Help! I cannot relate well with people close to me

Dear doctor, 

I hardly relate with people who are close to me. I find it uncomfortable to share a bed with anyone, even my boyfriend.

Sharing a bed with him for more than three days irritates me.

Worse still, making friends is difficult. What do I do? 

Moraa

Dear Moraa,

The way people interact is influenced by their learning experiences, expectations and beliefs. This guide, or attachment style, tends to be stable throughout our lifetime, though it may be influenced by other experiences. This guide can contribute to the quality of our relationships and can even affect our emotional and mental health; positively or negatively.

Attachment styles can be traced to our interaction with our caregivers as children, and our interactions with peers. In grown-ups, attachment styles include secure, anxious-pre-occupied, dismissive-avoidant and fearful-avoidant.

You seem to have a fearful-avoidant attachment style. What this means is that while you desire to be close to people, you are also uncomfortable doing so. You may also find it difficult to trust others or depend on them, and may be worried that you will get hurt if you get close to others.

So you try to build the relationship, and then move away, or push the other party out when he or she is too close for comfort. You may also have a negative view of yourself, imagining that you are unworthy of the closeness. This probably makes you desire less intimacy and to deny or suppress your own feelings. This affects you and the people that you relate with, whether it is a boyfriend, siblings, colleagues or friends.

It would be advisable to see a counsellor or a psychologist to be able to understand where all this started, and to be able to learn how to deal with other people in relationships.

*******

Dr Flo,

My monthly period usually lasts four to five days but last month, it was over after just two days.

About two weeks later, I noticed blood clots.

What could the problem be?

Shiku

Dear Shiku,

The lighter and shorter flow, followed by blood clots after two weeks shows that your body is experiencing hormonal changes. This could be due to pregnancy, which for some people, is accompanied by some mild bleeding or spotting at the time of implantation of the pregnancy, or bleeding due to a threatened loss of the pregnancy. Another common cause of hormonal changes, leading to irregular flow, is medication such as the emergency pills and other methods of contraception like the daily pill, the patch, injections and implants. Because of the extra hormones in these drugs, they may alter your monthly cycle. The other cause of irregular periods is changes within the body due to a hormonal disorder, significant change of climate, living situation or diet.

You need to have a pregnancy test done. If it is positive, then you need to see an obstetrician or gynaecologist to determine if the pregnancy is at risk. If the test is negative, you would need to have some hormone tests done to determine the cause of the irregular flow. If the hormonal medications are the cause, then you need to discuss that with your gynaecologist and chart a way forward.

***** 

Dear Doc,

I’m 20-year-old university student and I have been wiping blood after long calls.

It is not frequent though. I’ve been to clinics and been given drugs but the problem does not seem to end and this is worrying me.

Please help.

Red

Dear Red,

Having blood after passing stool is a sign that part of your body is bleeding at the time. This could be due to a tear in the lining of the anus or rectum, because of friction from passing large or hard stool. Diarrhoea can also make one bleed. This is called an anal fissure, and it could be a simple tear that heals after a short while.

However, it could also persist and become a chronic fissure. Symptoms of an anal fissure include pain during, and/or after passing stool, itching and drops of fresh blood on the tissue or toilet bowl. The bleeding could also be due to haemorrhoids, otherwise known as piles. These are veins that bulge or prolapse in the lower part of the rectum and anus.

The walls of the veins stretch, get irritated and are easily torn. The piles may be on the outside around the anal opening, or may “come out” when passing stool, and can sometimes even be pushed back in. These are called external haemorrhoids. If they are far up inside so that they cannot be seen or felt, they are called internal haemorrhoids.

They can be caused by straining when passing stool e.g. due to constipation or diarrhoea or any activity that causes repeated high pressure in the abdominal region such as a persistent cough and lifting weights. They are also more common during pregnancy or in people who stand or sit for long. Most of the time, they resolve easily with diet and lifestyle changes, and with treatment, though they can recur.

To manage the problem, prevent constipation by taking a lot of fluids and a high fibre diet every day, and exercise and schedule time for a bowel movement daily. Use baby wipes instead of toilet paper to clean up after passing stool. You can also take a sitz bath or sit in warm water for about 20 minutes twice a day to help soothe the ruptured part.

There are fibre supplements, like fybogel, which you can take to soften stool. Some laxatives and stool softeners can be prescribed by the doctor, in addition to creams that you can apply to help with healing of the torn area. Since the bleeding has persisted for a while, see a surgeon, so that a proctoscopy can be done to visualise the lining of your anus and rectum, to establish the cause of the problem.

If the problem is severe, you may need surgery.