Dear Dr Hilary
I’m worried about our 16-year-old daughter. She left school last year and
spends all day in bed and is up all night. She gets in terrible rages and
sometimes bangs her head against the wall. What can I do to help?
Many teenagers lie in until late in the morning, but your daughter’s total
reversal of the night/day sleep pattern could signify clinical depression,
and the rages and head-banging are consistent with that. I recommend taking
her to your GP to see if she’s suffering from depression and, if so, how
severe it is. They’ll do this by checking for symptoms against the Hamilton
Depression Scale. Talking therapy will be recommended, as will medication.
The idea of her taking pills may be worrying, but antidepressants can be
effective. Although they can have side-effects like slowed reactions,
they’ll help until she can cope on her own. Visit Mind.org.uk/help/carers
for more advice.
Dear Dr Hilary
I have black skin, and lighter patches have appeared on my arms and neck.
What’s causing this?
Over-use of steroid creams, often used to treat eczema, could be to blame, but
the patches should disappear after a few weeks. However, it sounds as if you
may have vitiligo, a condition where your own antibodies destroy the skin’s
pigment-producing cells. It is more common in people with black skin,
particularly if there’s a family history of it. Unfortunately, you can’t
cure this condition, but there are camouflage creams such as Keromask,
available on prescription, which can help disguise it. Try to avoid exposure
to the sun as it’ll darken the unaffected skin, making paler areas even more
noticeable. And if your condition is severe, ask your GP about narrowband
ultraviolet B treatment, which may darken the whiter areas.
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