Family

The Exercise Prescription

We all know that we need to get more exercise. In today’s technologically driven world we sit too much and move too little. Being a working mom, I am well aware of how I am always rushing around, but not physically moving very much. It is hard to find the time (and inclination) to exercise with dedication. Doctors have been telling their patients to exercise more since  Hippocrates said: “walking is man’s best medicine”.  A medical prescription is very clear as to the dosage, duration and frequency that is needed. The recommendations on how much and how often to exercise…

The spirit of community

Simon and Garfunkel sang “I am a rock, I am an island” in the 60’s. Concepts like autonomy, self-reliance, winning and individuation have all been useful in carrying mankind forward. “Tall poppies” are no longer cut down, but celebrated. You no longer have to feel bad for being ambitious beyond your circumstance, or for putting yourself first. The pendulum might have swung out a bit far; there has been a cost to this kind of mindset. Loneliness and isolation are on the rise. In a US survey, the number of adults with zero confidants has tripled since the 80’s. Adults, especially…

Shout out for the good men

We are within Sixteen Days of Activism, and the stories of abuse are horrendous. One in five adult South African women have experienced violence. Thank goodness that we have these drives because they make a statement of societal norms: domestic violence is never okay. They also raise awareness of the help that is available to the victims of violence. We have just had the worldwide social media campaign of #metoo. It was very important. Women found support to speak out. Some very prominent abusers were finally called to task. The #metoo stories made my skin crawl. It made me realise…

The holiday blues – tinsel and tears

Summer holidays are starting. I have learnt to close my practice doors in the middle of December. Partially because of increased family commitments, but also because everybody is so out of their routines that they miss their appointments or get the times wrong. During the December holidays, routine psychiatric work falls apart and emergency work picks up. We cannot compare holiday blues and stress to clinical depression and anxiety. It’s like comparing a cold to incapacitating flu. The emergency work I handle seems to be triggered by increased alcohol and substance abuse, less sleep than usual and financial stress. There is…

Exam time: the outer rim of hell

It’s the time of the year when I, as a psychiatrist, find myself writing letters motivating for extensions, deferments and more time. Nobody likes exams; it’s hard work and the feeling of being evaluated can be unpleasant. But for some people exam time becomes a psychic hell. A patient came to me having continuous panic attacks. She was incapable of sleeping or studying. She had been procrastinating with exam preparations; once she started, she was overwhelmed by the sheer volume. She started working non-stop, breaking only to refill her coffee or buy some cigarettes. Initially, she made good headway. The problem began when she was…

The Adolescent Brain- a treacherous frontier

My 10-year-old son is the sweetest, most easy going child. Recently, very occasionally and out of the blue, he has had a few moody days. It has been such a shock to me that I have been carefully listening to my friends and patients to hear what it is like to parent an adolescent. It seems as if most times adolescents are just wonderful. They are passionate, enthusiastic and eager to earn. But parents of adolescents also tell me of the dark side. The times when the teenager is moody, eye rolling and door slamming. When they push boundaries, lie and…

Post Natal Depression (PND) Just how am I supposed to feel after having a baby?

Having a baby is such a joyous, happy time. I am not referring to unwanted pregnancies or extreme situations such as abuse, war or poverty. I am speaking of a child that is very much wanted, within a stable and supportive relationship. Most of the moms in my practice with PND are slightly older. (PND can happen at any age, to any socioeconomic group. In this blog, I am reflecting specifically on the patients in my practice.) They chose to study or establish a career before starting a family.  They might have suffered from depression or anxiety in the past; they may…

Help! My daughter (or son) has borderline personality disorder

Parenting is challenging. Every parent (hopefully) wishes to raise their child into a successful adult. Someone who can be self-reliant and live life to their full potential. Someone who can find happiness and growth in a solid relationship, and then effectively parent their children in the future. Borderline personality disorder traits can be traced back to early childhood. The disorder has a strong genetic component. There are brain abnormalities detected on neuroimaging. All of this is evidence that borderline personality disorder is a disorder of the brain, not just a psychological disorder. Salient features of this disorder are: Emotional dysregulation (extremely unstable…

Help! My boss is a narcissist!

There are many arrogant, grandiose bosses. When I look at the CEO superstars, it seems as if success in many Western corporations requires some level of self-aggrandisement and ruthless ambition. That does not mean that every jerk boss is a narcissist. Narcissistic personality disorder is a diagnosable entity. Its salient features are a sense of deep entitlement and rage when this entitlement is not met. A narcissistic boss who believes that you are not on their side will make your life a living hell. But it usually does not start at this point. The gift that dealing with personality disorders gives us…

Help! My girlfriend has Borderline Personality Disorder

It’s so easy to fall in love with someone suffering from Borderline Personality Disorder (BPD). The early stages of the relationship are so passionate and intense. Initially, she adores you and idealises you completely. She is much more vulnerable and creative than the other girls you know. (Men can also have BPD, although it does occur slightly more commonly in women. I could just as easily have entitled this blog: “Help! My boyfriend has BPD”). Very soon though, you are the source of all her pain and suffering. You are everything that is wrong in the world. You are not entirely sure…

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