Ask the Therapist Ask our resident Psych Central therapists. 2016-08-24T11:35:57Z http://psychcentral.com/ask-the-therapist/feed/atom/ Dr. Marie Hartwell-Walker <![CDATA[Feeling Left Out when My Husband Is with His Family]]> http://psychcentral.com/ask-the-therapist/?p=42157 2016-08-10T17:43:40Z 2016-08-24T11:35:57Z

From the U.S.: I have been married to my husband for 3 years. His family is out of the country and visit us for 3 to 4 weeks every year. He has a younger sister who is very attention seeking and comes and lives with us for a month every year. She never tries to get friendly with me and is very clingy to her brother – my husband.

i always feel left out when she is around as they keep doing sibling things. she is immature and keeps hugging him taking pictures of the 2 of them etc.

i try to find something i can do alone for those few weeks, but at the back of my mind feel sad and depressed that my husband forgets about me when she is around. He is very loving when its just the 2 of us, but is overly attached to his family when they are around and I feel left out and ignored. If i let him know he says I should be ok with that for a few weeks when they are around.

A: I don’t have enough information to comment on whether your husband is “over-attached.” He may simply be “attached,” which is a good thing. A man who is loving and loyal to his family is usually a man who knows how to be loving and loyal to his wife. If his family was asking him to choose them over you, it would be another story. I don’t see that in your letter. Instead, I see a family that misses him and that tries to pack 12 months of contact into 1 month.

You didn’t mention how old his sister is. If she is over 21 and inappropriately hugging, it might be advisable for your husband to start asserting some boundaries. That’s a “might.” Since I can’t witness what goes on, I can’t venture a definite. If she has a boyfriend or is dating, it’s probably not a problem but if her only affectionate contact with a male is your husband, it may not be helpful for him to go along with all of it.

If you were seeing me as a couple, I’d be asking your husband what he can do to reassure you that he hasn’t “forgotten” you during his family visits. And I’d be advising you to make more effort to befriend the sister by taking her on some “girls’ only” lunches or shopping trips or events. You’ll learn more about her when she isn’t so focused on her brother. It would be helpful if your husband supported you by encouraging his sister to go with you.

I wish you well.
Dr. Marie

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Daniel J. Tomasulo, PhD, TEP, MFA, MAPP http://www.FormerChild.com <![CDATA[My Mom Won’t Look at Me]]> http://psychcentral.com/ask-the-therapist/?p=42570 2016-08-09T21:46:55Z 2016-08-23T18:45:19Z

My mom has bipolar disorder and depression, she will spend a couple months never leaving her room and watching tv. Then will be super happy for a week, making family dinners and trying to bond with me. Oftentimes her mood swings are timed with her work, she free-lances so when she’s working her moods regulate, but she hasn’t had work for a few months so its been a downward spiral.

She and my dad have are stuck in a very bad relationship and I think she believes that my father and I are allied against her. Because my dad thinks I have the same opinions of her that he does I can’t be enthusiastic about things she says when we are all in the same room together. But I am supportive and enthused when she and I are alone.

In the last few weeks the way she acts towards me changed. In the past in her depressed phases she would still speak and act pretty human towards me. She might have been a little withdrawn but she would still have some kind of emotion. She wont even look at me now.

When I interact with her she wont respond. she asked me if I wanted anything from the store and my answer was normal and friendly but she didn’t even speak or nod or anything she just turned and walked away after getting my answer.
I don’t know what I can do to help her. She is on medications and in therapy. Should I just leave her alone? I know how to handle her normal mood swings. But she’s getting worse. I’m worried because there is a lot of self-destructive behavior happening. Her diet is a pattern of scam powder diets and binge eating ice cream. which is very unhealthy, she wont go to doctors, she’s smoking cigarettes excessively. she wont talk to me about any of this because she still sees me as the child and I’m worried because my dad isn’t really looking out for her. should I try to confront her about this or would that do more damage than good?

A: I appreciate the struggle you were having with your mom. But I do not think confronting her is the right thing to do.

Emphasizing that your dad needs to step-up would be an important way for you to help your mom. Having an in-depth talk with him is important. Explain that you’re not going to be around, that you’re in college — and eventually will have more of your own life — and not be there to help. If she’s getting worse and making a plan together to help her might be valuable. Working together with your dad and talking with him about your concerns is an important step.

Your dad may offer to go with her to therapy appointment to explain that there are some issues at home. Most therapists would welcome this from a family member.

Secondly you may want to talk to your college counseling center about resources in your area for family and friends of people with mental illness. You may also want to take advantage of the counseling services offered by them. This may help you cope as you continue to grow and take care of your own needs while dealing with with the family dynamics at home.

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

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Kristina Randle, Ph.D., LCSW <![CDATA[I Feel like I Want to Commit Murder]]> http://psychcentral.com/ask-the-therapist/?p=42507 2016-08-09T21:16:37Z 2016-08-23T11:35:40Z

When I was about 4, I used to bully this girl in my class. I pushed her down the slide and hurt her, but she was too afraid to tell anyone that it was me. As I got older, I began to feel like I wanted to kill someone. I don’t want to feel like that, but I do. When I get that feeling, I’ll stop whatever I’m doing and I’ll think about murder and how I would do it. Sometimes I’ll giggle and/or laugh while I’m thinking about it. My parents think that I’m lying and over-exaggerating. I’m not sure what to do, and I’m not sure if there’s some sort of problem going on. Half of my mind tells me to go out and kill someone, while the other half says that it’s wrong and I shouldn’t. I’ve gotten to the point where I have cut myself so the feeling would go away. Is there anything I can do to stop this feeling from becoming too strong? I don’t want to hurt or kill anyone, but sometimes I’ll get that feeling, and I’ll hurt myself instead.

A. It is important that you know that hurting or killing people is wrong. It’s immoral. It should not bring you pleasure to think about hurting people. You might feel this way because someone hurt you and you want someone else to feel the pain that you once felt. Revenge is an understandable human emotion, but it is not a healthy or an appropriate one.

You should want to bring goodness into the world and to help people. Most religions have a variation of the Golden rule that they follow which essentially states that you should treat people the way that you would want to be treated. That message should be one to live by

Painful emotions are distressing and unpleasant. Some people have good mentors who teach them how to deal with painful emotions when they arise but not everyone is so fortunate. Never having learned these skills could explain why you think about murder and engage in self-injury. Those are unhealthy responses to strong emotions that can be corrected with counseling.

It’s good that you have shared this information with your parents because they need to know that something is wrong. You should tell them that you wrote us a letter detailing your concerns and that you want help. Ask them to help you find a therapist in your community. It is especially important because of your self-injury. If your parents don’t take you seriously, then tell a trusted faculty member, family friend or clergyman about this problem.

Self-injury is common among people with emotional problems. Counseling could help you immensely. If you feel that you might harm yourself or someone else, contact emergency services. They can prevent you from engaging in destructive behavior. Please take care.

Dr. Kristina Randle

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Dr. Marie Hartwell-Walker <![CDATA[My Body Is Ruining My Life!]]> http://psychcentral.com/ask-the-therapist/?p=42081 2016-08-09T20:56:21Z 2016-08-22T18:45:26Z

From Egypt: i have acne not only in my face but in my body too , shoulders , chest and my back i aslo have stretch marks, cellulite and im over weight! i have every thing that makes me hate myself, i go to the gym but still hate myself , i aslo tried to treat my acne but its not helping. this really affecting my self-esteem and my social life i dont feel confident at all and i hate myself

whenever i look to the other girls i feel like they are so lucky to at least have good skin but for me i got nothing , im so ugly and i cant do anything about it just to keep hating myself

A: I’m so. so sorry that you feel this way. But your problem is not your body. Your problem is a low self-esteem. You don’t like yourself so you won’t let other people like you either.

There are several American actors and actresses who are overweight and not leading man/woman beautiful. None the less, they are stars because they are friendly, engaging people. You could do the same. But at this point, you are so discouraged, you don’t believe it.

I don’t usually recommend my own book on this site but in your case I think it might be helpful. The title is Unlocking the Secrets of Self-Esteem. It’s a workbook that focuses on practical strategies for improving self-esteem.

It might also be helpful to see a counselor for some support and encouragement as you work to make changes in your self-image and your health.

That’s not to ignore the physical issues. You do need to follow up on treatment for the acne. I hope you are seeing a dermatologist for advice. Some strategic use of make-up might also help you feel better about your appearance. Exercise is not enough to control weight. I suggest you see an nutritionist to develop a plan.

You deserve treatment, not self-hatred. Please follow through and see the professionals who can give you the guidance you need.

I wish you well.
Dr. Marie

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Daniel J. Tomasulo, PhD, TEP, MFA, MAPP http://www.FormerChild.com <![CDATA[Extreme Guilt and a Desire to Be Alone]]> http://psychcentral.com/ask-the-therapist/?p=42563 2016-08-09T21:08:28Z 2016-08-22T11:35:18Z

From Sweden: I really, really want to be alone. I strongly dislike socializing and I’m really not a people-person. I never really feel like I connect with others and often feel like a misfit around other humans, like I simply don’t belong with them.

I’m incredibly not interested in socializing, not interested in other humans. Every second feels like a “waste of time” and I get bored out of my mind. When I’m by myself I never feel lonely or bored, there’s always something I want to do. I’m always itching to do those stuff I really want to do and find everything else pretty tedious. I spend a large amount of time in my head, and honestly, I feel no desire to become more social.

The only people I got in my life are my mother and my sister. I guess you could say we’ve got a special bond, it’s kind of always been us three together. The problem is, I’m starting to feel like we’re beginning to contrast in a completely wrong way. They’re social – whilst I’m not. They like talking and socializing, “hanging out”, – I loathe it. But since it’s “just us” we’ve only got each other, which means I’m “expected” to be social with them, which I’m not really is.
I know my mom yearns -needs- me to interact with them more, I know my sister is growing a strong dislike towards this solitary side of me – is starting to get annoyed and maybe thinking I don’t care about them.

While I’m incredibly grateful for these two amazing people, I really start to find myself wishing that I was born in some else, less social or caring, family. Or for me to simply stop existing. Or that I would’ve never been born. I’m not sure I can live with the guilt of the situation. Hurting them is the last thing I want to do, but I feel like caged animal nowadays, like I’m forced into a habitat I don’t belong in. Though I also can’t just leave – that would also hurt them.

I’m so lost of what to do. It feels so unfortunate. I just want to thrive in my lonesomeness, and I don’t think that will change, but by doing so I’ll only hurt the people I care so much about. The guilt is killing me. But what is there to do?

A: Thank you for your important question. I don’t believe wanting to be on your own is a problem. Some people prefer and thrive in this way.

The core issue is here is the ambivalence trying to satisfy the demands of the relationship with your mother and sister. It is this core contradiction that needs to be addressed.

This solution may be in discussing your concerns with them. Instead of this being an emotionally burdensome struggle you take on all by yourself, explaining to them what is going on can help at many levels. First, they may be relieved that you are sharing this ambivalence with them, secondly they’ll likely to have some empathy for your struggle. Finally, they may have suggestions about what the three of you can do moving forward to preserve the quality relationship you already have.

Moving toward the conflict by expressing it to them is the most direct method of helping to bring about a change.

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

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Kristina Randle, Ph.D., LCSW <![CDATA[Truth about a Fatal Motorcycle Accident]]> http://psychcentral.com/ask-the-therapist/?p=42451 2016-08-09T20:52:24Z 2016-08-21T18:45:58Z

I saw two motorcycles race past my house a few nights ago than I heard a loud bang and glass breaking a second later. Then I heard a lot of screaming. I went inside to get a phone and I called 911. One of the motorcyclists had t-boned a car making a left across the street a few houses down. I was the second neighbor to the scene and expected the worst. When I got there the first neighbor was trying to talk to the driver of the car and the screaming was coming from a group of the motorcyclists’ friends who witnessed the accident because they were there watching the motorcycles race. I went to the motorcyclist and instantly knew he was gone and that he went in an instant. I tried calming down the spectators and getting people back until help arrived. A few of the spectators started to become hostile. They began throwing things at the nearly split in half car and yelling threats to the driver and myself. I became so angry at them I decided to walk away. I could hear police coming so I decided to slow down and redirect traffic on the usually busy road. Now here’s what I’m having trouble dealing with:

Local news reports:
“The crash took pace on East Padonia Road, when — was traveling east and collided with a 2017 Toyota Corolla making a left from Treherne Road onto a west-bound travel lane of Padonia Road near Dulaney High School. Dezurn was pronounced dead at the scene, police said. The 26-year-old man driving the Toyota was taken to shock trauma, where his condition was unknown Sunday.”

The motorcyclist was racing and was probably doing 100mph. There is no way the car driver would have seen them from the stop sign and the motorcyclists knew what the risks were because they already had their friends there to watch them race.

Social media and local news forums are full of furious comments about the driver and I really want to let people know what really happened. As terrible as the death of someone is, I want to tell the world the truth. How can I do that? Should I do it? I’m sure the police investigation will prove me right but why there is much hatred and blame towards someone that can’t defend themselves? Thanks.

A. It is important that all true citizens work to improve their community. You went to the crash site and you tried to help the victims but were repelled by angry observers. There is an inherent risk in riding a motorcycle. One small stone, one unseen pothole, loose dirt on the road, all can be fatal for the person on the motorcycle. Under the best of conditions, riding a motorcycle is more dangerous than driving a car. If you do a little research, you will quickly see what appears to be a rising national problem with a certain type of motorcyclist, who deliberately violates traffic laws and then runs away from chasing police. These motorcyclists have fled the scene, gone to great lengths to outmaneuver police officers and have reached speeds of 170 mph on our public roads. At those speeds, the motorcyclist will not survive a crash and his motorcycle becomes a lethal missile, if it hits a car.

According to your letter, these motorcyclists were racing at speeds of 100 mph. Yes, they were aware of the fact that a crash would likely prove fatal, but they chose to race with their friends watching.

It is not up to you or I to determine the facts. It is up to the police to do an investigation and come to their conclusions. Every good citizen, should do their utmost to help every police officer. Since the founding of our country, we the people have made the laws through our elected representatives and we have created a police force to enforce those laws. They are our laws and we should do our best to live up to those laws. We should be offended when anyone breaks our laws and if we are dissatisfied with any laws we should work hard to have our representatives change those laws but until they are changed we must obey those laws.

Our police are underpaid and often under respected. They are not all perfect but then not all attorneys or judges or surgeons are perfect. We should do our best to get rid of bad attorneys, bad judges, bad surgeons, and bad police officers. Bad attorneys should be disbarred, bad judges should be removed from the bench, bad surgeons should have their licenses revoked and bad police officers should be retrained or fired.

The vast majority of police officers are quite good. They serve us the public and we should honestly and sincerely thank them for their service. Never let us forget that they put their lives on the line every time they stop a car for a traffic violation or they answer a 911 call.

We as American citizens should do everything in our power to help our police. We as a society have asked them to do a job for us and we should be grateful and fully supportive of those who have chosen to serve us.

You should call the police department, ask to talk to the investigating officers and offer your help. Perhaps they will accept your offer or perhaps not but I would be willing to bet that they will both thank you for your offer and treat you with respect. They deserve that same respect and never less.

If you feel that an injustice is being done to the driver of the car, in the social media, then you should feel free to post your honest and sincerely felt comments. Again, it doesn’t matter what you or I believe the truth to be, it only matters that which is ultimately proven to be the truth and that will certainly be best determined by the police, through their investigation. Thank you, for being a good citizen.

Dr. Kristina Randle

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Dr. Marie Hartwell-Walker <![CDATA[Uneasy about Wife’s Psychiatrist]]> http://psychcentral.com/ask-the-therapist/?p=42205 2016-08-09T20:42:34Z 2016-08-21T11:35:27Z

From the U.S.: My wife was prescribed sertraline, lorazepam and trazodone by a psychiatrist she had one video chat with for complaining about a variety of mental health issues. After an hour or so “therapy session” the psychiatrist told my wife she was giving a few mild medications that didn’t have any side effects. The psychiatrist also said to me that it would be fine if there was no one around to check in on my wife during the first few weeks of starting these medications, after I expressed my concern that I was concerned she might hurt herself if she was left alone (I am in the army and was suppose to go on a month long training exercise the day after my wife was prescribed these meds). And she then called my commander and disclosed specific information about my wife’s therapy session; even though we only asked if she could recommend that I stay back from the training so I could watch my wife during the first couple of weeks of taking these new medications.

The whole thing just seemed (at least) very unprofessional to me. My question is, did the psychiatrist make any mistakes? If yes, what were they? And Did she do anything illegal? Thank you for any help you can offer.

(Also yes my wife signed a confidentiality form at the beginning of the session saying everything said during the session would remain confidential.)

A: Every state has a review board to address concerns like yours. In your state, it is the Office of Professional Medical Conduct in the Dept of Health. Go to the website and look at the section on Rules, Regulations and Laws. You can submit a complaint by clicking on the “File a Complaint” tab.

Please do follow through. Your wife deserves good treatment. You both deserve peace of mind that she is getting it.

I wish you both well.
Dr. Marie

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Daniel J. Tomasulo, PhD, TEP, MFA, MAPP http://www.FormerChild.com <![CDATA[New Baby, Depression and Anger]]> http://psychcentral.com/ask-the-therapist/?p=42560 2016-08-09T20:39:27Z 2016-08-20T18:45:58Z

From the UK: We have a new son, now 9 months who is lovely. Most of the time I am absolutely fine. But regularly I feel depressed, I comfort eat, I feel that I am being a terrible father, I feel that I am not supporting my family correctly and feel extremely guilty for having these feelings. I am finding it very difficult to enjoy any element of my life. One of the most upsetting elements is the strain having our baby has put on my wife and my relationship. I also am becoming angry far quicker than I ever have. I guess I am really after a little advice for coping. Many thanks.

A: Thank you for your email. Research has shown at birth of a child has a very strong impact on the relationship satisfaction levels for a couple. It does tend to go down-for good reason. For women there is often a biochemical readjustment and postpartum reaction usually involving depression. For men the additional pressures of finances, and feeling the burden of being provider, chronic sleep loss and worries about the future begin to take their toll.

There is also a shift from being couple centric too baby centric. Almost always this results in a loss of intimacy and wariness to the adjustment of a new schedule.

In other words many of your feelings a perfectly normal.

For you self-care is at the very top of the list. If you’re not exercising or doing
some form of meditation these are two very important ways to help yourself on a day-to-day basis. Even if you can only devote small bits of time these are two activities that have known positive effects on well-being. If you are doing these trying to increase the amount of time you to go to them will also help.

Secondly, invest time in rekindling your relationship with your wife. What she’s needed from you in the past has changed radically. Offer a back rub or a foot massage, and be sure to take your turns holding your son and making sure mom gets a break. Believe it or not — studies have actually shown that is a direct correlation between the number of diapers a father changes and the quality of marital relations after baby is born. If I were you I’d put this research into practice.

I’ve actually written about some of these things in my book: Confessions of a Former Child: A Therapist’s Memoir. It gets better — but you need to take care of yourself, and each other.

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

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Kristina Randle, Ph.D., LCSW <![CDATA[Curious about the Way I Talk to Myself]]> http://psychcentral.com/ask-the-therapist/?p=42445 2016-08-09T20:27:43Z 2016-08-20T11:35:47Z

Ever since i was a kid i talked to myself and i knew i talked to myself – i just never acknowledged i did it in the way i did and that it wasn’t usual. when I talk to myself, it is as if my mind is split in half and i will say something like “yeah i wondered that too” and then the other part will respond saying something like “yeah me either, it was weird.” and it will always be that way, as if it a conversation with myself and i respond to my self. Like i am two different people. Recently I’ve been wondering about it and realizing , wow this isn’t typical.

A. The idea of a “mind [that is] split in half, or a “split mind,” is a common misconception about mental illnesses. It comes from the word schizophrenia that means “split mind.” Many people take it to mean that a person has multiple personalities. People with multiple personalities might have dissociative identity disorder (DID) and not schizophrenia. DID is a rare disorder and likely not applicable in your situation.

I don’t have enough information to know why you talk to yourself, but it’s more typical than you might realize. It might be your way of calming yourself when stressed. Perhaps it helps you to think through difficult problems or to organize your thoughts. It could be a function of a developing brain. New research has indicated that the teenage brain does not reach full maturity until about the age of 25. Whatever the reason, it is generally not a problem unless it’s causing you significant distress. Thankfully, that doesn’t seem to be the case. Thank you for your question. Please take care.

Dr. Kristina Randle

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Dr. Marie Hartwell-Walker <![CDATA[I Don’t Like Being around People]]> http://psychcentral.com/ask-the-therapist/?p=42083 2016-08-09T19:18:28Z 2016-08-19T18:45:18Z

From a teen in the U.S.: I feel a sense of relief and happiness when I am alone, but my family is social. We go to parties and gatherings, where I would prefer to be in my room, ALONE. My family doesn’t realize that, they like, I am online the whole time when I am just lying there. What can I do?

A: What you can do is get out of your room and offline. My guess is that you like to be alone because you are uncomfortable around other people. Being online gives you the illusion of relationships without having to take the risk of being judged as socially awkward.

Unfortunately, you can’t gain social skills without being social. I suggest you do some research on how to develop those social skills and put them into practice. Start slow. When your family takes you to events, make it a point to talk to a few people.

Here’s one reminder: You probably know that most people love to talk about themselves and their interests. Just think of a few questions to ask them and you don’t have to say much. That will give you some much-needed practice.

I wish you well.
Dr. Marie

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Daniel J. Tomasulo, PhD, TEP, MFA, MAPP http://www.FormerChild.com <![CDATA[I Stopped Loving My Daughter]]> http://psychcentral.com/ask-the-therapist/?p=42558 2016-08-09T19:16:34Z 2016-08-19T11:35:04Z

I stopped loving my daughter. I usually live alone with her thousands of miles from my family and her father. Usually my whole life is devoted to her, who is just turning ten years old. I am a bipolar2 and a borderline 50 years old woman. I struggle being a mother with mental health issues. Now she’s in europe, visiting my family and her father, and I don’t want her back. Suddenly, in the past three weeks, I stop having any feeling whatsoever for her. I even try to picture her in pain, or crying, to see if it would stir any emotion in me, but instead I feel nothing, like I have never loved her. I’m in a panic, she’s due back in a month and I just can’t face her, I’m scared I would make her life miserable if she was to come back to me.

A: I very much appreciate you sharing your struggle. My best guess is that it is hard for you to control your feelings and the fact that your emotions are shut off and on the other end of the spectrum of how you usually feel may indicate that it is hard for you to regulate your discomfort.

Given the diagnoses you’ve mentioned this makes sense to me. I would recommend some personal therapy beginning immediately so that you can prepare for her return. Shutting your feelings off may be your way of defending against the pain of missing her.

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

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Kristina Randle, Ph.D., LCSW <![CDATA[Wanting to Die and/or Kill Someone (Family and Activism Issue)]]> http://psychcentral.com/ask-the-therapist/?p=42448 2016-08-09T19:13:47Z 2016-08-18T18:45:12Z

Although I know it’s wrong to self-diagnose, I self-diagnosed myself with dysthymia just in February because I started thinking about killing myself, although I never actualized my thoughts (because I know it’s wrong), when before, starting when I was around 8, I just thought of about how life for me and for everyone else around me might be better off without me being born – because I noticed the favoritism of my parents toward me over my sister.

I think it started in February because I’ve started to link it to unfortunate events (i.e. I got sick/got into an accident every February since 3 years ago -this time, I got into an accident in March).

But it started getting worse in April (because election’s in May). I started wanting to kill myself even more, in hopes to convince my family about how wrong their presidential choice is (I’ll explain later).

Election day came and my weird thoughts haven’t gone away.

Back to my family’s presidential choice, everyone except me, voted for one certain candidate and that candidate won, and he’s starting his platform (“Oplan ****”) -killing drug users/pushers/whatever.

Because of that “Oplan”, many activists and the Commission on Human Rights (CHR) stood against the candidate. What annoys me the most is the fact that my family is hating on the activists and CHR for protecting the druggies -which they’re not, their point is that innocent people may be killed and will never get justice because of that (the candidate condones extrajudicial killings).

And now I’m starting to have thoughts of “I hope someone in my family dies, whether it’s me or not, and does not get justice because he/she’s accused of (or framed-up) as a drug pusher.” Then I suddenly thought of how I could be the one to kill someone for that matter. I don’t think of plans to do it, but my mind already imagines the situation afterwards -how reality strikes my family then I’ll just smile.

I’m pretty sure this isn’t normal… I think it might be because of my activism, but it’s already a part of me and I don’t want to stop it. I’m also thinking it might be because of other reasons -right now, I can think of around 5 more reasons.

What can I do to stop these thoughts? Or should I just let these thoughts flow?

A. The only way to know if you have a mental illness is to be evaluated by a mental health professional. As you correctly noted, it’s not good to self-diagnose. Therefore you should avoid it.

Your thoughts, as of late, are concerning. Any time someone is considering suicide or homicide, it’s a sign that they are in distress and need help. Thoughts about suicide and homicide are indicators of a problem. Contented people don’t think about ending their lives or the lives of other people.

If you suspect that you have a mental illness, then seek professional help. It would help to reduce or eliminate your distressing thoughts. I’m not familiar with the mental health system in your country but seek out counseling, if such services are available. That would be the most efficient and responsible course of action. Please take care.

Dr. Kristina Randle

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Dr. Marie Hartwell-Walker <![CDATA[I Feel Stuck, Unfulfilled and Am Always Imagining Myself Being Somewhere Else]]> http://psychcentral.com/ask-the-therapist/?p=42085 2016-08-09T00:00:58Z 2016-08-18T11:35:18Z

From Canada: I would like to describe to you how I have been feeling lately and am interested to hear your thoughts and advice about how I could best deal with these emotions and feelings in a positive and constructive way.

I love traveling and experiencing new things however, every time I return home from a trip, whether it is shorter or longer, I start to feel really down and like my life is being wasted at home.

I am constantly dreaming of and imagining myself being somewhere else and living a different life, yet I feel almost powerless to change my current situation and not in control of my life. My job as an administrative assistant is unfulfilling and boring, yet I am paid well and am too scared to quit my job and find another, because I keep thinking, “what if the next job I choose is even worse?” I do feel like I need to change my job, but I just don’t know where to begin and am fearful of not finding something any better, with my limited skills.

I can’t stop my brain from thinking about my past travel memories and trying to relive those moments. I feel like it gets in the way of me enjoying the present moment when I am always trying to live in the past or dream of the future when I can get away again.

I am also always thinking that the grass must be greener on the other side, yet I understand that nobody’s life is perfect and there are always challenges. I follow a lot of travel bloggers on social media and can’t help but wish for their life of constant travel and exploring.

I feel completely unmotivated and stuck in my current life and routine and sometimes find it difficult to get out of bed in the morning and go to work, in addition to actually working, finishing projects and setting goals for myself.

I have trouble finding joy and happiness in the mundane and routine aspects of life. My daily life feels so monotonous and every day blends together.

Do you have any advice for how to deal with these feelings that I have been experiencing? I would greatly appreciate any tips that you can provide to me!

A: I think it’s possible that your unhappiness is a way you are telling yourself you need to make important changes in your life. I understand why you are afraid to leave a good job. But you said a very important thing in your letter: You said you have limited skills.

I imagine that as an administrative assistant, you do have skills in organization, word processing, and managing tasks. What you don’t have are the skills you need to put them to work to advance your interests.

My advice is that you start taking courses at your local college that are compatible with your dreams. Have you thought of the hospitality business? How about cruise line work? Or maybe you’d like to work outside your own country for a few years (in which case, you might need to learn another language).

Start with one course you can take during evenings or with workshops that happen on weekends. Taking some positive action and being around classmates who share your interests will probably give you the push you need to start feeling better and in more control of your life.

I wish you well.
Dr. Marie

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Daniel J. Tomasulo, PhD, TEP, MFA, MAPP http://www.FormerChild.com <![CDATA[How Do I Tell My Parents to Leave It Alone?]]> http://psychcentral.com/ask-the-therapist/?p=42556 2016-08-08T23:59:09Z 2016-08-17T18:45:56Z

My older brother was diagnosed with schizophrenia 10 years ago. Before his psychotic break, we were close. After he got sick, I moved away for college and never moved back to my home state.
For almost a decade, he’d only communicate with me in person. He was afraid to use email or the telephone because he thought people were spying on him. We I did talk to him, depending on what meds he was taking, he might be talkative or might not speak at all.
He’s not really in treatment. He sees a psychiatrist every 2 or 3 months and takes a long term injection. That’s all. Other than that he never leaves the house. Technically he’s been medicated for 10 years, never off antipsychotics, but his delusions are always a problem. He still believes that certain people have betrayed him and tried to ruin his life. So I can’t say he was ever recovered or stable. His psychiatrist is aware of his ongoing delusions.
In the beginning I encouraged my parents to get him to see a psychologist or other therapist and work out a treatment plan. They said, “He doesn’t want to do that.” So it never happened.
Now I’m not close with my brother. He’s missed much of what happened in my life over 10 years, including my wedding because he didn’t want to go out of the house.
My parents are trying to get us talking more. They use group text or Facetime. At first it was strained, and a year later I feel like I just don’t like the guy anymore. I don’t like the way my brother acts now. He’s rude, pushy, arrogant. He’s always criticizing and belittling me. He tries to manipulate me into buying things for him online. He starts fights about politics that seem endless and he won’t ever let them go (and we all have the same politics, we’re all registered democrats, so I don’t even know how we manage to fight).
He never asks me about my life, job, husband, hobbies, house, town, etc. When I talk to him about my life he changes the subject. He only likes to talk about his interests (movies, politics, music). If I talk to a friend I haven’t seen in 10 years, we catch up. My brother’s not interested in that. It feels really one-sided. There’s no give and take the relationship.
I currently have health problems and my physician asked me to avoid stress. I just feel like it’s impossible to do that with his toxic tantrums once a week. But I don’t know how to tell my parents to just leave it alone, let us grow apart, we have nothing in common and just shouldn’t be talking. If he was in REAL treatment maybe things would be different but he doesn’t want things to change.
If a friend was this judgmental, rude, abusive, manipulative, I wouldn’t associate with them anymore. I think I shouldn’t have to be subjected to that.

A: I appreciate how difficult it would be to have a brother with schizophrenia who is hard to communicate with, paranoid, abusive, and irritating to talk to. I don’t think there’s any merit in forced communication — just because your parents think it’s good. It doesn’t sound like it makes him feel better, and certainly doesn’t make you feel better. Your parents can hardly see it as a success.

I suggest three things: first and foremost to take care of your self. Don’t be doing these talks out of some kind of weekly obligation. Doing it out of guilt or responsibility isn’t healthy — for anyone. Instead I would encourage you not take part in the group FaceTime and shift to more individualized contact. Be direct. Let your parents know you’d like to talk to them separately from your brother so that you could call and catch up, this might also include talking one-on-one with them, but importantly this is these are conversations without your brother.

Secondly let your brother know that you’d want to talk with him individually from time to time. Put the responsibility on him for calling you once a month and you could call him once a month. Make sure you keep up your end of the bargain regardless if he does, and he can decide if he wants to keep up his. Just be sure you don’t let him abuse you when you are on the phone. Hang up by saying you are uncomfortable with how you are being treated. This isn’t a debate. It is the last thing you say before you hang up. Letting him berate you serves no purpose.

Finally I recommend doing a loving kindness meditation for your parents and your brother. Generating these compassionate feelings as you are lessening your contact with him should help emotionally with the process. You aren’t doing this to be mean — you are doing this to take care of yourself.

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

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Kristina Randle, Ph.D., LCSW <![CDATA[Voices In My Head?]]> http://psychcentral.com/ask-the-therapist/?p=42442 2016-08-08T23:56:36Z 2016-08-17T11:35:51Z

I have over the last few days been having voices in my head commenting on my thoughts and small events in my life, tell me I’m going to be ok, etc.

For awhile (year or two) I have times, especially when under lots of stress, I’ll get this feeling.. Like someone sent me a thought. I thought maybe it was God telling me something. But I realized the thoughts weren’t based on reality.. I concluded that it was just my very stressed brain’s way of coping. Because it was usually comforting thoughts that related to what I was stressed about.
I’ve had the feeling that I can sense when someone reads my text messages. I’ve proven that wrong. I still think it.

Now I’ve been having voices.. I know these voices aren’t real. I know they are only in my head, similar to those thoughts. I don’t hear them with my ears. Its not really hearing voices, it’s more like having voices. Its almost like those thoughts just turned into voices.

I have a therapist who I see every month and a half and I’m diagnosed with anxiety and social anxiety. I don’t trust her to tell her much of the big things.(like this) I have a HUGE fear of abandonment, depressed some,suicidal thoughts (which she knows) and occasionally anger problems, and HUGE problem trusting people. I’ve been emotionally abused all my childhood until age 17. I’ve had to take on the role of a parent so often since age 6-7 and no one was there for me until now that I’m older and have 3 great friends.:) I have trouble with trusting them enough to be friends a lot though. They’re trying to help me.

I feel very hollow and empty. My mom has Schizophrenia. She developed it 3 yrs ago. I’m afraid I’ll get it too. If I am getting it I want to catch it early on.

I know you can’t diagnose over the internet, but is this concerning? What is your advice? Thank you in advance.

A. You said that you have been diagnosed with anxiety disorders. The voices you described are generally consistent with those disorders and not with a psychotic disorder. People with psychotic disorders hear voices that are not their own. The voices might be your conscious mind trying to calm you when your stress level is high. That is a plausible explanation.

It’s also common for some people with anxiety disorders to believe that they are developing other, more serious ailments. People who are preoccupied with the idea of having a serious illness might have a diagnosable anxiety disorder called, as of the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), illness anxiety disorder.

The fact that you continue to have symptoms might be attributable to only going to therapy every month and a half. That’s an unusually long time between sessions. You could benefit from more frequent sessions.

Part of why you only go to therapy every six weeks might stem from your not trusting your therapist. You don’t tell her “big things” and therefore, it’s going to be difficult for her to help you. If you were honest with her about everything that is wrong, she could help you more effectively which, in all likelihood, would build trust in the relationship. She can only work with the information that you provide to her. Withholding information about your life hinders her ability to help you and therefore limits your progress. You might have more success in therapy if you were more honest.

The probability of your having schizophrenia, because your mother has it, is only slightly higher than if you did not have a family member with schizophrenia. In addition, you did not say how old your mother is but you did indicate that she developed schizophrenia only three years ago. It seems that she developed it much later in life than the norm. It’s unusual to develop schizophrenia over the age of 40. It does happen, but it’s unusual.

I would encourage you to report your concerns to your therapist and to increase the frequency of your therapy sessions. It might help to reduce your fears and help you to overcome these problems. Please take care.

Dr. Kristina Randle

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