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Counselling and Psychological Services

Competitive friends

It just hit me that I have not smiled or laughed in weeks. I am not exactly unhappy because I am thankful for everything I am given. But instead I definitely do not feel happy. I have a really competitive friend that I spend a lot of time with, as I live alone, and it makes me worried whenever I tell her things for I am afraid she would judge me and use it against me. As a result I have been distancing myself with this person and I am left alone most of the time. Making friends is hard when we are half way through the semester and since I don’t have my family with me I feel very alone.

 

Thank-you for reaching out to Ask Counselling. It very much sounds as though you are struggling with loneliness, which has been described as the experience of negative feelings when there is a mismatch between the quality of our perceived relationships, and those we wish to have. We’ve all felt lonely at some time, and it is very common among university students, both international and local. It can be especially hard when, like yourself, students are far away from their usual support networks.

Research studies have focused on four main strategies for helping to reduce loneliness. These include improving social skills and social support, expanding opportunities for social interaction, and challenging unhelpful beliefs about social interactions.

In terms of your own situation, there may be opportunities you could explore to make new connections with others. Sometimes this means overcoming initial anxiety about interacting with new people. You might need to practice introducing yourself or making small talk to feel more comfortable initiating conversation with others. Some examples include starting a conversation with a classmate, going along to an interest group, volunteering or getting involved in a university club or society. Each semester, Counselling and Psychological Services also run student workshops on improving social connections.

It may be that there are existing friendships that you could foster or improve. It sounds as though you were worried about being judged, and this caused you to pull back from a previous source of support. The assumptions we make about others can have a powerful influence on our behaviour. I wonder if you think it is worth talking through your concerns about being judged with your friend? Although it might initially feel uncomfortable to discuss relationship issues directly and assertively, you could also see it as an opportunity to potentially improve the quality of the friendship. Some specific strategies for assertive communication can be found here.

Meaningful, mutually respectful relationships can take time to develop. If you have tried a few things and don’t feel as though your mood is improving, you might like to talk things through in more detail with one of the professionals at Counselling and Psychological Services.

Detached

Hey, I’ve been feeling very disconnected with everything recently. I don’t feel sad or angry, but I just feel empty? Detached? Frankly, this is affecting my study quite a lot. I have no sense of urgency. I don’t feel panicked when deadlines for my assignments are coming. Last semester, I submitted all my assignments late. Everyday I feel like getting up is a chore, but not to the point that it completely hinders my overall functioning. I can’t distinguish if this is only my laziness or it’s really something serious? I don’t know if my situation warrants enough reason to seek professional help.

Awareness is the first step to address problems. So good call to connect with us! Your question actually highlights a very important issue for people wondering whether or not they should seek professional help. It is useful to remember that people seek professional help for a variety of issues of varying severity, all of which are equally valid concerns.

The changes you are describing may be warning signs of a mental health problem, even if you are not experiencing symptoms (e.g. persistent depressed mood) that are commonly seen as a reason to seek professional help. Equally, they may not be a sign of any underlying problem at all. It is hard without further exploration to identify what could be at the bottom of this change. Many of us from time to time will experience periods of reduced productivity. For some, this may be related to life stress or loss of motivation. For others, a loss of interest in things that are important to them can be a symptom of emerging depression or another mental illness.

What stands out to me is that you have identified a change in the way you feel that has had a big impact on your ability to function academically. This in itself is certainly reason enough to book a session with one of our counsellors. We are a low-threshold service for exactly that purpose: to identify what could be going on, and to find out if there are mental health concerns, or if there is something else that should be addressed.

An appointment (or more if required) where you can talk frankly in an open-minded atmosphere might just help you to figure out what is going on and what steps you can take to address this before things get out of control. There is no particular criteria you have to meet to access professional support, in fact, most of the time it is better to seek help before things get too severe.

To connect with us you can book an appointment here. You may also find it helpful to take a look at some of the self-help resources or workshops that are offered by Counselling and Psychological Services. In addition, an appointment with your GP may be a good first point of contact. They can work with you to review any physical health issues and discuss other referral options for with you.

Body symptoms of stress

I’ve been seeking psychological help for depression and anxiety and while this therapy has helped I can’t kick the physical toll stress takes on my body. When I’m stressed my skin crawls with dermatitis and acne and makes me hot and itchy, regardless of the prescription cream I use and my digestive system goes into pendulum mode swinging from constipation to diarrhoea at the drop of a hat. My doctor says I need to work on managing my stress levels through the therapy. But when I’m sitting at my desk I can’t escape my anxious mind, and my dysfunctional body.

Thank-you for your question and sharing your experiences,

I encourage you to continue working with the psychologist you are seeing, as you have indicated that this has been helpful. It may be important to raise with your therapist the physical symptoms you are experiencing and to discuss whether any of the strategies suggested below could be practiced in your sessions together.

Excess stress can certainly manifest in a variety of emotional, behavioural and physical (somatic) symptoms. Common somatic symptoms can include: tiredness, headaches, muscular tension and pain, changes in sleep/eating patterns, and as you have mentioned – digestion and skin issues. Symptoms of pre-existing medical conditions can also become worse when we are stressed.

Stress can differ significantly from one person to another, both in how it affects us, and in how we respond to it.

At times, people can engage in unhealthy behaviours as a way of coping with stress. Such behaviours may include: over-consumption of alcohol, cigarette smoking, misuse of prescription drugs, illicit drug use, unhealthy diet, or over-committing to events and deadlines. Whilst these behaviours may provide some brief temporary relief, these unhealthy behaviours tend to make stress symptoms worse in the longer term.

Stress is common in daily life and is part of being human. In fact, we need a certain amount of stress to feel motivated and energised to do the things that are important to us. If it is prolonged, or at extreme levels however, it can have a significant impact on our mental and physical health. Thankfully there are simple steps we can take to help manage our stress levels:

  • Make time for regular exercise (small changes can have a big impact)
  • Schedule in time for enjoyable activities and socialising with people that make us feel good about ourselves
  • Avoid long studying or working hours
  • Not over-committing to things – trying to get a healthy balance between work/study and things you enjoy doing
  • Taking time out to relax
  • Breathing and mindfulness exercises
  • Getting enough sleep – this will vary from person to person but aim for 8 hours per night
  • Addressing the causes of our stress in a constructive way such as problem-solving and tackling challenges directly rather than avoiding difficult tasks.

The way that we think about situations can also impact on how much stress we experience – if we can view stressful situations as challenges that we can rise to, rather than as a threat or something to fear, this in itself can reduce the negative impact of stress on our body and mind.

Where we focus our attention can also impact the amount of stress symptoms we experience – for example if we are preoccupied with physical symptoms of stress this can make us feel worse. It can be more helpful to try to focus our attention and energy on engaging in helpful stress management techniques such as those listed above.

See further information for managing stress on the Counselling and Psychological Services website.

Bad break-up

I just had a really really bad break-up. It’s not really because we broke up. It’s because of a handful of other factors. I cannot concentrate on anything. It’s affecting every part of me. There is additional financial stress from different angles. Now I’m thinking it is a mistake coming to Unimelb. I feel like I have lost so much and I cannot concentrate or do anything. Please help.

I’m sorry to hear about your break-up. Break-ups can be devastating and it is normal to experience a range of emotions following a break-up including: grief, sadness, anger, fear, loneliness and guilt. For some people it can be hard to stop thinking about their ex or the break-up and they may experience difficulty concentrating, reduced motivation and other changes to sleep or appetite. Depending on the circumstances, it can be especially hard to accept a break-up when there are still strong feelings of attachment or love. This resource from headspace has some helpful information on dealing with relationship break-ups.

In addition to the break-up it sounds like you were already under stress because of financial issues amongst other factors in your life. The university has services to assist students who are experiencing financial difficulties. It might be worth getting in touch with Financial Aid to see if they can help you at this time. In times of stress, our brains can revert to focus on information relevant to survival, which takes power away from our rational mind. This can affect our concentration, motivation and ability to do things such as study or work. When we experience cumulative stressors it can be pretty common to feel distressed and to have difficulty coping for a period of time.

When we feel overwhelmed it can help to do the basics and show ourselves some kindness, physically and emotionally. Maintaining diet, exercise and connections with others are all still important, yet we can easily neglect them in times of emotional distress. See here for more suggestions on how to manage stress. As people often engage in self-critical thinking during and after break-ups, it can be a compassionate step to lower expectations of yourself for a little while and reduce pressure. It may help to spend time with supportive and caring others. The relationship sounds like it was important to you – give yourself some time to grieve this significant change in your life. If your difficulties continue, professional help is available. Don’t hesitate to get in touch with us at CAPS.

Managing psychological disorders

I live with severe depression and borderline personality disorder (the former is being treated). Being new as a MA it has been very challenging to manage my study, work, Centrelink and the constant symptoms of my illness. I often have low energy, feel overwhelmed and cope in destructive ways. BPD is very hard to talk about because it is still highly stigmatised, despite there being hundreds of ways you can experience the disorder. How do I go about discussing a stigmatised disorder on campus? At the moment I’ve managed to apply for extensions when I need it, but it also affects my (part time) contact hours.

Thank-you for your question, and sharing your difficulties. I agree with your observation of borderline personality disorder (BPD) still being a stigmatised mental health issue that can be misunderstood. It is understandable that the symptoms you describe may affect your study at the moment. Embarking on a postgraduate degree is also a challenging task in itself.
In regards to your question about how to go about discussing BPD on campus, I imagine that your approach might depend on who you are talking to and the reasons for discussing it. For example, talking to a friend, compared to a GP or counsellor, or to teaching staff in your course. It is difficult to offer specific advice around this without knowing your particular circumstances.

I am wondering what kind of treatment you are undergoing to address your symptoms of depression and whether you are receiving psychological or psychiatric treatment. If so, I’d encourage you to bring up your concerns with your psychologist or psychiatrist who may be able to support you in making a plan. If you are not currently receiving psychological therapy it may be something to consider, as there are specific psychological treatments for BPD that can be effective in overcoming destructive coping patterns and managing your mood and stress. If you don’t have an existing psychologist you are welcome to book an appointment with a counsellor at the Uni Counselling Service who could discuss these options with you and assist in finding a suitable referral option for you if this is something you would like to pursue.

It sounds like you are taking proactive steps to improve your mental health by seeking treatment and also applying for extensions when you need it. I am wondering if you are aware of the option of registering for ongoing support from the Student Equity and Disability Support service (SEDS). This is for students whose study is impacted by their health or life circumstances in an ongoing way. You can read more about this and the eligibility criteria from the SEDS website.

Finally, you may already be aware of this, but there are some helpful resources available online to help others understand BPD such as this fact-sheet from Orygen Youth Health or the Spectrum website. These may be useful when discussing BPD with others.

Stress and how to seek help

I often find myself overwhelmed with stress and that I worry excessively about things. I try to manage and plan my time well so that I don’t stress about deadlines however I still find myself feeling overwhelmed often to the point of feeling ill. I want to seek help and talk to someone about this but I’m not sure how to go about starting a conversation about this and I find myself nervous about talking about this.

It sounds like you’re experiencing something that is quite common for anyone who faces deadlines, that being stress and anxiety. Whenever we face something that is considered final, such as a deadline, loss, a breakup, then the human brain can struggle to reconcile this and it results in stress. When we can foresee something like this coming, then we often become anxious about this pending threat or problem. This is actually a biological process and can have a number of effects on the body, including feeling physical ill, poor concentration, or memory issues. In fact, studies have shown how long term stress can be damaging to the brain itself .

You mention that you’re not sure how to go about starting a conversation about this, well, the good news is that you already have! If you want to take the next step then I would suggest either booking an appointment with us here at CAPS, or maybe seeking some online support via services such as eheadspace. You could also see your GP to talk about other referral options. That nervousness you experience when you talk about this, well it tends to subside the more you get use to talking about it. Anxiety is a very common problem, and it is also one of the most treatable problems people face, as long as you can rally yourself to take the necessary steps.

Coping with anxiety about physical health

Last week, I found out that I have big lump on my neck. I went to the GP last week to consult. However, the GP was unable to determine what’s wrong with me and asked me to do some tests.

While waiting for the result of my tests and the next consultation with the GP, I have found that I am unable to concentrate, especially to do the mounting assignments because I’m worried that the lump on my neck is something dangerous. I have a mild anxiety problem, and this anxiety causes me to think about the worst scenario that will happen.

I try not to think about it too much, but I can’t. What should I do?

Thank you for your question. It sounds like a time of uncertainty for you, and the anxiety or concern that you are having about the lump is an understandable and normal reaction. Sometimes when people are already feeling anxious (e.g. about health concerns) additional stress, such as your university assignments, can increase anxiety and also affect concentration. As you have noted, your concentration is affected because you try not to think about the lump, which makes you think about the lump. Often, that is the paradox of trying not to think of something – it makes you think about it. In some ways, thinking about the possible scenarios or worst scenarios can be seen as functional during that time, as it is often seen as preparing oneself for the uncertain future. However, once that starts affecting your ability to do what you need to do on a daily basis, it can become problematic.

Sometimes, practicing mindfulness (try some of our guided exercises here) can help us be aware of where our attention is directed, so we can redirect it back to the task at hand. This could be useful for you when you are completing assignments and you find yourself worrying about the lump. With the practice of mindfulness, you’ll hopefully find it easier to redirect your attention back to your assignment.

It may also be useful to schedule some “worry time”. This involves setting aside 10-15 minutes during the day (preferably not close to bed time) to allow yourself to worry. When you find yourself worrying, remind yourself you will have time to think about it later, write down a short note about this worry (only a couple of words) in a notebook and turn your focus back to the task at hand. Here is a fact sheet and an app to help you practice.

This chapter from Centre for Clinical Interventions offers a good summary of these strategies and provides activity sheets to help containing your preoccupations about health.

While you are waiting for the results and feel anxious, you may also need to adjust your study strategies to your current level of concentration. Don’t hesitate to divide your work in smaller blocks of study, set a time for each task, alternate between tasks demanding different levels of concentration and use active learning strategies to keep you more engaged. Academic Skills have good resources to help you plan essay writing and revision.

Remember that this period of uncertainty and anxiety will not last forever. As you have mentioned, you will be seeing your GP to confirm the results and this could be something to remind yourself when you start to worry about possible outcomes. If you are finding that the anxiety is becoming worse or less manageable, you can also talk to one of our counsellors. I hope you find this information helpful, and I wish you all the best.

Getting over an Abusive Relationship

I was in an emotionally and sometimes physically abusive relationship for 2 months. The guy I was with had been raped when he was younger, and had terrible anxiety and so I thought I could help him. In thinking that, I fused a connection with him and he opened up. He used to “play fight” with me which was never enjoyable and no matter how many times i told him to stop, he wouldn’t listen. He bruised me. If he didn’t get his way, he would not take my calls or anything. Eventually I ended it. Its hard to get over him now that he has removed me from his life even though he hurt me so much. Help!

Thankyou for asking this question, and having the courage to share both your experience and how much it has impacted and hurt. Unfortunately, such an experience is not uncommon, and it raises numerous questions about how to manage and respond to such situations.

Some of the themes that seem to be present in the question include:
1. Where is the line between healthy and unhealthy support of/for a loved one?
2. What do we do if an intimate relationship becomes emotionally and/or physically abusive?
3. If the best thing for us is to separate or break from such a situation, how do we move on?

These are all important questions in any relationship, and unfortunately there are no easy answers for any of them. One response is that the answers are different for every individual, and part of the challenge in that regard is trying to understand and respect/value yourself, your needs, your limits, and your response styles with reference to such situations.

Regarding the first point, it is very normal to feel that we can help someone who has their own challenges, and hope that by showing unconditional love and support that things will improve for them. In reality, sometimes this helps and sometimes it doesn’t (at least in the short term). The person may or may not be ready for change, or may or may not have the skills or insight to do so. Part of the question then becomes “where are my limits”, in terms of how much support/love we can give in relation to the consequences and ability to hope for change/improvement, and in relation to how well our own needs are being met.

This leads into the second point. Sometimes, despite our best efforts, relationships can still become “toxic” in terms of things like manipulation or emotional/physical abuse. Sometimes these things can be improved or managed with open and assertive communication. Unfortunately, despite the direct communication that you note in your post, your partner seemed to be unable or unwilling to respond appropriately. In such cases, seeking help or advice (from friends or counsellors, or police if there is a concerning physical threat), or removing yourself from the abusive situation as you did are all options available.

The latter option, as you note, is often (initially at least) highly distressing, for a number of reasons. Maybe we still have strong positive feelings for the person, maybe we feel guilty for
“letting them down”, and maybe we feel lonely or lost or confused in the aftermath. Sometimes part of this is how about how the relationship impacted our sense of self or identity or even confidence. Sometimes toxic relationships have a way of undermining our self-belief and sense of who we are. So part of the gradual response might be about slowly rebuilding this sense of self/identity, as well as sense of community and self-belief outside of the relationship (see here for example).

In this regard also, such experiences, as distressing as they are, also afford the opportunity for personal growth in terms of understanding our own preferences for future relationships and styles of interaction (see here for some thoughts on break-ups from challenging relationships).

Feel free to book an appointment with one of the counsellors at Counselling and Psychological Services. For concerns related to physical or sexual violence, options also include domestic and family violence services or Centre Against Sexual Assault (CASA) for assistance and information. Counselling is private and confidential, and can focus on helping you to understand and process what has happened.

Traumatic Gay Sexual Experience

I had a sexual experience a year ago when I was drunk and while it was initially consensual stopped being consensual. I said no, he didn’t stop for a while and then eventually finished. He is not the most intelligent person and wasn’t aware of how violated I felt, I never told anyone, and I left straight away worried that he may had transmitted HIV because he stopped using the condom. What he thought was spicing up our sex life, I found traumatic and I haven’t had sex since and I’m struggling with body image issues, confidence issues etc. How do I move on/understand what happened to me?

Thanks for asking such an important question, as it’s clear this has had a real effect on you and unfortunately you are not alone in having an experience like this. There is no doubt the person in question should have stopped as soon as you said no, and the fact that he doesn’t understand the impact on you doesn’t make your trauma any less valid.

It sounds like you’ve been carrying this on your own for some time now, which can make it harder to process. Often these experiences are kept secret and people can feel ashamed and/or embarrassed to talk about them, or the only ones we hear about can be very different so it’s hard to make sense of what has happened. The issues you’re now experiencing are a normal reaction to a traumatic experience and don’t say anything about you as a person.

When you are ready, it can be helpful to talk to someone you trust in your personal life and who you feel would respond to these issues with respect and validation, while remembering that you are in control about what you share. Similarly, when you are ready a professional counsellor can help you overcome these issues and while this can be a difficult thing to do, the process can be a valuable experience. While we cannot undo the past we can learn to live our lives without the past holding us back.

Feel free to book an appointment with one of the counsellors at Counselling and Psychological Services. You can also contact Centre Against Sexual Assault (CASA) for assistance and information. Counselling is private and confidential, and can focus on helping you to understand and process what has happened.

When to seek help?

I have had problems with anxiety all through my degree and I managed to live through it, headaches and chest pains and all. But I am often miserable and in a lot of emotional pain. Because I can function normally I feel bad for seeking out professional counselling—even for writing this question. When should I seek help? Or is it better to pursue relaxation techniques at home?

Thanks for your question, it sounds like your anxiety has negatively impacted your emotional wellbeing a great deal, and that you have been battling with a number of unpleasant physical symptoms for some time now. I think your question highlights a very important issue for people considering whether or not they should seek professional help. It is important to remember that people seek professional help for a variety of mental health difficulties of varying severity, all of which are equally valid concerns.

There is no particular criteria you have to meet to access professional support, in fact, sometimes it’s better to seek help before things get too severe. Even if you are still functioning well and meeting the demands of your life, if anxiety is taking a toll on your emotional wellbeing then it is important to seek help. Working with a professional may help you gain another perspective on the anxiety you experience and why it may be occurring. Ultimately you may be able to learn not just how to cope with your anxieties, but how to move beyond them toward living a more enjoyable life.

I want to re-assure you that professional help is safe-guarded by high standards of privacy and confidentiality. There is nothing wrong with experimenting with relaxation techniques, but it can be helpful to do this in consultation with a health professional. You can choose to see a counsellor one-on-one at Counselling and Psychological Services. We also often run workshops on anxiety, check out our website for information and how to register.

Another option is to go through a GP at the Health Service. A GP would also be able to assess your eligibility for a Mental Health Treatment Plan which allows Medicare rebates for allied mental health services (e.g., psychologists, social workers).

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