Family

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…

How to love someone with serious mental illness

My gut still churns when I see that look in family members’ eyes. The one of desperate confusion and frustration. The fatigue and anger, especially if the symptoms their loved one suffers from has been ongoing for some time or involved aggression. If your loved one has a serious mental illness like schizophrenia, profound depression, bipolar mood disorder, addictions or eating disorders, it is awful. They aren’t the only ones suffering. You are too. The good news is that improvements for mental illnesses are as good, or even better than, chronic physical illnesses like diabetes or cardiovascular disease. But there is…

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…

Does Fortnite cause ADHD?

“Does Fortnite cause ADHD?” was one of the questions a parent in my practice recently asked me. She was wrestling with whether to put her son on Concerta for ADD (Attention Deficit Disorder). He is a very bright boy and has always done well academically. His first year of high school has been challenging, with a drop in marks and an increase in anxiety and moodiness. His teacher had mentioned ADD, saying that there was a huge discrepancy between his IQ and his marks and that he seemed to “zone out” in class. These are typical symptoms of  ADD. ADD,…

How to talk to an abused friend

I cringe when I think back to how I used to talk to domestic violence victims. I was a newly qualified doctor. At 26 years of age, I was dealing with life and death on a daily basis, long before I had any real-life experience. Such was the clarity of my convictions when I met my first battered woman in the emergency room. Her drunken husband had broken her jaw. “You must leave him,” I said. “Mm,” she said. “One woman dies every eight hours at the hands of her partner. He might kill you if you stay, ” I…

Parenting with a mental illness

Parenting is hard. We have to keep our children safe and fed; we have to attune to their emotional needs. We sacrifice everything for them: our time, our money, our sleep. And we wouldn’t want it any other way. Having a mental illness is hard. Sometimes getting out of bed is daunting. Acutely self-regulating one’s emotions is impossible. Reality might, at times, become a vague concept. Nobody asks for or deserves a mental illness. It is a painful and often incapacitating disability. When my patients hear that they have a diagnosis of serious mental illness, say bipolar mood disorder or…

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…

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…

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