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Ask A Therapist: Sister Needs Therapy But Can’t Afford It

Q: Are there any resources for my sister-in-law who’s suffering from anxiety, mood disorders, depression and wants therapy but can’t afford it? (concerned sister in St. Louis, MO)


Ask A Therapist: Depressed, Anxious, and Socially Awkward

Q: I don’t remember a time in my life where I’ve been totally happy but for the past approximately 2 years i have been extremely depressed as a result of my social anxiety and loneliness. I have always found social situations ‘awkward’, in fact the last time I remember frequently leaving my house for social reasons was when I was about 13. I then became more and more of a recluse from there on, i went out with my friends less and less outside of school, then upon leaving school i stopped doing things with my friends more and more until the point where i have not left my house for social reasons for about 2/3 years. I no longer have any friends and although my family is nice and supportive they cannot provide me with what I need. I have not spoken to anyone in person about my problems, I simply can’t. My parents will just tell me to go to a doctor. Doctors will just prescribe me with a drug that I don’t want. I don’t feel a psychiatrist can help me. I’ve become extremely lonely and depressed. My self esteem is extremely low and although I’m not a bad looking person I simply cannot accept my imperfections, no matter how hard I’ve tried. I feel I am in so deep that I cannot make a recovery. I cannot throw myself into social activities to make friends because of my social anxiety. I no longer find anything enjoyable and nothing at all interests me, this leaves me with the motivation to try nothing. I feel like I’m in a corner with no way out, every possible path I need to take to fix myself, I cant bring myself to walk down whether its my self esteem, depression or social anxiety stopping me. I hate it and I hate the person I am, I’m so sad it hurts. I feel so lost and lonely I cry randomly, its pathetic. There is no reason why I should feel like this, I’ve had a very normal life without any trauma, this only makes me feel guilty for the way I am. Guilt I don’t deserve to feel when there’s so many more out there in far worse situations.

I just want to live my life and be happy, but I truly believe I will never get there. Sometimes I feel like giving my life and donating what i have to give someone else a shot at life. Someone who can appreciate life.

I have read a lot of advice online about people in similar situations to myself but what are my options when the things I need to do to fix myself, I simply cannot bring myself to do?

A: Thanks so much for writing in and reaching out for help. I have seen many clients in my therapy office who express similar feelings of hopelessness, worthlessness, focus on their own imperfections, and have extreme guilt for feeling so sad and lonely because they’ve had a “pretty normal life.” It sounds to me like you are suffering from severe depression and anxiety that are keeping you in a downward spiral, unable to reach out for help. The good news is you have reached out on this forum, so I am very hopeful that you can reach out in other areas.

I urge you to talk to your parents and ask them for help. You said you haven’t talked to your parents because they will tell you to go to a doctor. If they love and care about you they will tell you to go to a doctor or a therapist because that’s the right thing to do when a family member is ill. I suggest that you keep an open mind about medication. While it doesn’t need to be the first course of treatment, it can definitely be a helpful tool in treatment. Ask your doctor for a psychotherapist referral as individual psychotherapy can be very effective. Often, a combination of medication and psychotherapy can be effective in treating depression and anxiety.

In order to experience some change in your life and find happiness you will need to take some action, even if you don’t want to, and even if it’s a small one – like talking to your parents about how hopeless you feel. You can do it. It sounds to me like what you’re experiencing isn’t really “you” but is mental illness clouding your thoughts and feelings. You can have more satisfaction and joy in living than what you’re experiencing.

Take good care of yourself!

Julie Hanks, LCSW


Ask A Therapist: Am I Really Bipolar?

Q: I have just recently dealt with the trauma of being molested by a friend’s father. I thought all of my erratic behavior resulted from this, but now I’m hearing that I am Bipolar. I am confused and scared. I have been given lithium, but the doctor has not spoken to my family and only spoke with me once for about 20 minutes. His assistants did separate interviews with me as well. I don’t have insurance so I am paying a lot and don’t if I can afford to get a second opinion.
Facts: I was in a state of depression from February to July 5th. Attempted suicide 3 times. I attempted suicide 2 other times, once at 13 and another at 21. I have also worked overseas and traveled extensively on my own. I feel great when I am traveling. I know several languages (minor) but never stick to one long enough to learn it well, which is a habit in every study I’ve undertaken.  Jobs: Baker, Insurance Sales, Teacher, Prison Guard, Carnival Ride Operator, Counselor, PCorps Volunteer, usually stick to a job for 6-8 months and then move on. I need help.  I have no money and am in serious debt because of the way I’m living.

A: Thanks for writing in. You raise an excellent question: Is your erratic behavior due to sexual abuse history or bipolar disorder, or some combination of trauma and mental illness? While I can’t provide you with a diagnosis in this format, I can point you in the direction to get a psychiatric evaluation to determine whether or not your bipolar disorder is accurate.

I suggest that you get an additional evaluation and second opinion.  There are community resources available for mental health services free or at a reduced fee. Here’s a link to state funded mental health services in Indianapolis, Indiana. Another resource is the Find Help link at the top of this page and here is the link to providers in your city. When you contact them, ask if they have a sliding fee scale based on income. Here’s another link to help you gain more information about the causes, symptoms, treatment of bipolar disorder to empower you in your quest to get an accurate diagnosis and treatment.

Take good care of yourself!

Julie Hanks, LCSW


Ask A Therapist: My Ex Has Dissociative Identity Disorder. Is There Hope For Us?

Q: How can I explain to an ex-boyfriend who left state and returned that he needs help for is DID? My current psychologist couldn’t answer this question, but flipped it off as insignificant.  I fell in love in Jan. 2010 with a foreign worker who was here to repair damage in the condo after carpet removal and air scrubbing.  I texted him I was i terested and we had a first date.  He ran out unexpectedly, with no excuse and did not return.  ‘Gone then for 3 months to his “country”, back once, ran out with no reason, gone another month, “for a funeral”; back, ran away, then back after another 3 months saying he was emotionally sick and went back to his home country, and was sorry he didn’t call.  During all this strange interims, I hired a detective, then, found out in July he ran to another state, after saying he had gotten a new apt., broke his leg, came back, called me after I left a message at his work, then went back to the other state, back in two weeks to give no reason for his leavings, except that, “a man leaves because a man leaves.”  My question is:  since I noticed he had DID, and he agreed, and had tried to get help, can I assume the relationship is doomed or is there hope if he gets help, that he could ever be stable, or so men with this affliction just drift through life never really finding happiness?  Thank you for reading.  I would not give him a second thought, except that I did have real feelings for him, not just because of his illness.

A: What a tough situation. I think the best approach is to express your concern about his illness and strongly encourage him to get into a psychiatric evaluation to see if he indeed does suffer from Dissociative Identity Disorder. If your ex doesn’t want to get help, there is nothing you can do. If he does seek help there may be some improvement in his behavior and his stability through individual psychotherapy. I suggest you ask yourself “Why am I attracted to someone who is so unavailable and unstable?” There may be some deeper issues for you to explore in your own therapy. Thanks so much for writing in.

Take good care of yourself!

Julie Hanks, LCSW


Ask A Therapist: Who Can I Tell About My Depression and Cutting?

Q: I’m pretty sure I have depression, I mean I have most of the symptoms. But I have nobody to talk to me and my mum aren’t close. I cant see a doctor without my mum finding out. So I think I should go to one of my teachers but I don’t know how to start the conversation and what to say. I think I really need help because I’ve been self harming for over 2-3 months now. Please help. (13 year old girl)

A: Thank you so much for writing in for help. You are wise to recognize that you need to talk with someone about your pain and reach out for help.  If you have a trusted teacher at school, or a school counselor, they may able to help you find a way to talk to your mom about your struggle with depression and self-harm.

If it seems a little easier to talk to your mother about physical health concerns you may want to try asking your mom to take you to your physician by saying something like, “I haven’t been feeling well for a while. Will you take me to the doctor?” Your doctor will be able to do a depression screening, rule out any physical illness, and give you some recommendations for therapists in your area.

I would recommend individual therapy to address your depression and self-harm, and family therapy to help you and your mom communicate better.

If you can’t talk to your mom, please talk to someone soon. Depression is treatable. You don’t have to continue to suffer.

Please, take good care of yourself.

Julie Hanks, LCSW


Ask A Therapist: Never Alone But Always Lonely

Q: (16 year old young woman in India) I am an intelligent girl. Always one of those A+ types. And like all geeky girls on the planet I have no friends. I do have these bunch of people I hang out with in school but we aren’t really true friends. Once when we had a talk with this career counselor our lunch period got missed. I was supposed to eat from the canteen that day. But since lunch was over the canteen got closed. And my so-called friends happily came to the place where I sit and had their lunch which they had brought from home without offering me a thing! I remained hungry throughout the day.

My parents are separated and like typical chauvinistic men my father can’t think beyond my brother. Whenever we meet he only talks about my brother and his future. My father didn’t even want me to be born!! He had tried to get my mom to abort me.


Ask A Therapist: I’m a 26-Year-Old Virgin with No Close Friends

Q: I’m 26 and very lonely, a virgin and I have no close friends. I’m socially awkward and it has affected me all my life. I’m so alone that I made a time limit in my journal that if I don’t make friends or have sex when I reach 30, I’ll kill myself. Crazy right? I even know it’s crazy. I’m a really nice girl, but quiet. What is wrong with me? I have no help what-so-ever around me. I don’t even know what to do anymore. I’ve tried making friends, but it’s so hard. I’m getting desperate, I’m so alone.

A: Thanks for writing in about your desperate need to connect with others. I hear that your overwhelming feelings of hopelessness and helplessness are so painful that you have considered putting a time limit on your life. Ironically, putting a time limit on getting close to others will likely increase your anxiety level and create situations that will make it less likely that you’ll create close and successful relationships. Instead of giving yourself an ultimatum (“You get close to someone or else I’ll end your life”), I suggest that you work on seeking sources of emotional and relational support, on self nurturing, and on actively seeking relationship skills.

I strongly recommend that you seek a psychotherapist as soon as possible to get someone on your “team,” someone you can explore your pain with, ease your loneliness, and help you find the tools to connect with others.  Opening up to a therapist may feel very scary; however, therapy can be extremely helpful in resolving emotional blocks that are making it so difficult to get close to others, and help you develop emotional and relationship tools.  Your therapist will also assess for a mental illness that is contributing to the feelings of loneliness or isolation. If you need help to find a qualified therapist please click here. Group therapy may also be a helpful treatment option for you at some point. Groups are a wonderful place to explore your relationship patterns and to practice relationship skills in real time with the support of a therapist. Thank you again for writing in.

Please take good care of yourself.

Julie Hanks LCSW


Ask A Therapist: Low Self-Esteem, Technology Addict, and Fear of Relationships

Q: I feel like nothing I do matters and nobody really understands who I am. Every time I reach out to someone they let me down. I guess they just don’t care. The last few years I’ve taken to locking myself away in my bedroom to read or watch movies; it gives me more enjoyment than people do but I’m always feeling guilty about it too. I’m 19 years old and I’ve only kissed 4 guys ever, and never anything more. I’m afraid and self-conscious and I feel like I don’t get the opportunity to meet boys that other girls do. I know its my fault but its so hard to change, and I don’t know if I really want to be in a relationship anyway; I don’t think I’d be good at it at all. I’m always fighting with my parents, especially my dad; he yells at me a lot. I used to be so afraid of him when I was younger; he has quite the temper and is always criticizing me. My mother constantly nags me to go out more, to find a job, to stop watching so much TV, to eat better, to do more chores, to act older, the list goes on. I often get excited about little things and become quite childish and energetic, but the smallest thing can also send me into a spiral of sadness, anger or  frustration for the rest of the day. Both reactions seem to annoy my family. My few friends probably find it annoying too; if I could stand being thought ill of I’d probably ask  them. I always think if I were prettier or smarter or talented at anything, life would be better. I don’t want to be different or behind; I just wish things were easier. What should I do?

A: Thanks so much for writing in for help. The fact that you are reaching out for advice in this forum means you have some hope that things could be different for you, that you can feel differently about yourself and your life.

What you’re describing sounds like depression: social isolation, insecurities, withdrawing from activities, negative thoughts, hopelessness. First, I want you to go to your physician and have a physical to rule out any physical illness. While you’re there please talk to your doctor about your hopelessness, isolation and fears. See if medication is an option for you. Your tendency to turn toward technology may be a way to numb your emotional pain.

Also, ask your doctor for a referral to a psychotherapist in your area to work on ways to improve your mood, gain self-confidence, and gain relationship skills. You may also want to consider asking your parents to attend family therapy  to improve your family relationships.  Even though you’re 19, it sounds as if  you’re still stuck in experiencing the “childhood” disapproval of your father, and criticism of your mother, and letting those emotions dictate, on some level, how you feel about yourself. The good news is, you can feel differently.

Your family relationships greatly impact how you feel about other relationships.  If you think about your relationship with your dad as the “template” for male relationships, and you experienced him as scary and critical, then it makes sense that you would be hesitant to open up to other male relationships, like friendships and dating relationships.  It makes sense that you’d have only a few female friends, too, because you’ve experienced your mother as nagging and constantly correcting you. She is your model of how to relate to women so you likely may fear disapproval in your female friendships as well. Your therapist can help free you from these patterns so you can experience relationships with others differently, and not as extensions of your parental relationships.

In addition to meeting with your physician and therapist, I’d like to recommend a couple of books to you: “Feeling Good: The New Mood Therapy” by Dr. David Burns and “The Relationship Cure” by Dr. John Gottman. Both books will provide excellent tools and new perspectives on yourself and your relationships.

Thanks again for writing in. Take good care of yourself!

Julie Hanks, LCSW


Ask A Therapist: Can Dream Journals Be Helpful in Understanding Weird Dreams?

Q: Having weird dreams and therapist is questioning if they are happening because i could be repressing  internal battles. My new therapist is having me keep a “Dream Journal.” Freud has said that “dreams are the royal road to the unconscious mind.” I’m wondering if you think that this could be helpful/not helpful/why would she be having me keep one, and how many people here are keeping a dream journal???

Click arrow below to listen to my response.


Take good care of yourself!

Julie Hanks, LCSW


Ask A Therapist: How Can I Get My Baby’s Father Back?

Q: My daughter is 3 now. Her father and I have been split up for almost 2 years now. Due to postpartum, hormones, stress, loss of a family member, and cancer health related issues I was having and needed treatment for. My emotions were too much. He had been dating a girl from his work for the amount of time we have been split up. I previously got engaged, and am now 7 months pregnant. This relationship failed. During this time of me not connecting my self and my previous EX fiancé being too needy and clingy drowning every ounce of me. Playing games to see “how much I cared.” I couldn’t handle it anymore and shut my wall up. Trying to reason with him if I hadn’t at one time cared I wouldn’t be pregnant or previously engaged. Although that ended I feel relieved and not controlled. And our personalities were too different; I wanted the idea of him trying to fill the hurt.

Although being my daughter is 3 my ex (her father) and I keep in close contact. And being through these last 7 months of pregnancy I realized I missed him. And he’s whom I wanted and WANT to be with. Not someone who looks like him.

These last 7 months also made me realize that the way my ex fiancé was treating me was very similar to the way I was treating my daughter’s father. Because I didn’t have the confidence to believe he cared enough to be there through my emotional roller coaster at the time. And now that this has hit me in the face and my life is in a positive place and knowing I was never happier I want him back.

Is there any advice you can give me on approaching my daughter’s father in time, to take the steps to try and make things work?

A: Thanks for writing in. It sounds like the last 3 years have been extremely stressful for you on many levels, some of which you had no control over, and other stresses that you chose. I know your question is regarding getting your ex-boyfriend back, but I hope you’ll consider that there are other things that need to be addressed before you get back into any relationship.

Please get in to a therapist to explore why you are having such difficulty in love relationships. To find a qualified therapist in your area click here. We often replay our childhood issues in adulthood and my guess is that there are some deeper unresolved issues playing out here.  My biggest concern is not how you’re going to get your ex back, but in you developing the stability and strength in yourself that your children will need in order to thrive, whether you’re in a relationship or not.  Rather than focusing on getting your daughter’s father back, I urge you to focus on being a strong person, and a strong mother for your children, and developing the confidence and the skills to maintain a healthy, long-term, committed relationship. Focus on being the kind of person that would attract a healthy and committed man to build a stable life for you and your children.

Please, be cautious about having more children until you have a healthy, long-term, committed, stable relationship. Focus on getting healthy yourself for the children you already have before you focusing on getting your daughter’s father back. Be the kind of woman he would want to be with. Once you’ve worked on yourself please get relationship counseling before you get into any relationship with your ex or anyone else.

Take good care of yourself and your children!

Julie Hanks, LCSW