My granddaughter (7 years old, 1st grade) is having problems in school with behavior. She is extremely intelligent, reads numerous books each week on approximatly a fourth grade level. But, she has no self control, she talks (blurts out things) all the time and at inappropriate times. It’s very hard to reign her in once she starts talking. She also can have a melt down if she is over stimulated, ie: the Mall with all the noise and people send her over the edge. She is in trouble at school most days. My son and his family just move back to our home town, the school she was in before moving was on the verge of expelling her (they refused to allow her to enroll for next fall), she was kicked out of YMCA care last summer. She also has a high shrill voice and is extremely immature in social settings. She is very emotional, crying over each perceived slight or getting extremely agitated agressive. Please let us know what we should do and where we should go for help.

A: Please take this child to an experienced child psychologist for an evaluation. I can’t, of course, make a diagnosis on the basis of a letter. But many of the behaviors you describe are consistent with Aspergers. Although academically advanced, your grandchild doesn’t read or respond to social cues. Further, she is hypersensitive to certain stimuli. (Do some research on the internet and see if you think the descriptions of kids with Aspergers seem to match your grandchild.)

Having an accurate diagnosis is the first step to figuring out how to help. Whether it is Aspergers or something else, knowing what you are dealing with can offer a kind of relief as well as direction for what to do next. There are counselors for kids and their families and support groups for parents for almost every diagnosis. With appropriate treatment and practical support, children like your little grandchild can often learn how to feel good about themselves and fit in with peers.

I wish you all well.
Dr. Marie

Q. My husband blames me for our failed marriage and I have guilt. I am a recently divorced woman. A few years ago I wouldn’t have imagined being in this situation. But I feel that I have learned a lot about myself.

I met my husband in a whirlwind — and in just 3 months he asked me to marry him. He was perfect — the house, the teaching and coaching jobs, funny and sweet. We married 9 mths to the date we met. I couldn’t believe such a wonderful man would want to marry me. I didn’t have much, but a wonderful 7 year old…

Two weeks before we married he was accused of sending sexual messages over the internet to two highschool students. He denied them and lost his jobs. I stood by his side, which also meant paying the majority of the bills which he had accumulated before our marriage, including the house payment. I started resenting him for what had happend and that he was spending most of the time with my daughter. I told him that and he said it would take time…

But a year later it was still the same. Something told me to look at his computer. I found two dating sites he was registered to and left for two weeks. I returned when he said that it was during college he did that. I found more and more dating and perverse sites he was registered to asking for sexual things I couldn’t even imagine, even gay dating sites. I confronted him and he denied them. Then he said it was my fault!!! Then he said it was no big deal.

We separated for a month and when I went back to get some of my belongings, he changed the locks on our house! (I was still giving him money to pay the bills!). I tried to confide in his sister-in-law and she just told me to get a divorce! We went to counseling when he said he was going to kill himself and he lied to the counselor!

I hold this mound of guilt over my shoulders. I have tried to talk to him and tell him that he has a problem and he says that I cheated on him! I didn’t have time. I had to get a restraining order on him when he was threatening me at my work! I had to go to divorce court where he tried to take my daughter and my savings! During our marriage I never put money into my savings it went into bills! My question is — I never got any closer. I feel that I was used! I feel that it was my fault - the divorce. And I don’t know if I will ever trust again. Did he use me? Did I run from our marriage? I am still afraid he is going to try to hurt me, but most of it is mental. He never was abusive during our marriage only after I confronted him.. It was almost like he was trying to cover something up about himself!

A. What happened is that you rushed into a marriage with a man you did not know. You did not take the time to know who you were marrying. You knew him for only three months before he proposed and were married only six months later. This is not enough time to get to know a person before you decide to get married.

You also said this was a “whirlwind” relationship presumably meaning you were “head over heals” in love. This type of love is always dangerous because people tend to overlook elements of a person’s personality or behavior that would normally alarm them. You may have become “blinded” to problems in the relationship that might have otherwise concerned you. This may be what happened in your situation.

Since I only am getting one side of the story I do not know if the divorce was “your fault” as your ex-husband claims. Based on your letter, it certainly seems as if he was the one who ruined the marriage. He lied to you, possibly cheated on you, stole your money, and much more. If this was the case, then it would have been his behavior that destroyed the marriage.

But even if the divorce was “your fault,” and I said above, it certainly does not seem like it was, maybe it was the best possible outcome for you. Once you got to know the man you married, you learned that that he was a liar, and a thief who is now trying to gain custody of your daughter. This is not a man you want to be married to. Your decision to get a divorce seems more like a blessing than something you should feel guilty about.

What should concern you is why you married this man to begin with. Don’t feel guilty about deciding to divorce someone who betrayed you and much more. Rather, focus your concern and energy on trying to assess what led you to marry someone who you did not know and who turned out to be a liar and a thief. A therapist can help you greatly with assessing what led you into this type of relationship, and more importantly, to help you never make such a costly mistake again.

Q. I have Borderline Personality Disorder & Bipolar Disorder Type II, with transient psychotic episodes. I was prescribed a brand new anti-psychotic, Invega (3 mgs.) about two & a half weeks ago for: distorted thinking, amplified emotions, & daily crying spells. As opposed to the same class of more recent anti-psychotics, such as Seroquel, I am tolerating this one very well — with the exception of weight gain. I have been dieting & exercising in an effort to eliminate or decrease this side effect, but have still already gained 5 pounds! I’d like to know if this side effect will subside as my body gets acclimated to it, or with time. I discontinued the others because this is the one side effect which I will not withstand. I discontinued the others due to this reason. If the answer is no, then should I try the older anti-psychotics, such a Haldol? Do they cause weight gain, too? Will the other drugs help my symptoms? I’d appreciate your opinion. My psychiatrist says he isn’t sure about my concern, since the medication is so new. Thanks in advance.

A. Most of the antipsychotic medications seem to contribute to weight gain. Some are worse than others. Zyprexa and Risperdal, for example are some of the worst offenders. Invega, as you mentioned is a relatively new medication. As your doctor has indicated, Invega’s true effects are not well known because it’s so new.

From what I know about Invega, those who take this drug seem to tolerate it better than some of the other antipsychotic drugs. There seem to be fewer side effects. One client who recently switched from Haldol and Zyprexa to Invega said she feels less “drugged” and less drowsy. She feels that her thinking is much clearer, and not “muddy” or “cloudy” like she used to have when she took the other two drugs.

Concerning weight gain, you might want stay on the Invega for a while longer to see if you gain any more weight. If all you gained on the drug was five pounds maximum and your symptoms remained under control, and you had no other side effects it might not be worth the effort it can sometimes take to find another medication that works as well.

Also remember that your weight can vary approximately two to five pounds each day. Depending on when you weight yourself (e.g. after a meal, after a large glass of water, before a bowel movement, the first day of your period) your weight can vary. It is possible that you didn’t actually gain the weight. Consistently checking your weight, using the same scale each time over the course of at least two weeks can tell you if you did in fact gain weight.

It’s good that you are dieting and exercising. These activities can surely help to keep possible weight gain at a minimum. If you find that you continue to gain weight despite your healthy efforts, then it’s probably time to talk to your doctor about trying a new medication. Take care.

Q. Both of my parents are mentally ill, my mother suffering from Schizophrenia and my father from Manic Depression. Both of my parents had regular auditory hallucinations and paranoia.

At 21, I’ve yet to suffer from any of their symptoms, but have been struggling with PTSD and related anxiety. Since I was aware enough to know my parents were ill, I’ve constantly monitored myself to make sure I wasn’t sick like they were.

From reading on this site and others, it appears that Schizophrenia shows up in women later than men. Could someone please talk about this more? Since I’m a 21 year old woman, I’d like to know if it’s possible for me to still develop Schizophrenia (though I show no signs of it now and haven’t in the past). I also just want to know at what age can I finally relax and know I’m past the threshold.

A. You are correct. Schizophrenia does tend to occur later in women than in males. The average age range for a female to develop schizophrenia is roughly ages 25-29 (18-21 in males). The reasons for the age difference between genders are not well understood.

Not every male or female who ultimately develops schizophrenia does so within the above-mentioned age range averages. Males can develop schizophrenia later than late- adolescence and females may get it sooner than their late twenties.

But you must know that just because both of your parents had a mental illness in no way means that you will be mentally ill. One does not necessarily lead to the other. It is true that people whose parents have a mental illness are at a greater risk for the development of a mental illness. Heredity does seem to play a role but there are many more factors that contribute to the development of a psychiatric illness.

The environment an individual grows up in can affect whether or a not a disorder develops. The majority of people with schizophrenia, for instance, report childhood physical, sexual or mental abuse. This is not to say that all people who are abused go on to develop schizophrenia. This is clearly not the case. But in some instances, the abuse could have possibly contributed to the development of the disease. Maybe if these individuals had never been exposed to abuse they may not have developed schizophrenia.

Drug use can also play a role in the development of schizophrenia. Drug use is commonly associated with schizophrenia, as well as bipolar disorder. I am familiar with a case in which a “normal” young adult male spent his weekend using LSD. By the end of the weekend, his LSD “high” never wore off. He never returned to his “normal” state of mind and subsequently suffered many psychotic breaks and was later diagnosed with schizophrenia. No one can be sure that his drug use definitely led to schizophrenia but it is a distinct possibility.

You are not doomed to develop the disease just because your parents did. You mentioned you have some other psychiatric issues, such anxiety and PTSD but neither of these are signs of schizophrenia. You also mentioned you have no other symptoms that would lead you to believe that you have the disorder. Please know that realistically, your chances of developing schizophrenia are very slim.

It’s unhealthy for you to constantly worry about this issue. By constantly focusing on this fear, you are keeping it alive and helping it to grow. If you do continually worry about this, it would be helpful for you to contact a therapist. You may feel better if you had someone you can discuss these fears with. A therapist can also help you with your anxiety issues as well as the PTSD. I hope this helps.

Q. I am 25 and been with my fiancée for eight years. She was my first girlfriend and I her boyfriend. In the 8 years we have broken up twice for short periods of a couple of months and dated other people. I love her very much and she wants to wait until married to have sex which I have respected for these years. Our wedding is three months away and the thought of it makes me feel ill. I recently met someone who made me feel alive — a 40 year old man! My fiancee doesnt wish to travel etc and is happy with what i see as a typical suburban life! Me too! But I am panicking that I’ll never get to see the world etc. I have slept with this man and it was amazing! Now I dont know if im gay or is it just because I have never slept wth a woman before as we are waiting for marriage. Our families are so excited and happy and I am in turmoil! I really dont know what to do!

A. Only you can know if getting married is the right choice but your letter raises some concerns. The fact that you recently slept with a man and thought it was “amazing” is problematic for several reasons. One reason is because this may indicate that you are gay. This may partly explain why the thought of marriage makes you feel ill. Heterosexual men would never sleep with a man even if their fiancé refused to have sex with them. Why? Because they are simply not attracted to men. If there are questions regarding your sexuality it may be wise to postpone the marriage until you sort out these issues.

What is also problematic for the relationship is that you cheated on your soon-to-be wife. Cheating before you’re married is not a sign of a healthy relationship.

You also mentioned that you feel that getting married means that you will not get to travel. If this is important to you and you feel that your fiancé will be holding you back from traveling, this can cause problems in the relationship. You may later come to resent her for “holding you back” from engaging in activities that you enjoy.

As I mentioned before, only you can know if you want to be married to your fiancé. It is important, however, that you get married for valid reasons and not because you feel pressured by her and her family, your family or because it would be too difficult to call off the wedding. These latter are not good reasons to get married.

Based on your letter, it seems as though you might need a little more time to know if you are making the correct decision. You need to be sure getting married is something you want and you are not doing it to please others or because you can’t say no.

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

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

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

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

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

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

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

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

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

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

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

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

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

I was with my ex for 5 months. It was the “first love” for me, so probably I was seeing more in that relationship than there really was. He left me for another girl a year ago. I should have stopped talking to him the same moment, but I was stupid and tried to make him come back to me. When the girl left him, I was by his side, but when he found another one I just couldn’t stand it and told him I’d rather not see him again.

I know that this sounds stupid, but my mind has no influence on how I feel. I love him, but I wasn’t worth him. Everyone was telling me that time heals the wounds, but it’s been a year and it’s only getting worse. I miss him, I cry at night because of that. I’d do anything to be with him, even for a moment, even to be able to touch him. And I know I mean nothing to him, he probably even forgot that I exist. Every time a smallest things reminds me of him I feel as if someone throw a huge, heavy stone inside of me. I can’t ever imagine being with anyone else. I know I’m broken and not worth fixing, so hoping someone could love me has no sense. I just don’t know what to do, I know nothing. For some time I wanted to kill myself, but I’m too weak.

There’s one more thing I fear. I’ve always wanted to go to Medical University, but that’s where my ex and his current girlfriend study. I’m afraid that I won’t be able to bear this if I see them together and it would be 4 years on the same university… If I run away from him, I’ll lost the last thing I want and can have. For a year I haven’t been really happy and I’m afraid I won’t be anymore. Even writing this the stupid me is crying. I just really don’t know what to do.

A; I really am sorry that you have been feeling so sad for so long. First love is often a very powerful experience. But you already know that your feelings are way out of proportion to a 5 month relationship. When someone becomes so obsessed and depressed that she can’t function, it usually means that there is more to the situation than a broken heart.

One way to figure it out is to ask yourself what you would be thinking about and doing if you were not so upset about the breakup. Is it possible that it is easier for you to maintain the upset than to face whatever it is that you should be attending to? Could it be that you are anxious about going on to university, for example? Or maybe you are so afraid to open your heart to someone again that there is a part of you that would rather be stuck than chance it.

I want to remind you that there are medical schools all over the world. If you don’t want to run into your ex at school, you could look into alternative places. There are lots of worthy men your age in your city, in your country, and in the larger world. Someone out there is looking for someone just like you. In either case (school or romance), you won’t find what you are looking for by sitting home and thinking about one failed relationship.

Most important, I don’t believe for a minute that you are “broken and not worth fixing.” Your self-esteem and self-confidence have suffered a blow but that doesn’t mean that you aren’t worthy of attention and care. Please find a counselor to help you sort all this out and get on with your life. You deserve to be happy again.

I wish you well.
Dr. Marie

I wrote to you 3 weeks ago about an issue with my boyfriend´s son ignoring me. I received an answer from Dr. Marie on April 7, 2008. She wrote what she thinks the reason is and that my boyfriend should have a man to man talk with his son about it.
I told my boyfriend about her suggestion. He said he can´t force his son to like me and wanted to know what Dr Marie suggests I should do. Please advise. Thank you.

A. You’ve been dating this man for 6 years and you’ve known this boy since he was 11. He’s now 17 and is still being rude to you. In your last letter, you said your boyfriend believes that no matter how his son treats you, you need to love him, respect him, and make him feel welcome. He doesn’t think his son should have to reciprocate. I disagree.

Please remind your boyfriend that I did not say that the boy should love you, or even like you. I am, however, strongly of the opinion that it is not asking too much for a young man to have good manners, nor is it asking too much of his father to insist on it.

Making polite conversation with the partner of someone you love, regardless of your own feeling about the person, is part of being a mature adult. If the boy comes home with a girlfriend you and his dad aren’t crazy about, he’ll want you both to treat her well (as you should). He should be expected to do the same for his dad and for you.

At this point, I think your problem is with your boyfriend as well as with the young man. It’s your boyfriend’s job as a father to teach his son good manners. After 6 years together, it is only reasonable to expect that he teach his son how to treat you properly. If he can’t do that, he should at the very least be willing to give you an honest explanation and an apology. Only you can be the judge of whether his reasons are enough to compensate for living with the situation as it is.

I wish you well.
Dr. Marie

I sought counseling and was told that my actions during that time resembled the symptoms of BPD (although after much research not one thing matches me even during that period). I was disappointed with the diagnosis or lack of a correct one and saw another doctor who told me I had PTSD but that he was unwilling to go against another naval shrink’s diagnosis.

I want to schedule a visit with yet another doctor but since a lot of what I’ve read on BPD says people who have it are manipulative, is it worth it if I may be seen as just “playing” the doctor to get a more preferable diagnosis. Is it possible that I am just missing the symptoms in myself?

A: Anything is possible - including that you are right. But more important to me than what label someone decides fits you is this: What are you doing to feel whole and safe again? You were traumatized by a near rape, then retraumatized by being made an outcast for having complained. Then your doctors got into debating a label instead of helping you work it through. It sounds to me like you need an experienced therapist who can work with you, regardless of your diagnosis. Move beyond diagnosis into the work of therapy so you can once again trust your own instincts and find loving relationships.

I wish you well.
Dr. Marie

My son is in the 8th grade and seemingly has no friends. His only 2 friends at school moved away, and he says he has no friends, eats lunch by himself, etc. His teachers confirmed this. He has a younger brother in 6th grade which he hangs around with, but the younger does have a set of friends and doesn’t always hang out with his big brother. He’s really not an unhappy kid, except he does get down sometimes. He gets decent grades and is overall a great kid. I know I can’t make friends for him, but the thought of him sitting in the lunchroom all by himself breaks my heart. Is there anything I can do to help him?

A: What a good dad you are to want to help. Being 13 years old can be the pits. When a kid hasn’t figured out the social scene in middle school, it is so painful. I suggest you start by having a private conversation with the school guidance counselor and his teachers. How do they see the problem? Is it that your son doesn’t know how to make friends? Has he inadvertently alienated the other kids? Or is this one of those mysterious situations that happens in middle school where some kids just aren’t accepted and the adults don’t know why? Having some idea of the nature of the problem may help give you some direction in solving it.

You could also ask the guidance office if they can find some job your son could do during lunch hour that will take him out of that lonely eating alone situation. Can he grab a quick sandwich then man the office or staff the library desk most of the lunch time? If it’s posed to him as a need for help rather than a rescue for him, he might accept the offer.

Fortunately, school’s almost out and you have the summer to work on building him up and helping him gain some skills. I’ve worked with many kids whose emotional lives have been saved by becoming involved in a regional theatre or music group or a specialized sport or a volunteer project that draws kids from many towns. They may not have friends in their own school, but the phone rings at home and they are engaged with peers on weekends. If you can manage it, I strongly suggest that you follow his interests and find a local camp that will let him develop a skill and at the same time meet kids with similar interests who don’t go to his school. Once he feels better about himself and develops more self-confidence with these kids, the problems at his own school may gradually disappear.

Then again, September will bring a new year and a fresh start. Stay tuned in to your son and give it a few weeks. Sometimes these problems evaporate just as mysteriously as they started.
I wish you well.

Dr. Marie

Six months ago I met the man of my dreams - except there is one catch - he has a 2 year old daughter. I am 24 and he is 34, we have been dating for 6 months and are now living together. I am finding it very very challenging to accept his daughter into my life. He was not previously married to his daughter’ mother, in fact she accidently got pregrant in there 2-3 week dating period. They tried to make it work when they found out about the pregnancy but could not. My partner is extremely committed to his daughter and has promised to always be there for her. I am feeling very resentful of him and his past mistake. I am angry at him for having a daughter and get physically ill often when she is around as it makes me think of him and her mother. I often think about what it will mean to accept his daughter as a permanent part of our lives when we get married and worry that I will always hold resentment towards her. I am hurt, frustrated, sad, angry and overwhelmed with how this is effecting me emotionally. My partner is extremely supportive and listens with an open heart to all of my ridiculousness constanly. We are constantly working together to find solutions to our dillema. I know I am hurting him though and that he wishes I felt differently. I wish that I could accept his daughter with open arms and be much more understanding however i am constantly angry!

Recently I have started to hate the way that I act about the whole situation. I have asked him who he would chose it he had to - me or his daughter. I have thought about asking him to give her up and let us move on with our own lives and let her be with her mom. I have also thought about leaving. Thought maybe that i am not cut out to be a step mom and that I cannot live with my partner’s mistakes for the rest of my life and that love is really not enough in our situation. But whenever I try to leave I just cannot! I really truly love him and want to spend the rest of my life with him - but I need to get over this.

I have also been thinking lately that the issue may be inflated by the birth control that I began taking 2 months ago. Since i started the medication it seems as though I am struggling much more with this situation then I was before. Could my emotions around this situation be inflated by the birth control? What can I do to fix this and change the way that I am feeling?
I love my boyfriend with all of my heart and want to be the supportive girlfriend that he deserves.

A: The question you should be asking is why it is that you are so insecure that you need to compete with a 2 year old. You have found a man who doesn’t walk away from his mistakes, who is committed to his child, and who listens to your irrational complaints. No wonder you love him. He’s one special guy! But your relationship hasn’t got a chance if you continue to put him in the position of having to choose between you and his toddler daughter. This little girl deserves love and care when she at her dad’s house, not resentment and bitterness.

Yes, your birth control could be inflating your emotions but it isn’t causing them. It seems that you want your boyfriend to have no past, even though he is 10 years older. It’s unrealistic and unfair for you to be angry at him for having lived a life. Perhaps counseling would help you figure yourself out. Please don’t even consider marriage until you do. Your boyfriend, his little girl, and you deserve better than you are able to give right now.

Iwish you well.
Dr. Marie

Q. Four months ago I met a man in two of my classes. We started studying together and developed a friendship. We are both married and shared similar religious beliefs and goals. Our friendship turned into an attraction that was obvious to the both of us and to those around us. Despite this attraction, we both set boundaries that prevented us from being unfaithful to our spouses.

Besides studying, we also flirted and continued to grow in our friendship. It was a strange relationship, because we never talked about having an affair or leaving our spouses for each other. In fact, we would encourage each other in our marriages. However, I feel that deep down we were unhappy with our marriages. He was a great friend and we often did things to help the other one out. He even gave me gift once just because.

Then, without any warning or understanding of what happened, he told me over the phone that he was talking to his wife and that our flirting was wrong. He apologized for doing that to me and said we couldn’t study together anymore. He also said it would be best not to speak to each other anymore.

I understand and respect his decision, but I felt that I deserved an explanation. I have honored his request and have stopped calling, texting, emailing, and talking to him in class. At first he ignored me and wouldn’t make eye contact. However, he’ll bring my name up in a positive way to others around us, laugh at my jokes that he overhears, and at times, seems to be very unhappy about the situation. I feel that if he would’ve asked me not to contact him anymore, I wouldn’t, but that we didn’t have to be so distant in class. We could at least be friendly.

I’ve had friends tell me to continue what I’m doing and to just be myself and some friends say I should approach him on the matter. Either way, I feel that we cannot be friends considering it caused problems for his marriage and that was not my intention. I think if I talk to him about it, then I would be disrespecting his request, but if I don’t talk to him, I feel that I will never have any closure. It’s been extremely difficult for me considering how close of friends we seemed to be. He used to tell me things that he didn’t reveal to anyone else. He felt comfortable with me and appreciated my friendship and my assistance in class.

Was he possibly falling in love with me? Does he still think about me? Is this as difficult for him as it is for me? Why didn’t he just talk to me about it so we could’ve figured it out together? I know he made the right decision for him and his family. I guess I was immature to think that we could have remained friends despite our attraction for each other. I miss him terribly and I know that secretly I was falling to him, but I also knew it would never get to that point because of our beliefs and my desire to be a good friend. I feel torn between trying to talk to him about this or just continue to ignore each other.

A. You must recognize that this relationship was more than a friendship. Just because you didn’t sleep together doesn’t mean you weren’t cheating. The two of you were carrying on a close, emotional relationship. His wife was correct to point out that the relationship was inappropriate for two people married to others. He was doing the right thing by ending the relationship and you should respect his decision to do so. It was the absolute correct action to take.

This relationship was dangerous to each of your respective marriages. You were attracted to one another and shared more than just class notes or study tips. You had developed a close bond. He was likely fulfilling a need that your husband is not able to at this time. You were probably fulfilling that same need for him.

In your mind, this relationship was not cheating because there was no sex. But in reality, this type of close relationship that the two of you had established, is more dangerous to a marriage than a strictly sexual affair. With the strictly sexual affair, there is usually only sex involved, no emotional ties. But with the type of relationship you and he had developed, you grew to care about each other. You were concerned with each other’s well-being. With a sex-only affair individuals share their bodies but in the type of relationship the two of you had, you shared your heart and mind. These later types of relationships, in which the two individuals grow to really care for one another, are the ones that usually lead to divorce.

You feel that he owns you a deeper explanation because you are hurt that he chose to end this relationship. But he ended it because it was wrong and it threatened his marriage. It threatened yours as well. Be glad that he chose this action because otherwise you might be facing a divorce. He did the right thing and you should respect this and move on.

Q. I know that I have issues that I need to deal with, such as anxiety, depression, and unsuccessful suicide attempts (obviously); and all of these recently have been becoming more worrisome. I have only ever once seen a psychologist for one visit, while in college (been out of college for 4 years) only so she could give a report to the college doctor; I was placed on a med (not sure what though and was only on it for about 3 months before not taking anymore). I am now very open to going to my pcp, a therapist, and/or a psychiatrist to hopefully decrease some of my issues. My question is who am I suppose to see first? My pcp, a therapist, or a pdoc? I have read my health insurance policy contract and I know I don’t need a referral to see any of these people. I have gone online but can’t find much and what I can find contradicts what something I found somewhere else stated. Who are you supposed to begin with for mental health issues?

A. Start with a therapist. Not all therapists are created equal so you’ll need to be hunting for not just any therapist but a well-qualified and seasoned therapist. One way to begin this process is to go to your phone book (or check out Psych Central’s Therapist Locator ) and call approximately six to ten therapists and talk to them over the phone.

Explain the issues that you want help with and ask if he or she has treated others with similar problems. If so, you want to know how they treated the issue. How many years have they been in practice? The purpose for calling the therapist is to get a sense of what they are like and what method he or she uses to treat his or her clients.

While you’re calling around you will likely get a sense of whether a therapist is friendly. Do they seem interested in helping you? Does the therapist seem knowledgeable? Make appointments with the therapists that you liked over the phone and meet them in person. Choose the therapist who seems the most qualified and who you feel the most comfortable with.

Once you find a therapist, he or she can refer you to a doctor or a psychiatrist for medication if the two of you judge this to be an appropriate action.

Conversely, you could start with your primary care doctor (PCP) and ask if he or she knows any good therapists. You can also ask around to see if your friends or family know of any competent clinicians.

If you begin this help-seeking process with a psychiatrist he or she is likely to give you a prescription on your first visit. Psychiatrists generally do not engage in any form of talk therapy. You may be interested in medication but medication alone rarely effectively cures any of the issues you are struggling with. If you begin a medication regimen you will still likely need therapy so it may be more efficient to start with a therapist and then seek a psychiatrist if you and your therapist deem it appropriate. I hope this answers your question.

I wish you luck.

Q. It sounds so crazy so why do i do it? Is it like another personality? I’ve never done it before and he’s the only one i do this with.(for like 2 years now) Would it have anything to do with the fact my father died 3 years ago when i was 16 and i never dealt with it because I couldn’t and still can’t.Like every time the emotions almost get to the surface a wave washes over me and it goes away no matter how hard i try to make it stay. Or maybe because my mother was untreated for her bi-polar and very abusive(emotionally,mentally and physically) through my whole childhood. She had alot of bf who lived with us. Bad guys.A drunk, a felon and a drug addict. They all had really violent tempers. One time her boy friends cut his chest open right in front of me. I was like 7. I’m afraid one of these men may have sexually abused me? I’m not sure but it freaks me out a great deal.I’m married and sex scares me. I feel so dirty. Also I feel EXTREMELY “dissociated” ALL the time. I just want to feel normal. Feel real. Why can’t I keep one train of thought for longer than a few seconds? Why do i get so emotionally overwhelmed that i cut myself?I do it to punish myself for being “bad” and also as a cry for help. Why is my memory so bad. Short and long term. Like things are missing. Why do i hide all these things and try my best to appear normal? Why am i so good at it? I feel so out of control on the inside but the outside i seem so normal.I get so depressed I have a hard time holding up my own body and I impulsivley eat. I have gained 20 pounds in 2 years and i hate it! I hate my body.(my mother had an eating disorder and used to pick on my weight growing up even though I wasn’t fat) I know I’m not really fat but what i see and what i feel say i am.(I don’t see what others see) Why do i push people away and then think they don’t love me? Why am I so dependent on my husband? Even things that i should do for myself! When i actually realize the way i act sometimes. I’m so ashamed.Why am I so anxious and CONSTANTLY worrying about everything?The smallest things I imagine the worst possible thing that could happen. Why am I so paranoid? Why are all my dreams about terrible things happening to me or the people closest to me? Why do i jump at every little thing? Is it possible for this madness inside me to stop? I go for an evaluation on Wednesday and I’m so scared of what I might hear or be told. I know its for the best. I don’t want to be like my mother. I know that there is no possible way anyone reading this can have the answers to the questions I’m asking but any insight would be very calming.I have control over myself in all the things mentioned above. Well for the most part. I try really hard. Sometimes i feel as if I’m hanging on by a thread. Any thoughts you may have will help.

A. You said that you talk to your husband like a baby but you did not elaborate further. When does this occur and how much? Does he tell you that you do this but you do not remember? Are you consciously aware of this behavior?

The reason I am asking these questions is because there are cases of individuals with dissociative identity disorder (DID) (formerly multiple personality disorder) who have engaged in similar behavior. I am familiar with a case of a client who used to call her therapist late at night and talk to him as if she were a very young child. It was not her pretending to be someone else, she had no idea that this behavior was occurring. Psychologically, the client actually became this separate child-like personality.

If your situation is similar you could be suffering from DID. DID is thought to occur in individuals who have experienced severe trauma, such as physical or sexual abuse. You mentioned that you have endured several traumas in your life (e.g. abuse, losing a parent) and acknowledge that you are unable to cope with these past traumas. You also said you feel “extremely dissociated.” You say that you have gaps in your memory. These are all possible signs of DID.

Please know that from your letter alone, I could never know if you suffer with DID but you do seem to meet some of the diagnostic criteria.

I am glad to hear that you are being evaluated to explore this further. The reality is that this is a complicated situation and you will need assistance from mental health professionals and support from other concerned family members.

Another concern is that you seem to be on the verge of losing control. You’re also anxious and jumpy. You’re essentially living in constant fear. This way of living cannot be easy or pleasant.

You are making the right move to seek help. During the evaluation be sure that your treatment plan includes some form of therapy. Medication will likely help you, especially with your anxiety, but it’s also important that you have a therapist who can teach you more effective life coping skills. Thanks for writing and I wish you luck. Please consider writing back and letting me know how your evaluation went and how you are doing. Take care.

Q. I think im Bipolar but i meet nearly all the things for schizophrenia to, please take me seriously i am a psy student..I am almost certain i am Bipolar i have thought about it for a number of years, recently (the last 18 months)ive begun to wonder if there is something else happening in my head. Diagnosing yourself is not something that works theres always going to be denial and i am a psychology student meaning mabye im biased..

I dont hear ‘voices’ but i have been hallucinating i often feel like im drunk and like nothing around me is actually seperate or external to me i just feel like im detached from my body kinda thing all the time. I feel like im in a dream when im awake i can find myself walking down corridors then i’ll be in diffrent areas walking somewhere else and my memory has gone, it feels in a way sometimes like ive just teleported, i dont really believe that but thats what it feels like.

When im not feeling detached and really there im thinking, crazy things.. i dont even want to call them delusions you dont wake up one morning and suddenly think i suffer delusions, for so much of my life i havnt realised ive never questioned my own thoughts before. Now ive realised it i think its worse everything in my head has become so scary, ive fallen out with my best friend very badly and we are always arguing im blaming her but i carnt tell if what im thinking is rational. I think at the time its all her im seeing things how they really are im not stupid this is whats really happening i can see and predict whats going to happen next, i have realised many times i have thought some very strange things, things that i think about now that scare me and i dont know how they could have been racing around in my head.

I feel guilty and sometimes try to stop crying and thinking of anything then i get angry that people will be able to know my thoughts and be angered by them but without me even telling them, like they would have access to them, so subconsciously its been there, if i heard it from someone else i would never think i was like that.

Ive been scared to talk about this all for so long,i want some medication even if its just for the depression and insomnia i just need something, i know ill need to see a doctor for any medicine but i dont know if i can, now ive realised these delusions have always been with me im understanding why ive always been so scared i need help, i imagine the days after my death what people would think or say, who would be annoyed or glad, i get scared of doing it i know i wont so close before but to weak to let go. I need some advice from someone who knows what their talking about, writing this has been hard for me

A. I realize that what you wrote was difficult. I commend you on gaining the courage to admit that there may be a problem with your thinking and how you’re feeling. Now that you have established that you need help, it’s time to get it. If you can get help now then you may be able to prevent any further suffering or ward off your chances for developing a serious mental health condition.

But keep this in mind, the truth is that at this point you have not been evaluated by a mental health professional and you do not know exactly what is going on with you. You mentioned that you have several symptoms such as dissociation, stress, feeling guilty, insomnia, depression and thinking people can hear your thoughts. This set of symptoms does not necessarily point to any one disorder so before you jump to any conclusions and diagnose yourself as schizophrenic you need to meet with a mental health professional and get an expert opinion.

You recognize that your symptoms are becoming too difficult for you to handle on your own. You are suffering and you are not sure what your diagnosis is. Now is the time for you to see a mental health professional for not only an informed diagnosis but also for assistance in dealing with the many issues you live with daily. It is wise for you to get help now. I wish you luck.