Ask Dr. Annie K: How Mental Health Can Affect Relationships

 

I’ve (34M) been with my girlfriend (40F) for 3.5 years and very much do still love her. I suffer from severe anxiety and PTSD but have been active in therapy for well over 15 years. My girlfriend suffers from BPD or bipolar (hasn’t been fully diagnosed yet) and unlike myself, is just starting to go through therapy and seeing a psychiatrist as well. I love her to absolute death but she’s become a very difficult person to be in a relationship with and have it not be a miserable ride.

She’ll pin me down for 2+ hours trying to explain and get me to side with some of her destructive relationship behavior. It’s very exhausting and it’s hurting our relationship. I try to give advice, but it usually doesn’t get absorbed or even listened to at all. I don’t look forward to seeing her anymore and I hate that feeling but I’m not sure how or if I can get back to the excitement of being around her again.

What do I do? Establish that we need to take a break? Break up completely? Toughen the heck up and quit being a wuss? I’m at a complete loss because even though we love each other, being her boyfriend while she’s in this state is bringing the most unhappiness I’ve ever felt in my life…

Sincerely,
A guy stuck between a rock and a hard place.

Love+Medicine

Dear Guy,

Thank you for consulting me. It is always difficult to assess the entire picture when having only one side of the story but I will offer my observations.

I am sincerely happy to hear about your own personal progress with your anxiety. You are clearly invested in treating your illness and realize how valuable it is to stay in therapy. You do not want your illness to prevent you from having a healthy, loving relationship.

If you read your letter to yourself again, you will see that the answers are there. You are clearly in love with this woman. Yet you describe yourself as experiencing “the most unhappiness I’ve ever felt in my life.”

This is understandable. Anyone who has a relationship with someone suffering from bipolar disorder knows the challenges. Your girlfriend is just now starting the healing process. It can take time to reach stability.

In the meantime, you are unhappy and this can impact your own mental stability. Giving the relationship a break may be the way to go for both sides. Your partner needs time to get healthy.

You would not be splitting because she has mental health issues. You would do it because you are miserable right now and appropriately concerned about the future.

After a period apart, you can both reassess how you are feeling. A couples counselor can be helpful particularly when confronting painful emotions – especially when facing the possibility of an end of your relationship.

Ask Dr. Annie K: B12 Injections

Love+Medicine Vitamin B12
 

Should I get a B12 shot weekly @ 65 years old?

Love+Medicine

B12 injections have been popular for decades. This is the most fun part of my job as a writer – I learn new things. While researching for this article, I have learned that I am borderline B12 deficient. Enough about me (more later). Let’s get to the facts.

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Ask Dr. Annie K: Ovulation

 

How do I know when I am ovulating?

Love+Medicine

Your question is a very good one.

There are many reasons why someone would want to know about ovulation. These can be women and their partners who are trying to get pregnant, those who are trying to avoid getting pregnant, and anyone who is curious to know more about how women’s bodies work.

Ovulation is when an egg is released from the ovary.  This happens every month in women with regular cycles. Ovulation usually happens around day 14 in women with regular 28-day cycles. But it can happen any time between day 11 to 21, day 1 being the first day of the last menstrual period. The egg lives for 12 to 24 hours after leaving the ovary, while sperm are viable for several days. If sperm enters the egg during that “fertile period” pregnancy can happen.

When you ovulate can change from month to month. It is not an exact science. Predicting when ovulation is happening is the basis for Fertility Awareness. Fertility Awareness-based methods are not reliable forms of contraception but may be helpful for women trying to get pregnant.

The body goes through changes during ovulation. Getting to know these changes can help you figure out if you are ovulating. 

Basal Body Temperature (BBT)

Prior to ovulation, body temperature falls. After ovulation, a woman’s body temperature rises as a result of an increase in progesterone. Because temperature changes can be influenced by things like stress, illness, poor sleep, inaccurate readings, etc., this alone is not a reliable method to predict ovulation.

Changes in vaginal discharge

During ovulation, the consistency and look of vaginal discharge is noticeably different in most women. Normal discharge is white, cloudy and not stretchy. During ovulation it is more like egg whites – it is clear and when stretched out, it will not break.

Mittelschmerz (German for “middle pain”)

Happens in about 20% of women. There may be a twinge or cramp in one side of the lower abdomen, close to the ovary where the egg is released. If you pay attention to your body mid-cycle, you may feel it. Sometimes it is subtle pain but for some women, it is very painful. 

The cervix never lies

“The cervix never lies” is an old medical school phrase. It can tell you a lot! In the case of ovulation, the cervix softens and opens a bit. This may be nature’s way of preparing it for the entrance of sperm. It is closed and more firm at other times. Some women can feel these changes by using their fingers. 

Increase in sex drive

Some women notice an increase in their sex drive during ovulation as a result of a surge in hormones. This may be evolution’s way of priming women to feel most aroused when they are most likely to get pregnant. 

There are apps, (many apps!) that claim to predict ovulation. Most of these apps are designed for women trying to get pregnant. 

I have done some research regarding which apps are most reliable. The American College of Obstetricians and Gynecologists (ACOG) recently published a review of cycle-tracking apps and have determined that they cannot 100% accurately predict ovulation. However, ACOG did offer suggestions of apps they comfortably recommend at this time: Clue, Glow, and Pink Pad Period Tracker Pro are the top three. 

Understanding the fascinating process of ovulation is essential for all women and their partners. The basis for most contraceptive methods is to stop ovulation – now you know why. Learning when you ovulate is part of knowing and appreciating the female body. 

Ask Dr. Annie K: Breaking The Cycle

I lack trust in my boyfriend of 7 months. This has been caused by his total and complete honesty of his past relationships, which honesty is a good thing, but it has triggered my insecurities, fear of being hurt and that bad feeling in my stomach. When he brings up his past flings in causal conversation or accidentally calls me by his exes name, is still friends with the opposite sex that he has had history with…it is testing my insecurities. As of recent, his ex girlfriend reached out and I wanted to know the extent of the message she sent him so I went through his phone. This lead me to finding promiscuous photos of other past exes (none of which were sent during our time together) and several pictures of other woman that look like screenshots from social media. He was single for three years prior to our relationship so I am unsure and feel weird about what I found. Everything outside of this is good. We have a lot in common and care about each other very much. And he is not in the wrong for having a history before me. I am just not sure what to do and how to address why I feel this way about our relationship. It probably has something to do with things I need to fix about myself, but want to make sure I am not missing any signs.

Also, I have come to realize that I have a vindictive side of me. Ive been reflecting on past situations and I know it comes out full force when I feel bad/disrespected because I think something is happening to me. I hold grudges, punish people for past situations, I resent them without communicating how I feel. I need to stop doing this or I will lose and push away everything and everyone near and dear to me. I resent my family, I resort to acting like them – defensive, passive aggressive, non-commutative, selfish. It’s not right and makes me feel horrible. I need to communicate better and use the “I feel” method with all my relationships. I think I am ready to put in the work to fix myself so I don’t resort to how I was taught to deal with conflict. I think I can do this, I want to be better, to do better. I know I have a good heart and have a lot of love to give. I just need to let the resentment go that I’m holding onto with my family so there’s room for growth, peace and happiness. Is this fix something I do when another situation happens and I hold my actions accountable or is there something else I can do so I can be better?

Thank you for listening and possibly any guidance you might have.

Sincerely,
Someone who wants to break the cycle

We have no secrets
We tell each other everything
About the lovers in our past
And why they didn’t last…

Carly Simon

Dear Someone who wants to break the cycle,

Thank you for reading loveandmedicine and for reaching out.

Both of your questions address relationships. Let’s start with your new boyfriend.

Being in a mutually caring relationship is a wondrous thing. Things are good

Whomever we meet will have a past. He is being painfully honest about his, which is stirring up feelings of insecurity in you. These feelings are so strong they led to invasion of his privacy in a big way. Doubt and anxiety are setting in.

Your feelings are entirely normal in this situation. It is not easy to hear about old girlfriends and imagine him with anyone else. He has been in other relationships – they are over. The fact is he has chosen you. These are the early stages – try to keep the focus on trusting your feelings when you are with him. As long as he is monogamous now, then these thoughts are based on irrational fears. Focus on the positives in your relationship. As you gain confidence in him and in the relationship, you’ll have less of a need to snoop around. It is hard to build a relationship based on trust when you are, at the same time, violating that trust.
 
Flow with it. Try to focus more on the present, rather than the past or the future. Practice gratitude every day.

Regarding the family conflict, your desire to repair it means that it matters to you. You don’t want to lose them. I can see you have insight into your challenges and that is half the battle. You also have the tools to follow through with your plans to repair it. 

The common thread to both questions is insecurity. This makes you doubt your partner and family. It leads to ineffective communication which then leads to grudges. Holding grudges are a manifestation of suppressed communication. 

You may benefit from one to one personal attention to break this pattern. Bouncing things off a caring friend or professional can offer other perspectives. You are insightful and intuitive. That is on the cerebral level. Practicing mindfulness, self trust and gratitude should be part of the plan also. 

You are on a new journey that can be scary but is also exciting. You are brave enough to reach out for help. Trust yourself. 

Dr. Annie K

Ask Dr. Annie K: Legitimizing Mental Illness

I recently felt the need to take a mental health day off work. I had to tell my boss I was also feeling physical illness symptoms in order to justify my absence. Why does society act as if leave from work is only justified if I am physically ill?

– Anonymous

Dear Reader,

You have touched on a very sensitive topic for me. What you are describing is having to “legitimize” your illness by adding physical complaints. 

Unfortunately, even in this day and age, mental illness is treated differently than other illnesses. It is considered a weakness to have a mental health problem. People expect you can just “get over it.” Just eat healthy, exercise, breathe and it will go away.

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