Hi, I’m sixteen years old and a male. I’ve been diagnosed with major depressive disorder, and generalized anxiety disorder since age 13. Also, I have used numerous drugs, alcohol, self-harmed, contemplated/attempted suicide twice, I don’t eat or treat myself very well, have critically low self esteem, etc. I’m living with my mother and older brother, they both express concern with me. I sleep too much, and have had to switch to online high school due to sleep issues. I used to do well in school, but now I have no motivation to do anything. I have things I enjoy doing, but I don’t enjoy them like I used to. My mother feels like she is an inconsistent parent, and I think that she tried to make up for it by punishing me harshly for every slip-up. It makes my quality of life much worse. I like the thought of suicide, although I don’t plan on it. Help?

A. You stated that you been diagnosed with major depressive disorder and generalized anxiety but have you received treatment? The fact that you continue to experience symptoms indicates that if you are receiving treatment, it’s not working. You also mentioned suicide but don’t have a specific plan to end your life. Any thoughts of suicide, even in the absence of a plan, are concerning. Your family is concerned about you and rightly so. By your own admission, you are not well.

It’s imperative that you seek mental health treatment. Ask your mother if she would be willing to have you evaluated. A mental health professional could determine what may be wrong but more important, develop an appropriate treatment plan to deal with your symptoms.

You may also consider family therapy, a type of therapy that includes your family in treatment. You mentioned that your mother is an “inconsistent parent” and is contributing to your unhappiness. Family therapy could address that problem directly. You can suggest this type of therapy to your mother and or the mental health evaluator, who could advise you about how to access family therapy.

In the meantime, try to improve your self-care. Not eating, depriving your body of the nutrients it needs to function properly, is likely contributing to your emotional instability. Your body needs food to survive and without it you will not feel well physically or psychologically.

You also mentioned that you don’t “treat yourself very well.” You’re using illegal drugs and alcohol and engaging in self-harm. The use of drugs and alcohol can also significantly increase your distressing symptoms. Alcohol is a nervous system depressant and can intensify your depression. Drugs and alcohol alter one’s mood. The initial ingestion of drugs or alcohol may seem to improve your mood but it does not last. Drugs and alcohol alter your brain chemistry and ultimately complicate mood disorders. Avoid all drugs and alcohol.

Finally, self-harm is a form of self-destruction. When people engage in self-harm, it usually means that they lack important problem-solving skills. The most efficient way to learn these important life skills is through the assistance of a mental health professional.

I hope you will take my advice. Speak to your mother about seeing a mental health professional and do what is necessary to receive treatment as soon as possible. Don’t ignore your suicidal thoughts and go to the hospital if you feel you might be a danger to yourself or someone else. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

My 5yo has been diagnosed with severe ADHD, Autism, ODD. He is on medications and has been doing so well until about the last three months. He has always had more problems with ADHD but now it seems like Autism is taking control of him! My 3yo is very delayed and does not speak due to 18q syndrome & Autism. We are all of a sudden having major problems with both of them. I’m wondering what we need to be looking for or many what to expect next.. Thanks

A: You have children who have big challenges and who can be very challenging. I hope you’ve had some help from an Early Intervention (EI) Program. In Florida, this is run by the state’s Early Steps program. Early Steps is administered by Children’s Medical Services (CMS) of the state’s Department of Health. Early Intervention programs both diagnose children under age 3 who have special needs and provide guidance about how to get further services. The phone number is (800) 654-4440.

Children over the age of 3 in Florida who need significant modifications in their educational programs may be eligible for special education services through their school district. About.com has a page that describes how to obtain these services. Check out this site.

In addition, ask your pediatrician if there is a local support group for parents of children with autism. Other parents are often our best resource to find out what services are available. Just as important, they completely understand what it is like to love a child who has special needs.

I don’t know what it is that is making your children act up these days. I do have a guess that they react to each other and also to your stress. Often things get going in families where people start to react to each other’s reactions. So it’s very important that you parents do everything you can to de-stress and take care of each other – even while caring for the kids. That’s another good reason to get to know other parents who can commiserate and offer practical advice.

I wish you well.
Dr. Marie

I am fairly convinced that my wife has some degree of bi-polar disorder. She goes into fits of rage over any question about her, her parents or upbringing. She constantly belittles me and talks bad about my family to the children.

It has escalated in recent years with her attempting to push me, going into 20 minute tirades where she brings up everything that I had done over the last 12 years and her drinking has increased. She drinks to the point that she is carried out of neighborhood parties with the children crying out of embarrassment then blames me. Those who dont tolerate it are ‘fake people’ but the others are ‘true friends’ and she has been going out and staying out all night this past month.

What is of greatest concern is that her explosions have increasingly come in front of the children resulting in them crying hysterically and her threatening to ‘kick me out’. She yells at them and then goes into a dialog of how much she does for them and how lucky they are.

It is very stressful but I need confirmation that this is what I am dealing with and how do I proceed?

A. It’s unclear whether your wife has bipolar disorder. Emotionally she is unstable but it might be due to her drinking. The fact that she is drinking makes it difficult to determine if a mental health disorder is present or if her drinking is the main problem. It may be a combination of both but I cannot make that determination based on this short letter.

What is clear is that your wife’s drinking is excessive and is causing a great deal of distress for your marriage and for your children. Both you and the children are subjected to her tirades. It’s abusive, unacceptable and something needs to change.

Encourage her to seek psychological treatment or inpatient rehabilitation if necessary. If she is unwilling to seek treatment, then you must take action. This might include seeking psychological help for yourself so that you know how best to deal with your wife or temporarily moving out of the home. Your children should not be subjected to your wife’s tirades. It most certainly frightens them and it’s abusive.

You may also want to consider an intervention. By this I mean you and members of your family come together as a group and ask your wife to seek help. During the intervention, members of the group describe how her behavior is affecting them and ask her to receive help. Perhaps she would be willing to seek help if she knew how her behavior was negatively affecting friends and family.

I can confirm the fact that there is a problem but I cannot determine the precise problem that is causing your wife to behave in such an unstable manner. Utilize the help of mental health professionals to assist you in dealing with your wife and children. I firmly believe that trained mental health professionals can give you the best advice about how to proceed. I wish you the best of luck. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

Hi, I hear voices in my head. It’s been going on for 3 years now. At first i heard a woman calling my name over and over. She sounded very gentle and calm, gradually I began to hear a very aggressive male voice as well. They ask questions like “Are you okay” or “Why did you do that”. It sounds like it’s coming from behind me, but so close like they could be just behind my shoulder. I hear both voices whispering at the same time as well, but I can’t make out what they’re saying, when I try to concentrate on them, they suddenly stop. They try to make conversation with me, but I’ve never replied to them. They’re not familiar voices that I think I have heard before. But I went through sexual child abuse during my childhood from my step-dad, who I am still living with now. I haven’t told anyone about this. Could that be why I hear the voices? I self-harmed because of the abuse and I became very paranoid, but it’s a lot better than it was before. Do you know how I could make the voices stop without visiting a doctor because I don’t want my Mom to know as she worries a lot and I’m afraid of being diagnosed with a disorder, because I feel that my mental health is fine. Thank you.

A. I don’t mean to alarm you but hearing voices is a concern. It is important that you are evaluated by a physician as soon as possible. As you noted, these symptoms have become increasingly more problematic. At first the voices were gentle and calm but they gradually became aggressive and frightening. The fact that your symptoms have progressed is precisely why you need to take action immediately.

Hearing voices is associated with psychotic disorders. I’m not saying you have a psychotic disorder, because it’s impossible for me to verify a psychiatric diagnosis without having interviewed you, but it is a concern. Without treatment, you are at risk of developing a psychotic disorder; thus, it’s imperative to receive help. The doctor will determine what the problem might be and develop an appropriate treatment plan.

It’s possible that your doctor will also prescribe medication. Medication can significantly decrease or eliminate the voices and possibly prevent the development of a psychotic episode. When it comes to the development of a psychotic disorder, prevention and early treatment are profoundly important. Medication might be what is needed to prevent a psychotic episode.

Report these symptoms to your mother even if it means that she will be worried about you. She needs to be aware of your symptoms. Next, ask if she will take you to see a mental health professional. Once you meet with a mental health professional, report your symptoms. The mental health professional will then advise you about your next steps. I hope that you will follow my advice and seek treatment immediately. Hearing voices, especially aggressive and frightening voices, is a symptom that requires immediate intervention. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

My wife’s erratic behavior has gotten me tied in knots. She’s acting like she did before we got married, like she did when she was 15-18. She lives like two people. We had an “intervention” a couple of weeks ago. I have three children all with either spouses or are in a serious relationship. Two live outside of home & my son is graduating university this spring. She has talked so terribly about me that it was affecting us all. When we had the intervention she took offense that we were “attacking her”. The issues of our hearts & feelings were ignored, denied, & she was unwilling to acknowledge any of it.
I really need some help knowing what happened to my normal world all of a sudden.

help

A: It’s not at all unusual for long-married couples to re-evaluate their marriage once the children are grown. It may be that your wife has been unhappy for some time but hasn’t had the time or energy to deal with it in the midst of raising kids. Now that they all seem settled, she may be turning to her own desires and feelings. She may not be doing it in an appropriate way but it’s not an inappropriate thing to do.

This is between the two of you, not something to sort out with adult kids. They need to be kept out of the middle by both of you. She shouldn’t be talking to them about her unhappiness with you. She should be talking to you. You shouldn’t be enlisting the kids to gang up on her through a surprise intervention. You should be reaching to her.

I suggest you, alone, have a quiet talk about how sad you are about how the two of your have grown apart. Ask her with all your heart if she would be willing to see a couples therapist with you to see if you can reconstruct your marriage. Tell her that you are willing to hear what she has to say and to take your part of the responsibility for what has happened.

With some 30 years of marriage, it’s at least worth a try to see if you can put things back together.

I wish you well.
Dr. Marie

I was diagnosed Bipolar II in 2007. My family and friends have had a hard time accepting this and most of my friends stopped talking to me and said I was faking it for attention and my mother told a family member that I could be different if I wanted to. I try so hard to be “normal” but sometimes it’s hard for me not to be overly anxious or very talkative.

When I’m around my family, I feel like they don’t like me very much and I don’t know if they love me anymore. Before my diagnosis and my “break down”, things were fine but after, things changed drastically. Even the way they speak to me has changed. There are times I feel anxious and I talk a lot and I try not to but my sister will admonish me in front of the entire family and tell me to calm down and stop cutting people off (my family is very boisterous and everyone speaks at the same time but she singles me out, even though every one is doing the same thing). My brother will shake his head and walk out on me and my father calls me a drama queen. I don’t know what to do anymore. I try to ignore it while I’m there because I don’t want to make a scene and ruin the evening but it makes me so sad and then later on, when I’ve had time to reflect, I get so angry and I want to cut them all out of my life. Last time I was there, I had such an awful time that once I got home, I had such an emotional melt down that affected me for hours just from the stress of the family get together. I don’t know what to do anymore and my family is one of those families that feels justified in their actions so no family therapy, no rational sit downs to tell them how I feel because they’ll turn it around on me and call me a “drama queen”. I know not all of this is because I’m bipolar II. I can usually recognize when I’m having issues but I get this treatment even on good days when I’m fine and quiet. Maybe it is me? Maybe I just don’t see it? I don’t know anymore but whatever the reason, being with my family makes me more miserable than any other time. Thanks for listening.

A: I am sorry you are having so much trouble with your family and friend relations. It was unclear from your email if you are in therapy and if you are being prescribed medicine for the bipolar II. If you are not in therapy and have not had a medication consultation I would strongly recommend finding a therapist and a psychiatrist who has experience in treating this condition. Being in the care of people who are trained to help can be an important step in coping with this.

On the good news side it sounds like you have some internal sense of when an episode is happening. This can give you options in dealing with your responses. I believe the strongest vehicle for learning what these options are is through group therapy. The find help tab at the top of this page can bring you to a person in your area that may be able to help. Often your local community mental health facility has an outpatient program where groups are available. In a group you will learn how to deal with your internal activation as well as how to come with feedback and confrontation from others. It can be a powerful source of support as you find your way.

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

My 6-year-old daughter has become so contrary! Every answer to every question, (when there is an answer) is negative. She has huge tantrums at school when she feels she has been slighted in any way and becomes violent when reprimanded. She has been kicked out of two extracurricular activities due to her extreme behavior and is becoming isolated from her peers. I just don’t know what to do anymore. She has never been abused or neglected, and I have been as consistent as possible but it’s like she doesn’t care what happens to her at all. I am very worried about her. What is going on? How can I help her?

A: Thank you for writing. You are right to be worried. When there is a sudden change in behavior, it usually indicates that something is very wrong, either medically or psychologically.

It’s always important to check out the possibility of an undiagnosed medical problem so the first thing to do is to make appointment with the pediatrician. Another possibility is that she has been hurt by someone and is scared to tell you about it or doesn’t know how. You know she hasn’t been abused or neglected by you but are you sure that she hasn’t been hurt by someone else?

Rather than scold, correct or punish your daughter, I think you need to have a quiet and heartfelt talk with her. Explain that you are very, very worried about the change in the way she is acting. Tell her that sometimes when people don’t know what to say, they act out their problem. Is she angry about something? Afraid? Sad?

One useful question to ask is this: “How would things be different if you couldn’t have a tantrum?” Sometimes the answer to that question gives us insight into what is bothering a kid.

The key in this is to be as calm, caring, and supportive as you know how to be — no matter what she says. She is only 6. You are 35. You can keep your head even if she can’t keep hers. If she is negative, simply stay with her and ask what else she has to say. Reassure her that you love her and that you want to help.

Once you have more information, you may be able to figure out how to be more helpful to her. If not, I suggest you find a family therapist. You and her father, if he is in the picture, need to learn new ways to support, encourage, and help your daughter. It’s important to lay down a good foundation now so that the rest of her childhood and teen years are not filled with strife and stress.

I wish you well.
Dr. Marie

Hello! Between age 21-25 I went through 3 very bad relationships ended in rejection, on the last one I had to be hospitalized, I couldn`t eat for days huge stomach pains from stress but I recovered and moved on. I noticed now in my 30+ I have no feeling of compassion, my friends say I have no heart. If somebody dies I don`t feel anything I have to pretend that I care. Even my own father end up in hospital in critical condition and deep down I felt nothing. My body can`t produce any sense of emotion about anything. I don`t care, I do`n bother anybody but people around are affected and say I need to see somebody. Is this serious?

A. You described yourself as someone who does not feel emotion. Friends are also concerned about what they perceive to be your lack of emotion. In one instance, your father was in the hospital and you said you felt nothing. If I had the opportunity to interview you, I would want to know more about your relationship with your father. If you and he were not close and you did not love your father, then I would not see your reaction as odd. Parents and their children do not always have close relationships. It may seem odd to the outsider that you felt nothing for your father when he was critically ill but if you and he were never close, then your reaction makes sense. It’s difficult to feel emotion for someone with whom you are not close.

With regard to what your friends say, it would been helpful to have had specific examples of why they think you lack emotion. It would’ve also have been helpful to have had more details about the times in which someone dies and you feel no emotion. If the person who died was not someone with whom you were close, again it would not be unusual for you to feel no emotion.

One thing that we can say with certainty is that there was a time when you could feel emotion. In fact, you felt very strong emotion. The breakups you experienced were emotionally difficult. If you are indeed stunted in your ability to feel emotion, then it may have been in response to the devastating effects of those earlier breakups. Lacking emotion, or having an inability to feel emotion, may be an unconscious defense mechanism that protects you from having to feel strong, negative emotions.

My recommendation would be to have an evaluation by a mental health professional. The purpose of the evaluation would be to determine if your perceived lack of emotion is accurate. It may be but I do not have enough information to make that determination. It’s worth having an evaluation to know if this problem is serious. It is abnormal to not feel emotion and there are treatments that could assist you in correcting this problem. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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 have always felt different than everyone else. I had never had real friends or anything besides my family (that is, my dad, my brother, and my mom); it’s not that I am myself with them; it’s more like they accept me with all of my eccentricities. I love math and I am currently participating in the Math Olympiad; thanks to it I knew about Aperger. There was a girl in there that was the only one I talked to, but unlike me, she could talk to everyone. One day (it happened two years ago) my father told me that the other girl father’s approached him and asked him if I had Aperger, because he saw me clumsy and antisocial and I remembered him of his daughter (that’s how we discovered that the other girl have Asperger). My father had never heard about this syndrome, so he investigated and told my family about what had happened and the symptoms and everyone began to make jokes about how I have Asperger and how I was even worse than the other girl, that last till this day. I try to ignore the jokes and pretend that I don’t care, but I am always wondering why they do this; if they actually think I have Asperger, and if they do why they had never been interested in trying to find out for sure. I don’t tell them anything because I am not sure if I want to be diagnosed. In a way I think I will feel better if I knew I have Asperger because then there will be a lot of other persons suffering the same thing, and I will feel less alone, but on the other hand, I don’t like been labeled and it would be useless anyway since I don’t think I will accept therapy. I am currently going with a psychologist (I had had three sessions) because of depression and anxiety but one of the things that she also treats is autism, so I been thinking about telling her so maybe she could send me to a professional or something, but I don’t want to sound as if I wanted to have Asperger. Is being diagnosed going to help me feel better? And should I tell my family first about my concerns?

A: I am very glad you are asking the question and writing us here. I think the best place to start now is with your psychologist because your family has not been as helpful as you would have hoped. Talk to the psychologist. She will be able to give your more information about what Asperger’s is, give your some idea of what treatments are available for it, and most important, give you a sense of the range of indicators that are part of making a diagnosis. She is the safest person for you to talk to about it right now.

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

It’s not like I’m depressed or anything, I’m not suicidal or self-harming, thats why I haven’t really sought out any help until now. I’m not sad in any way. I’m usually either really happy, or neutral. I used to do well in school. I’d try to ace all my courses, but recently I just really stopped caring. I feel almost like I’ve experienced everything but dying. I’ve been in most cliques at school, I’ve had major and minor surgeries, and I have a lot of medical conditions (that I was forced by my parent to visit the doctor and take care of). I still ,obviously, haven’t experienced everything though. I hardly pay attention to the actions I carry out and how they affect others , the way they react doesn’t bother me. Even though I should care about how they feel,I can’t and I realize it’s hurting my family and the people I’m around and I wish I could care. When my grandfather died a few months ago, I couldn’t even cry. I attended to my grandmother, but I didn’t feel like I lost anything; even though I was close with him. Late February, I adopted a pet, hoping it would pave the way to caring, it doesn’t feel like I’m cherishing the time with it though. It just feels like a responsibility that I must attend to regardless if I want to or not. I have no idea if theres something wrong with me, I just don’t want to live the rest of my life in this grey void. I’m not looking for a diagnosis, just advice.

A. You may be having a normal reaction to difficult life events.

You had both major and minor surgeries, “a lot” of medical conditions and recently lost your grandfather. These are all major life events and all seem to have occurred in close temporal proximity. Virtually anyone would struggle with these issues.

Your medical problems and surgeries could be affecting your mood. Your medical problems may require you to take certain medications, which may also be affecting the way you feel. Virtually all medications have side effects which could produce changes in your thinking and behavior and feelings.

Losing your grandfather may also be affecting your mood. Sadness after the death of a loved one is normal.

Medical problems, surgeries and losing a close family relative will undoubtedly have an effect on your mood and behavior. Therefore, it’s possible that these events are the reason why you are feeling the way you do.

It’s highly unlikely that you will “live the rest of your life in this grey void.” You’re experiencing a difficult time in your life but you will not always feel this way. I would encourage you to share your feelings with your parents. Ask if there’s anything they can do to help. They may offer advice or perhaps suggest counseling. During this difficult time, be open with your feelings and make it your goal to gain as much support as possible. The more support you have, the better you will feel. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

Hello my name is luke, my mother is going down hill fast including anti social and chucking items away and not eating she has been diagnosed with schizophrenia and other things in life and it is getting to the point where i’m ripping my hair out from stress.I woke up this morning to find the coffee table has been chucked away all my stuff from the lounge room is gone I brought her a new bed and she doesn’t want to sleep in it she sleeps on the lounge from about 10pm to 1pm no movement she doesn’t go out or do anything she won’t help her self or let anyone help her. i’m 20 looking after my mother and the house I have no life. I can’t have a girlfriend and if I have friends over she gets angry at them. what should I do? Move out and let her be by herself? or put her back in mental hospital???

A. While I understand your frustration, I would advise against moving out and “letting her be by herself.” I also don’t think putting her “back in the mental hospital” is advisable or even possible unless there is evidence that she is in grave danger because of her behavior or illness.

You mentioned that she wasn’t sleeping and eating, two signs which may be indicative of a psychotic episode. The fact that she’s not eating may mean that she does need to be in the hospital to protect her safety. If that is the case, then it is imperative that you call emergency services or do what is necessary to ensure that she is evaluated at a hospital.

Your mother needs more help than you or any other family member can offer. That seems clear.

If this is not an emergency situation, then contact the local community mental health center, the local hospital, her doctor if she has one, or any other psychiatric or medical professional who you think could refer you to the proper services. There may be home health care services that could assist in your mother’s care. There may be residential living facilities or group homes in which she could be better cared for by a trained, professional staff. Your goal at this point should be to find the best possible treatment for your mother.

Also consider contacting other family members who may be able to assist you. I hope that you’re able to find the proper assistance for your mother. She is clearly not well and you shouldn’t be managing this problem alone. Utilize the assistance of others if possible. I sympathize with your situation. Caring for a family member with a serious mental illness can be an overwhelming task and few lay people realize this. You almost have to live through it to know what it is like. I know that you did not exaggerate when you said you “have no life” of your own.

Hopefully, your mother will improve. You should see a counselor to help you through this process and period in your life. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

I have been in a committed relationship for 1.5 years to a man that truly loves me. He has 3 daughters 22,18,16. I have a 19 year old daughter who lives with me. We moved in together then 3 months later his 18 year old moved out of her mom’s house and moved in with us. His 22 and 16 lives with their Mom in another state. His daughters are disrespectful, rude, pretend I don’t exit and truly unappreciative. The 16 year old visits as much as she wants, and for as long as she wants. Things got worse and eventually my boyfriend and his 18 year old daughter moved into their own apartment.

All I have been to these girls is kind, nice and generous. I have treated them no different than my own daughter. A couple of things that bother me that I don’t know how to deal and I need help. When I am around them, they completely ignore me like I don’t exist. My boyfriend still talks to me,and he says don’t pay attention to them but I think their actions are extremely rude.

The next thing that really bothers me is that they talk about my daughter and I on social media. Especially the youngest(16). She doesn’t say my name, but everyone knows who she is talking about. She says that she honestly cannot believe he is still with me and that I believe that I should come first before his own kids and this is not TRUE!

They have caused so much stress to our relationship and my sanity I have decided to disengage from these girls.I will be cordial, say hello, but will no longer seek their approval. What advice can you give me to help me with what I am experiencing? This is the most horrible situation I have ever experienced.

I love this man and luckily he is on the same page as I am and I have his support. He has confronted them about how they treat me and remind them that I only have treated them with respect and love. Please help me because when I go and visit their apartment all I feel is anxiety and stress. We plan on getting married in the next 6 months but I do not know how to deal with his awful disrespectful daughters. Thank you!

A: I’m so, so sorry for the stress and distress this is causing you. It must be wonderful to find someone to love again. It must be awful to be targeted on Facebook and to be so badly treated by girls you were prepared to love.

As difficult as it is, please don’t take their behavior personally. It’s probably not about you. You are the symbol that their parents are never going to get back together. They are loyal to their mom. They want life to go back to the way it was. As soon as you moved in with their dad, they knew that the breakup of the family was indeed permanent and they hate it.

You don’t have to be a “mom” to these girls. As you know, they have a mom and they don’t need another one. Hopefully, they will eventually let you be an adult friend. Meanwhile, all you can do is be yourself and stay cordial. You don’t need their approval.

What you do need is for their dad to step up and give you more active support. He may have “confronted” them with words but from the sounds of it, he’s a bit of a doormat with their behavior. There don’t seem to be any meaningful consequences for their disrespectful behavior.

How is it that the 16-year-old gets to come and go as she likes, regardless of her behavior? How is it that she’s allowed to keep a cellphone if she uses it to hurt you? It seems to me that he should be telling her that if she wants to visit, she needs to be at least polite. She doesn’t have to love you but she does need to treat you as she would any guest of his who is important to him. Ditto for the 18-year-old. How is it she just moved in? He can let her know in no uncertain terms that staying at his place means treating you well.

I hope you will insist, for your own sake and the sake of your daughter, that your boyfriend take charge of this situation before you marry him. There needs to be a significant change now or you will never feel welcome and at peace in your own home if they are around.

I wish you well.
Dr. Marie

My 8 year old adopted daughter has had 4 different therapists including neurotherapy. She has yet to have someone really diagnose or help us with exactly her problems. She was adopted at 2 years old and spent the first 2 years of her life being seriously neglected and abused.

Up to this point we have treated each behavior problem individually but recently my husband and I realized they are ALL connected. She exhibits a disconnected behavior from her mind/body. In that she doesn’t seem to care if she is uncomfortable or in pain. She urinates herself at night but also daily. She doesn’t seem to care and yesterday even walked around with feces in her panties. She will wear her pants backwards and will not tell an adult if she is hurt. She will not wipe her face or complain of bad smells. She would sit in the bath and burn herself if the water was too hot rather than complain or try to get out of the bath. She seems to have very little conscience when it comes to other people’s feelings.

One therapist diagnosed her with RAD and another with ADD. She is very manipulative and passive aggressive. My question is without knowing all the other details what type of mental disorder(s) would cause a mind/body disconnect? She seems to not feel pain physically or mentally. She can feel physical pain but does not react to it in a normal way. Please help!

A: How very, very sad. I agree that everything you are observing is connected. What concerns me beyond the lack of reaction to pain is the apparent regression to very primitive behavior.

It is indeed possible that she has reactive attachment disorder. When a child doesn’t have the nurturing and care they need when very little, the child doesn’t have a model for caring, for self-care and for socially normative behavior.

Unfortunately, it’s also possible that your daughter has another mental disorder. Autism, intellectual disability, childhood disintegrative disorder and childhood schizophrenia all include some of the symptoms you describe. That’s just to hazard a few guesses.

Without a clear diagnosis, therapy can’t be helpful. The therapist doesn’t know what should be treated. I urge you to take your daughter to a medical facility that specializes in childhood psychiatric problems. First, she should be thoroughly checked for any medical condition that may be contributing to her behavior. Then she needs to be screened by specialists in childhood psychiatry.

Having a chronically ill or mentally ill child is as stressful as it gets. I hope you and your husband are also getting help for yourselves. Ask your doctor for information about support groups for parents. Often other parents are the best source of information, support and practical help.

I wish you well.
Dr. Marie

I am engaged to the man of my dreams but his mother and I can’t seem to get along. Sometimes we are fine, but for the most part we are screaming and fighting with each other. She has a drug problem and steals from us a lot. She also has another son and treats him way better then my fiance and it bothers us big time! I try my hardest to reason with her and get along but it will be good for a day and then its right back to fighting, I want to get along but I am worn out and feel out of options! What can I do to stop this vicious cycle that’s putting a big strain on our relationship?

A: Why are you making this so complicated? Just drop your end of the fight. Don’t set her up to steal from you by having her anywhere near things worth stealing. Don’t respond to provocations. You can’t change her. You can’t make her love your guy as much as she loves his brother. You can’t make someone who is an addict and behaves like one want to clean up her act.

Talking, reasoning, screaming, and cajoling won’t work. You can’t reason someone out of unreasonable thinking. If she tries to pick a fight, all you need to say is something like, “I’m sorry you feel that way. I don’t agree so let’s move on.” If she persists, simply, quietly and calmly leave! Don’t give in to the temptation to start a fight by moralizing, preaching, begging her to be nice or scolding her. As you’ve pointed out, it discourages you both even further.

It’s the relationship with your fiance that is your first consideration. If he can’t back you up in staying out of the fights, you have another problem. I hope he learned long ago what I’m trying to tell you. It’s up to his mother to decide to change. He can’t do it for her. You can’t succeed any more than he can. Hopefully at some point she’ll understand that she is losing the chance to have a wonderful relationship with her son and new daughter-in-law and will get herself into treatment. Until that time comes, all you can do is lovingly and calmly detach from the whole thing.

I wish you well.
Dr. Marie