Question: My name is Stephen Nelson and I have a son who is moody and has a horrible, horrible temper. He denies this. I am just wondering what this could indicate.. Thanks, Steve.

David Johnson Says...:

Thanks for your question, but I need a lot more information to answer you. Anger and or moodiness could mean many different things in difference ages and contexts. How old is your son? Give examples of his moody behavior and his angry outbursts. Tell me about what you have done to attempt to teach him another way to express his anger. Tell me your story about your son, his moodiness and his anger. What else is going on in the way of stress or unusual events in his life?

Did you try to ask another question? I found this one that looks a lot like your question: "Hello,
My son has a temper. What could that indicate? He is also moody. Thanks..."

Question: I live with three people I don’t really like. I don’t really have any other place I can afford. And they are also pretty much my only friends. I thought I liked them and I thought my life was pretty good but then I stopped smoking weed a couple of weeks ago and my friends did not and now that I am looking at things with a clear head (I was wake and bake and then go all day for 8 years – no job I am on disability) I can see that we are all losers and the only thing we really have in common is getting high all the time. It turns out that when you’re not high, playing video games and looking at porn all day don’t really add up to a satisfying existence. Now the problem is it is so depressing that the only thing I can think to do is get high. When you have no friends and no money and no skills and no social skills and aren’t good looking or interesting and disabled and not real mobile…how can you even start changing your life? I feel stuck and if I don’t get unstuck soon I know I am going to go back to my old ways. What should I do?

Andrew Nichols Says...:

1.  Do you have any family to reach out to, even for a short time?

2.  Get in touch with a local chapter of Narcotics Anonymous (http://www.na.org/) and start meeting people who are working at the changes you are...they may also know of resources you can use.

3.  Consider visiting your local health department.  If you have disability benefits, you may also be able to get psychiatric care.  There are medications that can help as your brain learns to give up pot.

4.  Consider using melatonin to help with sleep.  It's an herbal remedy that stimulates your brain's natural sleep mechanism.

Good luck!

Andrew

Question: I am a 32 year old binge eating male. I have been binging for 6 years. I do not purge. I am dangerously overweight. I am sick of living like this. I want to get treatment. Diets do not work for me. Nutrition plans do not work for me. I have a compulsion that is beyond my control. I understand this now. I have never had any kind of therapy or psychiatric treatment before but I suspect I also have borderline clinical anxiety and depression on top of the BED although I think that much of my anxiety and depression gets mixed up with the tension and shame of the eating. I feel like I want to really get away at a rehab type place but most of these places seem to be for people who already have a treatment team and all that. How do I get started with treatment? Is a residential facility going to be an appropriate place for a male of my age? Can you recommend a good facility for someone with my types of problems?

Katie Brooks Says...:

Hi there-

I'm glad you have decided to take the step to get treatment.  It sounds to me like you have an unhealthy coping skill rather than a dieting problem.  It seems like a weight loss program would have worked if dieting was the issue.  You do not have to have a treatment team to go to a residential facility.  Because I do not know appropriate details like where you live or the severity of your disorder, it is very difficult for me to refer you to a specific treatment center.  It would probably be a good idea for you to see a therapist in your area so that you can be properly evaluated.  You may not need to go to such a high level of care in order to effectively treat the BED.  Once the therapist evaluates you, he or she can then refer you to a local treatment center that treats men and fits your needs.  If you have any further questions please don't hesitate to contact me at goodtherapysandiego.com. 

Question: He is 16 and he is struggling and he is smoking a lot of pot. Some days he is happy and some days he seems really depressed and he cries in his room. I do not really understand what is going on with him. We are very supportive of him as a family but we aren’t with him most of the time as he grows up. The issue is we are almost sure he is gay (like 99.9% sure) but he has not come out to us and we have asked him about it he has denied it. I wish he could just come out with it so we could help him deal but since he won’t admit it I feel like we’re stuck in a holding pattern. Can you offer us some advice on how to help him accept himself?

Emi Whittle Says...:

Wow - so much in one question!  I'm not sure if you are a parent or other relative, but teen issues such as these are tough ones.  Without further information, I can only give general thoughts, but here goes.

Depression - does he acknowledge feeling depressed?  Have you offered to help him find a counselor?  Or a support group for teens?  Is there a trusted adult with whom he might be willing to discuss treatment options, such as counseling or other venues?  It is good to hear you are supportive, but "support" can mean different things to the giver and receiver.  Discussing what assistance he might be open to and what his parents/loved ones believe is necessary may be useful.  Don't let it go - too many young lives end far too soon.  

Pot smoking - Drug use is often a method of "self-medicating" to escape unhappy feelings.  This is often very unhealthy, however, especially for a teen with a still-developing mind and body.  Are there "house rules"?  Are there other substances being used?  Again, seek help sooner rather than later.  

Is he gay?  At this age, he may not have all the answers for himself, so even if you end up being "right" it is irrelevant.  Whatever his struggle is with his sexual identity is not for you to determine.  Being supportive is usually good, but whatever happens should be on his timeline, and with his understanding of his own self in place.  Counseling, self-help groups, support groups, books, camps...  there are many resources to support teenagers,  You may want to go see a counselor on your own first.  Discuss the issues and seek assistance in finding resources for your teenager.  Discuss ways that you can help - or avoid hurting - him.  Education will help you to offer him more.

Contact your local crisis hotline for further information about resources available to you and him.  Express your support, love and caring.  Help him locate any help he may need.  Best wishes to you.

Question: For privacy reasons I would prefer not to have an insurance record of my drug addiction treatment. I would like a 28 day rehab program. I do not need anything fancy but I would like quality care and I would like to get into a program within a couple of weeks to coincide with downtime at work (so no waiting lists). What is the minimum I should expect to pay for this. Is $8000 going to be enough to find what I need? Can you recommend any programs, preferably in California but nearby states are also OK?

Katie Brooks Says...:

Hi-

Historically 28 day programs are cheaper than 90 day, so you should be fine with $8000. Due to the lack of knowledge that I have about your addiction/ condition, I am not able refer you to a specific facility.  However, you can inquire about program at www.rehab.com.

Another great way to find resources is to dial 211.  Good Luck!

Here are two that I personally refer to:

Sharp
McDonald Center 

7989 Linda
Vista Road

San Diego, CA 92111

1-800-734-3477  (flexible night programs)

Sharp
Mesa Vista

7850 Vista Hill
Ave.

San Diego, CA 92123

858-278-4110

Question: Do you know about dr. Stanton Peele. What he writes seems to make sense to me but he really seems to say that my alcohol problem is not at all a disease. So do you think he is correct? I am confused by how many doctors can say what seems to be totally opposite stuff about these basic things. Either something is scientific or it is not and isn’t what doctors use too make judgments supposed to be science? So is he right or is he wrong?

Jim LaPierre Says...:

Thanks for your question. It can be confusing to make sense of differing treatments and clinical "experts" who disagree. I suppose I could give a professional response regarding the work of Dr. Peele that does not include words like "quack" or "snake oil salesman" but that feels like a disservice to you and disingenuous to me.

The American Medical Association recognizes addiction as a disease. To me, that should settle any question folks have.

Diseases like addiction are NEVER cured (much less in 8 weeks as Dr Peele promises). Remission and long term recovery are options. Being "cured" isn't.

It's very tempting to believe that shortcuts are possible but the truth is Recovery is a lot of work. My biased opinion is that the real experts on addiction are NA and AA (and this from a professional who has never experienced an addiction other than caffeine and nicotine). I wish you luck and I urge you to avoid anyone who claims to have a "cure."

Question: Does coffee have any influence on OCD? My brother drinks like 10 cups a day but swears it has no effect on things. I am not so sure…

Katie Brooks Says...:

Hello there-

First of all, everyone is different. Your brother may not
experience negative side effects from caffeine at this moment. It is also
possible that he has been drinking coffee for quite some time and does not know
the difference. That being said, over forty research studies have
shown that excessive caffeine can be harmful to your health.

Here are just a few
of the effects that caffeine can cause in the general population:

• Rapid or irregular heartbeat
• Restlessness
• Nervousness
• Insomnia
• Flushed face
• Twitching or trembling
• Distracted thoughts and speech
• Physical agitation
• Nausea
• Light-headedness
• Diarrhea
• Mood swings

These symptoms make up the "fight or flight" reactions designed
to protect you from harm. Excessive amounts of caffeine can prompt the body's
fight or flight response even though no real danger exists. This overactive
fight or flight response can contribute to anxiety.

Caffeine
exasperates Anxiety, Insomnia, and Panic Attacks.  Since
OCD is an anxiety disorder, and caffeine causes anxiety, it would be worthwhile
for your brother to quit or decrease his caffeine intake.  My guess is he would see a significant
decrease in symptoms.   

It
sounds as if your brother is very addicted to caffeine.  Although caffeine seems to be one of the
least dangerous substances, a substance it is. 
Addiction is addiction.  Your
brother may report not being agitated by the coffee because he is protecting
his addiction and does not prefer to give it up.

Unfortunately, you cannot force anyone to
give up a bad habit, but you can educate.  It might be a good idea to refer him to a
therapist who can educate him and teach him how to manage/ cope with his
disorder in a healthy way.  Cognitive
Behavioral Therapy has been shown to be the most effective form of therapy for
OCD.  If you have any further questions
or would like to make a phone appointment please visit my website goodtherapysandiego.com.

Question: My wife and I are having intimacy issues. There are physical components. I believe that we should speak to a sex therapist but in truth we are both quite bashful to do so. I believe that if we could do this at home it would be much easier and less embarrassing. If there needs to be physical demonstrations in a session I think I could do that much easier over a webcam than in an office. But I am worried that things we transmit are not secure and I work in a sensitive position…it would be very embarrassing, politically disastrous, if any video was ever leaked. Does this ever happen? How safe is this for me?

Mark Hughes Says...:

Hi,

Thanks for contacting me and explaining the situation so clearly. Firstly I understand your concern and it seems to me that even if you were a webcam or Skype type link were 100% secure, there would be some fear that might make it ineffective for you.

I certainly can't say it is 100% secure because nothing is, so while the risk may be small, I'd like to suggest other things to consider.

The first thing that I notice is that you have not said what your wife thinks about any of this, so I wonder if you have discussed it with her yet. If not, then that needs to be done before you will be able to investigate options and proceed. Perhaps you have and she's in agreement with you though, so I'll assume that for now.

My first thought is that you are unlikely to have to do a demonstration, and no therapist should "require" or pressure you to do anything you have concerns about, or just don't feel ready for, whether your concerns are about confidentiality, or anything else.

Without speaking or working with you I can't speculate on what might be needed, or what might work for you and your wife, but would be very unusual for you to need to be physically intimate together while the therapist is present (even by webcam), and I would not recommend that as a starting point.

So I question why you think that. Perhaps you've seen or read about this and are assuming that's what it would require? That certainly is not the case, and you might even find a couple's counsellor or therapist could be equally helpful. As I say, I can't really talk about you, so I'm speaking generally here, but most therapists with significant experience will have come across intimacy and sexual relationship issues, since they are very common and so important to us.

I hope this opens up some possibilities and alleviates your fear about what you might need to risk in order to address this. I'll be happy to respond to any other questions you may have, and hope you'll find a way that works for both of you, and brings the intimacy you want.

Best wishes,

Mark

Question: I have avoidance, flashbacks and disassociation along with a lot of stress and psychosomatic problems (headaches, pains in my flank etc.) that my doctors say there are no physical reasons for, so they are most probably stress caused (I have a prescription for xanax that I thankfully never filled). I was the victim of an armed robbery 6 months ago and I believe this is the reason why I have all of these symptoms. Now I am pregnant, unexpectedly (which is why I am glad I didn’t use the Xanax). I do not have money for any type of counseling at the moment (I work as a cashier in a gas station). I am very worried that the stress and PTSD symptoms I am having will have a negative affect on my developing baby. Is this the case? Can you recommend ways that I can minimize the impact, on my own?

Takiya Paicely Says...:

Hi Anonymous,

I am sorry to hear that you are experiencing difficulties.  It can be hard dealing with traumatic events that take place in our lives and try to pick up the pieces and move on.  It is important that you learn how to positively and effectively manage these symptoms.  Pregnancy creates a significant increase in estrogen, which can affect our moods. 

I would encourage you to look into a local community mental health center to meet with a therapist.  Many of these centers have sliding fee scales and are able to work with you.  Counseling has been shown to be very beneficial for individuals struggling with PTSD.  It is important to identify your current support system.  Those people you feel comfortable talking to and are willing to listen.  Look into attending support groups that may be in your area.  It can be helpful talking with others who are facing similar situations.  Make sure you keep your prenatal and medical appointments.

Additionally, engaging in regular exercise is not only beneficial to your overall health, but helps in manage anxiety and depression.  It will also help your pregnancy as well.  Always consult with your physician before engaging in any physical activity.  Monitor your diet.  The foods we consume have a significant impact on emotional health.  Try to limit your caffeine intake and eat plenty of fruits, vegetables, and unprocessed foods.  Make sure you are getting plenty of water daily as well.  Consult with your physician on the types of foods and nutrients you need to consume daily.

Keeping a journal can also be helpful in managing anxiety and depressive symptoms.  Use it to write down your thoughts, feelings, and emotions.  Additionally, use the journal to keep a log of when you experience any symptoms.  Write down what happened before, during, and after.  This will help you identify triggers, how you feel when they happen, and how you deal with them.  Keep positive thoughts, images, music, people, etc. around you.  Limit watching the news, violent movies or television shows.  Meditation and deep breathing exercise can be helpful in managing your symptoms as well.  It is important that you practice these daily, even when you are not experiencing anxiety. 

Learn to recognize when your body is stressed before it becomes more intense.  For example, you may start to lose your appetite or overeat, you may feel tightness in your shoulders, you may get tension headaches, etc.  Our bodies sends us messages when it feels that we are under duress.  Write positive affirmations and post them around your house, keep them in your car.  

Set small and realistic goals.  We can become overwhelmed when we are trying to squeeze too much into our day.  Break them up into smaller steps and if it becomes too overwhelming or too much to handle at the time, take some time away from it.  It is important to take it one day at a time.  There will be some days that are better than others and that it is okay.  It takes time to heal from trauma. 

Helpful websites:

•  www.ptsd.va.gov
• www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd.

Question: I quit drinking last week because my stomach was starting to hurt all of the time. I was a daily drinker and I knew enough to never combine Tylenol with alcohol because of the liver damage. I get a lot of headaches and my stomach doesn’t hurt anymore. After a week of not drinking is it safe to use Tylenol again?

Jim LaPierre Says...:

Hi!

Thanks for your question. Yes, it is safe to use Tylenol in moderation (not exceed recommended dosages).

It takes a solid 30 days for the lion share of detox to occur and it may take up to 18 months for the body and mind to be fully restored. I highly recommend extra water at this juncture (at least 64 ounces a day and much more if you take in caffeine).

I also am a huge fan of taking a multi-vitamin and improving your nutrition and exercise (I'm not a health nut I just know what it takes to recoup).

I encourage you to get a physical from your primary care provider and consider to consider that stress and anxiety also cause headaches.