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Recent questions

I don’t know if I’m self harming by not eating.

I don’t know if I’m self harming by not eating. For the past week I’ve not really eaten much or when I do I throw/gag it all back up, I am trying to manage my weight but not trying to harm myself. I don’t know what to do.

First thing I would say is everyone is different and it is not necessarily a bad thing to be larger. The important thing is that you eat healthily and exercise.

Getting into the habit of not eating is likely to cause more harm than good, not only emotionally but it will also have a negative impact on your ability to exercise both physically and in terms of concentration.

It can also be counter productive when it comes to weight management. Food avoidance can cause your body’s metabolism to slow down and therefore weight loss can become even harder. We are likely to overeat when we do have an opportunity to eat after avoidance also.

If you are concerned about your weight you might like to discuss this with a dietitian in confidence who will be able to help you plan an appropriate and healthy plan. You can get a referral for a dietitian from your GP.

    The main points to remember are:
  1. Have regular meals?
  2. Don’t avoid any food groups
  3. Aim to have healthy portion sizes

I’m scared my boyfriend will run off when he sees my genital warts! what should I do?

This is a common worry with people diagnosed with genital warts as they are visible and generally people with them do not want them!

Have you had them diagnosed by a professional because this is essential to ensure they are the problem? Other things can be mistaken for warts and sometimes it is just a person’s normal anatomy. 

Genital warts are extremely common and they are caused by a virus called the Human Papilloma Virus (HPV). There are numerous types of this virus and the majority of types are harmless.

There is a vaccination called Gardasil which is offered to all girls between the ages of 12 years up to their 18th birthday.  This vaccine protects against the two Human Papilloma Virus types (16 and 18) that cause over 70% of cervical cancer, Gardasil also protects against the two HPV types (6 and 11) that cause about 90% of the cases of genital warts.  Gardasil is used to prevent infection from happening in the first place, but even if a person already has a type of HPV infection, Gardasil can still protect against diseases caused by other HPV types.  It does not protect against infections such as chlamydia and it won’t stop you getting pregnant so it is very important to find out about safer sex information before beginning a sexual relationship. 

You and your boyfriend need to understand that this is not a serious condition and the warts will disappear in time with any treatment you have been given. The primary goal of treatment is to speed the clearance of symptomatic warts. Giving no treatment is also an option since warts will clear spontaneously.

It may be helpful for you and your boyfriend to attend the GUM clinic together to have a chat with one of the nurses. This will give you both the opportunity to ask any questions and also to be advised how best to avoid passing the wart virus on. The best protection against any STI’s is condoms however this may not prevent the transmission of HPV as this is acquired through skin-to-skin contact and during sexual activity.

It is useful to know that the majority of people who have the virus will show no symptoms, which is sometimes confusing for couples. The symptoms can also appear many months and sometimes years after they acquired the virus. It is always worth considering a full sexual health check up to exclude any other infections, which may not show symptoms e. g.  Chlamydia. Perhaps you and your boyfriend should both have a check-up.

Some facts about HPV worth knowing:

  • An individual’s lifetime risk of HPV infection exceeds 50% but most have no symptoms with only about 1-2% developing genital warts.
  • About 90% of genital warts are caused by infection with HPV types 6 and 11. These types are not associated with a significant risk of developing cancer, which a lot of people worry about.
  • Types 16 and 18 are the types most associated with any health risks but only 10% of genital warts are caused by these.

With the right information and support you should be able to talk to your boyfriend before embarking on any sexual activity to make sure you are both comfortable with it. The GUM clinic sees many people who feel exactly the way you do right now. Some people prefer to delay having sex until the visible warts have gone, while others continue to have sex with their partners, it is a personal choice.  The following website may be useful: for both of you to look at.

If you need an appointment the GUM clinic can be contacted on: 650710. Try not to panic, talk to someone who can help and you will probably feel a lot better about the situation.

I think I might have depression but I don’t want to go to a doctor. What should I do?

First of all, you are not alone. Depression is one of the most common mental health problems with five per cent of teenagers and one in ten adults experiencing depression at some point. It’s also important to know that it is treatable.

A lot of young people experience ups and downs in their mood and there will be occasions when they will feel down or upset by certain things going on in their lives. If you are feeling low in mood for a short period of time there are a few things you can do to see if it helps you to feel better: such as talk to someone you trust (as they may be able to offer you support and just talking about how you are feeling often) as does doing some physical activity, eating healthy food and making time to do things you enjoy.

However, if you are feeling sad, down, lonely, anxious or stressed for longer periods of time and to the extent that it is affecting your daily life and how you feel or is preventing you from doing things you would normally do, it is likely that you are experiencing symptoms of depression.

Depression can be hard to diagnose on your own, as mood affects our judgement of ourselves but here are some of the symptoms of depression:

- sleeping more or less than normal

- eating more or less than normal

- feeling irritable, upset, tearful, miserable or lonely
- feeling tired and not having any energy
- being self-critical

- feeling hopeless
- not wanting to do things that you previously enjoyed
- not wanting to meet up with friends or avoiding situations
- maybe wanting to self-harm

Remember, depression is a treatable illness. The first step towards getting help is to recognise that there might be a problem which you already seem to have done. The second step is to talk to someone you trust.

Often young people who have depression are worried about seeking help.  I see that you don’t want your family to know that you feel you may be depressed, this is not unusual. Many young people feel worried about how their family will react, fearful of upsetting them or of being unsupported or taken seriously by their family. Often people can feel embarrassed, guilty or ashamed for feeling the way they do.

However, we know that many young people in the same situation feel a sense of relief once they have talked to someone. Just being able to say how they feel out loud, being listened to and understood is an important step in getting better. Also letting others know about how you feel is important for getting the help and support which is right for you. 

Please talk to someone you trust, someone like a school nurse, the listening service, or if you are at College, student welfare. I know that you are reluctant to speak with your GP, but all of these people do maintain confidentiality, providing you or others are not at risk. GPs regularly support people of all ages who are experiencing symptoms of depression; and they have the experience and knowledge to help you identify what support and treatment will help you with your recovery. Your GP may make suggestions on steps you can take to try to lift your mood and manage your symptoms. Your GP may suggest that you see a counsellor or arrange a referral to the local child and adolescent mental health service (CAMHS).

There are some really good sources of information online that may help too.

See the Young Minds website here.

Also, there is a useful factsheet for Young People and depression here.

I have phimosis and I’m 19 years old, it says I should see my GP , what can I do?

I have been researching on the Internet and it seems that I have phimosis and I’m 19 years old, it says I should see my GP but it is such an awkward situation what can I do?

Phimosis does sound awkward but you really shouldn’t feel embarrassed when visiting a health professional, they offer a fully confidential service. Phimosis is a condition where the foreskin is too tight to be pulled back over the head of the penis - usually this is nothing to worry about and there’s nothing to be done about it. However, in males your age it could be something else especially if it’s painful, red and sore with a discharge, even so, it may just need simple treatment like a cream and improved hygiene practices.

It is certainly best to see a doctor (who will be sympathetic even though you feel embarrassed – remember they’ve seen it all before!) who can check it out for you and give you a direct diagnosis. Alternatively, if you do not wish to make an appointment at your GP’s then you can self-refer to GUM. The team there are very experienced in dealing with these kinds of problems. The internet is a very good source of information but the information can be confusing and at times incorrect so I would definitely recommend getting a professional diagnosis.

Theoretically, could a tapeworm help you lose weight? If so, why and how much?

The tapeworm is a parasite that may use up nutrition from your diet that keeps you healthy.

Having a tape worm inside may lead to undesirable weight loss which cannot be controlled safely. As this could be very dangerous, having a tapeworm would not be advisable.

As a host to a parasite, you would not be receiving the vitamins and minerals you require to keep your body healthy and in good working order.

Is it ok to use poppers if you take an intrarectal medicine?

Poppers are a class of drug called alkyl nitrites: these are the amyl, butyl and isobutyl nitrites.  They all have the same effect.  They work on the cardiovascular (heart and blood) system by dilating blood vessels: basically making blood vessels larger so more blood gets to and from the heart.  This results in a head rush, which some people find enjoyable. 

Poppers are also said to relax the sphincter muscles in the anus, so it is unclear if the medication you mention is going to be affected by poppers.  It would depend on what the medication is for.  Taking poppers is dangerous if you have chest or heart problems, anaemia or glaucoma.  If you are on medication to lower blood pressure poppers will make blood pressure fall further, often to dangerously low levels. 

You can check likely side effects of your medication from the Patient Information Leaflet supplied with all medicines.  Using poppers with alcohol is risky and using poppers with stimulant drugs such as ecstasy, cocaine or MCAT can put considerable strain on the heart.  If any doubt it is safer not to use poppers.

Can I test someone for M-Cat myself?

I’m trying to find a drugs test to test the father of my children.

Firstly, if you have concerns that your children’s father is under the influence when he picks up or drops off the children and that there are any risks or safety concerns then I would advise that you discuss your concerns with the Department of Health and Social Care’s Initial Response Team (Isle of Man based). You can contact them on 686179.

Also, have you discussed your concerns with the children’s father? Is he receiving help from services? It could be he is experiencing a relapse and may need to access services. Depending on your relationship it may help to discuss this openly with him.

If you really suspect he is using M-cat and don’t want your children to be with him than you need to be having this discussion with him and/or a relevant agency.  Who knows, he may welcome the opportunity to prove he’s not using.

I personally would not advise you to test someone yourself. Usually, if there are concerns about such matters then testing can be done but usually as part of a care order and arranged by Social Care staff.

I would not encourage you to take this on yourself and instead would recommend contacting services who can assess the situation and provide the necessary structures to manage any risk.

Although it may feel scary it is perfectly natural to be concerned as a mother and it is great that you are seeking help. Professional organisation will help you make the right decisions and protect you and your children.


How can someone be tested for Khat?

Khat is a leafy green plant containing two main stimulant drugs which speed up your mind and body, the leaves are usually made into a small ball and chewed in the mouth over a period of time. Their main effects are similar to, but less powerful than, amphetamine (aka speed). Khat is used mostly in North East Africa and the Arabian Peninsula and by expatriate communities from these regions. Khat makes people feel more alert, happy and talkative, it also suppresses the appetite. There is a risk of significant liver toxicity from excessive use, and it may cause disrupted sleep and make pre-existing mental health problems worse.

Khat became a controlled class C drug in the UK in June this year (2014) – making it illegal to have it for self-use or for someone to sell or provide anyone else with it.

Khat is usually tested for by the presence of cathinone or cathine, the main active ingredients, although other active compounds can also be tested for. Cathinone and cathine can be detected via urine testing, blood testing or hair analysis. Testing for khat is not available on the Isle of Man. However, in the UK, a commercially available biochemical test to detect khat constituents in the urine can now be used to confirm khat use. As there is a close similarity to amphetamines, samples should be sent to an appropriate laboratory for a more definitive analysis to avoid a ‘false-positive’ reading for amphetamines i.e. a positive result for amphetamine when it is not there.

Have a look at our Khat information page or Talk to Frank’s Khat page for more information.

In cases of sex without consent, will all details still be private?

In cases of sex without consent, will all details still be private?

The GUM has a strict confidentiality policy and generally all information given is not shared with any other departments.

Sometimes the terms consent and underage gets mixed up by people. Just to be clear consent means that a person didn’t give their permission or agree to have sex at that time, underage means that a person is having sex under the legal age of 16 years old. In both cases the care and advice that the person receives will be private and will only consider what’s best for you.

In cases of sex without consent the clinic will be guided by what the person chooses to do and who to inform. Sometimes people choose not to inform the Police or take any further action and the clinic respects this. This would be discussed fully when the person attends and all options explained. The clinic would support whichever choice was made. This can be a really difficult time for the person involved and the staff in the clinic would be fully supportive as they are aware that the person may be feeling upset and traumatised.

Sometimes initially after an incident like this all the person wants to do is forget that it happened and get on with their lives. This is understandable and it is very common to feel like this. It would be advisable in order to protect their health to get checked out for any STIs just in case. The GUM clinic can be contacted on 650710. Ask to speak to one of nurses who will advise regarding booking an appointment.

Please try not to put off getting help. Once a problem is shared and the right help and support is given it is surprising how much better people can feel in even in this situation.


Can tests be done to see if you have infections such as thrush etc?

Can tests be done to see if you have infections such as thrush etc?

If you suspect you have an infection and you have symptoms then the tests that will be done at the clinic can include a test for ‘thrush’. Any infections identified are treated in the clinic so you would not have to attend a pharmacy or pay for the treatment.

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