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Dr. Annelle B. Primm, Deputy Medical Director of the American Psychiatric Association (APA) & Director of the APA’s Office of Minority and National Affairs answers your mental health questions.


What are symptoms/warning signs of PTSD?

Some of the symptoms of PTSD include low mood, fear, avoidance, social withdrawal, feelings of numbness, and flashbacks of the traumatic event, intense startle response to loud noises, poor sleep, and difficulty concentrating

Is mental ilness heredity?

Mental illness can be hereditary.  Studies have shown that illness like depression, bipolar disorder and schizophrenia tend to run in families.

I’m bipolar and want to get off my meds and try homeopathic meds. Do you know of any such meds that might help me?              

My husband had a massive heart attack almost died and I see signs of some mental issues is this normal it is common that people who have had a heart attack to experience depression.  It is important that he be evaluated because treatment of mental health needs can help him recover from the heart attack.

Does the doctor have any suggestions on how schools deal with more and more kids with psychiatric disorders?  We have 5-year-olds who are psychotic! Can’t put them out because it violates their rights BUT they are a danger to other kids. HELP!

The American Academy of Child and Adolescent Psychiatry may have resources that may be helpful.

How long should one stay with a therapist before expecting results or is there  no set time for staying with a therapist?          

It really depends on the situation.  Usually, at the beginning of treatment, a person receiving care and the therapist identify certain goals and work together on a plan to achieve those goals.  If the first approach doesn’t work, there is usually a plan B. What you want to have is a good working relationship with the therapist. If not, it may be best to find another person to work with.

How do you tell someone they may need some mental health assistance without getting cut?           

You could let them know in a caring way that you have noticed some changes in them and share whatever you have learned about warning signs. Stay away from terms like mental illness or “crazy”. Instead, ask if they’re feeling stressed out.

What are some signs of depression?       

Signs of depression include sad mood, feeling bad about oneself, blaming oneself for things, negative thoughts, poor sleep or increased sleep, poor appetite or increased appetite, low energy, moving slowly, isolating oneself, trouble making decisions, poor concentration, poor memory, difficulty thinking, thoughts of death or suicide.

If I see someone displaying mental health issues and I have no insurance, how can I get help for them?         

SAMHSA, the government agency that handles mental health services has a hotline.  They can help. The Affordable Care Act may help this person if their state has made arrangements. Some states have ways people can get help through primary care centers called Federally Qualified Health Centers (FQHCs).

Does depression and anxiety ever go away?  How do you get rid of stress when life keeps going downhill? Finance, the stress of hospital bills, house pay..etc.                             

Get checked out by a doctor. Counseling, support groups can help you develop coping skills for life’s difficulties. If you have symptoms like poor sleep, trouble concentrating and making decisions, medication might help also.

 I’ve been on and off of meds for depression and anxiety for many years. I am extremely concerned that even when discontinued, these medicines can cause long-term brain damage even permanently. Doctors claim that this isn’t true but I’m not convinced, your thoughts?                                                                                                                                                                                                                       

There are no studies to suggest that depression and anxiety medications cause long-term brain damage. Some studies have found that medication and psychotherapy or counseling can help repair brain damage caused by severe stress.

My 40-year- old sister has shown signs of mental instability since she was in the 3rd grade and her daughter had shown signs from age 12 until now at age 17. It’s gotten so unstable between them that my niece was just placed in foster care. When we try to talk to my sister she’s so depressed that she can’t talk about it, she just cries. What can we do as a family to help them?                              

The best thing to do is to encourage and accompany your sister to see a doctor to be evaluated to see how her depression can be helped and also determine how her daughter can get help.

 When my husband shares his delusions: do I ignore, change subject, say it doesn’t make sense, what?

Thank you, be caring, don’t criticize him or be negative about it. Ask if the thoughts are upsetting and if so, suggest focusing on something else.

I have Bipolar disorder 1 and also Borderline personality Disorder. I always had Bipolar disorder as well as a few of my siblings. I do not always take my meds due to the side effects. However, I am a vegetarian and I work out a lot. I know by polar disorder is a medical condition because it works with the brains chemicals. My question is can mental illness be corrected by nutrition?         

There is no evidence to suggest that mental illness can be corrected by nutrition. However, it is good to eat nutritious foods, get physical activity as you are doing because this supports overall health including mental health

Can bi-polar affect your ability to make sound social relations?                                                                                                                         

Yes, bipolar disorder can affect your judgment and decision-making, causing you to take risks that you might not ordinarily take. If you have mood swings or irritability it could have an effect on relationships, also.

Are there any studies that show that marijuana affects the mental health of people?   

Studies show that marijuana can cause people to experience anxiety, panicky feelings, paranoia and low mood, but this is usually found in first time users. Sometimes, when marijuana is laced with other drugs like PCP it can cause people to be out of touch with reality.

My son has just been placed on vyvance for ADHD after years of Ritalin and concerta. Is it possible for him to become angry after starting this new med?

It is possible for people to experience anger in adjusting to a new medication. It is also possible that there could be reasons for the anger unrelated to the new medication.

I’m bipolar & schizophrenic. anything I can do other than taking meds? I want a normal life. don’t like living this way.

Psychiatric rehabilitation is often helpful to people in supporting them in preparing to work, providing support groups, and helping them develop living skills so they can reach their goals and live a quality life.  It is doable.  Don’t give up hope.

Is ADHD a form of mental illness?

Yes, Attention Deficity Hyperactivity Disorder is a form of mental illness.

My wife currently is serving in the U.S. Navy, She recently served in Afghanistan, she  has now been diagnosed with PTSD and she cuts her self now, can you ask the Doctor to please address this issue?

Post traumatic stress disorder is a common mental illness in individuals returning from war. There are many symptoms, including low mood, anxiety, flashbacks, startle response and numbness. Self-injury such as cutting is not a common symptom.  It is important that your wife receive medical attention.

Please explain agoraphobia. Being scared of people and fear of being judged with panic attacks and depression. My fear is body disfigurement, but I don’t have a real disfigurement I’m just fat and fear people judgement because every time I get around people or jobs people eventually hate me.

Agoraphobia is a fear of crowds.  People with this condition usually avoid supermarkets and events that draw a lot of people and as a result, they may stay inside their home.

My spouse of 15 loving, happy years is having a “breakdown” and is very depressed. How do I get him help?

Approach him in a caring way and offer to accompany him to an appointment to be evaluated to determine what is going on. Check the SAMHSA website for the hotline for where to get services in a location near you. He can also be seen by his primary care doctor who could do depression screening or refer him to someone who could provide mental health services.

Can post partum depression last for years?

Post partum depression could last for a long time, especially if someone had depression before they gave birth. The hope is that with treatment the person would experience relief from depression.

How do I get a parent to see that their child has some responsibility if they have ADHD and they choose not to medicate.

Getting the child counseling with a mental health professional can be helpful to help them understand ADHD and how to manage it.

In a state of North Carolina, if you are on Medicaid and are a mental health patient, the system seems to believe that half an hour with therapy session and medication is the answer. How can we change this?

Advocacy is important.  Talk to your legislators and connect with mental health advocacy organizations such as the state and local chapters of the National Alliance on Mental Illness or Mental Health America (Mental Health Association).

I’m in the process of adopting a baby. The bio mom has a mental disability. How do I determine when to have the baby evaluated for any mental disability?

Talk with the pediatrician who will advise you about this.  The pediatrician will be monitoring the baby over time and so will you.  Be sure to report any concerns to the pediatrician if you have concerns about the baby’s behavior and development.

Is it safe to drive a vehicle when you have 5 meds in your system: Cymbalta, Prednisone, Glycoside,  Prostate meds, and Anxiety meds?

Ask your physician and/or pharmacist  about whether there are risks associated with driving or operating heavy machinery while on certain medications. Of course, if you are feeling unsafe when you drive while on these medications, you should notify your doctor.

If two families who  have history of mental illness, children marry each other, is there a strong possibility of mental illness?

There is a risk but no guarantee of mental illness in the children of people who have family histories of mental illness. People should be aware of warning signs so that if mental illness appears in their children, they can get help early. Some people who have strong history of depression in their family receive preventive depression medication to keep depression from occurring.

My dad has Alzheimer’s and my daughter and grandchildren are going to be moving in with him to help watch him. Do I need to kill proof the house first?

It is good to make sure the home is a safe environment.

How do I get my wife to test for being bi-polar disorder?

If she has a primary care doctor, they may be able to do a screening test for bipolar disorder or refer her to a psychiatrist or other mental health professional for evaluation.

My son in Illinois has schizophrenia. How can I find a psychiatrist who won’t just prescribe him anti-psychotics? We need a treatment program. He’s on risperidone 3 mg and is hardly speaking or going out.

There are other services besides medication for people with schizophrenia. Some people benefit from individual psychotherapy, group psychotherapy, psychiatric rehabilitation, supported employment.  Some mental health programs offer assertive community treatment that includes home visiting which has been found to be very effective.

Can the doctor speak on Mental health First Aid? I just finished this training and believe it will be beneficial for families with loved ones suffering with mental illness. Especially dealing with a crisis situation.

This training is very helpful in preparing the community to understand the warning signs of mental illness and help people in need get connected to services. It is useful public health approach to mental health that helps reduce stigma of mental illness.

My daughter who is 30-years-old suffers from mental illness, but she does not want to admit it. She is supposed to be on medication but does not want to take it. How can we help her get back on her meds? I am raising three of her four kids.

Having her working with a caring mental health professional in psychotherapy and motivational interviewing could help her see how in achieving her goals, whatever they may be, medication could help her.

Hey guys, I live in a bad community, I am a single mom with five kids. Recently my home was invaded, luckily we were not home, but now my fifteen-year-old sleeps in the hall with a bat and I can’t get him to go to bed; I installed an alarm system and put up bars. Help me!

Keep encouraging him to sleep in his own bed even if he keeps the baseball bat handy. Over time, he will see that the safeguards you have put in place are making your home safe.

My son was diagnosed 4 years ago with bipolar disorder. The last 2+ years he is taking the invega shot. Now he is prepping for school to get his diploma but he can’t focus. What can we do at this point?

Be sure to let his doctor know what his current difficulties are. If necessary, changes can be made to your son’s treatment plan and medication.

Ultimately, who is going to pay for mental illness treatment? Who’s going to take care of the person suffering with a mental illness? Family members are not going to chip in to help cover the expenses or share in the responsibility of taking care of a family member with a mental problem. So,  black folks typically ignore mental illness by pretending it does not exist!

Most insurance don’t pay for mental health treatment. If they do then its limited to 30 or less treatments a year. Sufficient insurance coverage would be a start.

The first thing a doctor asks is ‘do you have insurance?’ and when you say no, they can’t help you. Plus,  I have 4 siblings,  one who died from mental illness. I have exhausted myself and lost my marriage because I constantly try to help my siblings. I have tried to find the crux of this mental illness in my family. I joined NAMI thinking I could get some support but that’s a front for people in high positions to tell you what to do but with no solution. I stay in prayer and help each sibling the best way I know how; I am taking it one day at a time and I continue to help my family!

Sometimes caregivers like you take on a great deal of stress. Be sure to take care of yourself and your needs, too.