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Wednesday, January 30, 2013

My Boyfriend and His Daughter...what are they doing?!

Question: I just witnessed my 39 year old boyfriend in bed with his 14 year old daughter. He was completely naked and she was fully clothed. When I asked what was going on, he said that when she heard me come through the house she jumped in bed to act like she was asleep. Is this normal? There are also other instances when she constantly wants to hold his hand, hug, kiss, and sit in his lap... Is this normal as well... I don't want to sound jealous, but I was never like this with my father and we were always distant... I am unsure if this is something that I should say something about.

Answer: Well go with your gut girl! I can tell by how you wrote your question, you think this is quite odd and worrisome. This is way over in the creeper zone. Time to find a new boyfriend. And, if you suspect abuse, it is your duty to report it to department of family and children.

Buddhism as a Therapy and Psychiatric Medications

Question: I believe I am going to be prescribed medication for PTSD and Depression at my next appointment and I am really nervous. If you were to prescribe medication to me for those conditions, what would you choose and why?

Answer: After seeing thousands of clients over the past 18 years, I have developed a prescribing style that targets your symptoms and not your diagnosis.  I am not a big fan of the diagnostic system in psychiatry today, but I realize we need to use it for insurance reimbursement purposes. That being said, what medications I would prescribe for you would depend solely on your most bothersome symptoms. And, sometimes I recomend therapy only. If your PTSD symptoms include nightmares that cause you insomnia and that leads to anxiety and depression, I would want to minimize your nightmares with prazosin. If your main symptom was irritability and anger, I might prescribe you prozac or seroquel. If your main symptoms are anxiety and panic, I might prescribe you zoloft or celexa or lexapro. If your main symptoms are depression and sadness, I might prescribe prozac, or celexa, or lexapro.  With PTSD though, therapy seems to work best. For people with a history of trauma, reducing anxiety may seem scary because our anxiety keeps us alert for possible attack...so with Buddhism and CBT, we can feel safer with mindfulness and virtue. It takes work and it's not as easy as swallowing a pill! To practice virtue in a Buddhist way, with a therapist who believes like I do, you can eventually regulate your actions, words, and thoughts to create benefits rather than harm...benefits for yourself and for others. You got through the trauma, you are still here, and many people love you. You are strong. You have a right to be strong and strength helps you do good things.  So maybe you need medication while you work through therapy...and that's ok.

Thursday, January 24, 2013

Am I a Psychopath?

Question: I am concerned that I might be a psychopath. I'm not a criminal though. At least, I don't steal or commit violent acts. Actually that's not entirely true. I have committed violent acts in the past and I have stolen from corporations but never individuals. I am really more concerned about my apparent lack of emotion. I don't have a normal fear response, and I am unable to make emotional connections with people, including my own family. I have had many people in my life describe me as being soulless, or unfazable. I think I know the difference between right and wrong, and I believe myself to be a moral person, but I will admit that I do not believe that this has anything to do with a concern for other people's feelings. Rather, i think I am just following a set of rules that I have put in place for myself based on my own definitions of integrity and honor. This is where I start to have doubts. From what I have read, true psychopaths have no comprehension or regard for these concepts. Also, I am not a pathological liar. In fact, I am usually honest to a fault. I don't see myself as being manipulative either, but some of my friends tend to disagree with me on that point. I guess what I want to know is: How can I know for sure, and is it something that I should really be concerned about? From what I understand, if I really am a psychopath, there is no treatment for it. Could there be a better explanation for my specific apparent condition?

Answer: Because this is so concerning to you, and you have strong feelings about the kind of person you want to be, I don't think you are a sociopath. Sometimes, when we are little kids, our parents are unable to show us empathy and love and then we don't learn how to relate to other's feelings. I do worry about the past crimes and violence. You may have some character traits of antisocial personality disorder. And, you may have schizoid personality traits as well. Schizoid personality disorder is a pattern of detachment from social relationships including family, appears indifferent, lacks close friends, shows emotional coldness, does not find pleasure in social activities.  So maybe how you grew up and how your parents taught you how to interact and feel has a part in this and maybe you have some schizoid traits. With some therapy, you can learn how to relate more effectively with people. I encourage you to get therapy. And...no more crimes ok!

Does Abilify Cause Sleep Paralysis?

Question: Hello, I'm taking 30 mg of Abilify per day for my anger and 0.5 mg of Sedoxil (Mexazolam) per day so that Abilify doesn't cause me sleep paralysis. I'm taking this medication for many years now and I can't study. Can you suggest other medication for me?

Answer: I don't think the abilify would cause sleep paralysis. If anything, abilify may cause insomnia, or difficulty sleeping and it has actually been prescribed to treat sleep paralysis with good effect. There have been several studies that reported zero patients taking abilify experienced sleep paralysis. Mexazolam is a benzodiazepine and is used to treat anxiety in some countries. You don't say what symptoms are causing you trouble studying. Is it that you can't focus, can't sit still? If that is the case, abilify may be causing the restlessness. There are many medication options and I encourage you to see the professional who is currently prescribing your abilify so that you can explain what's going on for you.

Sometimes It Is Mom's Fault You're Screwed Up!

Question: Hello, i think i might have Dependent personality disorder but I'm not sure. i am 20 years old and I cannot do things such as make my own bed or pour a glass of water for myself. I depend on my mommy and grandma for everything. its not like i don't know how but something is keeping me from doing those things. in my mind i am not lazy. My mind tells me that if i am lying in bed and have to pee and if i don't get up then that's being lazy. My fiance calls me a big baby. My mommy still wakes me up in the morning and has my cereal already made and everything. If there is no cereal i would not even eat. I am very sensitive. Almost anything will make me sad and cry. I know that if i was alone, i will NOT be able to survive on my own. I get scared just thinking about it. If i am in a place with unfamiliar people, i feel as if someone needs to take care of me to make sure that i am safe and alright. i don't know what is wrong please  help.

Answer: Well, I'm assuming you finished school and took all your tests yourself.  I'm assuming you have an intimate relationship with your fiance and your mom is not there helping you kiss you fiance. So you are making choices about what you want your mom to help you with. In other words, you are in control of all of your behavior and you do it all purposefully.  I'm not so sure you have a personality disorder. Dependent Personality disorder is a pervasive and excessive need to be taken care of that leads to clinging behaviors and fear of separation. That could be you...OR...maybe your mom has done you a great disservice by feeding into your every need. You say you would not survive on your own...but we don't know that for sure because you haven't tried to live alone. Is your fiance going to bring you cereal when you get married? How are you able to successfully have a relationship with a man yet not be able to get a bowl of cereal for yourself?  You see...these two things just don't go together in any sensible way.  Your mom needs to stop doing everything for you and then see what happens. I'm pretty sure when you get good and hungry...your survival instincts will kick in and you'll get some cereal!

Not Having Control May Lead To Danger

Question: I see things, hear things and have what I call "bad moments". In these bad moments I act not at all myself, doubt reality, am convinced those close to me are out to get me, and am sometimes suicidal, once the moment is over, I struggle to remember it. I have mood swings where I'm perfectly happy one moment, and angry and taciturn, and sometimes holding back strong feelings of violence. Also, it is difficult for me to fall asleep, and once I do I have terrible nightmares. I don't have any traumatizing event in my past. Do you have any idea what could be causing this? Possibly some mental disorder that explains it? I'm scared to seek help.

Answer: You say you are scared to seek help yet you are more scared of what's happening to you. Having moments when we are not in control of ourselves is a very big deal. Because, when we are not in control of our emotions and behaviors, we sometimes do dangerous things.   Although you say you don't have childhood trauma, it seems that something may have affected you as if it was a trauma. I wonder what the nightmares are about. It's not going to go away until you go to therapy and try some medication. Holding back feelings of violence may be working for you temporarily, but what if the day comes when you act on the feelings...will someone get hurt, will you hurt yourself??? I know that's not how you want this suffering to end. You must see a psychiatric professional. You can feel better with help.

Sunday, January 13, 2013

Should I Stay In My Marriage?

Question: My husband and I have been married almost 4 years and we both hold a lot of resentment towards each other. Our children were removed from us because I had been drinking heavily after my husband was incarcerated for assaulting me and our home was not safe for our kids. 2 years later we are still together trying to make it work. I was diagnosed as having borderline personality and he was diagnosed with paranoid personality. Clearly you should see just by that how hard it is to be married. I guess my question is how can I cope with how he is? He is so cold and untrusting. He has no attachments to anyone or anything and I can only communicate when he is in the mood to. Its very frustrating and depressing and I'm afraid for myself. For every good day we have I anticipate what's to come.

Answer: You say you are afraid for yourself.  I think it may be time to leave the marriage. Living with someone you are afraid of is not healthy and obviously not safe. I wonder why you stay. Is it for financial reasons? There are now many services for women who need help financially when they leave a relationship.  You can call your local shelters or community mental health clinics for help. At this point, it's hard to find a reason for you to stay.