Mental Health

Have Mental Health Questions? Ask a Psychiatrist Online

Ask an Expert,
Get an Answer ASAP!

Mental Health
This answer was rated:

When considering women over 45 - who takes birth control

pills and who may display...
When considering women over 45 - who takes birth control pills and who may display the symptoms of bipolar, cyclothymia, SAD or depression with no family history of any type of modd disorders - how do you know which might be possible? and how do you convince them? and is it worth getting assessed at such an age if they would not ever go along with any type of drug treatment? Although my sister seems to have cycles of depression and euphoria, there always seems a logical explanation as well - she was assessed with postpartum depression fifteen years ago with her last child, but she also had an adulterous, alcoholic husband who abandoned her and two kids. Then there was five years of being unable to find work that paid enough to provide for her family and being a single mum. Her depression finally seemed diminished with a new marriage and better work, but she lost both a few years ago - which plunged her into a deep, suicidal depression, from which, with family support, she seemed to conquer. She does not seem to be able to completely shake it now though, and I am worried as she has completely isolated herself from everyone since she feels very ashamed of her 'failures' (as she sees them) - she has sold everything and moved to another province to attend university in the hopes of turning her life around with a new degree. She also has a new man in her life. In considering the possibilities and reading over some information on line regarding mental health I also realized that she has never gotten along with her work mates at all, (she was even quietly let go a few times because her employers felt she did not fit into the corporate culture even although she always received praise for her work and her work ethic) - she is also considered 'overly sensitive' and emotional (quick to anger, laugh, or take offence) - we have all accepted this as part of her artist temperament - but knowing her all my life, and considering the whole story, I am starting to wonder if we have done her a diservice in being accepting instead of seeking out more assistance for her. Please advise.
Show More
Show Less
Ask Your Own Mental Health Question
Answered in 5 hours by:
7/18/2012
Steven Olsen
Steven Olsen, Therapist
Category: Mental Health
Satisfied Customers: 1,765
Experience: More than twenty years of expertise in counseling, psychological diagnosis and education
Verified

Great question:

The easiest way to show someone who is suffering from a mood related issue that it is clinically significant is through something called the cognitive triad. This method was developed by Dr Aaron Beck, a key figure in research on depression, and is simple and nearly 100% accurate.

There are three questions to the triad.

1) Are you feeling hopeless, or can others see that you are acting hopeless about the future? (EX: Plans are avoided or put off. Things seem to not be worth thinking about regarding upcoming events. Holidays that were once looked forward to are not, etc.)

2) Are there feelings of hopelessness about the outside world? (Has interest in outside activities diminished? Favorite things are avoided or ignored? Expressions of despondency or irritability about situations in the outside world [such as work] are shown, etc.)

3) Are there feelings or actions that support hopelessness about one's own self? Has self-care or dress or diet or person hygiene or simply trying to look as good as before, diminished? etc.

If the person has all three, this is a direct marker for a clinical level of depression, whether caused by biochemistry, circumstances or both. The triad does not give a specific mood disorder diagnosis of course, but it does identify clinical issues.

Trauma can cause depression as well as biochemistry, and she sounds like she has been through a great deal. Medications for depression only help about 50% or less of people who take them, and the best practice protocol for depression, mild or severe is medications combined with weekly cognitive behavioral therapy. CBT as it is called, combined with medications where appropriate, can raise treatment outcomes to 80% or more. Most therapist practice CBT; it is short term; highly effective and can be accessed via a referral from a family doctor. As with all therapy, it is confidential.

What would I do if this was my sister? I would ask your sister the questions outlined above. If she has now, or in the past met the criteria I would express my concern to her as well as raising the fact that medications alone are almost never the answer, and that many people recover through talk based therapy.

Her ongoing irritability is also a classic sign of depression, and she is suffering, without doubt. Importantly, not all depressions are severe and one of them, dysthymia (also known as chronic depressive disorder) is very common in 30-50 year old women, yet is it highly treatable. She can easily feel better by dealing with it if she wishes.

You cannot make her go to therapy, but you can be a resource of encouragement for her to do so. Soft words, over time, break hard bones. Encourage her that no matter the reason, she can feel better... and why suffer? Over time, with steady encouragement and motivation from you she has a very god chance of trying some supportive professional assistance. Steven

Ask Your Own Mental Health Question
May I help you further?
Ask Your Own Mental Health Question
Customer reply replied 5 years ago
I had asked for more clarification but I see that it is not longer here - must be a glitch - will have to re-write later today - sorry!
That is okay...When you can, write me and I will try to respond promptly. Steven
Ask Your Own Mental Health Question
Customer reply replied 5 years ago

It took me ages to write my follow up - so I am really disappointed that it did not post - I am not sure I can remember everything now.

She met the criteria in the past - at the end of her marriage - but some fairly dramatic stuff went on as it turned out that after seven years of marriage she knew nothing about who he really was - he went to jail and she divorced him. It was really awful as her kids were involved. Anyway - cannot go into the details, but it only lasted about 3-6-months and she has pulled through.

I know that the answer to all of the questions now would now be "no". She is making plans for a vacation with her new man and very excited about it and is looking forward to finishing her degree to move on in her life.

I have been reading about Schema Therapy and thought that might be something she would benefit from because what I have noticed is that there are definite patterns in her life – she never holds a job for more than three years, she has never stayed in one residence for more than three years – there always seems to be some compelling reason that she has to move or change jobs. Although she is a generous, kind and caring person who is always doing volunteer work – she rarely gets along with the people she works with because I think she thinks very differently from them and has very different values (ie: she values family not consumerism) and is working in jobs that she is not suited for and that she dislikes intensely but does them to provide for her family.

She always has a plan for the future and is always forward looking – but things rarely work out the way she has planned or expected. She doesn’t do anything by halves – and is very passionate, compassionate and high energy. She is also ultra-sensitive to other people’s moods, or the things they do or say – she often clues into things that no one else does, but she also takes things more personally than other people tend to.

As I said before, I thought this was just her “artist’s temperament” but now after some of the articles I have read I am wondering if this is all part of a pattern? That perhaps she was affected deeply by our father leaving her mother when she was two and rarely having the opportunity to see him. He married my mother when she was seven and I was born, so we have never spent more than a weekend or a summer together here and there growing up and when I was a little older than seven he left my mother.

He is now married to someone else with whom he has been with for over twenty years now and we have a half-brother who is almost the same age as my nephew. When he was brought home (he is adopted), and when my nephew was born we all made better attempts at being a ‘family’ – but it hasn’t always gone smoothly and I have always felt guilty about how much more time, affection and support from our father that my brother and I have received compared to my sister. The last five years have been the best – but with my sister in another province it is more challenging to keep ties.

My sister was raised primarily by her grandmother as her mother didn’t really want to be a mother and was in university for the first seven years of her life. Then when she started working she dragged her across the country here and there and never stayed in one place long (so that is where we assumed my sister learned that from) and when her grandmother died she was hit hard at fifteen, because I think she had a closer bond to her than to her mother. She has always seemed like regrettable baggage for her mother and I know my sister thinks so too. So by sixteen or seventeen my sister left home and none of us even saw her for fifteen years as she left the country and eventually got married overseas. She cam home to give birth to her second child since there was a big earthquake where she was living and then a year after that, she came home for good to escape her wretched husband. Even though he completely abandoned her and their children, she kept hope for over ten years, that there would be a change for the better. When he finally sent her divorce papers, she finally moved on, met and married the guy she was with for seven years who also turned out to be a jerk.

So – I am wondering if there is some online psychological test that I could get her to do just for the fun of it that might get her to see these patterns and see that maybe there is a different way of living? Or am I making a mountain out of a mole hill? I wanted some advice before taking this any further because I think people who read things like this can start thinking too much :)



Thank you for the post. The information is helpful, and do know what you mean about losing posted material. I have lost my share of them, and it is really frustrating as you can never duplicate what was written in the first place.

Your sister sounds like she had a major depressive episode at one time and now has resolved it. However, there seems to be patterns in her life that do not seem to allow her to experience the full richness of life. At times, she almost appears to be self defeating in her behavior.

I am sure that her general temperament has a lot to do with her patterns, at least in a basic sense, but it the patterns where she seems overly sensitive and those that limit her enjoyment of life are most concerning to me.

This tends to be a pattern that is most often seen in adults who experienced a great deal of emotional rejection as a child. The sense of deep, but often invisible to others, inadequacy and insecurity creates patterns such as you describe here.

For, what is really being said here is that your sister is hurt; and that developmentally when she experienced this hurt she became stuck in a developmental stage of life, unresolved. Normally as a child, we become self accepting and move away from our parents and caregivers and grow accepting of ourselves But for her...she was painfully rejected, and loss on top of that, and now shows that rejection through the behaviors you describe. Although functional, she is still, I am certain, deeply hurt.

What can you do? I would recommend that she see a therapist as this is something that can be resolved. And, as a teacher of counseling I often tell my students that the methodology of therapy is not as important as the need to address the issues. So, the type of counseling is important, and Schema Therapy is good, but really the competence of the therapist in these cases is most important rather than the theoretical approach.

On line tests tend to be very limited. Certainly depression scales abound on-line such as http://psychcentral.com/depquiz.htm but these can only identify simple issues such as general depression or anxiety.

I often find that offering a book that you have read as a wonderful way to raise the issue without seeming pushy. Few people when they hear that you liked a book and thought of them will utterly reject the suggestion. Now: which book is best.? I would recommend: Adult Children of Parental Alienation Syndrome: Breaking the Ties That Bind by Amy J. L. Baker and Adult Children of Abusive Parents by Steven Farmer. Both are very good and the second one is a classic within the field.

I hope these suggestions insights and resources were helpful. Steven

Ask Your Own Mental Health Question
Customer reply replied 5 years ago
Thank you Steven! I am so glad to know that I was not misreading the situation and will look for those books for sure. As for therapists, what is the best way to go about finding one?
Two ways to find a good therapist. One, ask the local General Practitioners of Medicine in your area. They are asked for this type of information regularly, and have to have good referrals. I also tell people to call the universities in the area that have psychology programs. The professors usually know very good local resources as they often trained many of them. Steven
Steven Olsen
Steven Olsen, Therapist
Category: Mental Health
Satisfied Customers: 1,765
Experience: More than twenty years of expertise in counseling, psychological diagnosis and education
Verified
Steven Olsen and 87 other Mental Health Specialists are ready to help you
Ask your own question now
Customer reply replied 5 years ago
Awesome! Thank you so much! - VERY HELPFUL! :)
If you found this interaction helpful, please rate me. Steven
Ask Your Own Mental Health Question
Customer reply replied 5 years ago
Sorry - thought I did!
Thank you
Ask Your Own Mental Health Question
Ask Steven Olsen Your Own Question
Steven Olsen
Steven Olsen
Steven Olsen, Therapist
Category: Mental Health
Satisfied Customers: 1,765
1,765 Satisfied Customers
Experience: More than twenty years of expertise in counseling, psychological diagnosis and education

Steven Olsen is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!!

Janet VPhoenix, AZ

< Previous | Next >

Meet the Experts:

Dr. Keane

Dr. Keane

Therapist

1,379 satisfied customers

Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.

TherapistMarryAnn

TherapistMarryAnn

Therapist

4,021 satisfied customers

Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.

Dr. Olsen

Dr. Olsen

Psychologist

2,336 satisfied customers

PsyD Psychologist

Norman M.

Norman M.

Principal psychotherapist in private practice. Newspaper contributor, over 2000 satisfied clients on JA

2,246 satisfied customers

ADHP(NC), DEHP(NC), ECP, UKCP Registered.

Dr. Michael

Dr. Michael

Psychologist

2,177 satisfied customers

Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.

Steven Olsen

Steven Olsen

Therapist

1,765 satisfied customers

More than twenty years of expertise in counseling, psychological diagnosis and education

Anna

Anna

Mental Health Professional

1,656 satisfied customers

Licensed Clinical Social Worker with 29 years in addictions and mental health.

< Previous | Next >

Related Mental Health Questions
I'm a Bipolar 36 year-old male with severe anxiety and
I'm a Bipolar 36 year-old male with severe anxiety and depression. What is the best anxiety medicine I should be taken? I've taken Clonazepam for 8 years and it no longer helps. Would another drug lik… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,677 satisfied customers
I'm depressed just finished my divorce yesterday feel so sad
Hello, I'm depressed just finished my divorce yesterday feel so sad how to get over it faster no energy my eyes tell on me. My X is who wanted it he has abusive and acts like the victim and blames me … read more
Linda D.
Linda D.
Master\u0027s Degree
794 satisfied customers
I have anxiety and recently think it is playing tricks with
Second opinion] Hi. I have anxiety and recently think it is playing tricks with my eyes. Is this possible? Sometimes feel things are moving when there not etc. Thank you… read more
Dr. Kaushik
Dr. Kaushik
PSYCHIATRIST ( MD Psychiatry)
Doctoral Degree
204 satisfied customers
I have anxiety and recently think it is playing tricks with
Hi. I have anxiety and recently think it is playing tricks with my eyes. Is this possible? Sometimes feel things are moving when there not etc. Thank you… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,677 satisfied customers
I've been taking Prozac and Buspar for some anxiety and
I've been taking Prozac and Buspar for some anxiety and depression. My therapist just added Abilify to help with some lingering depression. At first she was going to add Wellbutrin but decided on Abil… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
767 satisfied customers
I have issues with anxiety. I meet with a behavioral
I have issues with anxiety. I meet with a behavioral therapist and have practices to help with my anxiety, but I'm feeling super anxious with some current ongoing stress that may continue for the next… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
767 satisfied customers
Im struggling alot about handling. Strws. Sad and i dont
Ever since i was little i always struggled with waking up sad and then bursting into tears for no reason… read more
Linda D.
Linda D.
Master\u0027s Degree
794 satisfied customers
Is this a paid service? History of depression and anxiety.
Past 8 months. Relationship problems make it worse.… read more
Therapist Leslie
Therapist Leslie
Masters, Professional Psychology
5 satisfied customers
A week ago Saturday I took 20mg's of Latuda for my Bipolar
A week ago Saturday I took 20mg's of Latuda for my Bipolar Disorder when I was upset I crushed it with my tooth not realizing that I was not supposed to do that. I had a sore throat after. I was afrai… read more
Dr. Kaushik
Dr. Kaushik
PSYCHIATRIST ( MD Psychiatry)
Doctoral Degree
204 satisfied customers
I feel this feeling of guilt and sadness and I'm not sure
I feel this feeling of guilt and sadness and I'm not sure why Would you happen to have an explanation for that … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
767 satisfied customers
OKMH115211 My daughter struggles with anxiety depression
OKMH115211 My daughter struggles with anxiety depression OCD. She has tried numerous medications without any luck. She is at a new inpatient facility and her psychiatrist put her on zyprexa and Prozac… read more
Dr. Kaushik
Dr. Kaushik
PSYCHIATRIST ( MD Psychiatry)
Doctoral Degree
204 satisfied customers
I feel sad so much I need help dealing with how I feel
I feel sad so much I need help dealing with how I feel because it's affecting with my relationship with my boyfriend and my happiness in general… read more
JohnMichaels,MS,LPC
JohnMichaels,MS,LPC
Counselor
Master\u0027s Degree
170 satisfied customers
I've had anxiety due to trauma... I've had anxiety due to
Hello, I've had anxiety due to trauma... Hello, I've had anxiety due to trauma in the city I lived in, I moved out to a different city, I accidentally spoke to somebody associated with the trauma , in… read more
Vakul Aren
Vakul Aren
Consultant Physician
Post graduation (Liverpool, U.K.)
3,982 satisfied customers
I I have extreme anxiety especially social anxiety I over
I I have extreme anxiety especially social anxiety I over worry about everything and I have PTSD from being stabbed and assaulted I've been prescribed Xanax for years and I got up to 2 mg which was wo… read more
Vakul Aren
Vakul Aren
Consultant Physician
Post graduation (Liverpool, U.K.)
3,982 satisfied customers
Second opinion] OKMH98-130 I've been very sad and in a bad
second opinion] OKMH98-130 I've been very sad and in a bad state of mind ever since my mother figure passed away last year. I suffer from insomnia ever since. Loss of interest in daily activities. I p… read more
Juliet Cooper
Juliet Cooper
Doctorate of Psychology
29 satisfied customers
OKMH98-130 I've been very sad and in a bad state of mind
OKMH98-130 I've been very sad and in a bad state of mind ever since my mother figure passed away last year. I suffer from insomnia ever since. I've been sad often. I noticed my mood is better when I'm… read more
Linda D.
Linda D.
Master\u0027s Degree
794 satisfied customers
I suffer from cyclothymia a milder form of bipolar2. Was
I suffer from cyclothymia a milder form of bipolar2. Was diagnosed on a year back after years of using ssris and other antidepressants Am now on lamictal 100 and have never felt better in my life. No … read more
Dr. Kaushik
Dr. Kaushik
PSYCHIATRIST ( MD Psychiatry)
Doctoral Degree
204 satisfied customers
I have Bipolar disorder clinical depression and anxiety I
I have Bipolar disorder clinical depression and anxiety I have a 16 y/o son who is exhibiting a lot of depression he's always been kind of a loner but he's showing more symptoms low self esteem doesn'… read more
Dr. Ravoof
Dr. Ravoof
Doctoral Degree
1,923 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x