about me? Don’t I matter? Are they just keeping me around to bill my insurance? I’m angry yes, mad, yes. Tired of hurting, yes.. I need help! I told my doctor my ideas about suicide, she said, do you think you’ll really do it? I said I don’t want to, but what other option do I have? She took this as I am having suicidal idealation. To me once again, no one takes me seriously. What can I do? Even my boyfriend has said. Honey I am so sorry, I don’t know if I could take what you deal with everyday, but I am so glad your strong. I’m not strong, I can’t even walk without help. Please can you help me?

A. I am sorry to hear about the pain that you have been experiencing. The fact the you are considering suicide as a “way out” is indicative of how much you are suffering.

You are in a gripping depression. Your decision to end your life is being clouded by this depression and your extreme pain. It is important that you seek professional help immediately.

There may be other options that you have not considered with regard to relieving your pain. Hypnosis can provide effective pain reduction. Find the right hypnotist and you could experience a significant reduction in pain.

Other people have reported achieving significant pain relief through the use of medical marijuana. Research the laws in your state. Perhaps your pain physician could provide a referral. If medical marijuana is not permitted in your state, then perhaps you could move to a state where it is legal. In many ways, this is a matter of life and death. Moving to a new state may mean a reduction in pain and thus regaining your life.

If you were to commit suicide, it would mark a negative turning point in the lives of your family. It could be the worst experience of their lives. They may even blame themselves for your suicide. It could affect their lives in other negative ways. Studies have shown that individuals who have had a family member who has committed suicide are more likely to commit suicide themselves.

Many people believe that the only choice for them is suicide. In many cases, they’re experiencing immense psychological pain. In your case you’re experiencing both psychological and physical pain. Persons with suicidal ideation are making assumptions based on desperation and irrational thoughts. The time to make an important decision is not when you’re ill or in mental or physical pain.

Consider exploring the options that I have mentioned above but don’t do this alone. Utilize the support of mental health professionals. They can help and support you at a time when you are most in need of this assistance. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

More than usual I have been obsessed with thoughts of killing myself. More so than any other time in my life. I am currently seeing a therapist once a month for head trauma, depression and total loss of my sense of smell due to head injury. I really can’t talk to him about it because he gets so angry at me when I mention my thoughts of suicide. He thinks I am bipolar and borderline which I had to read up on because I had no idea what it was. All I know is that I can’t go back into the hospital again but the intense feeling to hurt myself is escalating and I am starting to feel so much anxiety and detachment from all aspects of life. I guess my question is, do I change doctors or will things ever get better?

A. It is simply not acceptable for your therapist to become angry when you mention thoughts of suicide. It’s not a professional response. Perhaps there is “more to the story.” You may be correct that he becomes angry but it is also possible that it’s a misunderstanding.

Suicidal thoughts should always be taken seriously. They have become an obsession for you. It is important for you to work with a mental health professional with whom you can report your suicidal thoughts. I do not know if things will get better for you with your therapist but if you feel that he can’t help, then you should try a new therapist.

It is possible that you have chosen the wrong therapist. It is also possible that you might be misperceiving your therapist’s response. Be very upfront with your therapist. Be frank. Ask, your therapist if he is angry with you. Tell your therapist how you feel and why your feel that way. Never hold anything back from your therapist. When you withhold information from your therapist you are asking them to be more detective than therapist. It might not be appropriate to tell a friend all that you feel. It might not be appropriate to tell your dentist all that you are feeling but is very, very appropriate to tell your therapist. What I am saying is that your therapist is very unique. He or she deals with emotion. You should share all of your thoughts and feelings with your therapist. If you feel pain in your tooth, don’t share that with your therapist. If you feel fear of going to the dentist to have your tooth fixed, share that with your therapist. He will help you overcome that fear.

I understand that you do not want to be hospitalized but perhaps a short-term hospital stay is necessary to keep you safe. It may not be ideal but it might be necessary to save your life. If you feel that you cannot keep yourself safe, then you must seek emergency services. Change therapists if necessary and ultimately do what you must to keep yourself safe. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

I’ve considered the possibility of murder for many years now, starting with my father when I was around 8 (he was heavily psychologically and physically abusive to me, and I have vivid memories of watching him beating my mum and hearing him rape her from the next room) though admittedly I did not fully understand the implications of the actions at the time, but rather just wanted a release from the constant fear in which I lived.

These fantasies eventually developed to being about other people, and now I have them about random individuals I may know nothing about. If I see an attractive man or woman (I’m bisexual) I’ll often imagine what it would be like to choke them to death, or tie them up and kill them slowly using an range of devices, more often than simply gaining a desire to have sex with them. There have been times were I have sat for hours with these things playing out in my head, and I really would like help in repressing them.

The desire to kill is not always present, as I seem to go through cycles of the urges disappearing for up to a month, leading me to believe they are gone for good, before they return to be just as extreme as before. My suicidal thoughts come about in a similar fashion and usually start up around a similar time, though the two are seldom present at once.

I have an exiguous conscience, I cannot perform sexually unless the act involves some form of violence or aggression, and my empathy for other people is outstandingly limited. However, I would like to repress these urges I’ve been having, as I know my death would upset my mum and siblings (the only people I really care for; friends are just for amusement, I wouldn’t shed a tear if they all died tomorrow, and I’m claustrophobic so don’t like the idea of spending the rest of my life in a prison cell. It feels good to get this in the open, even if I have used an alias, but if you could provide me with any help on this matter it would be much appreciated. Just to clarify, I’ve no killed anybody up to this point. Thanks for reading. Side note: drinking blood and cannibalism are also things I’ve considered, though I believe they are more down to curiosity.

A. You have articulately described how you are feeling. The fact the you have decided to share these feelings, perhaps for the first time, is a positive sign. You’re acknowledging that they are a problem and that you would like help. I commend you on your willingness to be open and to consider seeking help.

As you’ve noted, if you were to kill someone, you could spend the rest of your life in prison. Prison life is horrendous. Claustrophobia could be the least of your problems. Have you read about what it’s like to live in a prison? If not, you should. Michael Santos just finished serving 25 years of a 45-year felony drug sentence. He’s written several books on what it was like to be in prison. He also spends a great deal of time writing on his blogs and on his Facebook page about that experience. Below are several excerpts from his book “Inside: Life Behind Bars In America:”

“The system would cage me within the forty-foot walls that surround the penitentiary alongside nearly three thousand men, many of whom never expect to leave prison. Those felons live without hope of anything better. Every prisoner in the penitentiary [is only ]whispers away from extortion attempts, from savage gang rapes, from bludgeoning and stabbings… Prisons remove hope. They create resentment. They thwart family relationships, degrade each individual’s sense of self, and separate offenders in every way from society…”

Most of the experiences in his book “Inside” could not be reproduced in my response because of their graphic nature. I would encourage you to read the book so you can see firsthand what life is like inside an American prison. It’s worse than most could imagine.

Depending on which state you live in, committing murder might also mean being sentenced to the death penalty. Your decision to end the life of another, or several others, could devastate the lives of many people. Should you carry out your desires, your actions could be immensely destructive. All religions condemn murder as an act of evil.

I would strongly encourage you to seek help from mental health professionals. It is your responsibility to attempt to control these admitted desires. A mental health professional could assist you in controlling your feelings, repressing your emotions, and providing you with the necessary skills to control your behavior. You should not attempt to deal with this problem on your own.

Your urges are likely related to a need for control. As a child you were abused and surrounded by abuse but you had no power to change it. Any love and kindness that you received was in an atmosphere of fear and danger. Your mother was beaten and raped by your father. The abuse filled your mind. These circumstances had negative effects upon your normal development.

You were a victim. You were an innocent victim. It was wrong, very wrong. It was horrendously wrong. Don’t do this to another. Don’t be guilty of the sins of your father by replicating his actions. Condemn his actions and do not allow yourself to be like him.

You haven’t hurt anyone. He is guilty. You are not. You are still the victim. The victim of your father’s sinful actions. A good therapist will end your father’s abuse. He or she will end the lingering effects of your father’s abuse. If you deliberately hurt another, then how are you different from your father? How can you condemn your father’s actions, if you willingly, deliberately do as he did?

It would be irresponsible to ignore this problem and simply hope that it will go away. This problem requires professional treatment. I hope that you will take my advice. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

I want to be sure before I go to a doctor. My dad is abusive to my brother, I get bullied because I like rock music, and i have had other life events which make me want to cut myself and often think about suicide. I see and hear things that others don’t, I have sleep problems from being restless to having sleep paralysis/denationalization.I have self esteem issues and have many phobias from clowns to my own imagination. I have some small habits when i’m worried or nervous like picking at my skin on my thumb and cracking my knuckles. Please help me to find out what I can so and if I need help or not.

A. It sounds as though you want to be certain that seeing a doctor is warranted. I would say yes. You describe a number of psychological issues that are negatively affecting your life. You are contemplating cutting and often think about suicide. Those are not normal ways of thinking. People who cut or who have the desire to cut and those who contemplate suicide are often depressed. Cutting and thoughts of suicide are always indicators of someone who needs help.

Your other symptoms are also concerning. Sleep problems may be related to stress and anxiety. Your sleeping difficulties may be also be contributing to other problems, like hearing things that others don’t. Anxiety also seems to be a problem. Picking at your skin and cracking your knuckles are potential indicators of stress and anxiety.

You have much stress at home. Mishandling stress, over time, can cause many psychological problems. Counseling can help and it can help a lot. It can help you to properly handle and react to the stress you presently have and help to prevent the development of more serious issues.

I hope that you will seek the proper psychological help. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

I am coming to this site for a few reasons. My roommate and good friend is a psychology student. He fears that I may have some psychological issues that stem from a wide variety of childhood abuse I endured at a young age. Since I’m young and on my own, I can’t really afford professional help, but I don’t want to scare myself with information on the internet that doesn’t cater to my exact situation.

As a young child, I was sexually and physically abused by my father on a regular basis. My mother was also physically abusive towards me, but was in prison the majority of my childhood. My father abandoned me and I was left with my maternal grandparents when I was 9. They kind of let me do whatever, and weren’t abusive, but didn’t always see that my needs were met.

I never thought that in later years, these things would come back to haunt me. Through much of my teenage years I brushed off the negative feelings I had as “teen angst” and assumed it would eventually go away. Since the age of ten however, I have self-harmed, had issues with my body appearance, and even attempted suicide. I am always anxious, and more recently, I have began to have awful night terrors that wake me up in a sweat. It has been almost a decade, and these problems are taking a huge toll on me in my attempt to lead a normal adult life.

I’m not sure how to handle the pain I go through on a daily basis. I’m not sure whether any psychological problems could be the result of the abuse I endured either. I have told myself time and time again “I’ll get over it” or I felt stupid for feeling this way over things that happened over a decade ago. I never honestly thought it was a big deal. But with my roommate insisting that my childhood could be the cause of these symptoms I’m having, I thought I would ask a professional for help.

A. There is a good chance that the problems you are currently experiencing stem from your abusive childhood. Your childhood was characterized by abuse, neglect and abandonment. The very people who were supposed to love, care and protect you harmed you and abandoned you. Thankfully you had your grandparents who did the best they could but still fell short.

You stated that you feel “stupid” for feeling the way you do but you shouldn’t. What happened to you was not your fault. No one easily “gets over” an abusive childhood. Your formative years were damaged by your parents. Having had an abusive childhood does not mean that you are irreparably damaged. There is damage from childhood for many people, if not most. The degree of damage varies but nonetheless the damage must be corrected. Therapy is a corrective process.

If you’re in college, then in all likelihood you can receive free psychological services through the counseling center. It would be advantageous for you to see a therapist to deal with the psychological pain that is degrading your life. It would be ill-advised to ignore your psychological pain or attempt to deal with it on your own. Psychotherapists are trained to deal with the very problems with which you struggle. Seeking professional psychological help would be the most efficient way to deal with this problem. Many people who are in counseling are dealing with issues that stem from childhood. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

My therapist and I had an emotional and sexual affair for nearly a year. After her spouse found out about the affair, our relationship ended quickly. I was distraught and had a near fatal suicide attempt.

After some time, I’ve come to the realization the relationship was a huge mistake and ethical boundaries were crossed and broken. I am torn to whether I should report my ex therapist to the ethics board for license review. I threatened her with having her license revoked and she threatened me that she would reveal what we discussed in therapy to my husband in retaliation.

What should I do? This situation is causing me to constantly have suicidal thoughts and has made my mental state worse than ever. I can’t seem to get a grip and I don’t know the right the to do. I’m afraid to trust another therapist. What is my moral obligation to report the affair? I have proof of the affair with hundreds of emails that we exchanged. Please help me. I can’t take this anymore and have no one to talk to.

A: First let me say that I am so very sorry that your vulnerability and trust were betrayed in this therapeutic relationship. You reactions make sense to me, and I can certainly understand the struggle to trust a therapist again. I appreciate the trust you are putting in PsychCentral by writing us here.

What happened is wrong and not your fault. Therapists are bound by legal and ethical guidelines set by their profession and the first place I would look to the professional association that governs the type of therapist she is. Psychiatrists, psychologists, social workers, licensed professional counselors, etc. all have separate associations that have guidelines for ethical behavior and client rights. I would call the proper agency, explain that you have a serious complaint, but also concerns about trust and the symptoms that you are having. They will give you options and procedures that you can follow.

This process usually requires a great deal of courage along with support. While I understand your hesitancy in trusting another therapist, I do believe there is a way to move forward with a measure of safety.

Since it is support you need I would look to join a therapy group in your area, either one run by a facility or a private practitioner with a decent reputation. In a group the other members of the group witness each member’s self-disclosure—as is the group therapist’s response. Just like your instinct to ask your question here—in a public forum — a group process begins to undo the secrecy and inhibition that often accompany this type of betrayal. You can find therapists in your area by looking at the find help tab at the top of the page.

Let me end where I began: What happened is wrong and not your fault. My sincerest hope is that you find the information, courage, and support you need to deal with this and grow through it.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

My younger sister, 23, is spiraling out of control and my family is at a loss at how to help her. She married this past summer (June 2012) to a young man of the same age who started medical school 2 months after their wedding, she moved to a new town several hours away from her family and friends. She is very lonely and extremely depressed with thoughts of suicide. She is unhappy with her job. She and her husband do not communicate and they only appear to fight and are angry with each other all the time. Many of her thoughts and actions have become irrational and unrealistic.

Many people have tried talking to her. in many different ways. We’ve tried the tough love, we’ve tried to give nothing but support but she refuses to accept our help. She has frequent panic attacks and we are afraid that she might act on her suicidal thoughts. She goes through periods where she ignores calls from family which leaves us concerned about her safety.

We have suggested a therapist, we have tried talking to her husband. She only seems to be getting worse. Any suggestions on how to help her?

A: Your sister is at the top of the stress scale: New marriage, a move, a job she isn’t happy with, husband in medical school, apart from her support system and now quarreling with the husband. No wonder she is having panic attacks. She is reacting to what for her is an overwhelming situation.

This is complicated. Since I don’t know the whole story, I may be only repeating what you and the rest of the family already know. As a married woman, her husband is the one who should be at the forefront. I’m concerned that one of the things the couple is fighting about may be your family’s involvement.

I do understand why you and your parents are so concerned. But this couple has to start working as a team during this difficult time or the marriage isn’t going to make it. They both need encouragement and support.

I think your best bet is to sympathize with her and her husband. Let them know that you understand why they’re having such a tough time managing their situation. Make sure they know that you are all on the side of the marriage. Suggest they get into couples counseling to help them figure out how to manage the multiple stresses they are under. Then cut back on the advice and give them lots of love. If you can give them a vote of confidence, they may rise to the occasion.

I wish everyone well during this challenging time.
Dr. Marie