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Dear Dr. Robert,

My name is Amber Helmbold. I live in Ohio, U.S.

I told my mother this summer about what my grandfather did to me. She told me that i was molested. She learned that my two younger girl cousins were too. By the same man.

I'm 16 now, this happened when i was about either 4 to 6, that i don't remember. Everything else i remember like it was yesterday.

Details are really hard for me to explain, even if its not in person. But he'd constantly get me to touch his penis when nobody was around.

Now days i think of myself as a freak. I can't believe i actually used to think that was fun! I look at other people and see someone who's happy, who probably don't have to face a problem like mine.

I never realized til now that i've always been nervous around elder men and any guy who is bigger than me. I knew i started over thinking it when my great uncle was just trying to give me a hug. But i still couldn't help but to freak out on the inside. I got to a point that I HAD to tell her.

I never told anyone for 10-12 yrs. Now i bottle things up and hide it from my family and myself. I've tried to forget it but it would pop back up in my thought without warning. I have problems trying to explain my feelings and/or understanding them. everyone tries their best to pry it out of me but if i can't explain, i normally give them the answer that i think they want to hear. I have become used to putting on a smile even when i feel like i could make a new river for Ohio.

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I never know my emotions anymore. Lately i have just been sad all the time. I started cutting myself (already quit).

I will randomly just get a depression strike so strong i start crying. For almost no reason that i can find.

I've decided to look up the symptom of depression And these are the ones that fit me: sadness throughout the day, nearly every day; loss of interest in or enjoyment of favorite activity; feelings of worthlessness; excessive feelings of guilt; thoughts of suicide and death; trouble making decisions; fatigue or lack of energy; sleeping too much or too little; change in appetite; trouble concentrating; & last aches and pains(normally in the lower back)

I been to a therapist before but she didn't help me in the slightest.

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I don't know what to do anymore and my mother refuses to get me anti-depressants. Do you have any advice?


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Dear Amber--

Thank you for writing to me. I am glad you did.

Although I cannot make a firm diagnosis without a personal interview, the symptoms you mention are not just strongly suggestive of depression, but include many of the classic symptoms of depression, as you found out when you investigated depression. In other words, you should assume that you are suffering from depression, and, since you have asked my advice, I am convinced sufficiently to tell you that, in my professional opinion, you must seek expert help immediately. I say immediately because a depression such as the one suggested by your symptoms is not just a mood problem, but has physical aspects as well which can be profoundly harmful to the body. Furthermore, people with symptoms like yours, sometimes, tragically, decide to end their own lives through suicide. In other words, Amber, just as you would move quickly to seek help in treating a physical disease such as a serious, life-threatening infection, you should move quickly to treat depression.

Now you say that you have been to a therapist and that she did not help, but you did not say what kind of therapist or what qualifications she had. Unfortunately, there are many kinds of "therapists" out there, and only some of them truly are qualified to treat the kind of problems you have. If the person you consulted was not able to help you, she was obligated to assist you in finding a competent doctor who could help. I do not know the whole story, of course, but judging from your words, your therapist failed--not just failed to help you, but failed also in her obligation to help you to find someone who could help. Instead, apparently, she left you to try to puzzle this out on your own. That you found it necessary to research depression online, and then had to write to me about your suffering, are indications of her failure. In fact, to leave a depressed young girl with a history of sexual abuse alone and without proper assistance in her struggle is more than a just a failure; in my view it is tantamount to malpractice.

Amber, you are in great need of a competent psychologist who will hear and understand your story, and will provide the right kind of therapy, which probably will include some kind of medication along with frequent meetings to discuss your experiences and your present situation. Please look for such a person right away. In my opinion, he or she should be a licensed psychologist, not just a "therapist."

Now, regarding your mother: this is not just a question of getting you antidepressants. In fact, she was correct in refusing to get antidepressants for you, but, unfortunately, incorrect in leaving you to struggle alone with depression and memories of sexual abuse. This is not simply a matter of popping some pills which some doctor, who perhaps knows nothing about the aftermath of sexual abuse, and nothing about how to help a young girl such as yourself to handle such a burden, puts in your hand. Not at all. So your mother was correct there. But she was mistaken, and continues that mistake, by not understanding that you are in trouble, that you are finding difficulty in getting through a day without breaking down, that you are only pretending to be OK while putting on a false front in order to disguise your everyday experience of shame, fear, and pain. Your mother was and is mistaken in failing to understand that when a young girl is sexually abused--which your mother acknowledges that you were--there almost always are psychological repercussions which require proper therapy to heal. She was and is mistaken, I mean, by failing to realize that you are hurting badly and need real help right away. Her mistake consists of a common form of human behavior called denial which means playing the ostrich by sticking ones head in the sand instead of facing up to facts--in this case the facts that nasty grandpa molested my daughter and now my daughter needs professional help to deal with the emotional burden of that abuse.

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Since in a moment I will suggest that you share my reply with your mom, I want to be totally clear in my words so that I will be completely understood by both of you--by you Amber, who has reached out to me, as well as by your mom who now should and must help you to find and pay for the psychotherapy you so urgently require. If your grandfather is still alive, he should be confronted--by your mom, not by you, Amber--and made to pay for the therapy you need. But in any case, and no matter who pays or how, you need expert help in treating this illness from which you are suffering. When I say "expert help," I mean an ongoing therapeutic relationship with a doctor who is experienced in treating serious depression, experienced in treating the aftermath of childhood sexual abuse, and--above all--is a wise, kind, compassionate person who will listen carefully, who will understand what he or she is hearing, who will know how to enter into to your experience, and who will inspire within you, Amber, the confidence that you are being seen, heard, and understood.

Please show this letter to your mother. I hope she will take my words—the words of an experienced professional--seriously. I hope that you mom will have the wisdom to realize that you are ill—just as ill as if you were suffering from a serious physical illness—and that you need immediate help.

If your mother has any doubts or questions about this, please write again and tell me what they are, and I will get back to you quickly.

In brief, Amber, judging from your letter, you are not just mildly depressed, but dangerously ill, and you require proper treatment right away. Please ask your mother to help you get it.

By the way, I am sorry for your experiences of sexual abuse, and I am sure that the proper doctor will be able to help you to heal that damage.

Be well.

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