DR. RON’S Q&A POST…
(Dec 7, 2025)
Lonely B: I’m not sure where to start, Doctor. I’ve just been feeling so alone lately. My husband left me about six months ago—he just packed up and moved out after 18 years together. I still don’t really understand why. Since then, I’ve been living by myself, and it’s been really hard. I feel abandoned, like I’m not good enough for anyone. Most days, I just feel empty. I used to enjoy gardening and reading, but now I can’t seem to find any pleasure in those things. I barely have the energy to get out of bed some mornings. My sleep is terrible—I either can’t fall asleep or I wake up in the middle of the night and can’t get back to sleep. I’ve lost about ten pounds because I just don’t have much of an appetite anymore. I work as an administrative assistant, but lately, I’ve been having trouble concentrating. I make mistakes I never used to make. I don’t really have anyone to talk to. My parents are gone, and my only sibling lives far away. I don’t have many friends, and after the separation, I feel like I have even fewer. Sometimes I just sit and cry for no reason. I don’t think about hurting myself, but there are days when I wish I just wouldn’t wake up. I’ve never felt like this before. I’ve never seen a psychiatrist or taken any medication for my mood. I don’t drink or use drugs. The only health issue I have is high blood pressure, but that’s under control with my medication. I just feel so lost and alone. I don’t know how to get out of this.
Dr. Ron: I would like you to know that what you are feeling right now is understandable. Going through a separation, especially after so many years together, can be very painful and lonely. It is normal to feel sad, lost, or even hopeless at times. There are ways to help you feel better. Talking with a therapist can give you a safe place to share your feelings and learn new ways to cope. Therapy can help you understand your thoughts and find small steps to feel more in control. Sometimes, medicine can also help if your sadness feels too heavy or does not get better with time. It may be helpful to try to keep a daily routine, even if it is simple. Try to eat regular meals, get some rest, and do small activities you used to enjoy, like gardening or reading. Reaching out to friends, family, or support groups—even if it feels hard—can help you feel less alone. There are also groups for people who have gone through similar experiences, and you might find comfort in talking with others who understand. Remember, you are not alone in this. Many people have felt the way you do and have found ways to feel better. Please let me know if you would like to talk more about therapy, support groups, or other ways to help you through this time.
Sam: As a 28-year-old nursing student, my life was supposed to be focused on healing others, but my own body had become the source of immense distress. For the past year, despite being objectively muscular and physically fit, I developed an intense dissatisfaction with my physique. The gym became a sanctuary, a place where I spent excessive hours, pushing my body to its limits. My dietary regimens were strictly controlled, and in a desperate attempt to achieve an impossible ideal, I began using anabolic steroids obtained on my own. This preoccupation with my body image started to cast a shadow over every aspect of my life. My academic performance suffered as I became consumed by my perceived inadequacies. Social situations where my body might be exposed, like swimming or even just changing rooms, became sources of intense anxiety, leading me to avoid them altogether. I frequently sought reassurance from my friends about my appearance, a constant validation that never quite satisfied the gnawing doubt. My close girlfriend, unable to cope with my increasing obsession and the withdrawal it caused, ended our relationship three months prior to my presentation. Following the breakup, my mood deteriorated significantly. I experienced persistent sadness, spiraling depression, lack of sleep, and difficulty concentrating. Passive thoughts of suicide began to surface, though I did not think of carrying it through. Recognizing the severity of my symptoms, I finally sought psychiatric evaluation. The diagnosis of body dysmorphic disorder along with a major depressive episode, was a serios enough for me. I was prescribed Zoloft and within two months my sadness, concentration and energy levels improved. I returned to school and saw my buddies again. While I still feel weird about my body, the intensity of my obsession has diminished, and feel some self-confidence returning. What is next for me Doc?
Dr. Ron: Sam’s case illustrates the classic features of muscle dysmorphia, a subtype of BDD characterized by the belief that one’s body is insufficiently muscular, despite evidence to the contrary. The disorder is associated with significant functional impairment, risk of substance misuse (e.g., anabolic steroids), and high rates of comorbid depression and suicidality. In this case, sertraline, an SSRI, is usually considered first-line pharmacotherapy for BDD and has demonstrated efficacy in reducing both obsessive preoccupations and depressive symptoms. Your positive response to medicine and change of outlook on yourself and the people around you is encouraging. Continue your the progress and hope you succeed in nursing school.
Help4MySon: My 25-year-old son, Peter, recently lost his job, triggering severe depression, with worsening sadness, negativity, social isolation, and alcohol abuse. Living with me has worsened his feelings of dependence. Concerned, I’ve consulted his doctor and seek advice on how to best support Peter in regaining his emotional stability and sense of purpose. What further assistance can you suggest?
Dr. Ron: Your dedication and concern as a father are truly reassuring. Peter’s path to wellness requires a multifaceted strategy tackling his depression, alcohol addiction, and the restoration of his daily functioning and independence. A comprehensive psychiatric assessment is crucial for accurately evaluating the severity of his conditions and crafting a tailored treatment plan. This assessment forms the cornerstone of his targeted therapies. Cognitive behavioral therapy (CBT) is indispensable. This evidence-based approach will equip Peter with healthier coping strategies, dismantling the self-destructive thought patterns driving his depression. Concurrently, addiction counseling will explore the underlying causes of his alcohol misuse, providing him with practical tools to manage his drinking. A unified family approach is paramount. Family therapy will cultivate compassion, deepen mutual understanding, and forge a supportive environment conducive to his recovery. At home, a nurturing, non-judgmental atmosphere is vital, allowing Peter to express his feelings freely without fear of retribution. The delicate balance between unwavering support and fostering his autonomy is key – empowering him to lead his recovery while offering consistent encouragement to build his self-reliance and confidence. Holistic well-being is essential. This includes promoting regular physical activity, a balanced diet, and a structured daily schedule. Subtly addressing his alcohol consumption and guiding him towards effective stress management and emotional regulation techniques are equally critical. Connecting him with a peer support network and career counseling will provide invaluable camaraderie, shared experiences, and opportunities for growth. Patience and empathy are fundamental throughout this journey. Recovery unfolds gradually, and consistent encouragement and compassionate understanding are vital to his progress. Educating yourself on depression and substance abuse will significantly enhance your ability to offer informed and effective assistance. Help Peter define achievable goals and celebrate every accomplishment, reinforcing his progress and self-belief. Encourage self-care practices like mindfulness to reduce stress and bolster his mental resilience. Maintain close collaboration with his healthcare team to ensure his treatment remains effective and personalized. Finally, your exemplary role as a supportive and guiding father holds immense therapeutic potential.
JP: I am 27 years old. My journey with weed unexpectedly plunged me into a harrowing ordeal, a crucible from which I ultimately emerged stronger and healed. Initially, I viewed my marijuana use as recreational, a casual indulgence shared with friends to alleviate stress. But one evening, the familiar ritual took a sinister turn. I remember the sheer terror, a feeling of complete isolation despite being surrounded by people. The world felt distorted, colors seemed wrong, and sounds were amplified to an unbearable level. Sleep became a distant memory, replaced by a constant state of hyper-vigilance. Even simple tasks, like showering or eating, felt like insurmountable challenges. I felt like a failure, a broken person. I questioned my sanity, convinced I was losing my mind. I am still shaken up yet I seem to be hooked on weed. How do I find the strength to face recovering?
Dr. Ron: It sounds like you’ve been through a very challenging experience, JP. Here are some recommendations that might help you find the strength to face recovery. Consider reaching out to a mental health professional who can provide guidance and support tailored to your situation. Therapy can be a safe space to explore your feelings and develop coping strategies. Surround yourself with supportive friends and family who understand your journey and can offer encouragement. Joining a support group for individuals with similar experiences can also be beneficial. Practices such as mindfulness meditation, deep breathing exercises, or yoga can help reduce anxiety and promote relaxation. Creating a daily routine can provide structure and a sense of normalcy. Include activities that promote well-being, such as regular exercise, healthy eating, and adequate sleep. Break down your recovery journey into small, manageable steps. Rejoice each successful step, no matter how small, to build confidence and motivation. Understanding the effects of marijuana and its impact on mental health can empower you to make informed decisions about your use and recovery. Recovery is a journey, and it’s important to be patient with yourself. Document your stepwise progress and be compassionate towards yourself during setbacks.
Confused: “I am a 20-year-old psychology student, and my life has become a secret battle against the darkness of my eating problems. It started insidiously, with a desire to perform, to be the best, fueled by the pressure to maintain high academic standards and an overly busy schedule. I found myself turning to food for comfort, but the relief was short-lived. The guilt and shame that followed led to secretive purging, a desperate attempt to regain control. Binge eating, followed by self-induced vomiting and the use of laxatives, became my ritual, my dark secret. I knew my body was suffering, but I couldn’t stop. My therapist thinks that I need professional help. The fear that I have bulimia nervosa is distressing me. I realize that I really need help. What should I do now?”
Dr. Ron: You don’t have to face this battle alone. Programs for eating disorders provide comprehensive care that addresses psychological, nutritional, and medical needs. Early intervention in these programs is crucial, particularly for someone like you, as it can reduce the duration and severity of the illness. These programs offer structured environments for therapy, nutritional rehabilitation, and medical monitoring, which help stabilize patients both physically and mentally. Access to experienced clinicians and peer support enhances motivation and reduces feelings of isolation among patients. Recovery steps include assessment and diagnosis to create individualized treatment plans. Medical stabilization is prioritized to address any acute physical complications. Nutritional rehabilitation aims to restore healthy eating patterns and normalize weight. Psychotherapeutic interventions, such as cognitive-behavioral therapy, help address distorted thoughts and behaviors related to food and body image. Family involvement and education are crucial, especially for younger patients, to support recovery. Ongoing monitoring and relapse prevention are essential to maintain progress, and pharmacotherapy may be integrated for co-occurring conditions like anxiety or depression. It would be wise for you to participate in such an intensive treatment program and embark on your recovery path.
BodyMan: “My childhood dream of having the Mr. Olympia physique fueled intense bodybuilding and dieting. This ambition morphed into an obsessive pursuit of perfection, driving me to extreme measures, including excessive testosterone use. The resulting hormonal imbalance, depression, and irritability have been devastating. Despite the warnings, my relentless quest for an unattainable ideal continues to consumes me. What should i do to finally control it?”
Dr. Ron: I admire your present determination. Your case highlights the complex interplay between what is the distorted self image of a body dysmorphic disorder (BDD), with the use of anabolic steroids causing serious hormone imbalances, and intolerable mood changes. Effective management requires a comprehensive approach that addresses both the psychological and physiological aspects of the condition. By providing support and guidance, you may work towards recovery and develop a more realistic body image. There is a lot of stress and anxiety which you may be suffering. Cognitive-behavioral therapy (CBT) can help you channel your thinking, and address his distorted body image and compulsive behaviors. CBT may help you challenge your negative thoughts and develop a self accepting attitude with a realistic perceptions and appreciation of your natural body. You will need medical supervision, guidance, and treatment to stabilize your hormone levels, nutritional counseling and join a support group for individuals with BDD. You are not alone up to 1 in 35 people in the population are estimated to suffer from BDD. Worst case scenarios of BDD may result in severe personal distress, social isolation, and suicidal thoughts or behaviors. I hope that this information helps you on your way to an assisted recovery.
PanickyD: “While walking home from work one day, I witnessed a violent assault on the street. This event triggered a sudden surge of intense fear and anxiety. I become overwhelmed by sudden panic attacks. They seem to be random. I feel myself shaking with a pounding heart, shortness of breath, chest pain, profuse sweating, nausea, dizziness, fear of totally losing it. I sometimes have a strange a sense of detachment from people around me. How long will I feel this way?”
Dr. Ron: Experiencing a panic attack after witnessing such a traumatic event is completely understandable. The symptoms you describe—pounding heart, sweating, trembling, shortness of breath, chest pain, nausea, dizziness, the feeling of losing control, and derealization—are all classic signs of a panic attack triggered by extreme stress. While the intense physical and emotional sensations of the attack itself are usually relatively brief, typically in less than one hour, the lingering effects can be alarming. You may still experience a heightened sense anxiety, nervousness, and emotional instability for days, even weeks, following the incident. It’s crucial to prioritize self-care during this period. In addition to the calming activities such as deep breathing, meditation, gentle exercise, you may consider practices like progressive muscle relaxation, spending time outdoors in nature, or engaging in hobbies that you find soothing. Maintaining a regular sleep schedule and a healthy diet may further contribute to your recovery. Furthermore, connecting with supportive friends, family, or support groups can provide a sense of safety and comfort to you. If, however, your anxiety and distress persist or worsen, or if you find yourself struggling to manage daily activities, seeking professional help from an expert psychiatrist or experienced psychotherapist is highly recommended. You can expect individualized tailored strategies for managing anxiety, coping with trauma, and therapies like Cognitive Behavioral Therapy (CBT) or trauma-focused therapy to help you process the experience and prevent future panic attacks. Temporarily, you may additionally be prescribed an anxiety-reducing medication. Remember, seeking professional help is a sign of strength, not weakness.
TomK: “My girlfriend has a long history of toxic relationships. She was abused as a child. She has been in many relationships. She often idealized her partners who are in the entertainment world. She becomes impulsive and quickly abandons them. She goes on spending sprees, binge eating, and alcohol abuse when she has made several suicide attempts after breakups. How can I help her?”
Dr. Ron: Assuming these descriptors are due to a condition known as Borderline Personality Disorder (BPD), supporting a partner with this type of strong personality disorder involves a great deal of understanding and empathy, so educating yourself about her condition is crucial. The mood disorder, substance abuse and eating disorder have their own set of requirements for professional assessment and treatment options. A relationship with a partner who has such a complicated personality disorder demands your profound understanding, self-regulation and compassion. Therefore, immersing yourself in knowledge about the disorder is paramount. Urge your loved one to actively pursue professional help and steadfastly support her commitment to therapy and any recommended prescribed medications. You must really have inexhaustible patience and empathy, recognizing that her intense impulse control and emotional dysregulation may at any time lead to disproportionate reactions to perceived offenses. Holding yourself back from reacting is a real challenge. Try to consistently use firm and consistent limits in an attempt to foster a structured, balanced and sustainable relationship. Transparent and sincere communication is essential. Practice non-judgmental, attentive listening and articulate your emotions with composure. Most of all, prioritize your own mental and emotional health, and guide your partner toward adopting constructive coping strategies. All that being said, you may definitively want to explore and analyze your own internal needs and strengths to be in this type of a highly challenging relationship. Good luck!
Sammy: “How is schizophrenia different from bipolar disorder?”
Dr. Ron: Schizophrenia is mainly identified by ongoing psychotic symptoms, including hallucinations, delusions, and disorganized thinking. These symptoms in schizophrenia are accompanied by persistent functional impairment. For a case example, let’s take John, a 25-year-old man who begins to hear voices that no one else can hear, which criticize him and give him commands (hallucinations). He believes that his neighbors are spying on him and plotting to harm him, despite evidence to the contrary (delusions). When speaking, John frequently jumps from one topic to another without logical connections, making it hard for others to follow his conversation (disorganized thinking). These symptoms significantly impair his ability to work and maintain normal social relationships. In contrast, bipolar disorder is characterized by episodic mood disturbances, such as manic, hypomanic, and depressive episodes. Psychotic symptoms in bipolar disorder usually appear only during these mood episodes. For example, take Jane, a 30-year-old woman who presents with a history of bipolar disorder. Her symptoms include recurrent episodes of mania and depression. During her manic episodes, Jane exhibits elevated mood, increased energy, racing thoughts, and a decreased need for sleep. She sometimes experiences psychotic symptoms such as actually believing that she is Wonder Woman. On the other hand, when she becomes depressed, her depressive episodes are marked by extreme fatigue, low mood, loss of motivation, inability to concentrate, and lack of appetite. Unlike schizophrenia, the psychotic symptoms in bipolar disorder usually do not persist between episodes. Schizophrenia is considered a chronic psychotic disorder. On the other hand, bipolar disorder is an episodic mood disorder with psychotic features generally confined to mood episodes. Recent research however indicates overlapping genetic and neurobiological factors between the two disorders.
FlyHigh: “After my car accident I has serious nightmares, I have tried mediation and counseling, but still having avoidance, anxiety and the nightmares. What can I do?”
Dr. Ron: It sounds like you’re experiencing symptoms that could be related to post-traumatic stress. While I can’t provide you with clinical advice, I recommend discussing your symptoms with a healthcare professional who can offer a comprehensive diagnostic assessment and guidance tailored to your situation. A psychiatrist or therapist might explore options such as cognitive-behavioral therapy (CBT) or other therapeutic approaches that can be effective for trauma-related symptoms. Additionally, they can assess whether any medication might be appropriate to help manage your symptoms.
In my practice, I have tried patients on low-dose Prazosin which if your doctor considers trying it for you may possibly be effective (off-label) for reducing PTSD-related nightmares. it would additionally be indicated for you to consult with a sleep medicine specialist if there are additional symptoms at night, such as snoring, restless legs, tooth grinding, sleep walking, etc.
John1200: “How do I know if I have major depression?”
Dr. Ron: To diagnose major depressive disorder (MDD), one needs to consult with a medical doctor or a mental health professional and have a comprehensive evaluation as other conditions may mimic depression. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, an individual must experience a persistent depressed mood or a significant loss of interest in activities for most of the day, nearly every day, for at least two weeks. Additionally, at least four other symptoms must be present, such as significant weight changes, sleep disturbances, psychomotor changes, fatigue, feelings of worthlessness, difficulty concentrating, or recurrent thoughts of death or suicide. These symptoms must cause significant distress or impairment in important areas of functioning. Common symptoms of depression include feeling sad, anxious, or empty, losing interest in activities, experiencing changes in sleep and appetite, feeling fatigued, having difficulty concentrating, and having thoughts of death or suicide. If these symptoms persist or worsen, it is important to seek professional help from a mental health provider. Early intervention can help manage symptoms and improve quality of life.
Carol5010: “How can I stop a panic attack?”
Dr. Ron: To stop a panic attack, several strategies can be employed. Breathing techniques, such as deep, slow breathing, help calm the body and mind by focusing on the breath. Relaxation methods, including muscle relaxation, yoga, or meditation, can reduce anxiety and panic symptoms. Cognitive techniques, like those used in cognitive-behavioral therapy (CBT), help individuals recognize and challenge distorted thoughts contributing to panic attacks. Regular physical activity can lower overall anxiety levels and improve mood. In severe cases, medications such as benzodiazepines for short-term relief or antidepressants like SSRIs for long-term management can be effective. If panic attacks are frequent or severe, seeking professional help is advisable to develop a comprehensive treatment plan.
ThinLinda: “Why do I have anorexia?”
Dr. Ron: Anorexia nervosa is caused by a complex interplay of genetic, biological, psychological, and environmental factors. Genetic predisposition plays a role, with certain inherited genes being linked to increased risk. Environmental and social influences, such as cultural pressures valuing thinness and negative attitudes toward obesity, significantly contribute, especially in societies where dieting is common from a young age. Psychological traits like perfectionism and compulsiveness are often seen in individuals with anorexia, particularly those from middle or upper socioeconomic backgrounds. Hormonal and endocrine abnormalities are also common, affecting multiple organ systems and contributing to the disorder’s physical manifestations. Overall, anorexia nervosa arises from many possible causes, involving genetic susceptibility, societal pressures, and individual psychological vulnerabilities.
Ask Dr. Ron the Psychiatrist... 