Question: Is it really bad for a person with depression who is taking medication and has it under control to also smoke marijuana once in a while socially? I am writing about my brother who I am worried about. He says he feels OK and he is being careful but he always feels Ok before he one day does not feel Ok so I worry that he is not very good at watching himself and diagnosing himself.

Rebecca Ashton Says...:

Thank you for your question.

I do not know how old your brother is but a study published in the journal of Neuropsychopharmacology in July this year found that teenagers who regularly smoke cannabis offer long lasting brain damage and are in much greater danger of developing schizophrenia.

Teens aside, researchers have also said that the drug is especially dangerous for those who have a genetic susceptibility to schizophrenia and it could in fact be a trigger for the illness. Either way, there are clearly risks involved even if it makes one feel better in the short term.

You say you worry that your brother is not very good at keeping tabs on how he is feeling and it is possible that being under the influence could confuse things in that area further.

I feel that it could be useful for your brother to discuss it with his doctor if he feels able to and I also suggest that you are open with him-not just about the risks involved but open in your responses to what he has to say about it.

If communication is strengthened then it is possible that you could work together by checking in with each other; your brother gets to tell you how he feels he is doing and you get to offer feedback on your perspective of how you feel he is doing, in a constructive way.

These check-ins could help your brother get better at identifying where he's at and ultimately could give him the support he needs to be able to kick the habit altogether.

I hope this answer is helpful, best of luck to you both.

Question: Would you recommend that a man with a little bit of depression use St. John’s Wort in America since there is no guarantee of what is actually in the pills? I read a study this week that said that in a significant percentage of capsules there was none at all of what was supposed to be in there? Is there any way to be sure that what you are buying is the real thing?

Rebecca Ashton Says...:

Hello and thank you for your question. I am afraid that I cannot advise on the use of medication-natural  or otherwise.

However, what I can and will say is that before taking any medication at all-and that includes natural remedies-you should always see a Doctor who will advise you on what to take and how to take it so that you avoid creating further health risks.

For example, there has recently been a lot of attention on the potentially serious side effects of the interaction between certain medications and grapefruit. (More info here; http://www.nhs.uk/news/2012/11November/Pages/Prescription-pills-and-grapefruit-a-deadly-mix.aspx ) so as you can see, it really is important to be aware of what you are putting into your body as well as taking into account any existing conditions you have that could be exacerbated by taking the 'wrong' thing, so I cannot stress enough the importance of seeking medical advice when wishing to start-or stop-taking medication.

By seeing a Doctor, you can also be sure that you are getting the 'real thing' as they will either be able to prescribe you something or discuss in their professional capacity, the brands/types which they know to be better than others.

I hope this helps.

Question: I am having a hard time coping after the death of my husband Mark in January. I feel stuck and half of me doesn’t want to move on and the otehr half just wants everyone to leave me alone and in peace. I haven’t left the house to do much more than the shopping since the funeral and my children want me to talk to a professional. They are quite insistent. Before I agree I want to know how long it takes. How many sessions can I expect to need?

Rebecca Ashton Says...:

I'm sorry to hear about your loss.

When it comes to grief, there are no time limits. The process can be as unique as the individual experiencing it and really it is about finding what works for you, which your counsellor will be able to help you with in as many or as few sessions as you feel you need. (Although some therapists work over a set number of sessions, so it might be worth checking around if you feel you need something more open ended.)

I understand your children's concern, however I feel that it is still very early days and that you needn't rush into anything right now if you do not feel ready-I suggest that you keep the option of counselling open for if and when it feels right for you. I wish you all the best for the future.