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Dr. Know

@askdoctorknow / askdoctorknow.tumblr.com

M.Soc.Sc (Hons) Dip.Clin.Psych.MNZCCP You must not rely on the information on this website as an alternative to medical advice from your doctor or any other professional healthcare provider. If Dr Know has helped you, or you feel that Dr Know could help someone you care about, please recommend/share us on Facebook.
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Self - Diagnosis

A number of you have asked me for my thoughts on self-diagnosis. Here are some of the reasons I am fundamentally against it.

This brilliant book highlight the complex nature of the diagnosis of psychological problems. She points out that not only do physical illnesses have depression as part of the symptom profile. A number of the psychological/psychiatric illnesses can masquerade as physical illness.

For Instance:

Symptoms

Common anxiety signs and symptoms include:

  • Feeling nervous, restless or tense
  • Having a sense of impending danger, panic or doom
  • Having an increased heart rate
  • Breathing rapidly (hyperventilation)
  • Sweating
  • Trembling
  • Feeling weak or tired
  • Trouble concentrating or thinking about anything other than the present worry
  • Having trouble sleeping
  • Experiencing gastrointestinal (GI) problems
  • Having difficulty controlling worry
  • Having the urge to avoid things that trigger anxiety

Causes

The causes of anxiety disorders aren’t fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor.

Medical causes

For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem.

Examples of medical problems that can be linked to anxiety include:

  • Heart disease
  • Diabetes
  • Thyroid problems, such as hyperthyroidism
  • Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
  • Drug abuse or withdrawal
  • Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications
  • Chronic pain or irritable bowel syndrome
  • Rare tumors that produce certain “fight-or-flight” hormones

Sometimes anxiety can be a side effect of certain medications.

Learn more about what causes depression, including the genetic link, so you can seek treatment before depression robs you of your quality of life.

Be sure to read about medicines that can cause symptoms of depression. Then talk with your doctor about your concerns if you’re taking one of these medicines.

Learn about thyroid-related depression and about other hormone-related conditions such as menstruation, pregnancy, and menopause that are often associated with depression.

Many people with chronic illness experience depression. Learn more about the symptoms of depression with chronic illnesses, available treatment options, and tips for coping with chronic illness and depression.

Discover more about chronic pain and depression, and learn how your doctor might treat your pain and depression symptoms.

Grief is a normal feeling after any type of major loss. Find out more about grief – the symptoms and causes – and what to do if grief is prolonged.

There’s a strong link between serious alcohol use and depression. The question is, does regular drinking lead to depression, or are depressed people more likely to drink too much? Both are possible.

So as you can see the overlap is phenomenal. Sleep apnea is another condition that can create depression. There are more, but this gives you an idea.  Often gastrointestinal problems such as ulcers and irritable bowel syndrome are a direct result of anxiety. 

I realise that all of you cannot access medical help readily but please avoid self-diagnosis via Dr.Google.

Do you have a question about anxiety, social anxiety, depression, sex, relationships, mental health. Dr. Know is online and ready to take your questions now. ASK DR. KNOW

for my previous enquirer.

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Anonymous asked:

Hey! Recently ive been reading a lot about chronic fatigue. Ive been dealing with depression for many years is it possible that i have both? Ive been diagnosed with depression but the symptoms of fatigue syndrome are very accurate for me too. Can you tell me anything about this?

yes it is possible that you have both. But self diagnosis will only confuse the issue. Various conditions overlap each other. If you are truly concerned about being depressed you need to talk to your doctor.

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This is the Part II of my tutorial on Worry.

“Worry Beliefs, Myths & Fairytales.”

However, there are a lot of reasons WHY people continue to worry and are not prepared to give up worrying. You see, there is a lot of mythology attached to worrying, it is like a superstitious belief system. Worriers worry that if they stop worrying this will ensure that something bad will happen.

One of my favourite quotes from a client of mine goes a little like this. She was worrying about her teenage daughter going out in a car with boys to a party. When I asked her about the purpose of her worrying she stated,

“Someone in this family has to worry. God knows what would happen if I didn’t worry, the whole family would fall apart. It’s not that I want to do the worrying, but given that her father refuses to worry I have to!”

Then what happens to cement the essential nature of worrying is when the worry and the universe collide. Let me explain. Teenage daughter goes out with friends, older boys driving and they are off to a party and there will be alcohol.

Visualise mother at window worrying, father in bed asleep or watching sport on television.

Father says, “Relax, you know those kids are responsible, the parents are there, they have a designated driver, stop worrying.”

Then as circumstance would have it, the teenagers are involved in an accident not of their own making. So the content of the worry and the event collide. The worrier then receives further ‘evidence/reinforcement”- perceptually speaking – that there was and always will be a need to worry.

When in reality ‘worry’ is a thinking process and last time I looked thinking cannot move matter, nor can it control what occurs in the world. You could be planning a wedding, and worry constantly about whether it is going to rain or not, but no matter how much you worry, you will not impact on the weather.

The example above does illustrate how worry is maintained and the belief in it’s importance. But this is “superstitious behaviour”.

Although this is parental example you will have your own examples. Worrying about exams, if you have social anxiety you will worry about what people think of you. 

However, the same understanding applies. You will not change your exam performance by worrying. In fact the anxiety can impair your performance significantly.

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Testing the effectiveness of worry.

Try this: Put a glass of fluid in a glass on the very edge of a bench or tabletop. Stare at the glass and worry about it falling off, the bright

orange soft drink staining the carpet, glass shattering and going all through the carpet. Then imagine that it is one of the most expensive glasses you have in the house, and breaking this one would spoil the set. Keep looking and keep worrying.

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Q: Has the glass moved?

A: Of course not, because thought will not move an object.

Suggestion: Now move the glass with your hand into the centre of the surface, where it is less likely to be knocked, bumped or fall.

Observe how much more relaxed you feel. You were concerned and you acted upon that.

Action not thought, prevents.

Yes, but “What if?” I can hear you thinking this from here.

What if? I don’t worry about my exams. I won’t perform well and I will fail?

What if I lose all my friends because I stop worrying what they think of me.

It is easily recognisable as worry. Essentially “WHAT IF?” is the mantra of the worrier.

Those two magical words “What if?” are tone of the main triggers of worry. What if this happens? What if that happens? Oh my Goodness, what if they? What if she? What if? What if? What if? All this thinking will do is exhaust you as you continue to produce adrenalin in response to your worrying. Breaking down your immune system with each additional What if?

You are continuously switching on your flight/flight mechanism, for imagined threat not real threat, which is what Mother Nature designed the response for:- jumping from the burning building, killing the Sabre Tooth tiger at the cave entrance.

The internal workings of Worry.

I like the use of spirals to explain patterns of human thought. Particularly when discussing worry, for those of you that are masters of worry you will of course relate to that constant going around and around, particularly at 3 or 4 in the morning. Going nowhere, changing nothing, just round and around the ‘worry spiral.’ Just like these dominos. 

Flick your thoughts into a negative gearing and they will continue to tumble in that direction. As a client once described to me, “like watching water go down a toilet bowl.”

What activates this phenomenon is “What if?” Nothing in the external world needs to occur for the worrier, the whole process can be activated by one thought. “What if?…. Then predict a negative catastrophic outcome and away you go, spiraling down

In summary the thoughts would look like this:

You can see the downward spiral of what if - disaster. What if predict disaster. This is called catastrophising. The disasters you predict are always huge.

A very helpful way out of this spiral is to ask yourself this question:

“How is this thinking helping me?” or

 “Where is this thinking taking me?”

Carry your favourite question with you on a card and get into the habit of looking at it for 15 seconds to reprogram the thoughts.

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For the worrier, there is always something to worry about and if there isn’t, the other gift the worrier possesses is the ability to create something to worry about. For instance, they are able to worry about how much they are worrying and if they’re not worrying, they can worry about having forgotten something that they should be worrying about! Whew!

Now, what was that you were worried about?

Did you know that:

  • 40% of our worries never happen.
  • 30% are about pleasing everybody (not possible).
  • 10% are about health, but we are not doctors.
  • 12% are water over the dam, or under the bridge.
  • Therefore, only 8% could possibly be helpful.

Thomas S. Kepler

Do you have a question about anxiety, social anxiety, depression, sex, relationships, mental health. Dr. Know is online and ready to take your questions now. ASK DR. KNOW

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“This is the first part of my tutorial on ‘Generalised Anxiety Disorder’..... (Worry)

Firstly a chart of the symptoms:

As you can see the common denominator is Worry. 

Worry exists throughout the family of anxiety conditions. In particular health anxiety(hypochondria) and social anxiety. Where the worry is to do with what other people think of you.

So here’s a section of an essay I wrote on Worry. Will let this digest and show the other two parts. There will be discussions on treatment, as we go on.

“Don’t Worry be Happy…Yeah Right!”

THE CONTENT

Welcome worriers.

You will be pleased to know that finally, in the healthcare professions, worry is now being looked at in a different way. Once the territory of; eccentric aunts, uncles, grandmothers, bank managers, midwives and lawyers. Worry now has it’s very own clinical name:- “Generalised Anxiety Disorder.”

“What does that mean in plain English?”

Bones appear to be the best way to illustrate what I mean. In English we have “Bones of Contention” resulting in long-standing arguments. Then if there is an ‘issue’ in the house this is announced by one of the individuals stating, “I have a bone to pick with you!”.

And here you have a dog, ‘worrying at a bone.” Imagine him going from one end to the other, turning the bone over and going back the other way. (Eloquently described by C.Paolini in his book Inheritance)

“Always he returned to the same set of doubts, worrying at them like a dog with a bone, only with nothing to show for it other than a constant and increasing sense of anxiety”

A working Definition of Worry” – Crystal Ball Gazing

Worry is the prediction of negative catastrophic outcomes.

Every worry thought takes you spiralling into imagined scenarios of absolutely terrible events. You feel as though you will never manage, that you will be out of control. The final outcome will be disastrous. But!!! Remember all of these thoughts are based on predictions created by your fear based imaginations.

Focus on the word ‘prediction”. Is it true that you can read the future, is it true that any crystal ball gazers can read the future, no! Otherwise instead of having this look on his face he would be happily cruising the Carribean having had a lottery win.

Believing you can read and predict the fuure is not based in fact and it is not rational. Anxiety creates room for irrational thought and irrational thought creates anxiety, Remember to stay focussed in what is Fact, Truth & Reality. Worry provides you with nothing, it is not a friend.

“The Gifts of Worry.”

“Nothing isn’t quite right. You can have a whole collection of the following bonuses. Yes, all of these can be yours. Just keep worrying”.

  • depression
  • stomach and bowel problems
  • ulcers
  • excessive anxiety
  • muscle tension
  • fatigue, feeling wound up or restless
  • concentration difficulties, irritability
  • difficulty sleeping (don’t forget sleep in the brain’s food)

NB: There are of course medications that can help with sleep, but these are really only recommended in the short-term. Learning how to switch your mind off and not worry is better for you, especially in the long-term.

Many people experience anxiety over certain things; health, finances, what other people think of you. However, there is a difference between appropriate concern and worrying. Concern is associated with action, worry is a never ending cycle with no apparent outcome, taking you nowhere.

Just stop worrying!”……”Yeah Right”

If you are reading this, to help you understand a loved one who worries themselves sick. The first thing to learn about worry is that there is no point at all, anywhere in the universe, in telling a worrier to stop worrying. Let me demonstrate to you WHY.

All the while you are reading this paragraph, I do not want you thinking about camels. You must focus and not visualise any images you have seen of camels. Including National Geographic covers, cushion covers, travel brochures, camels in or out of the zoo, camels sauntering past pyramids. Nothing just focus.

Right, I think I have got that point across, you can’t trick the brain in that way. This is why I have great difficulty with the New Age school of positive thinking. The assumption being that if you tell yourself to stop worrying and just feel at one with the universe, that all will be well in your world. Again, “Yeah Right!”

Remember the Bobby McFerrin song “Don’t Worry Be Happy” (Great youtube clip) when you listen to the lyrics a little closer the main message is: that worrying does not help fix anything.

“..In every life we have some trouble..

When you worry you make it double, don’t worry be happy…

In your life expect some trouble, but when you worry you make it double,  don’t worry, be happy…” Bobby McFerrin (1989)

The sentiment being, life is full of difficult and painful times, that you will have to deal with. So wait and deal with them when they are real not part of your fear driven imagination. In the words of the French philosopher Michael de Montaigne

“My life has been full of misfortunes most of which, never happened.”  

Do you have a question about anxiety, social anxiety, depression, sex, relationships, mental health. Dr. Know is online and ready to take your questions now. ASK DR. KNOW

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Anonymous asked:

How do I deal with a very depressed emotionally unstable mom who doesn’t believe in therapy, not even anything anyone says really. Doesn’t try to make things better. Only wants to run away from her life. She is an amazing mother seriously the best. But she’s so depressed and unstable it gets everyone down. She still continues to be hardworking always there for all of us. But she’s not there for herself and she wants us to fix her. But i don’t know how. And it drains me feeling so useless.

You can’t fix your mother or be responsible for her feelings. You can only tell her you love her, express your concerns occasionally but then you have to look after yourself.

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Do you have a question about anxiety, social anxiety, depression, sex, relationships, mental health. Dr. Know is online and ready to take your questions now. ASK DR. KNOW

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Anonymous asked:

I never felt good enough for my dad,he never give me the attention I want when I was a child.I felt like I wanted to kill myself when he died but I dint do it because of my mom. There have been 9 years since his dead and now I feel Im not good enough for anyone. Not even for my actual boyfriend,sometimes I feel I want to end all this fkn pain but I haven’t do it because I don’t want my mother to suffer more. Why she create me if my father dint wanted me? If him dint really care how others will?

There are a lot of confused feelings here. Have you spoken to your mother about how you feel, perhaps your father was just a man who didn’t know how to express his feelings. It is a big leap from not feeling as though your father cared and then generalising that to everyone you meet. Have you tried therapy, a start maybe to look through my book, read up on generalising and emotional reasoning this maybe what is causing the problem

Do you have a question about anxiety, social anxiety, depression, sex, relationships, mental health. Dr. Know is online and ready to take your questions now. ASK DR. KNOW

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Anonymous asked:

I've been to my therapist about 7 times now (1/week) and it's been helpful up until the last week where they made me feel bad for showing up and not knowing what to talk about just because I had a good week and didn't feel bad that day...Like they would just stare at me until I said something. Is this normal? (I was afraid they would drop me since this therapy is free for me)

Because you felt bad does not guarantee that they were intending that to be the outcome. I would clarify your concern with them the next time you go, In my experience I am pleased if a client has a good week, I would not set out to discourage that progress.

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Do you have a question about anxiety, social anxiety, depression, sex, relationships, mental health. Dr. Know is online and ready to take your questions now. ASK DR. KNOW

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Anonymous asked:

Hello. I have severe social anxiety and deal with depression I think because of this... i was referred to CBT therapy a year ago however it did not help me much. I don’t enjoy talking about my problems either which causes me to keep everything bottled up-

What I would like you to do is get a copy of my book which is based in CBT. It is for anxiety and will generalise across to social anxiety. Given that you don’t open up in therapy The Book of Knowing may give you some skills and give you more confidence in the therapy.

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