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Depression

I Think I’m Ruining My Life

by Kristina Randle, Ph.D., LCSW July 28th, 2021
written by Kristina Randle, Ph.D., LCSW

I think I’m ruining my life. I can’t figure out what my problem is and I can’t help but feel like I’m exaggerating the depth of it. I’m currently in medical school – in my 2nd year. I’m supposed to be in the third but I failed my very first year. It’s been like cycle, everything is repeating itself all over again. I can’t explain why I failed my first year. I didn’t fail any exams – I just didn’t go. I kept lying to everyone about it. Summer came and I had to fess up. My dad wanted me to pull out but I insisted on going back because I knew I didn’t fail for the reasons he thought I did. It wasn’t because I couldn’t handle the workload – I just never tried. I gave up in an instant. No one forced me into medical school – I’m here on my own accord.

My 2nd trie at 1st year didn’t go any smoothly. The same cycle repeated itself. I locked myself away from the world, ran away from my problems by watching K-dramas but I had friends to help me out. My family helped me out too. Now, I’m in my 2nd year, about to take a major exam and I’m screwing it up all over again. This year went well to be honest. I made friends, didn’t lock myself out and worked hard (but not to the fullest because I am lazy!) But exam is here and ipdespite having friends who are trying to help me out, I’m falling back into the same cycle. I’m locking them out, lying through my teeth, not going to my exams. My parents have no idea because I lied that I was already done with my exams. I wasn’t always like this. I knew how to motivate myself. I wasn’t always this helpless or childish. Out of three kids, I’m the level headed one. My friends have given up and I’m scared. Why can’t I stop lying? Why can’t I stop panicking? Why can’t I get my shit together? Why do I keep looking for excuses to justify my stupidity. Why am I single-handedly ruining my life? Why do I feel like I’m blowing things out of proportion. Maybe I’m just scared of failing. I’m tired of not being able to figure myself out when I figure people out easily.

Your letter indicates that you judge yourself harshly. Within the contents of a few short paragraphs you called yourself an exaggerator, a liar and someone who was helpless and childish. You also seem to consider yourself a failure because you can’t solve your own problems.

That type of thinking is consistent with people who are depressed and who harbor unrealistic expectations of themselves. Humans are not born with innate problem-solving knowledge. That type of knowledge is learned. Sometimes it is learned from a good mentor or from our parents or caregivers. For those wanting that knowledge, counseling could help. You are the perfect candidate for counseling.

It’s important to stop being so hard on yourself. That kind of attitude has the potential to prevent you from seeking therapeutic help. It is the same kind of attitude that prevails among many in our culture. Seeking mental health treatment is nothing to be ashamed of. Counseling can be immensely empowering and it can change your life for the better. I would recommend trying cognitive behavioral therapy. It is evidence-based and problem-solving oriented. It targets both thinking and behavior. Please take care.

Dr. Kristina Randle

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My Life Feels like It Has Been Messed Up Since the Beginning

by Dr. Marie Hartwell-Walker July 24th, 2021
written by Dr. Marie Hartwell-Walker

From a teen guy in the U.S.: I have had what one would call a rough life. Recently my step-dad and mom have been fighting and it’s becoming almost everyday. And I am scared about what’s going to happen. I’ve already ended up being abused in my step-grandmother’s house. Then was stuck in a hallway and slept in a sleeping bag where I would go to school smelling like mildew and ammonia. I have been picked on a lot.

And I have a girlfriend now. She has anxiety disorder, and I talk to her a lot for advice, but I try not to recently because it’s just way to much. She will find it annoying sooner or later. She does go to therapy and she tells me all the time that I should consider it. But I really can’t go, like it’s expensive, and my family would never let me go. They wouldn’t understand. If anything they would get angry.

What I’m really asking for is advice… How do I get rid of the ever wrenching feeling of emptiness out of my chest? How do I stop myself from purposely doing things that are bad such as deleting whole YouTube accounts, and tearing favorite books? I just…. I really don’t know what to do. Aside from my girlfriend telling me I need help and that I have severe SAD. What am i suppose to do….?

Should I just embrace it, let it just consume me? I’ve thought about it, and, boy, does it sound inviting. To just give up, to let the human part of me die. To stop being who I am. Because some reason….. I think so…. how can I put this?; 3rd person like. I think more from a 3rd person perspective. And it really has affected me. And I can’t help it. Now most likely no one will find this or no one even begins to comprehend what is wrong with me. Maybe theres nothing wrong with me. Who knows…….?

Please listen to your girlfriend. She cares about you. She cares enough to give you really good advice. You need a therapist to help you come to terms with your past and to take charge of your present and future.

Many communities have programs for teens who need treatment but can’t afford it. Please talk to your school guidance counselor about resources that are available. If free therapy isn’t offered locally, consider joining a support group either here at LifeHelper or in your town. Sometimes churches offer guidance through youth groups and individual conversations. There are also excellent books that can help you sort out your feelings. Explore your local bookstore. This article might give you some ideas as well: #/lib/when-you-cant-afford-psychotherapy/

Your situation is not unique. Many, many people do not get the family they wish they had. But family is not just about blood relationships. We can each create real “family” with good friends we take into our hearts. Those connections are just as real, just as precious and just as loyal as those that some people are fortunate enough to be born to. I hope you will start embracing other people to make yourself a strong and loving support system that will last a lifetime.

I wish you well.
Dr. Marie

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Everyone Hates Me and I Want To Die

by Kristina Randle, Ph.D., LCSW July 23rd, 2021
written by Kristina Randle, Ph.D., LCSW

I see a therapist at CAMHS under NHS for depression and Social Anxiety, I’m on Anti-depressants (fluoxetine) and take two 20mg tablets a day but they don’t do anything.

Basically I constantly feel like killing myself and I regularly plan how I’m going to do it. I can’t stop feeling like I want to die and shouldn’t be here and I also think everyone else hates me too.

Therapy isn’t doing anything because I find it so damn hard to speak and say I don’t know to every question because its too hard and triggers anxiety. I feel like I annoy my therapist and I think she hates me and cant wait to get rid of me but I like her. I have one friend which I haven’t spoken to in a while and I always feel like she hates me — we don’t speak much and I think she wants me dead — Basically I have no friends and its pretty much social isolation.

I hate my life and I want it to be over. I feel everyone else wants that too, even those who don’t know me well. I’m bad at everything and nothing is ever going to get better. But, if I kill myself would it ruin my therapists career?? Because she hadn’t stopped me etc, I read somewhere else that it would and I don’t want that.

Also I feel way too guilty about everything like if i kill myself then that will suck for my parents.. but I’m not scared to do it — I want to do it. Ive overdosed a few times in the past but the outcomes wernt that fatal. I feel alone like I have no one…because I don’t. Sorry this probably makes no sense I’m an idiot :/

First and foremost, it’s important that you know you’re not an “idiot.” Your letter makes perfect sense. You expressed your frustrations and struggles. I’m sorry that you are having these difficulties.

The problem with counseling might be that you are reluctant to say how you really feel. When clients withhold information in counseling, it is difficult for a therapist to be helpful. Clients withhold information for many reasons, commonly because they fear that the therapist will think negatively about them. Your unwillingness to be forthcoming will prolong your suffering therefore it’s in your best interest to talk about your true feelings.

Saying you want to die and that you hate your life are signs of someone who is suffering and who needs and wants help. Therapists train for many years so that they can help people with the very issues that you are facing. You might be feeling alone because you haven’t been open and sharing with your therapist. Try your hardest to tell your therapist what’s bothering you even if it’s difficult to vocalize. If the idea of vocalizing your feelings is too hard, then bring this letter to your therapist. It might be the start of a much-needed dialogue.

It’s important to realize that many people have felt the way you now do and that they have been helped by therapy. Life can be difficult but it does get better when you fully utilize the help that is available to you. Keeping things from your therapist and hiding your feelings, are ways of not fully utilizing your therapist. I hope that you will consider my advice. Please take care.

Dr. Kristina Randle

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Do I Have Depression?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP July 18th, 2021
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I’ve gone through a lot in my life it’s never been to a point where I can reflect and begin to worry. But ever since I stopped smoking weed a few years back due to smoking-induced panic attacks/anxiety I feel as if everything has changed. I feel like pre-existing anxiety got worse (social/general) I can’t get out of bed till like 4 pm I lose all my drive I cant sleep I get sad and constantly reflect and think. This goes away for a time and I begin to go back to usual but then it comes back I know having a purpose helps but when I got a job a few months back I felt better than ever and as if everything was great and then all the sudden it came back not sleeping, anxiety, sadness, avoidance having no drive etc. I’ve noticed this for a while but it’s only till recently I’ve really noticed this starting to affect me. As a side note social anxiety really affects me I regularly chew gum because when I get anxious my lips start to shake uncontrollably and I go into a panic because I feel as if I look crazy. I know this seems all over the place but it’s hard to summarize a lot of the things I’ve experienced the last two years and I’m looking forward to hearing someone’s point of view. (From Canada)

I think you are asking a good question. Whenever we look at a pattern of behavior and ask ourselves if it is serving us well or if it is a collection of symptoms that point toward a label identifying our pain, I think this is important self-reflection. Whatever the answer the question is a good, important one.

The best place to start is with an understanding of how depression is classified. Depression symptoms can vary from mild to severe and can include:

  • Feeling sad or having a depressed mood
  • Disengaged, with a loss of interest or pleasure in activities once enjoyed
  • Changes in appetite (weight loss or gain unrelated to dieting)
  • Insomnia or sleeping too much.
  • Loss of energy or increased fatigue
  • Anxiety-related physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
  • Loss of meaning or purpose, feeling worthless or guilty
  • Difficulty thinking, concentrating or making decisions
  • Thoughts of death or suicide

From what you’ve written it seems like smoking weed was a type of self-medication that helped to mask the symptoms. Now that it is gone they have re-emerged. I think what makes the most sense for you is to make an appointment with a psychiatrist, psychiatric nurse practitioner, or clinical psychologist. The first two can do an evaluation and screening for depression and make recommendations for medicine. A clinical psychologist can offer an evaluation that can help make a definitive diagnosis.

In the meantime, you can take this assessment tool here at LifeHelper and learn more about depression here.

Wishing you patience and peace,
Dr. Dan

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Boarding School Issues

by Holly Counts, Psy.D. July 8th, 2021
written by Holly Counts, Psy.D.

I chose to leave home and study abroad at boarding school when I was eight. I have been living away from family for the past 16 years. I regret this decision and blamed myself. Over the past 16 years, I have not been very happy and my personality changed but have only realized this over the past few years. Before I went to study abroad, I was happy but ever since, I am not. The older I got, the more secrets I have and the more I keep my true self to myself. My parents and teachers have always reminded that I have to be good. Ever since the first day at boarding school, I have learned to only act good and follow the rules and never to step out of lines. People/ teachers like good and trouble-free student.

I only got to go home and see parents three times a year, and the rest of the time, I lived at school or with my guardians. Over time, I have hidden my true self and no longer know how to act freely and have fun. I always feel insecure and doubting myself. I also get angry very easily, very emotional. I am very jealous of people who got to grow up at home and wish that I had the chance but cannot turn back time.

I find that I feel very isolated and lonely and don’t know how to be around other people. Whenever, I am in a group I feel even more isolated as I always seem to be forgotten by other people, almost invisible. Although, over the time I was away from home, there have been many people who have been very nice to me. For eg, My guardians, they treated me like their own but I cannot open myself to them, I still feel I do not belong.

I have recently moved back home but still cannot remove these guilty, unhappy, lonely feelings. I sometimes will start crying because I am so unhappy (sometimes with work/ colleagues) and got no one to talk to. I don’t have many friends and struggles to speak of my mind/ feelings. I recently read an article online regarding boarding school syndrome, saying that young children that leave home at an early age can have an effect on them as they have grown up without parents/ love. Do I need help? (age 26, from Hong Kong)

I’m sorry that you have been struggling with these issues for so long. It is true that being raised apart from our parents during crucial developmental years can have a negative impact on our personality. However, from what I can gather, Boarding School Syndrome looks at a broader range of issues. It not only addresses being outside of your parents home but also the possibility of being sent away against your will, having harsh or abusive teachers or guardians, being exposed to abuse by peers because of the 24/7 nature of the schools, and so forth.

Even though you said that you “chose to go,” I don’t feel that a decision like that should be up to an 8-year-old child. You also stated that your guardians were very nice to you and treated you like their own child. These factors are in your favor, and I am hopeful that you can still learn any skills that you may have missed by growing up in a boarding school. You did not mention any type of abuse either, so again, this is in your favor.

If you focus your energy on reconnecting to your family now that you are reunited, making friends and broadening your social support system, chances are that you will start feeling better about yourself and your life. I think it would be a great idea to find a therapist to help you fill in the gaps you may be missing. Especially one who has expertise with early childhood attachment issues.

All the best,

Dr. Holly Counts

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Life Doesn’t Seem Worth Living

by Kristina Randle, Ph.D., LCSW July 6th, 2021
written by Kristina Randle, Ph.D., LCSW

Hi, I’m only 15 years old, and I just want to give up. Every day I force myself to mask my emotions and act fun. All I want to do is just disappear. Criticism kills me inside yet I act like I dont give a crap. Recently, I was suspended for losing my cool and punching a guy in the face because of a bunch of issues that caused him to talk behind my back and smack talk me. I had enough. I continually lose friends, people talk behind my back, my grades are suffering, my family is driving me nuts and making my life hell, my dad is in prison, I was beat for 8 years and witnessed unspeakable things. I’ve done 5 years of therapy but nothing changed. I take anti depressants and they dont cut it. My ex girlfriend whom I dated for 3 years cheated on me and ripped my heart out, and I cant keep going on this way.. I need advice. I have been considering suicide, just so the pain inside ends.

You are obviously in a lot of pain. That is clear. It is important to know that there will be many times when life is difficult but the problems that you are experiencing will be solved and your life will return to happiness. Most problems can be remedied.

Throughout the course of everyone’s life, there are many ups and downs. There will be good periods and there will be bad periods. It is that way for everyone: rich or poor, celebrity or non-celebrity, young or old, etc.

To handle the inevitable stresses of life, one needs to possess coping skills. The fact that you are considering suicide as a way to deal with your pain likely means that you do not possess these necessary coping skills. However, you can develop them.

Your emotional pain may be preventing you from believing that there is hope and that things can change. Your life can become better. Realize that you might not be thinking clearly due to your emotional pain.

Try to see what can be learned from individuals who have attempted suicide and who have survived and who are thankful to have survived. Below, I have included a true story of such a survivor.

AJ was 13 years old when he began having problems. He had been misbehaving. He robbed a gas station. His mother married a man with whom he did not get along. AJ drank to cope with his emotional pain.

At the age of 16, his stepfather kicked him out of the house. He then went to live with a friend. While at the friend’s home, he took a gun from their gun cabinet and went outside and shot himself in the face. He shot off most of his face. He is barely recognizable.

At the time that he attempted suicide, he could see no point in living. He survived and he is now blind. Despite being blind, he’s thankful to have survived.

One might think that AJ would have later tried to end his life but he did not. He is glad to have survived.

AJ begs people to reconsider suicide. He realized that life can improve even when it feels like it can’t. AJ has this advice for those considering suicide:

“If we just step back and strive towards tomorrow, it will get better…And the day after that will be better than the day before. So never give up. You don’t know how many people you’re going to hurt by leaving them behind.”

Tell your parents how you have been feeling. Let them know that you are struggling and that you need help. Insist that they take you to see a mental health professional. It is also important that you reveal your thoughts of suicide. If you can’t tell your parents then tell someone at your school. This could include the school guidance counselor, the principal, a teacher or anyone whom you trust. If you feel that might harm yourself, please call 911 or go to the emergency room immediately.

I have years of experience dealing with people who are experiencing the problems and pain that you feel now. If you had my years of experience, you would know that these problems will work out and the pain will be replaced with happiness. It isn’t fair to expect someone with only 15 years on this earth to know that these problems are common and very solvable. Counseling will help tremendously. No matter what, suicide is a terrible mistake. I know that is true. With the passing years, you will also know it is true.

Please take my advice and write back to let me know how you are doing.

Dr. Kristina Randle

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I Disappoint My Family

by Dr. Marie Hartwell-Walker July 5th, 2021
written by Dr. Marie Hartwell-Walker

I am 15 years old and the youngest of five kids. Growing up all I ever wanted was for my sisters to like me but they forever criticise. They comment on my weight. On my love life and about how I look. They tell me to get the salad when we go out for tea and that breaking up with my ex-boyfriend was a bad idea because he was good looking, they didn’t care that he wasn’t nice to me. Then I was sexually abused by some boy and when I confided in them they told me I brought it on myself. They tell me they don’t like my friends and that I’m not very popular. My parents think they’re all perfect and call me the ‘disappointment child.’ I broke down the other day because when at church we were singing a hymn and my sister leaned in and told me I had to stop because it was awful. I study music and my voice is my instrument. Voices in my head constantly remind me that no-one likes me and that I am ugly I can usually make them say nice stuff but they’re getting worse. I cry all the time and they don’t care! They talk about me behind my back instead and I just don’t know what to do anymore!

Your parents and siblings are huge disappointments! No kid should be the target for criticism and harassment in her own home. Your parents should be ashamed of themselves for tolerating the way your sisters treat you and for joining in the bullying. I don’t really have enough information to analyze your family. My only guess is that your siblings are jealous of you. Unable to match your gifts, they put you down to feel better about themselves. Sometimes parents try to even out their kids’ abilities by putting a gifted kid down. They think they are preventing the other kids from feeling bad. As I said, I don’t have enough information to understand what’s going on so those are only guesses.

I do know this: Not every kid gets the family they deserve. Not every kid is loved, protected, nurtured and supported by their family as they should be. It’s sad and frustrating but it’s the truth. Some kids just don’t get a fair deal. But that doesn’t have to determine what happens in your life. You have a gift. Don’t let anyone take your voice away from you. It’s probably your ticket to a good college and to a different life. Work hard on your music. Write songs to help yourself with the pain. Get yourself involved with a chorus or choir or musical theatre or a band. Such groups will put you in contact with people who share your interests and who support each other is making beautiful sounds in the world. You may meet older people who can mentor you and help you on your way.

In 3 short years, you’ll be able to leave home to go to college. Work hard in school and in activities that support your music so you can apply for a music scholarship. The quality of your life doesn’t have to be determined by your family. You can set your own path and make a future that is filled with supportive people who love you for who you are.

I wish you well.
Dr. Marie

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Do I Have Depression?

by Kristina Randle, Ph.D., LCSW July 5th, 2021
written by Kristina Randle, Ph.D., LCSW

Hello, I was hoping to get an expert’s opinion on this before I seek help. I think I may have clinical depression. I’m not going to get too much into my personal life since I’m supposed to keep this short.For years now, I’ve been feeling very down. Nothing has really excited me and in general I have a pretty negative outlook on life. I feel completely hopeless both in my current situation and while thinking about my future. I always thought it was just hormones and well teenage stuff. I’m nearing the end of my teens now and it hasn’t gone away. In fact, it’s gotten much worse. Lately, I’ve been having a lot of trouble focusing. I used to be able to write school papers in one sitting without too much of a problem. This last week I was supposed to write a one page autobiography and how it relates to my chosen career. I sat down for a good hour and a half and all I had down was three sentences. I have been having short term memory issues-at the end of the day I have trouble even recalling what I did for most of it. I’ve also found that I’ve become very irritable. The littlest things will really start to tick me off. Most of the time I’m melancholy. I don’t really find any joy or excitement for anything, not even what used to be my favorite things to do. There are moments that I want to just break down and cry for no discernible reason. I do have a few moments throughout the day where I feel extremely happy and excited but they go away after maybe a minute at the most. Over the years I’ve just been able to knuckle down and muddle though the days but recently I’ve been having suicidal thoughts. They are nothing too serious as of yet, but they are a serious cause of concern. I’ve also been very fatigued. These days just walking up and down the stairs is taxing. Now, I do have breathing issues, but I really don’t think that’s all there is to it. I took the survey on this site and I scored a 58, severe depression. I have also been to several sites looking at the symptoms of depression. I have most if not all of the ones on every site I’ve been to. I’m writing this because I would like confirmation on what I have found out on my own. Also, I was wondering how I would go about seeking help. I would really like to avoid therapy if at all possible. I am very shy and reserved, I don’t think I would really be able to talk to the person much less enjoy it. If I were to go to a psychiatrist to get formally diagnosed, what would possible treatment options be? Also, I’m sorry that this is so long. I’m pretty sure it’s over 400 words. Thank you so much for your time and I look forward to a response.

From the information that you have provided, depression seems like a realistic possibility. You have many of the signs; most serious among them are suicidal thoughts. Happy people don’t contemplate suicide. Suicidal thoughts should always be taken seriously. Undoubtedly, you should seek professional help.

You stated that you want to avoid psychotherapy. It may not be what you want to do but psychotherapy is necessary to treat your condition.

You should also consider medication. Millions of people have had success with antidepressant medication. Medication works best when the client is also in psychotherapy.

Acquiring psychological services typically begins by visiting your primary care physician. Report your symptoms and ask for a referral to a mental health professional. Typically, you will either be referred to a psychologist or a clinical social worker for psychotherapy services. Your primary care physician may prescribe an antidepressant or suggest that you seek specialized services with a psychiatrist.

Therapy is the perfect place to learn to overcome your shyness. Being reserved may be your description of an inability to open up to another. Being reserved and shy is not beneficial to you. It is problematic for almost all people who feel this way. Have you ever wished you weren’t that way? Without exception, every client of mine who has described themselves as you have would have answered that they wished they weren’t that way. That is was and has been a problem in their lives. Shyness is a fear. Generally, shy people have been hurt early in their lives, when they opened up to someone. They were ridiculed or made fun of. They may have been described as being “too sensitive.” Sensitivity, as we speak of it here, is a gift to poets, philosophers, writers and therapists. Being described as “insensitive” is an insult. You need to learn techniques and methods to deal with social interaction while fully maintaining your sensitivity. A good therapist can teach you exactly what you need to learn.

Please search my earlier posts for my advice on how to find a good therapist.

Little things, over time, can add up to full-blown depression. Thank you for writing and from one sensitive person to another, know that I am rooting for you.

If you have any additional questions, please don’t hesitate to write again.

Dr. Kristina Randle

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Is This Normal?

by Dr. Marie Hartwell-Walker July 4th, 2021
written by Dr. Marie Hartwell-Walker

I’m only 13 years old. I think I am bi-polar but I honestly don’t know whats wrong with me. My mom is a single parent,my dad died when I was only 6 months old. Anyways, I am always depressed and sad for no reason. I’m always arguing with my mom and my two brothers everyday. When I do I act so crazy I dont even understand why I do. Then I cut myself. Not with a knife,with my nails.

I want to stop and I want help but I feel like everyone is gonna look at me like I’m crazy,probraly am. I feel like my mom doesn’t know how I feel in the inside and I try to tell her all the time but she always says that I need to go to a mental hospital. But only if she knew how I really felt,I don’t think she would say that.

Sometimes I just want to run away and never come back and hope that everyone will just forget about me and go on with their life. I dont know what to do. I’m so young and I’m just so crazy. I hate myself and I cry all the time about it and just think to myself why cant I be a normal kid and why can’t anyone just understand me. I only have one small scar. When people look at me they must think I’m happy cause I act normal when I’m out in public and with my friends but really in the inside I’m just depressed and filled with emotions that I don’t know how to get rid of. I just want to be normal and wish that my family can just understand.

I’m so very glad you wrote. I’m sure it’s frustrating that you can’t get through to your mom. She may be thinking that this is normal 13-year-old girl emotionality. She may not want to believe that her little girl is in so much distress. On top of that, you act normal a good deal of the time so your mom and other people may think you’re just into drama.

I can’t make a diagnosis on the basis of a letter. For what it’s worth, I don’t think you’re crazy. You do need to see someone who can help you sort this out.

I suggest you start with your school guidance counselor or school nurse. They can often be helpful in talking to a parent so that a student gets services. Your family doctor can also help. At 13, it may be that you have a hormonal imbalance that is contributing to your up and down feelings as well. Please do get that checked out. If you are physically okay, the next step would be a mental health evaluation and perhaps some counseling to help you deal with your stormy emotions and the tension in your relationship with your mother. You are motivated to be “normal.” You’ll do well in counseling.

I wish you well.
Dr. Marie

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Post Breakup Depression

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP July 4th, 2021
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I met a woman online in Norway, we emailed for 4 months, our emails became intimate, she ended up flying to Florida to be with me for 17 days. On the 4th day, she told me she had no feelings for me, then a day later she said she wanted to be alone, I left her at her hotel and went home, an hour later she called and I went back to see her, she apologized and said it was her, she felt far from home, she did try to change her flight but couldn’t. The next day she said she thinks she’s falling in love with me. The next 13 days until she left for home, everything was great, she made me feel like she did fall in love with me. Sex was great, we were very intimate, she told me many things, made me feel she would return soon and be with me.

Once she returned home, I couldn’t get a hold of her by any means. 4 days later she emailed me, said she needed time to think, thanked me for the good times we had and good luck and I cold write her anytime and we can remain friends. I respect her wishes and left her alone for a few days, then I sent her a small text once in a while, just saying hello, hope you are doing well or hope your day at work is good. but she would never respond, I tried emailing but never a reply. A week later I had a family trauma, my Dad ended up in the hospital, I tried to contact her for a few days, asking to just talk to her that I needed to hear her voice, but no response, she finally called, I tried to talk to her about our relationship ending, I told her I miss her and want her back with me, but she responded with, she didn’t feel safe with me, she had no feelings for me, I asked her why she said and did all those things to make me feel like we were to be together, she said she tried, but then I asked why she told me she felt like she was falling in love with me, she denied saying this and hung up the phone.

I’m confused and depressed about this situation, how should I handle this, Thanks

The distance, her instability, and the range of emotional responses suggest that what you saw in this person was her potential, not her reality. I wouldn’t invest too much with someone on the other side of the globe who doesn’t respond to your emotional needs. Chalk it up to a learning experience and move on.

Often what makes a relationship attractive is the lack of availability of the other. We want what is unattainable. I don’t know if this is true in this case, but the variety of obstacles that are between you now makes it too difficult for you to keep trying.

Wishing you patience and peace,
Dr. Dan

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Anxiety & Inability to Commit in Work, School, Relationships

by Kristina Randle, Ph.D., LCSW July 2nd, 2021
written by Kristina Randle, Ph.D., LCSW

I’m 23 and up until about 4 years ago, I was outgoing, had a big social circle, and a part time job I had maintained for a couple years. Since then, I’ve somehow become very depressed, self-hating, antisocial and have terrible anxiety whenever I’m obligated to a work or social situation, sometimes even when it’s just a family get together. It gets so bad that I’ve quit about 8 jobs in the past 4 years. It’s very hard to explain it in writing, but it feels uncontrolable when I start to feel the anxiety and apprehension. It’s embarassing and I feel like a child having a temper tantrum but I can’t stop it. I’ve gone as far as hysterically crying until my boyfriend told me I didn’t have to go into work, I’ve pretended to go but actually went somewhere else to kill time, or I’ve just stopped showing up to work all together and never called. It sounds so irresponsible, spoiled, and childish which is why it’s so hard for me to talk about because I can’t convey the way it feels to me inside. I prefer to spend my time alone in my apartment or with my boyfriend only and I don’t understand why it’s so hard for me to be around other people. My family growing up was very dysfunctional and my parents were verbally and sometimes physically abusive toward one another my entire childhood. I can still to this day vivdly remember some of their fights and the things I’ve heard them say and seen them do. As I’ve gotten older, I get preoccupied thinking back to those times and it bothers me more now that I can reflect back on it as an adult. I’m very hypervigilant and I’d say I’m in a state of fear or anticipating something bad about 75% of the time for no valid reason. I’ve been that way my entire life though, not just recently. I slept with my parents until I was 11 and I still have night terrors to this day, usually about myself being killed by a man. I just don’t understand how I was so fuctional as a teenager, but now as an adult I’m falling apart emotionally. I hate the way I am, it’s shameful and embarassing and the more I feel shameful, the harder it is for me to snap out of it.

Psychological problems are no more shameful and embarrassing than developing the flu or a toothache. You are not purposely causing your symptoms. You are doing your best to deal with your symptoms but you’re not a trained professional. Most people are not and thus can’t treat themselves.

You were doing great until about four years ago. Try to think back about what may have happened to trigger these problems. If you think about it, there’s probably something that caused a change. Identifying the trigger might provide important insight about what might be wrong.

As you already may recognize, untreated anxiety tends to become worse over time. That’s because people with anxiety disorders tend to inadvertently reinforce their anxiety. It’s called negative reinforcement. In your case, each time you avoid something because of your anxiety, you are inadvertently reinforcing your anxiety. This will cause the anxiety to increase in the future. Avoidance only makes the problem worse.

Highly effective treatments exist for the problems with which you are suffering. You should not hesitate to seek help. Mental health professionals are specifically trained to deal with anxiety and depression. Counseling and medication have both been shown to improve the symptoms of anxiety and depression.

Finally, do your best to refrain from self-criticism. I highly doubt that if you had the flu or a toothache you would refer to yourself as yourself “irresponsible, spoiled or childish.” Mental health problems affect many people, including smart and successful people. Your continued self-criticism might make the process of seeking help more difficult for you. I hope that you make the wise decision to seek help because it is the correct way to deal with this problem. Please take care.

Dr. Kristina Randle

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Depression or Teenage Hormones?

by Kristina Randle, Ph.D., LCSW July 1st, 2021
written by Kristina Randle, Ph.D., LCSW

How can I tell if I have depression or if I’m just a moody teenager? I’ve taken many online surveys before, including the SanityScore one, and they all say I have “Severe Depression” but I’m still skeptical. I have extreme mood swings, I feel hopeless and worthless sometimes, I feel like I can’t control anything in my life, but then sometimes I think I’m just overreacting. I think that there are people who have it worse than I do, and that I should just stop thinking about it. I sort of want to bring the idea up to my mom, but I don’t want her to judge me. I wrote a letter to her but I haven’t given it to her yet. Do you have any advice?

You have asked a very good question. It’s probably a question that many teenagers and parents have pondered. To give you the best answer I would need to interview you. My questions would be geared toward determining the seriousness of your symptoms. I would want to know information such as how frequently the symptoms disrupt your life, to what degree and whether you have contemplated or attempted suicide. Your answers to those questions could help me to determine whether you have depression.

From what you have written, it does seem that your symptoms are significant and concerning. Having extreme mood swings is not normal. Many individuals will occasionally experience periods of irritability but it’s unusual to have “extreme” mood swings.

The National Institute of Mental Health website states that “if you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:”

“Persistent sad, anxious, or “empty” mood
Feelings of hopelessness, or pessimism
Irritability
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in hobbies and activities
Decreased energy or fatigue
Moving or talking more slowly
Feeling restless or having trouble sitting still
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, early-morning awakening, or oversleeping
Appetite and/or weight changes
Thoughts of death or suicide, or suicide attempts
Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment”

NIMH also goes on to say, “Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.”

You mentioned feeling hopeless and worthless. You didn’t specify how often you feel that way. Teenagers especially may experience those feelings occasionally and that may be relatively normal. To experience them on a regular basis (a few times a week) would be abnormal. You also feel that you can’t control anything. I am not certain what you meant by that expression but usually that feeling is associated with anxiety. Depression and anxiety commonly co-occur. I wonder how often you feel out of control and if you have a reaction to that feeling.

I tried to provide a nuanced answer but the simple answer is this: If you feel depressed then you should seek help. It’s not advisable to let your depression symptoms worsen before you decide that treatment is warranted. It’s better to be proactive and treat the symptoms as soon as you notice them occurring. You already have a letter written to your mother. The next step would be to give it to her. It is important that she knows how you are feeling. It would be helpful for you to discuss this with her and put a plan in place to make an appointment with a professional. Please take care. Thanks for writing.

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Fearing Inpatient Hospitalization

by Kristina Randle, Ph.D., LCSW June 29th, 2021
written by Kristina Randle, Ph.D., LCSW

I’m a seventeen year old student in school, and I’m trying to figure out life. I have had issues with self harm for a short time (2yrs).My parents and friends are worried that the depression and self harm arent getting any better and im sufferring.I was diagnosed with major depression recently and i feel so bad all the time.So my therapist recommended inpatient to my family because i cant take care of myself anymore.And im afraid because i know how bad i feel, and i dont want to be locked away forever.Right now im having issues with like basic hygeine,i cant sleep, i havent been eating.I want to be normal and do normal stuff young people do but i dont see the point anymore.However i have told my parents and therapist im afraid of inpatient because i dont understand how it works and whos gonna help me there.And i have never been on medication so my family thinks this is a good time to consider it as a option.

I dont know what to do im tired of struggling to get through the school day. I’ve read horror stories on the internet about inpatient hospitals.And im so scared i dont want anything bad to happen to me.I agree with my therapist that outpatient therapy isnt enough anymore i feel so alone and afraid.I do trust my parents and therapist but im so afraid of inpatient and being locked away forever.I want to be able to take care of myself again and enjoy life.So my question to you is Does inpatient hospitalization have to be so scary?Also what happens when a young person is hospitalized for mental health issues? Thank you for time.

I’m sorry you’re struggling. I understand your concern about the hospital. Apparently you’ve heard very negative things about the hospital experience. You mention your fear about “being locked away forever.” That may be part of why you fear the hospital. Your fear may also be related to not knowing what to expect in an inpatient setting. People tend to fear the unknown.

I can’t be certain of what your particular hospital experience would be like but I can give you a general overview of what it might be like. It is important to note that no one can be “locked away forever” in a psychiatric hospital (or any hospital for that matter). In fact, individuals sometimes complain that their stay is too short. Generally speaking, individuals tend to stay for short periods of time in a psychiatric hospital. This is not true in every case but it is for many. Length of stay depends on the nature of one’s symptoms. Generally, psychiatric hospital stays are meant to be temporary, to help a patient stabilize. Once stabilized, the hospital staff is usually attempting to move the patient to the next least restrictive level of care, which may be a partial hospitalization program (where you attend sessions at the hospital during the day but go to your own home at night) or an outpatient setting.

Your family, friends and therapist care about you. They see that you’re unstable and not doing well. They believe that the hospital might be a temporary respite to help decrease your symptoms of depression and to help decrease your desire to self-harm. If you go to the psychiatric hospital, generally there are two ways that one could be admitted: voluntarily and involuntarily. If you choose to enter the hospital voluntarily then you are free to leave at any time. Yes, the inpatient floor doors are locked but you are under no legal obligation to stay. Generally, an individual may enter the hospital voluntarily when they know they need help to stabilize and if they feel that they are a danger to themselves or others. Your family may believe that you are a danger to yourself because of your cutting behavior. They may also be concerned about your depression. Some individuals with depression contemplate suicide.

Once in the hospital, you will likely meet with psychiatrists, social workers and other various mental health professionals. Their goal is to assess your situation, to make a diagnosis and to offer treatment. Their overarching goal is to ensure your safety, keep you stable and ultimately link you to an effective treatment. Perhaps outpatient therapy is not working for you now. The hospital staff may be able to reassess your situation and find a more appropriate program or a more intense treatment to better suit your needs.

During your stay in the hospital, in addition to meeting with psychiatrists and other mental health professionals, you may be asked to participate in individual or group therapy. Some people find group therapy helpful while others do not. You may not be forced to attend group therapy but these groups are generally encouraged. You may also interact with other patients. Some people find this helpful because they meet people who are struggling with similar issues.

Depending on the hospital, there may be certain times when phone use is restricted (i.e. during meal times, group therapy, and so forth). Most facilities will not allow you to have access to your cell phone or other electronic devices (i.e. laptops, computers, etc.) Many facilities allow visitors but like most hospitals, there will be specific visiting hours.

Your case will constantly be evaluated by mental health professionals. If an individual is not a threat to themselves or to others, the hospital staff will make arrangements for the individual to leave and to attend a new program or type of treatment.

If your friends, family and therapist are concerned about your well-being and are suggesting the hospital, you may want to consider their recommendations. You could go to the hospital with your family and be evaluated for inpatient admission. You can go to a hospital to be evaluated by a mental health clinician, psychiatrist or other mental health personnel who will assess your symptoms and determine whether inpatient hospitalization is necessary or recommended. This might be a good place to start. There is no guarantee that if you go to the hospital for an evaluation that you will be admitted. In many states, there are strict voluntary and involuntary commitment criteria. That means that even if you wanted to be admitted to a psychiatric hospital, there’s no guarantee that the hospital staff will admit you.

I would encourage you to speak to your therapist and family about your fears and concerns relating to the hospital. Please try not to be frightened and understand that the hospital staff is not going to “lock you away forever.” They are there to help.

I hope that I have shed light on what the hospital experience may be like. Please consider writing back in the near future and updating me about your situation. Also, don’t hesitate to write back with further questions. I wish you the best of luck.

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Stagnation in my Life or Depression in my Mind?

by Kristina Randle, Ph.D., LCSW June 29th, 2021
written by Kristina Randle, Ph.D., LCSW

I am a young male who feels depressed at the age of twenty I should be happy where I’m at. I live with three good friends who I grew up with I work at a ridiculously well respected dealership in a small city, I’m single. The ideal situation for a male my age, but I am feeling grounded my job is a emotional roller coaster that is aided by bitter co workers who put you down at every opportunity and make sure I know I’m “the new kid.” (note my closest aged co worker is 25 years my senior) I sleep more often now and often Haft to fight myself to get out of bed in the morning. I feel guilty for things that are not bad. I often turn to drinking to calm my pain. My real confidant passed two years ago when I was 17 and now I have no one to really talk about my troubles with I feel just sad constantly and seem to only be my old self (happy charismatic energetic) once I’m drunk and even then I feel this cloud hovering over me. I constantly ask my self what ski doing? Why am I here? What is the point? And of course is it worth it to even leave the house? It’s just so hard at this point in my life to smile. this isn’t a cry for pity but a request for help I need to smile again I need to find a new road to happiness how can I do that?

Based on the symptoms that you described, you may be experiencing depression. I can’t know that with certainty but it seems like a realistic possibility.

Further evidence of possible depression is the fact that you have resorted to drinking as a way to deal with your psychological pain. People often turn to drinking as a way to emotionally numb themselves. In clinical terms, individuals who utilize drugs or alcohol to numb their emotional pain are “self-medicating.”

In every case, drinking makes a situation worse, especially among those with depression. Alcohol, chemically speaking, is a nervous system depressant. That means it could be contributing to your depressed mood. The fact that you have begun self-medicating with alcohol may mean that this problem is becoming worse.

It is also concerning that you seem to feel as though your life has no purpose. That is evidenced by some of the questions you’ve been asking yourself such as “why am I here?” or “what is the point?” Such questions may also be indicative of an individual who is contemplating suicide. You expressed no definitive suicidal ideation but it is a concern in all cases of depression.

You should consider counseling. Medication might also assist with your depressed mood. Mental health professionals deal with these types of problems on a regular basis. Utilize their expertise to improve your life. I hope you will consider professional help. It could help you immensely. You might be very surprised by how quickly and easily a therapist could help with your problem. Please take care.

Dr. Kristina Randle

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My Family All Hate Me Because of My Moods, It Seems that I Just Can’t Be Happy

by Kristina Randle, Ph.D., LCSW June 26th, 2021
written by Kristina Randle, Ph.D., LCSW

Hi, Here is my issue, I seem to be able to go to work 5 days a week and function (for the most part) fine. However when I get home all I want to do is NOTHING. I have no pleasure in anything at home. Almost every weekend I lay on the couch and say very hurtful things to the people that love me (It’s like I want them to hurt like I hurt)!!! All I want is to be happy and NORMAL, my kids hate me and I don’t blame them. My husband sticks with me and I feel so bad for him because he deserves so much better.I am on wellbutrin at the moment, I have been on so many different drugs and nothing helps.I feel so empty and lost and can’t get motivated for anything. I have let my family down so many times and I just want to be HAPPY can you please help me, there have to be other people out there like me. My Dr. doesn’t know what to do with me, I think he thinks I’m nuts.When I get like this I just want to be alone…PLEASE,PLEASE can you help me so I can help myself?

I have helped many people with symptoms exactly like yours. I am not unique in my ability to help people. Somewhere, most likely within 25 miles of where you live now, there is a therapist who can help you. I can answer your questions over the Internet, but I can’t treat you over the Internet.

The most important thing for you to remember is that there is a therapist, close to where you are right now, ready and willing to help you. You need to open your phone book, do an Internet search, and begin your inquiries. Ask to speak to the therapist and read to him or her, a list of your symptoms. This should promote a dialogue between the two of you. Thank this person for his or her time and then call the next one on the list. When you have finished with all of your calls, you’ll find that there will be a few therapists that you did not like at all and there may be one or two that you seemed to “click with.” Studies show that it is this latter group of therapists who are the most likely to help you.

Carl Jung believed that depression was simply the conscious mind being forced into closer alignment with the unconscious mind, where the roots of consciousness and the beginning of the pathways of consciousness exist. This pathway of growth, he termed individuation. It is similar to Abraham Maslow’s concept of self-actualization. You may be interested in reading more about both topics.

You are able to function at work but do not feel emotionally well at home. Your specific circumstances would be highly suggestive to me of the need for talk therapy. Some people take the route of talk therapy others take the route of medication and some do both.

I hope you will take my advice and I wish you the best of luck.

Dr. Kristina Randle

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Can’t Get a Grip, Thoughts Are Painted All Over the Walls

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP June 26th, 2021
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

Well here it is, I’m 24-year-old male who has recently kicked a very serious heroin habit, I was using between a gram and half to two grams a day just not to go through withdrawals symptoms. For the last three years. While I used my thoughts and emotions took a back seat I forgot what it was like to left alone with my brain.

I survived years of physical abuse and emotions abuse, or that’s what I’ve been told. I can’t remember much from my childhood and the memories I do have, come back violently and uninvited

Before I was using I had 3 failed suicide attempts, I self-harm daily I was hospitalized 4 times for it. I was diagnosed either with bi-polar disorder or schizotypical. But always felt neither of them it. I never have been mania and I have always loved to talk to people even though I hate everyone and I don’t mean that in “fuck the world” type deal I mean something about everyone rubs me the wrong way. I can always find a flaw in them that I just can’t ignore.

But as of late I can’t seem to get a grip on my own thoughts, I go thru bouts of feeling so low and miserable that it hard to stand, and I’m constant edge during these times, footsteps seem louder, people seem bigger, every sound catches my attention. And the only way to even semi-balance me out is to self-harm.

My friends think I’m zooming out sometimes but it like a tornado in my head. I can see my thoughts spew about on the walls all grabbing my attention, each thought begging to have my attention

But then there are days where I’m “normal” these days I’m working ungodly long hours while we constantly busy, these days I have no time to think just act. These days I feel human

My life is in pieces right now, I’m homeless, I’m working though but only as lead cook at friendly’s ((I have my 4 year in culinary)) but I don’t feel stressed about. I feel like I should be but I can’t seem to bring myself to care.
So my question is where do I go from here? I’m terrified to ask for help, terrified if I don’t get help I’m going to do something stupid? And what is wrong with me?

You are brave and courageous for reaching out. This letter was a request for help — so maybe the terror is subsiding. Trying to balance your feelings, kicking the heroin habit, and holding down a job are no easy tasks. Right now, you already getting a lot done. The next step is to find someone who can help bring you to the next level.

I strongly encourage you to look for community counseling and recovery programs in your area. There are often services at low or no cost, and of course there is Narcotics Anonymous. All of these resources are important for you to find the support you need to continue your growth. Writing us here was a good start, now it is time to take it to the next level.

Wishing you patience and peace,
Dr. Dan

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Suffering From Depression?

by Kristina Randle, Ph.D., LCSW June 25th, 2021
written by Kristina Randle, Ph.D., LCSW

I feel like i have always suffered from depression but i’m not 100% sure. To start off with the issue/issues:

1)I have always been bullied for most of my life from elementary school onward not so much anymore. I was either mainly bullied by my siblings(brother and sister)when i was the middle child growing up. They picked on me for whatever reason they could think of. One main reason they picked on me was my weight. I was also bullied by peers in my grade, and or friends.

2)I have always been extremely shy, and i struggle with low self-esteem. As i got older, the low self-esteem was still there, but i have now noticed that i am extremely self-conscious of the way i look, i have always struggled with my weight, and i usually hate looking in any mirror because i can see all of my flaws with how gross and ugly i look from being overweight. I do believe this is a form of body dysmorphic disorder? i’m convinced i have it.

3)I was diagnosed with a learning disability so whenever it came to school, i struggled with that and grades sometimes. It was especially hard during the spring semester of the new college i was going to because of the harder classes. Even though i did well for the fall semester. I didn’t realize that i get anxiety a lot, with school but i do.

4)continued from number 3: I was seeing a counselor at the school that i was going to for the fall semester of 2012, because i was super stressed and anxiety driven. I continued seeing a counselor at school for the spring semester 2013, both of them said i had depression. The last one i was seeing said that counseling would not help, but medication with the counseling helped. I learned the hard way when i was at college during the spring semester that college can be extremely lonely at times. I was even hospitalized for suicidal ideation. At that time i was put on 3 medications, i guess all for depression. I have yet to see my doctor about it though even though its been 6 months from that specific incident.

However now that i’m home i’m still convinced that i have depression like the counselor and hospital said. Could the issues that i have struggled with all lead to major depression. any advice would be greatly appreciated.

Yes, the issues that you are struggling with can lead to depression. It’s good that you are seeking professional help but it seems that you require more help than you are currently receiving. As you mentioned, it’s been six months since you have seen your doctor. That’s too long to go without professional help, especially after being hospitalized for suicidal ideation.

The counseling that you have been receiving at school is a great first step but it’s not enough. Typically, college counseling centers are geared toward assessment, emergencies and short-term problems. Given the chronic nature of your depression, you would benefit from professional help that is more intensive and long-term.

I would recommend seeking mental health treatment, outside of the college counseling setting, that involves both counseling and medication. You can ask the school counselors for a referral to a therapist in your community. You can also check with your primary care physician for referrals. They can assist you in receiving the proper help.

The issues that you have been struggling with are correctable. Your depression has been chronic perhaps in part because you have only just begun to receive mental health treatment. Once you’re established with a long-term therapist, and have found a medication that provides symptom relief, your quality of life should improve greatly. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Therapists Confirm My Low Self-Worth or Seek to Lower My Self-Esteem

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP June 25th, 2021
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I have very low self-esteem. Every therapist I have seen in my life has made a point of telling me I am homely and unattractive, whether I brought up the subject of my looks or not. In a group they were intent on assuring another patient how pretty she was, but at the same time putting me down. We both had short hair and no makeup. Other therapists have put me down as unfixable unattractive, even when I had long hair, makeup, and a basically fit body. Male and female therapists alike expressed this opinion, even when they liked me as a person and enjoyed working with me. I know I’m not a supermodel, but I think I’m pretty enough for people in general. Why would providers tear down a vulnerable patient like this? (From of USA)

There are several elements of your question that I think are very interesting and important to explore. I’d like to focus on three of them.

The first is the fact that you’ve written to us about this issue. It demonstrates bravery, honesty, and humility in taking what sounds like a long-standing issue and putting it front and center. Since the issue is self-esteem you’ve begun with the most important feature, which is learning to speak up and having a voice about your needs. Bravo!

Our very own Marie Hartwell-Walker has written an excellent book on self-esteem that can be very helpful in continuing to develop your strength and voice. You can learn more about the book here and here.

The second of your concerns has to do with the fact that there is universality among different therapists at different times, in different formats, across gender. You identify the phenomenon as life-long, in group and individual psychotherapy, with every male and female therapist, and coming at you unsolicited. This is important because it means that no matter where you look in the therapeutic community there is one recurring theme happening — they are all pointing out how unattractive and homely you are.

Whenever there is a universal theme that pops up in therapy, particularly when the matter is life-long and with multiple activators, the first question to entertain is what could be causing this? If someone told me everywhere they are looking the world seems colored in an orange tint — the first thing I’d look to see is if they are wearing orange-colored glasses.

To test this out you’d want to ask yourself two questions. First, did this type of put-down occur in your family of origin or in other significant relationships? If it has, then this becomes a very fertile ground to explore because it means that there have been other incidents where the people who should have loved you treated you poorly. If this is the case, the therapeutic environment is where it is happening again. This changes the understanding of the phenomenon because it is a recurrence — not a first-time happening.

The second question you’ll want to ask is if there is any incidence where this wasn’t happening in therapy. Look for the differential. See if there were times when this wasn’t happening, or people that it didn’t happen with that could be explored. Understanding where it doesn’t occur is as important as understanding where it does.

Finally, I would highly recommend that whatever the results of your thinking on this topic produce that you bring it back into therapy. Tell the therapist immediately when you feel it has happened. This gives both empowerment to you, and insight for the therapist to work with in making a change that can be helpful.

Wishing you patience and peace,
Dr. Dan

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Who Am I and Why Do I Feel So Out of Place in this World?

by Holly Counts, Psy.D. June 23rd, 2021
written by Holly Counts, Psy.D.

I’m a 23 year old male living with my father in an apartment. I find that I have no motivation, fail at everything I’ve attempted so far in my life, and reflecting on myself, I have come to a conclusion that I actively hate myself, to the point I think I may be self-sabotaging… Some days I want to die… just end everything, but I have always hated the idea of suicide… And am too afraid of hurting those who care for me, and I feel like killing myself would only result in dumping upon them all the unresolved problems I leave behind… My life is a mess… I have no job, have dropped out of school and am facing massive debt… and all because I can’t stand my existence… I even sabotage all my friendships… and by the time I realize it, they’ve moved on. Who am I? Why the hell do I feel so disconnected from everything… including myself? I can’t sleep at night because I can’t shake these questions out of my mind… and when I do sleep, the same questions haunt me in my nightmares… I’m lost…. and I don’t know what to do. I’ve tried telling my family… but they don’t understand my reasoning… and I’ve hurt them so much by my actions (or lack thereof) that feel like they’re giving up. I want to know why I feel so out of place in this world… like I’m so different that I can’t even relate to the people around me. One reason I can’t make sense of it, is that I’ve committed to certain things before in my life without a second thought… such as not drinking alcohol or smoking cigarettes… being kind and considerate to others… and being patient and level headed. Why can’t I apply that same tenacity to anything else? I’ve tried… but I can never manage to pull it off… I know asking these kinds of questions online is not always reliable…. but I have no one to turn to… and no money to invest in serious counseling… so I don’t know what to do. Any advice… anything at all… even an angry or hateful response… is appreciated, I just need SOMETHING. (age 23, from US)

First of all, there is no way that you can fail at everything you’ve attempted in life. You need to examine the “measuring stick” that you are using. Maybe you are struggling with school and employment right now, but using some of your other examples like committing to not drinking or smoking, practicing patience and being kind to others are things that other people struggle with (even people with stable jobs). All of us have strengths and weaknesses. All of us have things that come easy to us and things we really have to strive for and put extra effort into. It’s part of being human.

If you are not finding helpful answers within yourself right now, it is time to look elsewhere. If you are feeling disconnected, then you need to search for ways to connect. Therapy is certainly one way to do this and you can look into what services your local community mental health center has to offer, but you may find other ways to feel more connected as well.

Try volunteering for a cause you care about, try a new hobby, or take one class in college instead of taking a full load. Set your goals small so that you can begin to feel some success and then build on this. Give yourself chances to discover things you enjoy outside of yourself and hopefully this will lead you to discovering things within yourself that you can embrace. Just don’t give up. There are many, many successful people in our world who floundered at some point in their lives.

All the best,

Dr. Holly Counts

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Husband Acts Inappropriate

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP June 22nd, 2021
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

My husband is acting inappropriately, being rude, and judges me when I am in pain. I am 13 weeks pregnant, and we are financially distressed. We moved in with my in-laws, which my husband LOVES. I am an introvert, his entire family is extroverted, controlling, and often manipulative. I set healthy boundaries on my terms for them, and insist on being respected while avoiding confrontation. My husband used to be blind to their disrespect and control, but is improving by learning to set boundaries as well. I have been in a lot of pain this week. The baby is moving up and out of my pelvis, I have been working long hours, the management at work has been chaotic, and I have developed pain in the tendons of my left foot due to pregnancy weight gain. I set a boundary for my sanity: if it cannot be fixed right now, I don’t want to talk about it right now. My husband cannot understand this. He arrived at my work, frantic about bills, and proclaiming extreme gloom and doom. I was in pain, and a little short with him, because I will not be dragged into despair while under so many other pressures that I must overcome. I told him to stop. I clarified the situation, and explained this was exactly why I set my boundaries where I did. He was maxing out my mental self control, and he needed to stop. I helped him through his crisis, which was nothing more than a temper tantrum and despair mixed together, and said I needed more time to work out solutions for the problems. I worked out a solution within the hour. He has done this many times in the past month, and I have become increasingly less tolerant of the setting, and approach of these discussions. Yesterday during my switch shift break, my husband wanted to discuss his frustration and failure in turning off our Internet provider. I tried to express my opinion twice, and twice he cut me off. I became angry. I told him that was unacceptable, and I was done speaking to him, because it was obvious he was not respecting my opinion. He tried to tell me all my faults to win the argument, I told him that he knew I was exhausted and in pain. That he was being a jerk, and I did not have to tolerate that. I stormed off to stop my reaction. Last night, my abdominal muscles hurt, my back hurt, my left foot felt like my tendons were being sliced, and I was out of mental reserves, so I introverted to keep from being mean or short. My husband could not respect my boundary. He could not even see it. I expressed the pain, told him what I needed, and he chose right then to be super emotional and sensitive to the way in which I made my request. I had enough. I found a scarf, tied my foot in my best copy of the therapeutic splints I found online, and realized my husband was still going on and on about his feelings about how upset he was, how he couldn’t help me, and more about him and his feelings. I told him he needs to pay attention to his surroundings more while he is talking. I made my own splint in the time it took him to get all that complaining out. I explained I was in great pain. That I had zero tolerance for this level of pain, and this has nothing to do with him. He wanted to make the situation off topic and dramatic, but I stopped him cold. The issue was my lack of patience due to pain, and that was the absolute only discussion I was having, and only now that I had gotten off my foot.

I feel like I cannot be respected. That I am constantly being misunderstood, and that my day to day struggles are somehow being made inferior to the emotional demands of my husband to meet his own needs. I am under too much stain to carry us both. Am I really being as cruel as he makes me out to be? Are my boundaries somehow inappropriate?

There is nothing in your story that would suggested it inappropriate or unfounded. However, it does sound like your husband needs to develop some coping skills with you. I would recommend contacting one of three places (or all three) to find some local counseling for both of you, or, if he is unwilling, for just you.

  1. Turn to your community hospital for outpatient therapy. They often have low or no cost therapy options for couples who are going through pregnancy. Your physician may also know of some referrals for you.
  2. Contact the women’s center in your county to see what they would recommend for counseling for you and/or counseling for you as a couple. Again, they often have low or no cost options available.
  3. Check the “find help” tab at the top of the page for counselors in your area who could help directly–or inform you of other resources.

Wishing you patience and peace,
Dr. Dan

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