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Query

My 22 year-old-brother, who is in the final year of his Bachelor’s level, has not been doing well in college. Lately, I’ve noticed he comes home late and drunk almost every day. He rarely talks to anyone at home and gets irritated if we ask him something. He isn’t his normal self. My family is worried. Knowing him, I can say he will not agree to get help. What should we do? -A concerned brother

Answer by Dr Rishav Koirala, psychiatrist, Grande International Hospital

With the information you have provided, the issue points towards addiction. Addiction into some substance (alcohol or drugs) doesn’t mean that the person will have withdrawal symptoms, it may be a symptom of addiction but doesn’t mean its compulsory.

First, it is important to look at addiction as an illness and it should be treated as such. And the sooner you seek treatment, the better. Addiction affects your thinking. It can reach a point where you cannot separate right from wrong, and don’t realize you are harming yourself and the people around you.

In fact, about 60 to 70 percent of those with addiction have additional mental health problems. Either they had it in the past, or they are struggling with a mental health problem right now. A large percentage try to self-medicate themselves using more alcohol. There is also the possibility of developing a mental illness. Those who have anxiety or depression are also more inclined to substance abuse.  

The best option is to seek expert’s help for your brother. A psychiatrist can make him understand what’s going on with him and how he can help himself. It is best to seek help now, when the problem is just starting. 

Even if your brother is unwilling to acknowledge that he is increasingly dependent on alcohol and refuses help, that shouldn’t stop you and your family. You can go and talk to the psychiatrist yourself in the beginning. The psychiatrist can advise you and offer treatment options for your brother.   

Meanwhile, your family members should try to engage and communicate more with your brother. Social interaction and guidance from a person they trust can be of great help for someone with addiction. 

In our society, seeking help for addiction can be difficult because of the associated shame and stigma. But you should understand that your brother is suffering from an illness from which he can’t get out on his own. It’s also the responsibility of friends and families to support them and encourage them to seek treatment.

Threats and rebukes will not make them sober. Empathizing with their struggle is a better option. 

“I am a 19-year-old female suffering from an eating disorder. I tend to binge eat as a form of coping mechanism against stress. Stress eating gives me a sense of comfort. But lately, I skip meals out of guilt of overeating and gaining weight. I am essentially trapped in this never-ending cycle of either eating a lot or not eating at all. What should I do?” - A

Answer by Kapil Sharma, Counseling Psychologist, Hudec Nepal

First, let’s start by analyzing the cycle. You feel stressed and you start eating as a form of coping. You might feel a sense of brief relief after binge eating if that is your coping mechanism against stress. Also remember to keep track of the time you tend to binge eat. After a period of relief, the guilt of binge eating comes in. This leads to you trying to restrict yourself and you end up skipping meals and counting calories. Then the stress factor hits again and there is craving. Again, the cycle continues.

In this cycle, people tend to eat their food rapidly and in large amounts. They also eat while no one is watching, they eat frequently and more than they want to. Essentially, they feel helpless about not being able to control their cravings. If these symptoms resonate, you are in the cycle of binge eating. 

There are multiple measures you can take. The first step to breaking any cycle is figuring out its starting point. Keep a food and mood journal to track trigger factors that lead to binge eating. Start by noting down when you enter the binge eating phase and what triggered it. Also note whether you were aware while eating and continued anyway because you felt helpless. Awareness is the key. 

Once you figure out the cause of your binge eating, find an alternative coping mechanism. Do something you like to distract yourself. Mindfulness and meditation works for some as well. Anything that helps release your stress in a non self-destructive way.

Plan meals and snacks and don’t skip meals. Eliminate all the trigger factors. Don’t watch shows about food or maybe shows with models who have perfect bodies. This latter might be a trigger if you suffer from body dysmorphic disorder. Staying hydrated is also important. Keep potential snacks away from reach. Talk to people, communicate about your problems. And lastly, try talking to a professional.

Query

I am a 36-year-old working mom to a 13-year-old girl. I provide for every need of my daughter. But I recently found out that she struggles with severe anxiety. She suffers from panic attacks, especially before her exams. So I took her for treatment and she is getting the help she needs. But I can’t understand why, despite having everything, she is struggling with a mental health problem. – A worried mother

Answer by Shreeya Giri, Founder of Happy Minds  

First of all, it is important for you to know that just because your daughter has everything doesn’t mean she is completely protected from mental health issues. 

There could be many reasons she is having anxiety attacks. For instance, when it comes to parent-child relations, the age gap is always a big barrier, making communication difficult. Maybe because you’re at work all day, your daughter could be feeling she is not getting enough time and attention from you. The distance created between you and your daughter by your professional life may have led to a situation where her emotional needs are not being met.  

 It is wonderful that you have prioritized your daughter’s mental health and given her the treatment she needs. You can also help her from your personal side by trying to understand her anxiety. Is it something she gets at school? Maybe it is the pressure of studying right before exams? Or is it because she is not getting enough time and attention at home? You will only know the reason with open and honest communication with your daughter. 

Understanding your daughter’s emotional needs can help you figure out what she needs. 

Perhaps she just wants to spend some quality time with you after you return from work in the evening or before you head out in the morning. 

Have patience with her. She will communicate what she needs and what she is going through. Teenagers find it more comfortable to confide in friends rather than in parents. If you build a loving and trusting relationship with your daughter, she will talk to you more openly. 

Lastly, let your daughter know you have unconditional love for her, so even when you aren’t home, she is reassured that you love her and that it is okay to share what she is going through with you. 

I am a 27-year-old male who has had anxiety issues since childhood. I recently started seeing a counselor with whom I share all my problems. She listens to me patiently and she has, in a way, become a motherly figure to me. (I didn’t have a good mother.) But of late, I feel that I am attracted to her. I think of her all the time. I cannot wait to see her again. I find that I am emotionally dependent on her. Is this feeling natural? What should I do? -A.R.A.

Nishma Choudhary, Student of MA in Clinical Psychology and Co-founder of My Sirani 

It is normal to develop feelings for your counselor. You are sharing your deepest secrets with her. Developing feelings for someone who patiently listens to your problems and who gives you non-judgemental advice is natural. She is giving you a space where you’re comfortable being vulnerable. Maybe that’s a state you associate with feeling loved, whether it is with a parent or a partner. 

You need to take into consideration a couple of things. How long has it been since you started developing feelings or attraction towards her? Is the termination of the feelings taking longer than needed? 

Maybe you can start by contemplating why you may be feeling this way. If counseling has been helping you with your anxiety, then you must be getting positive nurturing feelings out of your sessions. And perhaps this feeling is causing you to look at your counselor as a motherly figure. Your feelings may have also born out of the gratitude you hold for her for listening to you and helping you. Or, because you long to have someone to talk to, someone who understands your struggle with anxiety, which your counselor is for you right now.

One thing that you can do is talk about your feelings with your counselor. At the end of the day, she is there to support you emotionally. She understands your condition and she will know how you can understand and deal with your emotions in the best way. There is in fact no one better to talk about this issue than your counselor.

I understand it can be awkward for you, but chances are your counselor has experienced something similar before. So I advise that you talk to your counselor before you seek advice from anyone else. She is there to help you.