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Depression

Depression, Anxiety, Paranoia, Compulsions

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP March 23rd, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I can’t find it in myself to look forward to anything-everything is fleeting to me. I can only think negatively about anything as it is too exhausting for me to be optimistic. I constantly think about suicide but know that I don’t have the guts for it. Sometimes I feel like a god- smarter than everyone else and 5 steps ahead, other times I feel suffocated by my thoughts of nothing mattering, oblivion, bleakness. I feel hollow and empty sometimes. I have never experienced a manic episode, the closest would be impulse buys but nothing too bad. I feel like I have episodes of depression where my body feels sore, I can’t think about anything besides death, and wish to be in a year-long comatose or something. Every day is a struggle for me, I wake up with anxiety and when it prolongs itself through the day I feel so exhausted by it then depressed because of it. So many of my issues seem existential and therefore unsolvable to me unless I adopt an ignorance is bliss attitude but I’ve tried and physically can’t. I’m on 100mg of lamotrigine but I don’t know if I am worse or nothing changed at all. I just can’t find anything to stay happy about. Any time I ‘sense’ a disturbance, I immediately speculate the worst-case scenario and convince myself I am going to be broken up with, ghosted, or left alone. I feel like i am emotionally manipulative and have no control over some of the toxic aspects of my personality. For instance, when I feel like my BF is not giving me attention or something I go to the bathroom and cry until he finds me. I think that is awful of me. There are other behaviors related to that that i cannot control.
I feel like I am unbalanced beyond repair.

I am glad that you have taken the time to explain all of these uncomfortable and difficult symptoms. I think it is a good start and I want to dive right into your narrative because I believe it holds some important clues about a pathway for your recovery. Let’s start with your first 3 opening sentences.

“I can’t find it in myself to look forward to anything-everything is fleeting to me.” What is striking about your description is that it begins with you in search of you: “I can’t find it in myself…” I don’t want to minimize this because there is a very healthy part of you that is experiencing an unhealthy—or at least non-optimal part of you. That same healthy part then goes on to say: “. I can only think negatively about anything as it is too exhausting for me to be optimistic.” Again, in an important way you are saying that you know how to challenge these unhealthy thoughts by being optimistic—but that it is difficult because it is exhausting. Then you explain this struggle at its very core: “I constantly think about suicide but know that I don’t have the guts for it.”

In each of these opening sentences (and every other one as you review them), there is a healthy you that is being challenged by unhealthy responses. The healthy part is the one frustrated by the lack of progress and the one that is trying to get the right combination of forces together to feel better. It is up against the unhealthy part that, right now, is hijacking your healthy part and having you do things (like manipulating your BF) that your healthy part sees as “awful.”

Your last sentence has gotten it exactly right in the part that says you feel unbalanced—but this is definitely NOT beyond repair. You being able to notice and feel what is not okay tells us that the healthy part is what needs to emerge and grow. I am suggesting you do two things to make this happen.

The first is to learn about your character strengths by going to this website. Character strengths are something that, when used properly, bring us back into balance. They have to do with things like our persistence, gratitude, self-regulation, etc. Learning about them and how to use them is one of the best ways to bring yourself back into balance. Take the character strength survey on the site and follow the instructions about using your strengths more.

Finally, I would encourage you to work with a therapist to help speed this process along. The Find Help tab at the top of this page will help you find someone in your area.

Thanks for writing in and let us know how you’ve done!

Wishing you patience and peace,
Dr. Dan

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I Really Don’t Know What My Problem Is

by Kristina Randle, Ph.D., LCSW March 9th, 2023
written by Kristina Randle, Ph.D., LCSW

So, basically, I feel like I have real problems relating to people.

I’m a first year at uni and I’ve basically been having this problem my whole life. Its not that I’ve never had friends – or never had close or good friends because I have. The friends I have are important to me and I think I am important to them.
But I feel like they’re so much fewer than everyone else around me has. I don’t speak to people, I don’t know anyone, I only feel comfortable with so few.

Sometimes I feel like I have problems getting to know people because I’m unlikable in general, and sometimes because I am super ugly, or sometimes that I’m just awkward and don’t know what to say much of the time. I don’t think I am the sort of person who someone will go out of their way to spend time with.

Its not that I feel too bad in those situations. When I’m out or at a party I feel like I talk enough, and I make people laugh and form little bonds and all that, but they feel hollow and empty and they don’t last long. I have basically no friends in my course, or in my accommodation. And I’ve had basically no proper romantic relationships in my life.

I feel so okay alone, though. I can be so incandescently happy on my own, but I so rarely feel like that around other people. I never feel comfortable enough to be that happy with other people around me. And especially rarely if i’m not drunk or anything else.

Anyway, I just want to know if their’s something wrong with me or not. If so, what is it? I feel very lonely and awful. I feel kind of monstrous.

It’s very common for people to look out at the world, compare themselves to abstract “others,” and to think that they are not measuring up. Everyone else seems to be having a great time and you’re missing out on all the fun. This is especially true when it comes to social media. People post pictures of themselves experiencing what appears to be the grandest of times. Scrolling through those photos, seeing everyone having what appears to be a great time, can make you feel bad. It can make it seem like everyone else is having fun and you’re not. It’s easy to become envious of others who appear to be “living the best life.”

It’s important to remember that those images are, in a very real sense, doctored. They are not real. Not only are those images often literally embedded with filters, but people tend to post only the most positive aspects of their lives on their social media feeds. They omit the pictures in which they don’t look their best or when they’re unhappy, and so forth. People simply don’t post pictures of themselves in unhappy situations, at least not to the degree in which they post pictures of themselves having fun. This creates a false reality. In modern times, it can be difficult to avoid making comparisons between yourself and the social media images which many of us consume.

In fact, researchers have found that individuals, particularly adolescents, who spend large amounts of time on social media, have an increased level of depression. This mostly stems from people comparing themselves to the happy people they see on social media and judging themselves to be not as good. As a result, one’s mental health suffers. Individuals may come to believe that they are not as good as the people they see on social media.

In your case, you seem to be making comparisons between yourself and other people and then judging yourself harshly. In other words, you basically see other people having a great time and feel like you are “awful and monstrous.” Everyone else seems to be having a better time than you and in your mind, you are the problem.

You also mentioned that you basically had “no proper romantic relationships in your life.” The use of the word “proper” indicates that there is certain number of romantic relationships you “should” have had by now. The reality is there is no number of romantic relationships you “should” have had at this time in your life.

In reality, there are no rules about how many friends or romantic relationships you “should” have had by your age. Thus, if there are no rules, then you should not feel bad about having only a certain number of friends or relationships.

In fact, some of the psychologically healthiest people have only a few friends. That’s because true friendships take a great deal of time to develop. Having many friends may mean that those friendships are of a shallow nature. Have you considered that you may be doing things right, and that other people may be doing things wrong?

Often, when people presume the worst about themselves, it is because they may have low self-esteem, which can be indicative of depression. To know if you have depression, consider having an in-person evaluation with a therapist. They would be in the best position to know if something is wrong and most importantly, can advise you about methods to correct it. Give therapy a try. It could change your thinking to be more in line with reality. Please take care.

Dr. Kristina Randle

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Loneliness and Friendship Problems

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP March 7th, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

My bff and I “separated” in 7th grade and became very different people. Before that time I never had an issue with making friends and had quite a few but by the end of middle school, I was pretty alone. In high school it was not much different I had people to talk to, I was involved in extracurricular stuff but I rarely saw anyone outside of those activities. I am pretty introverted but I like people. I went to college and joined some groups and enjoyed their company but nothing really stuck. A couple of years in I roomed with a couple of people I knew and started to build a friendship with them but we’re just not close. I like them a lot and they seem to like me but I always just feel like I’m bothering them. And if I’m with them together I feel like a 3rd wheel. I realize that my issues are about me and not others. I can be annoying, emotionally distant, awkward, and occasionally clingy. I realize that but I don’t know what to do about it.
I feel more isolated than ever and just have aching loneliness. Sometimes I just lay in bed and cry and try to muffle the sound in my pillow so they can’t hear me. I’m just lost. (From the USA)

I think it takes a lot of courage to talk about this pain of loneliness. You’re not alone. Gallup poll has said that 40% of Americans are lonely. That’s the rough news. The good news is that there really is something you can do about it.

You already have a very good grasp on the dynamics of your interpersonal relationships. This is a very good start. You also realize that you bring something to the table that might make it difficult for people to make a connection, with you yet you are aware connections are possible.

Your capacity for reflection is important because it gives you the necessary skill for change. When we are aware of a pattern we want to change it gives us the power to choose something different. The reactions you have may be part of your personality, but they are largely the result of habits and lack of experience with other skills. This is where there is some real hope for change through group psychotherapy.

Group psychotherapy is a format where people who typically do not know one another come together for the purpose of helping each other transform. The kind of group therapy I’m suggesting has a trained facilitator and usually operates with from 6 to 10 people. The facilitator selects the individuals to join the group.

Some groups have a specific focus, like people who have recently been divorced, while others are more heterogeneous, meaning they have people with very different needs joining the process. A good group therapist would be able to facilitate a group that allows you to get feedback, experiment with new behaviors, and learn how to give feedback to others. It is important to find a therapist in your area that has specific training or expertise in group therapy. You can find a list from the top of this page under the “find help” tab, or you can look to this group. I would highly recommend group therapy for you. While the style isn’t as important as the skills of the facilitator the main type will have components of what is called “interactive” group therapy. This indicates that the primary function of the group is to interact with one another (rather than analyze, stop smoking, or recover from alcoholism, as examples), and is based on principles that look at therapeutic factors. These factors help make a group and its members healthy.

In joining a group you’ll have a chance to find your voice, learn from others, and most of all develop a better sense of who you are. People who join groups tend to understand themselves and connect better with people. If you want to learn more about groups you can check out this blog or this one.

Wishing you patience and peace,
Dr. Dan

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Not Sure What It Is — I Need an Answer

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP March 6th, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I can’t sit still ever even when in bed I’m always rocking my whole body involuntarily twitches or shakes I can’t focus can’t look people in the eyes I’m always hurting always feel bored have trouble being able to do what I need to not good with math when I read I see words that are not there my moods never stay the same –daily they change from happy sad crying frustrated angry I yell when I don’t mean I feel somewhat empty flashing lights, glitter, and paper interest me I don’t know why I can’t remember very well I am also hearing impaired and I have a few health issues but the problem om asking about needs a diagnosis for my doctor can you help please what it this called what do I do (From the USA)

I’m sorry you are having so many difficulties. It must be challenging for you to have these involuntary experiences. Twitching, rocking, not being able to focus, no eye contact, as well as difficulty reading, calculating, and hearing. It must seem like you are on a shaky tightrope from the moment your day starts.

The first question I’d have for you is: when do you feel your best? Is there a time when many of these symptoms aren’t present? Is there a time when you feel good—or at least largely symptom-free? I think trying to understand when these issues aren’t present can help tune into a deeper understanding of what’s going on. Too often the symptoms drive the treatment without an understanding of what may be naturally happening that gets you engaged and feeling better.

I am going to recommend three courses of action. First, let’s find out what it is that defines the best elements of who you are. To do this go to this site at viacharacter.org and take the character strength survey. There are a number of terrific articles written by Dr. Ryan Niemiec here, and these will help focus on what you are good at. Treating symptoms without knowing these strengths is only half the job. Understanding your character strengths will help you improve your healing from these issues as well as help you find more well-being in your life.

Secondly, I’d recommend a battery of tests done by a clinical psychologist or neuropsychologist. Almost all of your symptoms seem to suggest that a thorough evaluation of your abilities would be helpful. Rather than guess at a diagnosis, a battery of tests can determine why certain things are happening. They can help pinpoint causes and help identify patterns and links. While it may seem hard to imagine — a number of your symptoms could actually be the result of the same underlying issue. Issues like boredom, distraction, mood swings and reading problems can sometimes be linked together in ways that neuropsychological tests can reveal.

Finally, I’ll recommend an evaluation by a psychiatrist or neurologist. Sometimes the psychological issues you’ve described can be caused by underlying medical concerns. The physicians specializing in these areas can check for these possibilities.

By looking for those times when these symptoms are lessened or reversed, getting psychological testing to identify to the range of your abilities, and having a medical exam by specialists, you are gathering the information you’ll need to come up with ways to feel sustainably better

Wishing you patience and peace,
Dr. Dan

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Possible Depression?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP March 7th, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I’m an Education graduate Cum Laude and currently working as a BPO agent. I recently decided to continue to Law primarily to achieve my dream of being a lawyer but mostly to cure my academic insecurity. I think my cousins and friends landed a better course and better job. I ended up working in call center since I hate teaching. I only took up teaching because my mom says so. So, lately I had problem cooping up with school and work. I hate my work, I don’t like the way they do things there. I thought we should be working with integrity but all I can see are the opposite. Then I messed up school. So not like me. I ended up not reading my books, cases or not doing assignments because I cant fit my time to do work and school. I used to multi-task way back college, both working two jobs and studying.

Then last week, I broke down, I didn’t attend school, I missed my projects, I miss work. I cried all day, I throw all my books. I blamed myself for being irresponsible, worthless, dumb (well I think I am a total failure ) and keep asking why do I keep on pushing something that I cant. I even ended up noticing my room as ugly as hell and wish that I can find another that will suit me well. I loss all the confidence I had, I just want to evaporate or disappear. I sometimes thought of killing myself but cant find a way on how. I don’t want people to see my body and ended up being the talk of the city. I don’t want people to notice me, I just want to be alone and do things the way they should be.

Then I started being quiet, so opposite of me being happy and talkative. I use to have a lot of friends now only I a few that I want to talk to. At work, I seldom talk to my workmates but I still respond they way a normal person do. Back at home, I just sit quietly, staring at the wall, thinking of how mess up my future now is and how hopeless I am now. Then I took up a test here and got a result of severe depression, what a shocker (sarcastically speaking). I no longer love myself, I don’t want to do things anymore, I just want to rest and not think of anything. Can I do that forever? (From Philippines)

The sudden onset of his and he additional struggles on your plate suggest you should have a general medical exam first. When this rapid of a change happens the first thing is to rule out anything physical that may be responsible.

Secondly, I would recommend talking to the Counselors at your law school about time management, meditation, and self care practices. I think this will help.

Symptoms of Depression

But if you do believe you suffer from depression, here are the six (6) most common symptoms of clinical depression:

  1. Persistent sadness, feeling down or hopeless: The most common symptom of depression is a persistent feeling of sadness or low mood that persists for most of the day, nearly every day.
  2. Loss of interest or pleasure in activities: People with depression may lose interest in activities they once enjoyed, including hobbies, socializing, or spending time with friends and family.
  3. Changes in appetite or weight: Depression can cause changes in appetite, leading to either weight loss or gain.
  4. Sleep disturbances: People with depression may have trouble sleeping, either by struggling to fall asleep, staying asleep, or waking up early in the morning.
  5. Fatigue or loss of energy: Depression can cause feelings of fatigue or low energy, even after a full night’s rest.
  6. Difficulty concentrating or making decisions: People with depression may have trouble concentrating or making decisions, even on simple tasks.

In any case, you should seek out assistance from a local therapist or other professional in your community as soon as you can. It sounds like you are in pain and could benefit from professional assistance.

Wishing you patience and peace,
Dr. Dan

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Depression, PTSD from Military and High School Years: Please Help.

by Kristina Randle, Ph.D., LCSW March 4th, 2023
written by Kristina Randle, Ph.D., LCSW

Q. I’m currently a 3rd year college student, at 22 years of age. I’ve always had emotional problems throughout my childhood, although nothing so serious that would cause depression at the time. It was not until my junior high and high school years, where I actually began to suffer from depression, due to being picked on, spit on, and some cases, beaten up, in and sometimes out of school at the time. Eventually I was prescribed with antidepressants, which occasionally worked, although sometimes made little difference.

My high school years were a bit better, in that I was not picked on so much, or beaten up, but I did have the problem of being very shy, and having virtually only 1 friend throughout my high school years, so much so, that I had problems meeting people, girls, anyone, and mostly outside of school kept to myself. Again, I was taking antidepressants in my high school years as well, but never really got the feeling that it helped much. To be honest, things in terms of my personal life did not get so bad till I entered college, from there, shyness, lack of friends continued, this despite enrolling in my local ROTC officers training program, in order to try and combat this. Eventually after a year of being in it, and at this particularly university, I had felt that things were bad enough, and dropped out, and immediately made plans to join the Air Force, as at the time, a few of my friends were all planning on joining up.

My experience in the Air Force turned into a disaster however, for a variety of reasons. I suffered panic attacks often, as well as depression, while in training (and at the time of joining, i was not prescribed with antidepressants), eventually to the point where I could no longer mentally handle myself in the environment, and requested that I be relieved of training, due to suicidal thoughts, if I were to stay. I was then granted a transfer to a temporary training squadron, which was for those whom wished to leave the military. My problem however was that this of course took time, over 2 months processing, and my times there were as bad, if not worse than my regular training was, and again, I had depression and suicidal thoughts, I’ve more or less been emotionally scarred due to the events I went through in my few months in the military, specifically from two particular events, one of which I was violated by another recruit in the middle of the night, whom threw his feces in my face as I tried to sleep, an event that I did not report, due to fear of reprisal or trouble from chain of command. The 2nd event however, I felt was much worse, which occurred when I was removed from my training squadron, after suicidal thoughts, and put in the back of an ambulance, where I was confronted with two military ambulance crew, whom went on and on, insulting me, saying I was scum, that I deserved to just “off” myself, etc, refusing to let me out of the ambulance and into the Psych Ward of the hospital till I “acknowledged” what they were saying to me.

Flash forward to almost 2 years later, and I still suffer from depression, though now I am on antidepressants once again. I do however suffer from what I believe is PTSD, due to past events, and often feel like crying or screaming for no reason, get headaches often, have extreme shyness, and often think of my past difficult events with regret, wondering if I should of changed my actions, and mostly prefer to be left alone. I did speak with a Psych immediately after being discharged from the military, but found myself with little to say at the time (although to be honest, my problems seemed to of gotten much worse in the 2 years since then). I’ve yet to speak to a counselor or Psych, or friends, in the 2 years since then about my depression, for fear of being ridiculed (which, I have been from some family and friends, which has only made things worse for me). I’ve already taken a semester off from school, to take time off, a while back, but it seems every time I go back to school, my depression and PTSD seems to only get worse, and I am left wondering If I should seek hospitalization, for fear of possibly having suicidal thoughts at some point, or not being able to continue my studies in my school environment.

I am not sure what your precise question is so I will offer general advice based on the description of your situation.

Beginning in junior high and then into high school, you suffered from depression largely as a result of bullying, shyness, social isolation, anxiety and low self-esteem. You said that for a very short period of time you were placed on antidepressants. This meant that you had to have revealed your depression to your parents or a caregiver at some point and they probably took you to a doctor who then prescribed you medication. The medication, as you said, was unhelpful.

Then you began college and many of the same issues reemerged and seemed to get worse. Things were so unpleasant for you that you dropped out of college and joined the Air Force. Your experiences in the Air Force were not much better than college or high school and in many respects were worse due to two negative and psychologically damaging incidents. At this juncture, you again were treated with antidepressants, a treatment regimen that by your own admission did not help.

Currently, you’re back at college and struggling with the same issues that have followed you since junior high, except they are seemingly more severe and life-crippling.

What is missing from your treatment history is counseling. You have never addressed the real issues that have been plaguing you for years. You continually experience the same problems and each time they resurface you seek the same ineffective treatment of antidepressants. This needs to change.

Antidepressants do not seem to be working for you. This is not to say that antidepressants could not benefit you; they might benefit you but without counseling they will probably not be very effective. Taking medication alone is usually not an effective psychological treatment.

You mentioned that part of the reason you may have never sought counseling is your fear of being ridiculed. Maybe you feel shame for not being able to “fix” your own problems or perhaps you feel that the therapist will judge you. If you believe these things you’d be wrong. I can assure you that it is highly unlikely that a therapist would ridicule you for seeking treatment. Their job is to help individuals who are experiencing situations like yours, not to shame them for their decision to seek help.

There is nothing negative or shameful about receiving counseling. Counseling may help you gain the skills you need to finally combat your depression and other issues that have been crippling your life since junior high. It is possible that you were never taught by your caregivers how to effectively deal with stress or life’s problems. Instead of antidepressants for the problems you experienced in junior high it would have been useful for your caregivers to have offered you comfort, support, strategies or advice on how to help you solve your problems. Maybe if you had received this sort of help early on, the problems would not have followed you to college and beyond.

It is not too late to correct the issues that you have struggled with for years. Now is the time to seek treatment and not just antidepressants. Try counseling and don’t worry about what your friends or family think. Your life has been stifled for too long with the same issues that have only grown worse. Consider therapy and decide that it’s time to live without depression, fear, isolation and anxiety. Please consider writing back to let me know how therapy goes if you decide to take my advice. I wish you luck.

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Cheating

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP March 3rd, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

Recently, a few months ago, found out my dad was a cheat. It was shocking cause he’s such a religious man I never thought it could happen. But our family dynamics were already weird he moved when I was 3 so never really had a relationship anyway. It really hit my mum I guess as her parents had both died within the last year and she took it hard and i feel like she got quite sad. It was already tense that he didn’t want to go to the funeral, due to different religions. Then she found out about a month after her dad died that he was cheating. I was the one that discovered it by text anyway and I told her. Everything’s been a mess now and she’s changed so much. We used to be relatively close and in the first few months she was just always angry at me or crying because of him and since my brothers went to university it’s just been me and her. It feels like she’s so codependent on me and I can’t turn her away cause she’s my mum and that’s not me but it’s hard because I can barely deal with my own problems (depression). Now although it’s been a few months it just feels horrible all she’ll talk about is that other woman, whom she just follows around on social media and my dad. Everyone’s told her to just leave him but she won’t say that people told her it’ll affect us, but it really won’t it’d just be better really. She doesn’t think about what I want anymore just what she thinks or people tell her. She’s always on the phone to other people, got a massive extended family and it’s too the point where I’m just ignored and neglected, despite me making time for her. I feel like she doesn’t even love me anymore. Sometimes she’s say sorry so she knows she ignores me. It’s hard it’s my gcse year and this mess has just made my already bad mental health worse. I feel bad because life’s been hard for her since she’s essentially got with him, she got ill after pregnancy and poor financial decisions have moved her from the middle class to poor. I don’t want her, she’s 50, to be alone and sad. How will I ever have my own life leaving her alone? (From the UK)

I am so very sorry that you are, at 16, having to deal with all of this difficulty in your family. You are definitely in a difficult spot. This is a time when you should be being guided by your mother instead of having to be worried about her.

I’ll encourage you to talk to a counselor at your school. He or she will be able to help guide you in dealing with your mom and can maybe suggest psychological services she can obtain. You need help in dealing with her needs and yours—and your school is a good place to start.

You may also want to contact a behavioral health center near you. These are typically located in a local hospital or woman’s center. They are familiar with helping families and can help you and your mom get the help you need.

Wishing you patience and peace,
Dr. Dan

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Depressed or Normal Teen Issues?

by Kristina Randle, Ph.D., LCSW March 2nd, 2023
written by Kristina Randle, Ph.D., LCSW

I think I may be depressed. I really don’t know. I just need help! I think I may be depressed. I’m never really happy. I’m always bored. When i’m not home I can’t wait till i’m home soo I can get on my computer.. it just feels like i’m escaping everything. I never sleep at night. I mostly sleep the day away. I never feel good enough, skinny enough and pretty enough. I often find myself comparing myself to other girls. I seek attention from older men and I always feel like i’m not good enough. I often feel like my parents love my sister more, like there always giving her all the attention. I’m really shy and don’t have many friends. I have hurt myself before nothing major but like buirsing myself. I rather be alone then be with people. I’m really close to my mom(she’s like my best friend.) but I often think about my mom dying and that scares me a lot. Even if someone says the littest thing to me it hurts. If I get yelled at I will start to cry. Even if I do the stupiest little thing like say something stupid, I’ll feel embarssed and stupid by it.

I know I went on and on but I just need to know what’s wrong with me? Maybe this is normal? I don’t know. Btw I’m 14.

Depression may be a possibility but many of your concerns are common among individuals your age. Early adolescence can be a difficult time. There are many fears. Many will wonder if they are good enough, smart enough, funny enough, attractive enough etc., and will be very concerned about what others think of them. These fears and doubts are a very common experience. It is also common to worry about losing a parent or other that you love.

Adolescent girls in particular often compare themselves to other girls. If they do not feel “good enough” they may attempt to fill that void by engaging in unhealthy behavior. You mentioned that you seek attention from older men. There are complications to consider regarding relationships with older men. They may be interested in sex and feel that sex is a part of every relationship that they enter into. It is normal to want attention and love but it is important to be careful about from whom you seek it.

You also mentioned that you harm yourself. This is an unhealthy behavior. You described purposefully bruising yourself as “nothing major” but I would disagree. If an individual is intentionally harming themselves it is a concern. It is usually a sign of significant emotional suffering. Oftentimes individuals will attempt to physically harm themselves in an attempt to decrease their emotional suffering. That strategy never works. The relief it provides is temporary. It is an ineffective and maladaptive solution. It often leads to more self-harm and possibly permanent physical damage.

I would encourage you to speak to your mother about your concerns. She needs to know about what you are experiencing. She may be able to help you. You may want to ask her if she would be willing to take you to a therapist. A therapist can help you deal with the pain and trauma of adolescence. You may want to suggest that she go with you. Since you and she are close, then she may welcome the opportunity.

Psychology Today is a directory of mental health professionals in the United States. If you type in your zip code, you can search through local therapists’ profiles to see which one you may want to make an appointment with. Try to choose a therapist who specializes in treating adolescents.

Thank you for your question.

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No self-esteem following a betrayal

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP March 1st, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I am 21 years old, and lately I’ve been experienced a lot of anxiety. My childhood was a normal childhood, I am the oldest of four children, my parents are married, and both work and I grew up in a small town and had a really happy normal childhood. Since I was little (about 12) I lacked self confidence, but then I started gained it, and by the time I was 15 I was in a pretty good place in my life, I loved it, I had many friends a happy and great life, and that year I met my current boyfriend. After a year of being together, he cheated on me with another girl, that killed me he was the first person I had ever truly loved and he did that to me, he apologized and begged for me to take him back so I did; and we’ve been together since then. A year or so after that, he moved out of the country and we broke up, I was devastated, because I felt like after all the years spent with him nothing counted, and it was when this whole paranoia and lack of self confidence started. Not so long ago he asked me to get back together, I was really happy but then again my situation of low self-confidence and self-esteem got worse each day. Currently I feel like I have no control over my actions, I feel like in my past I was really outgoing and could make friends easily, now I can’t, I feel as if I am boring and I rethink a million times everything I want to say or do, which as a result brings having a difficult time meeting new people. I feel paranoid all the time thinking people are going to talk bad about me behind my back or will think I look bad or I’m fat or ugly, I feel as if I have lost all of my personality. I get really furious at myself almost everyday when I see pictures of other girls my same age or even younger than me that I know partying, traveling and having a great time, while I’m sitting at my house not enjoying my youth, because my paranoia of not being good enough won’t let me. These problems have affected my relationship with my boyfriend and my family. My boyfriend constantly tells me that I have changed, that I am not as fun and adventurous as I used to be, that I acted as if I had lost my personality, the one which he fell in love with, and I feel he is right, I also feel scared all the time that he will leave me any time and find a girl that is happier and more fun than me. Rewarding my family, I’m always moody I treat my brothers and sisters very bad, by getting easily irritated by them and I find myself screaming and yelling at them all the time, as if I had no patience with them and could not stand their site. Not only has my personal life has been going down the drain I have also been getting bad academic reports, in the past year I have failed 2 classes, and my grades have decreased incredibly. I mentioned the fact that my boyfriend cheated on me before, because I feel that in a way this has to do with everything that I am going through right now, after that happened my life started going down the drain and it hasn’t stopped. Every single aspect of my life was affected by the fact that the person I loved and trusted the most betrayed me, cheated on me, with a girl I even knew! I forgave him because he demonstrated he cared, and he showed me in so many ways he loves me and he was so extremely sorry. What makes me more mad it is not the fact that he cheated on me, but the fact that this girl with who cheated on me with had everything going for her, even though she is a horrible mean person she seems to have everything in a perfect way, perfect hair, perfect car, perfect body, perfect friends, perfect everything and I don’t. I feel like myself is in ruins, literally. Another thing that makes me so uncomfortable is my boyfriend’s family; because of my low self esteem and the fact that I am so different in every way from them, I feel as if they hate me; I’m paranoid about what they might think of me, when I’m with them I’m afraid to speak or say something, because of the fear of making a fool out of myself, so I come off as rude and shy, so I have no idea what to do. I feel so alone because I have no one to talk to, no one to express myself with, I have no friends, I have gotten FAT I have gained more than 10 pounds from eating so much (anxiety), my boyfriend lives in another country and currently reminds me of how much he’s noticed that I have changed, my academic has been awful, I am depressed, I cry every single night hoping my attitude will change. Please help me, I have tried to change but I feel lost, I feel as if something is missing, I am not satisfied with my life, I feel as if my best years are going by and I’m in my room crying and eating. Please help me I feel as if I have no control over my life, what do you think I should do?

I am glad you are taking care of yourself by reaching out to us here. Your self-esteem has taken a hit because you are too dependent on your boyfriend as a barometer for your own emotional wellbeing. This isn’t a very functional relationship, from what you are telling me, and I can understand why you would feel insecure and anxious. Your trust in him is shaky (at best). He is living in another country, and his criticism of your changes doesn’t help. It is time to reclaim yourself and become more self-reliant and resilient.

I am not suggesting you end the relationship, but I am asking you to put it in perspective. It sounds like you are drawn to his potential rather than his reality. Obviously you get something out of the relationship, but don’t confuse what you want him to be with who he is.

I would begin reclaiming your life and work on getting yourself back. Start a program of taking care of your body, your intellectual development and your emotional wellbeing. Your boyfriend cannot do these things for you. You have to take care of yourself. If you do this it is a win-win situation. If the relationship survives then you will be less needy and more capable and happier in it. If the relationship doesn’t survive you will be able to move on with confidence.

A therapist during this time is a good idea. If you don’t already have one you may want to begin and create some emotional support. The college you are going to will have a counselling center with a number of qualified therapists.

Wishing you patience and peace,
Dr. Dan

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Is It Possible to Continue Relationship After a Suicide Attempt?

by Dr. Marie Hartwell-Walker February 27th, 2023
written by Dr. Marie Hartwell-Walker

From a woman in the U.S.: I met the most loving guy 6 months ago through a dating app. He broke up with me a week ago through text saying he “couldn’t do this anymore” and “wanted it over” when he was having a depressed episode, a week after his family had called the psych ward because he was suicidal.

That week I had witnessed him hurt himself and he was suicidal. After he was handcuffed and taken in, he convinced them he wouldn’t hurt himself and the next day he sought a psych eval that showed major depression and PTSD, but he needed further evaluation to rule out bipolar disorder due to familial history.  He was very angry and aggravated that he couldn’t get help, argumentative at times and would blame me for fighting.

Lately, in the past 2 months, he had become distant and wanted to be alone, avoiding spending time with me. He was usually busy working or wanted to spend time with friends. In the beginning, he was very interested and by the 2nd week we had 7 dates and he met my family. He had been married twice before but wanted to have a committed, exclusive relationship. He made me feel loved before I told him on the 3rd week and then he told me the next week after.

We each have a son and would spend time together with the boys. My friends and family were very happy for us and approved. Earlier on I knew about his self-harm because he told me and I could see scars on his face. Communication was difficult at times since he has a hearing disability and during the 2nd month, he thought I broke up with him and we got back together 12 hours later. I had witnessed some PTSD episodes that he attributed to childhood abuse but never actually saw the self-harm till 2 weeks ago. He had mentioned that he felt pressured at times and that I was insecure.

We both love each other and wanted to be in the relationship 3 weeks ago. I am very hurt with how he ended it but confused as we are still friends on Facebook and he hasn’t deleted our pictures and posts. I still have belongings at his place and he hasn’t asked me to get them. I have given him space and only reached out twice to check on him and let him know that I am here for him. I really care about him and loved him. Do we have a chance to get back together?

There’s always “a chance” but in this case it’s really up to him. He has long-standing issues that need to be addressed before he can maintain a healthy relationship with anyone. Two of his marriages have fallen apart — probably due to inadequate treatment.

I don’t doubt that he has feelings for you. I do doubt that he can sustain a loving relationship when he is so distressed himself.

You’ve only known this man for 6 months and things already were shaky by month 2, and again at month 5. I’m sure he has many fine qualities or you wouldn’t be interested in him. But for your own mental health, I do think you should take a big step back. Block the FB. Get your stuff or abandon it. As lovely as he may be, he has too much personal work to do to be a consistent and loving partner for you at this time. To try to make a solid relationship with him now will be disappointing and frustrating.

I wish you well.
Dr. Marie

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Sadness and Anger

by Kristina Randle, Ph.D., LCSW February 25th, 2023
written by Kristina Randle, Ph.D., LCSW

For the last 2 years, I’ve been having trouble dealing with my own issues and sadness. I haven’t been going to school more then 2 days a week and I feel like I’m losing everything. I usually spend everyday trying to think of a way to find drugs and alcohol to make me feel happier, but even when I am high I’m very irritable and angry at everyone. I let my anger out by punching walls, and I even try to fight my own friends. I feel like I can’t make anybody happy, including myself. All my friends and family want to give up on me, and I want to tell my mom how I’m feeling but I don’t want to cause any more problems for her. I’ve already hurt her so bad by doing drugs and trying to commit suicide. I have no idea what I should do about my problems, I don’t even feel like I can write them all on this because there are so many thoughts in my head and I can’t put them all together. I have bad dreams almost every night, and I wake up frequently during the night. I sometimes get hot flashes and feel like I’m hyperventilating. The reason I think I feel like this is because I have been raped and molested 3 times since I was 13. Also, I’ve experienced a lot of traumatizing things in the last year, such as people getting beat up almost to death, party fights, and I’m always so scared to get raped again. All I can think to do is try to learn how to become stronger so I can protect myself from things like this. I don’t know what’s wrong with me, and I could really use help.

You’re not in a very good situation. You’re depressed, only attending school two days a week and using drugs and alcohol to make yourself feel better. Even when you’re high on drugs and alcohol you’re still feeling irritable and angry. This leads you to start fights with family and friends. This further alienates those who are attempting to help you. At this point you may be your own worst enemy.

You’ve experienced several traumatizing incidents in which you were almost beaten to death, raped and molested. These horrific incidents are likely, and understandably, the source of your sadness and anger.

You can’t go on like this. Something needs to change. You want to tell your mother how you’re feeling but you don’t want to “cause any more problems for her.” You say you’ve already hurt her by doing drugs and attempting suicide. Maybe your actions upset her. It has to be upsetting to learn that your child attempted to end their life. But by not telling your mother you’re prolonging your suffering and by extension hers as well.

Now is the time to tell her the truth. You need to do this because she may be able to help you find an appropriate treatment. Is your mother aware of the multiple traumas you’ve endured? If not you might want to consider telling her. If you are not comfortable with this then it’s imperative that you still find a way to make it clear that you want help. You’ve suffered long enough. So have your family and friends. The outcome of this situation will be infinitely worse if you decide not to tell your mother, continue using drugs and alcohol and fighting with friends and family, or attempt suicide again.

Maybe you’re afraid to ask for help. I can understand this. Asking for help is not easy. What’s even worse, however, is the idea of having to live a degraded life when there is help available. You’ve experienced at least three traumas and have yet to begin healing from these incidents. Studies show that discussing the trauma is a vital part of the healing process. You have yet to begin this process and it’s time that you do.

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I’ve had a 15 year history of depression and my family of origin just doesn’t get it.

by Holly Counts, Psy.D. February 24th, 2023
written by Holly Counts, Psy.D.

Q: I’ve been struggling with depression since I was about 23 yrs. old. I went to therapy for about 12 years and have been on various meds. They don’t seem to be helping much right now. I’m close to my mother and 2 older sisters, yet harbor a lot of resentment toward them for not even trying to understand my depression or even talk with me about it. They dismiss it as just something I need to get over (“everybody gets sad sometimes”).

I recently wrote them a letter trying to explain my inner world and what it is like to be me. It was so hard to write and took so much courage to give it to them. I never got a response from my sisters; they’ll call sometimes but never ask about how I’m doing. They ignore it. My mom’s response was to email me some links to websites about how to overcome depression. I’ve since talked with her by phone, but she just said I should read a book for overcoming depression. I don’t know what I expected for a response, but I’m just heartbroken & angry. I just can’t bring myself to initiate a sit down family talk. I’ve tried it; they stay behind their protective walls. What can I do about my need for emotional support from my family?

I think trying to have a sit down talk is a great idea but if you don’t feel brave enough to do it on your own, why not enlist the help of your therapist? If you aren’t currently in therapy maybe it’s time to find someone who does family therapy and treats depression to help you out on this, even if it’s just a short-term thing.

The other thing to understand is that they aren’t experts on this, you are. You are the one who knows how you feel and what you have already done to try to help yourself. I’m sure in the process you have educated yourself on depression and its treatments. Maybe if you take the approach that you can help educate them and teach them how best to support you, you might not feel so disappointed. Come from a place of empowerment and let them know what you need and what you find helpful.

Talking to your family about your depression can be difficult, but it’s an important step in getting the support and understanding you need. Here are four different ways to get your family to acknowledge your depression and talk to them about it openly and without judgment:

  1. Educate them about depression: Many people don’t understand what depression is or how it affects people. Sharing information about the symptoms, causes, and treatment options for depression can help your family better understand what you’re going through and how they can support you.
  2. Express your feelings: Let your family know how you’re feeling and how depression is impacting your life. Be honest and direct about your experiences, and try to communicate your emotions without blaming or accusing your family members.
  3. Ask for support: Let your family know that you need their support and ask for specific ways they can help you. For example, you might ask them to check in with you regularly, or to help you find a mental health professional to talk to.
  4. Be patient and persistent: Remember that it may take time for your family to fully understand and accept your depression. Be patient and persistent in your efforts to communicate with them, and continue to share your experiences and feelings in a non-judgmental way. Encourage them to seek education and resources on depression, and let them know that you appreciate their support.

Last but not least, sometimes when we aren’t getting what we need from our loved ones, we just have to accept them as they are (just like you want them to do) and find the support elsewhere. Find the local NAMI or depression support group, lean on your friends, join online groups, start your own support group, etc. Reach out and find what you need, even if it’s not coming from those closest to you. Once you do this, maybe it will free you up to feel close to your family again, even if they don’t seem to understand what your life is really like. Good luck and hang in there.

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Confused with Depression

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP February 24th, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I’m 16 and I’m not really sure what to do with myself. The past few months have been really hard; my “depression” has gotten really bad. (I put depression in quotes because I have not been diagnosed by any doctor. I’m assuming that this is what I’m going through after having done research online, and from my mom (who has depression) coming to this conclusion after I told her how I feel.) I have been really stressed with school and the craziness of my schedule lately, but it’s all stuff that I used to be able to deal with. It’s very often been difficult just to get through the day. I want nothing more than to hide from the world, and I cry all the time. I get extraordinarily sad and upset for no apparent reason, for hours or days at a time. I feel like I’m constantly on the edge of breaking down, and little things that shouldn’t bother me are liable to set me over the edge. I just can’t deal with anything it seems.

 

I used to be that girl who was always happy and always smiling, and even when this started, I was able to pretend I was, and became very good at hiding my true feelings. But now, many days I can’t even keep up this pretend face, and it’s all I can do to keep myself from breaking down right there in public. I feel like I’m just being weak or pathetic because I cannot think of any reason for me to have depression, but whatever it is is really wearing me down, and making me very unproductive and unsocial. Most of the small amount of energy I have now is spent keeping myself from curling up in a ball and crying at school, and I have a lot of trouble concentrating and keeping up my grades.

 

I’m very introverted, and have a lot of difficulty explaining and even admitting this to anyone. Almost none of my friends or family know I’m having issues. Even writing this is extremely hard, but I’m at the point where I seriously think I need help. I have self-harmed a few times, and thoughts of death are a norm in my everyday life. I don’t know what to do, or how to get help. Where do I start?

You did the right thing by talking to your mom and writing us here. There are many possibilities that may be causing your symptoms and I think the first thing is to have your mom make an appointment with your physician so you can have a physical. The physician can help sort through whether this is psychological or physical and make comments and recommendations from there.

You will also want to talk to your high school’s guidance counselor to see what he or she thinks. Talking to others who can help is the best way to start feeling better.

If you are experiencing thoughts of death and are unsure if you are depressed, it’s important to seek professional help as soon as possible. Here are four ways you can get help and find out if you have depression:

  1. Talk to your primary care physician: Your primary care physician can evaluate your physical health and refer you to a mental health professional who can help you determine if you have depression.
  2. Contact a mental health professional: Mental health professionals, such as psychologists, psychiatrists, and licensed clinical social workers, can help diagnose and treat depression. You can contact a mental health professional directly or get a referral from your primary care physician.
  3. Reach out to a crisis helpline: If you’re feeling overwhelmed or in crisis, you can reach out to a crisis helpline. They can provide you with support, resources, and information on how to get help. The National Suicide Prevention Lifeline is a crisis helpline that you can call at 1-800-273-TALK (1-800-273-8255).
  4. Take an online screening: Online screening tools can help you identify whether you may have depression or other mental health conditions. These tools are not a substitute for a professional diagnosis, but they can help you determine if you should seek further evaluation. The National Alliance on Mental Illness (NAMI) offers a free online screening tool on their website.

 

Wishing you patience and peace,
Dr. Dan

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Boyfriend Can’t Get Over My Past Relationship

by Dr. Marie Hartwell-Walker February 22nd, 2023
written by Dr. Marie Hartwell-Walker

I’ve currently been dating a man for 8 months. He’s 45, never been married and has no kids. I’m 1 month away from a finalized divorce and share 2 little boys with my ex. My married relationship has been over for years and I’ve dated a bit before I got into my current relationship.

My current relationship has been fast, but fantastic. We laugh a lot together, we can communicate really well, have been able to very successfully work through and resolve conflict, our sexlife is great, we share the same goals for life and we continue to share and build a trust and a bond which we both haven’t felt with anyone else.

The problem is, he feels like he’s living in the shadow of my ex and feels like he’ll always be standing on the outside looking in. THe only thing we fight about is my ex. I have not much contact with my ex except when it involves my kids. There has been a bit of drama going through the divorce but not much. My boyfriend has been very supportive but obsesses about my past life. I want to reassure him and make him feel like he is number 1 in my life, because he is. He just can’t get over me having an ex and says that will bother him always.

My boyfriend suffers from extreme depression and I know that the stress from my impending divorce must be brutal for him to deal with at times. But we love each other and we have put 8 months into this relationship, which in my eyes and I believe in his, a relationship that holds so much promise. What should I do?

What you should do is slow down. Eight months is a very short time to make a lifetime decision. You may think your marriage was over long ago but you haven’t been divorced. Please take the time to make sense of your prior relationship and what went wrong. You’ll be sharing parenting even if you aren’t sharing a life together so it’s important to gain perspective and, hopefully, a positive working relationship with your ex.

Your boyfriend seems to want you to have no past. That’s unrealistic and unfair. To be with you is to be with someone who has had a life that was different from his own. He’s right that he will always be on the outside to some extent. That’s not the problem. The problem is that he can’t accept that fact as your reality. You have two little boys who ideally should have a relationship with their father. They can also have a relationship with a stepdad, of course. But it’s unfair of your boyfriend to ask you and the boys to act as if the other man isn’t still an important person in the life of your family.

I very much hope your boyfriend is in active treatment for his depression. He needs to be doing the hard work involved in learning to manage a mental illness, not asking you to change your history to make it easier for him.

I wish you well.
Dr. Marie

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Do I Have Depression or Was I Just Depressed?

by Kristina Randle, Ph.D., LCSW February 21st, 2023
written by Kristina Randle, Ph.D., LCSW

Hi! I am a 17 year old male and recently I was in a very dark place. I want to be in the military and/or a police officer when I meet the age requirement.I can not speak to a professional because a diagnosis would almost certanly end my prospect of being these things.

When I was younger, from pretty much kindergarten to seventh grade, I was severely bullied both physically and verbally by almost my entire class. This left me with what I believe was severe depression for about five years. During this period I thought about suicide almost daily and made plans once, but never attempted to follow through. I was not exercising and my health deteriorated quickly. I felt much better after starting to lift over a year ago. In late December I began to see my symptoms come back. First I lost my appetite, then my sleep dropped down to 4hrs a night. Pretty quickly after that I started feeling down and from there I plummeted in to a severely depressed state where I felt nothing for anyone and wanted to die. During this state I had recurring thoughts of suicide and three instances where I held a knife to my throat but never followed through and used it. I lost interest in all of my former hobbies including police explorers and my grades rapidly declined. One month ago I started cutting myself and two weeks ago I stopped the self harm. I cut myself a total of 117 times because I convinced myself I was a bad person and I deserved it. I have always done the right thing in my life. I reached out to the officers in charge of my explorer post to let them know what was happening. Roughly two weeks ago, I started seeing major improvement when one night I went in to a very depressed state and cut myself again. Since that night, my symptoms have almost completely vanished and whenever I do feel depressed or have thoughts of self-harm or suicide they are quickly dispelled. My life has been back to the way it was recently and I have been much happier. In your opinion, is it likely that I have major depression or was I just depressed? I want to plan for a (possible) future remission in my symptoms. Anything helps, thank you!

From the history that you have described, I would highly recommend an evaluation by a mental health professional. In most Western countries, medical histories are highly guarded and not available to employers. In Western countries, therapy is available within the military and within law enforcement.

Though some form of psychological testing is often utilized, at some point in the application process, for the military and for law enforcement, mental health records are typically not available. But let’s say that they were and let’s say that by seeking mental health treatment you would be forgoing the opportunity to become a police officer or a military officer. Do you really believe that you would be unhappy in every other occupation and more importantly, do you think any chosen occupation is more important than life itself?

Surely, you do not believe that the pleasure and meaning of life is derived solely from your occupation. If that were the case, then there would be no depressed police officers, military officers, surgeons, dentists, physicists, etc. It is good to find pleasure and meaning in your occupation and I don’t mean to underestimate that but for most people their job is a way to earn a living and they will choose the one that they dislike the least and pays the same.

I apologize for the evil and ignorance that propelled the bullies in your childhood. My apology appears here in black and white and is easily understood but Gods sorrow an apology, is not as apparent. There is goodness in this world and there are good people in this world and they understand and condemn the evil and torture that you experienced as a child. A deeper understanding of goodness or God, will also reveal his condemnation of the evil that these underdeveloped human beings heaped upon you.

The most important thing in your life and your goal should not be to become a police officer or a military officer but to remove and repair the damage done to you in the past. Ask yourself these questions. Would I be a different person today if I had not been bullied as a child? If, instead of bullying, I had received love and nurturing, would I be a different person today?

Good counseling can make things right again. Find a counselor you like as a person and give them the time they need to help you. Good luck.

Dr. Kristina Randle

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Diagnosed with Anxiety and Depression at 13 But Don’t Feel Like I Fit the Criteria for Depression

by Kristina Randle, Ph.D., LCSW February 16th, 2023
written by Kristina Randle, Ph.D., LCSW

I have many other symptoms listed below:

Overthinking/analysing: to a very unhealthy degree, for example if I’ve messaged a friend and they haven’t responded I may check to see when they were last online or if they have posted anything then I will get angry or upset if they’ve not replied to me and have actually begun to have outbursts of this sort to friends. I will notice if certain people have stopped liking my photos and obsess over what I’ve done to offend them or them to dislike me all of a sudden, or the new narrative in my head is that their jealous of me which is why they don’t like me.

I care a lot about what others think of me. Always think people don’t like me and need constant reassurance. Desperate to be loved and liked and Im beginning to think it shows.

Jealousy: I get very jealous of people’s relationships with their other friends especially. Wonder why I’m no ones number 1 or go to person or why I feel generally left out always or unwanted. I can also get jealous of people’s social status, especially if I have met them and they’ve just not clicked with me for whatever reason but wonder why everyone else loves them so much as they weren’t that great and nice when I met them. I then get more annoyed seeing the interactions between these people.

There is also a voice in my head that sometimes decides everyone is jealous of me and that’s why I’m not so close with anyone. But I find hard to admit because outerly I feel extremely self conscious about the way I look and the way people think of me and perceive me. I almost strive to be absolutely perfect (whatever my idea of that is) 100% of the time and sometimes Im telling myself I’m too good for these people that’s why we never became close.

Irritability/anger: generally I try and be a very calm person, but feel sometimes I lash out in anger (never ever violently, I have only ever self harmed through anger. I could not imagine purposely hurting another human being, ever) I can have mood swings where I just could literally be annoyed by the way someone asked a question if I thought it sounded dumb. The closer the person the more likely I am to make this known.

Mood swings: I can go from feeling amazing to wanting to cry. This usually seems out of the blue but am slowly realising it is a result of my overthinking usually. Like if a friend didn’t respond to a part of the message that I felt was important I would get severely upset later and put it down to them not caring enough to even read it properly.

However, mood swings do completely come out of the blue. I wake up feeling like different people each day, some days feel the positive bubble and try hard and carry on some days I wake up and decide I just feel so outright awful before I’ve even got up. Have spend days in bed crying and I couldn’t even tell you what over now, as clearly wasn’t that important to be having such an impact on my life.

Anxiety: very much linked with the uncontrollable overthinking, worrying far too much about the future of if something bad is going to happen. Always going to worst case scenario in my head. Unable to relax and watch television sit still concentrate on something. Flitter from one thing to another constantly.

Change: get extremely upset if plans change. Minor or major. I’ve got annoyed with my Nan because she said in the supermarket she wanted hot dogs but then when we was home said she didn’t. I KNOW this is not normal!! I don’t consciously but feel I must subconsciously plan things to such an extent in my head I get annoyed or upset when something so minor changes. This is as worst as dropping out of holidays with friends because the plans have changed, getting really upset or annoyed with my mates if we agreed to have dinner together for example and they ate before they arrived.

I often consider ending my life as I feel like I’m in a constant battle to be happy and I know never will be if I continue to do all of the above but feel extremely out of control with my thoughts and how I look at not only myself but others too. I have never been “good”for more than 2 days for as long as I can remember. My first “attempt”to take my life If you can call it that I was 13 and took some tablets, nowhere near enough to do anything but put me to sleep for ages. When I told my mum what I had done she didn’t believe me. Many shoddy attempts to take my life after this and some very serious self harm which has scarred me for life.

I do not blame him at all because it was my choice and i have done it for many reasons unrelated to him, but I have noticed since breaking off from the ex boyfriend that I haven’t self harmed at all as yet. I’m not sure if I did it for attention from him or his mental abuse drove me to frustration, I just don’t know.

I have had A LOT of abusive relationships in my life. My Nan brought me up until around age 8 and I am closest to her. My mother was physically and mental abusive from age 10-16 ( this begun when she left my stepdad and stopped me from seeing him, my 2 sisters she had with my stepdad continued to see both parents – never knew my real dad)

When I did meet my dad at 14 he spent the last 10 years in and out of prison and on the run, Was physically violent with me once. Very mentally abusive man also.

boyfriends 13-16, 16-24 both abusive mentally and physically.

It’s impossible to diagnose you over the internet. I would need to interview you in person and collect a great deal of information about your life, personal history, and so forth. If you don’t agree with your depression diagnosis, it might be wise to seek a second opinion.

Alternatively, diagnosis is not an exact science. Getting a different diagnosis might not helpful in the grand scheme of things. A better focus might be finding good treatment. I would encourage you to seek psychotherapy and to find a therapist with whom you trust, with whom you feel comfortable, and has a track record of successful treatment. Specifically, you might benefit from cognitive behavioral therapy (CBT). CBT is an effective treatment for mood problems and illogical thinking.

You described a number of illogical thinking errors that are self-imposed and are causing you trouble. For instance, your belief that your friends should be responding to all of your posts, in a certain amount of time, is unreasonable. Your unreasonable expectations are causing you to feel distress. If you didn’t have unreasonable expectations, you would suffer less or perhaps not at all.

One good thing is that you recognize that your responses are unhealthy but it doesn’t necessarily stop your illogical thoughts. That’s understandable, especially if you have yet to try psychotherapy. The good news is that these skills can be learned.

The idea that your friends are jealous of you may be the story you tell yourself so that you don’t feel bad about their non-responses. At some point, you came to believe that if people don’t respond to you, in a certain amount of time, and in the manner that you want, that must mean something negative about you. Where did you get that idea from and why do you have such high expectations of others?

You believe that other people are jealous of you and at the same time, care so much about what others think of you. If you think about it logically, if people are jealous of you, wouldn’t you theoretically be better than them and thus, why care about what they think? People worry about what other people think of them when they don’t feel good about themselves. If you were more confident, the opinions of others would matter much less to you. It could be that you don’t feel good about yourself and that’s why you care so much about the opinions of others.

Mood swings are common with mood disorders. If you do have depression, your mood swings could be explained by your depression. In addition, you suffer with anxiety and change. Your anxiety leads to a focus on negativity which also likely contributes to your moodiness. It would be difficult to be in a good mood when predicting negative outcomes. The inability to tolerate change is another sign of rigid or illogical thinking.

These problems are all correctable with treatment. Hopefully, you will consider it. The fact that you recognize your problems and were able to describe them in such detail are both encouraging signs. It means that you have good insight and are open to correcting these cognitive errors. With the right treatment, your prognosis seems good.

During the pandemic, it can be difficult to find an in-person therapist. In that case, you might try telehealth or telephone therapy. Both are good options while awaiting an end to the pandemic. Hopefully, that will be sooner rather than later. Good luck with your efforts. Please take care.

Dr. Kristina Randle

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I’m Living in a Prison

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP February 14th, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

From Canada: I’ve always been the smartest kid out of all in my family and that’s why everyone expects too much from me. My mom and dad love me way too much and so do every other relative of mine.

I started smoking weed because I had anxiety and honestly it really helped but then I got caught. My parents yelled at me and hit me and I deserved it because I know that even if weed helped me, it’s against my religion and I shouldn’t have done it. But now they’re treating me like I’m way too special. I don’t want this. I don’t want all this love. They don’t trust me so they won’t let me leave, or even lock the washroom. Everyday my mom makes me promise that I won’t touch weed ever again and I promise her while I’m thinking of a way to run away from here. It breaks my heart to break her heart. I don’t have any friends because I can’t hangout with them. I don’t even have any social media or phone. I want to runaway and get kidnapped or something so I could never see these people ever again without it being a choice. The only reason I haven’t killed myself yet is because I don’t want my mom to die. I know that she wills if anything ever happened to me. She is a major heart and mental patient. It would kill a lot of people including my parents and sister, my aunts and uncles, and my grandfather. Everyone expects too much from me. 80% marks are average and I’m cool with that. But I hate it when people say that I will become something big because I’ve always just wanted to be a singer but I’m not allowed to sing or listen to music. I’m good at everything. I’m perfect at everything: courses, art, poetry, sports, health, everything. I like being good at everything because I’m a perfectionist and when I can’t do something–even if it’s something stupid like hitting a bowl.

I don’t even know what I want. Maybe ESCAPE, FRIENDS, FREEDOM. Why are these things so hard to get?
People are always mean to me. Some people at school call me a whore even though I’m a virgin. Sometimes I like to mess up everything. Sometimes I feel like someone is hammering a nail in my head, literally.

I’m not certain there was a question in here, but maybe the idea of how to get out of a prison you’ve created is implied. It sounds like it is difficult to take in emotional support from the people around you, and that you gravitate to the position of an outlier. Instead of pointing at everything you think is limiting you and holding you back (being too loved and supported by your family and that you are multi-talented) maybe it is time to figure out what you are good at, what you want to have happen in your life, and what you’ll need to get there. Instead of focusing on what’s wrong, perhaps it is time to look at what is strong and possible in you. Here is a well-known survey on character strengths. It’s a place to start.

Wishing you patience and peace,
Dr. Dan

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How to Solve My Problems

by Kristina Randle, Ph.D., LCSW February 13th, 2023
written by Kristina Randle, Ph.D., LCSW

So I can kinda say that my childhood was ok but tough at moments. My father is a lazy alcoholic and he was emotionally absent, my mother loved me a lot but her sharp criticism destroyed my self esteem and the fact that she didn’t care about me very deeply, but only on the surface. Also I grew up poor, so all the things normally kids would have I didn’t have those. However despite all of this, I was happy as a child. It wasn’t until later when I started comparing myself with others that I became depressed. I feel that because of what my life has been like (alcoholic father, growing up poor) it has affected my self esteem a lot and I even have depression. I used to be very ambitious, and even though I’m an A student I don’t feel confident enough to pursue a successful career. Right now the only way that I think would make my life better is to move out of my parents home and start therapy. But that is what gives me great fears and anxiety, that I don’t manage to move out (in my country it is difficult to live alone). In fact people ask me why I don’t go to college, but I only want my own normal life. I feel wounded, sad and my parents are never there to help me with my feelings, they don’t understand me. I love my mother but my heart is full of anger toward her to tell her this. Also I’m bisexual, so I’ve had to keep this a secret for a long time, and I still do. That kinda made me lead a double life where I don’t even talk to my parents anymore. So my question is, should I pursue my dream to move out abroad while I’m 18 or should I go to college and resolve my problems here? (which is impossible).

For many years, you were happy and did well in school, in spite of your parents. Developmentally, it is necessary for all individuals to become independent. That means independent of their parents. Essentially it means becoming your own person. You are not an extension of your parents and thus their behavior should have no bearing on your happiness. Understandably, that is easier said than done.

The fact that you were happy and maintained good grades, despite their problems, should give you some confidence. It is evidence of your resiliency. Generally, teenagers have underdeveloped self-esteem. Since self-esteem is developed through life achievements, teenagers are too young to have achieved many successes. They simply haven’t lived long enough. If you were to attend college (should you decide to go) and you continued to succeed, your self-esteem should improve. The more you achieve in life, the more self-confident you will feel.

You asked about counseling. I think that is a very wise idea. Many young people enter counseling because of problematic relationships with their parents. It is a common reason for young people having entered counseling.

Counseling will help you to live independently and to develop a healthy sense of self-esteem. It is also the ideal place to explore how you should proceed with your life. Good luck and please take care.

Dr. Kristina Randle

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My Mom Committed Suicide When I Was 7 or 8

by Diane Walcutt, Ph.D. February 12th, 2023
written by Diane Walcutt, Ph.D.

Q: It was during the summer between 3rd and 4th grade, i think i was 7-8ish, and my mom committed suicide days or the day before my birthday. I actually don’t remember much. I saw a therapist briefly, she was terrible, grumpy even.  Only went to a few sessions, got nothing out of it, at least that i remember. Now, i have major issues connecting with my family, friends, and much more, girlfriends. Opening up is near impossible, even if i really want to. ALL holidays and most major social events, from the super bowl to saint patricks day to christmas, are automatic lowpoints, with the only traumatizing event being near my birthday. I’m constantly worried i’m missing out on my own life because i seem to miss out on everything worth going to. I cling to friends who have done nothing but damage my life, and push away the ones who might actually help, and especially any potential girlfriends get shown the most aggressive detachment. What little sex i have had, i physically detach from, almost as if i’m viewing from 3rd person.  Since highschool i’ve been attending college, i moved 9 hours away to live with an uncle and aunt, rebuilt my life, ran it into the ground, rebuilt again, freaked out and medically withdrew from college to move again 45minutes from parents, rebuilt my life again, ran it into ground again, moved back home because i drove myself into debt and my roommate was an opiate addict. Now i’m sitting in debt, depressed on a regular basis because i have no friends here and i don’t have enough money to visit them, and i have no money to even attempt trying to make new friends here because everything costs money. My dad has always been closed off to boot.

I’ve never blaimed any of my actions on my moms death, but all on me (not her death though). I figure if i can figure out whats wrong and actively attempt to fix it, i won’t repeat mistakes.  But i do keep repeating mistakes and have constant issues opening up to people despite trying to, and i keep missing out because of it. Am i supposed to be having these issues because of my mom suicide? Is it supposed to be this hard to fix them? I keep chalking things up to “learning the hard way,” but at this point, thats the first 20years of my life, and i’m not sure how much more i can sacrifice before i truely lose any hope of being happy.

Suicide of a parent is a terrible thing from which to recover, and if we don’t get help, it will keep sabotaging us until we find a therapist who can allow us to heal. Whether or not you blame yourself isn’t the full issue, but it seems that you have become pretty self-destructive. I have never met you, but I suspect that your self-destructive behaviors are rooted in anger, anger at your mother for abandoning you, anger that you couldn’t have prevented it, and anger that nobody stepped forward to help.

The thing I know for sure about grief — if you don’t confront it head-on and get therapy, it will wait until you do. That is to say, it will fester and erode your self confidence, your relationships and your life until you get into treatment with a professional who specializes in your problem. Children of tragedy such as yours often go on to become depressed, sometimes for life. You should consult a psychiatrist for medications as well. Anger is considered a “secondary” emotion, that is, the primary issue is your woundedness and pain. 

You can find a therapist who specializes in recovering from the suicide of a loved one at Psychology Today. There you can find one who either takes your insurance or offers a sliding scale for treatment. But, you cannot do this on your own. You don’t want to be describing this same issue 20 years from now, so please find a professional in your area.

Kindest Regards,

Dr. Diana Walcutt

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I Can’t Tell What Is Wrong with Me

by Kristina Randle, Ph.D., LCSW February 12th, 2023
written by Kristina Randle, Ph.D., LCSW

I’m slowly coming to the realization that there is a greater possibility that I have some mental issues. Most of the time I feel numb – kind of like I’m outside of my own body watching myself do things. This happens a lot when I’m nervous (in any kind of social situation). I’m unhappy and I hate that because I don’t have anything to be unhappy about. I live a blessed life thank God. For that I am eternally grateful, I really am. My life hasn’t even been that hard – the hardest thing I’ve had to go through was just a big move and my crush (,his family) and my own family making fun of me. Its pathetic – extremely pathetic, I’m aware of that. If I could tell you what’s wrong with me I would, believe me, but even I don’t know that. There’s just this extremely unsettling feeling in the pit of my stomach that I just can’t shake. Not to mention this completely hopeless attitude to life that I can’t change. This looming sense that nothing’s going to work out.

My only goals are to get back home to Canada and to someday get a cat. However, I’m starting to back down from even those. I’m scared to go back home after all these years because obviously, things wont be the same. Its already been so long that I now feel like a foreigner to my country. Both of them actually (Canada and Sudan). I’m rethinking getting a cat because – like most things – cats hate me. I’m so hopeless, lonely and lost it hurts. It actually physically hurts. It’s been 3 years. 3 years of no ambition, of no hope. Honestly if it weren’t for my religion, there’s a large chance I would’ve ended it earlier on. I’m trying to be patient, I feel stupid, embarrassed and stuck up for feeling the way I feel and I just want to get to the bottom of this. Is this anything serious or am I just over exaggerating things?

To answer your question directly, I don’t think you are exaggerating. Your concern about exaggeration might be tied to your belief that it’s “stupid” or “embarrassing” to admit that you have problems. You should never feel “stupid” or “embarrassed” about having problems. Problems are a part of life. It’s important to refrain from inaccurate self-criticism (i.e. calling yourself “stupid”) because thinking affects behavior. If you believe negative things about yourself, then you might falsely conclude that you’re not worthy of help and thus not seek it. You are worthy and deserving of a happy, satisfying life.

The key to psychological health is having good critical thinking skills. These skills are not innate or instinctual. They are learned skills that can be taught in counseling.

I can’t provide a diagnosis over the internet but many of your symptoms might be consistent with depression and anxiety. People with depression often feel hopeless, have an inability to feel pleasure and lack energy. The thought of having to get out of bed can feel overwhelming, both emotionally and physically.

Feeling anxious in social situations might be indicative of an anxiety disorder. It’s common to feel slightly nervous in social situations, but a disorder might be present if social situations cause overwhelming distress and interfere with various aspects of your life.

The good news is that depression and anxiety are highly treatable disorders. Most people gain relief with a combination of medication and counseling. You should meet with a mental health professional who will evaluate your symptoms and determine what might be wrong. Treatment could provide you with a great deal of relief. Please take care.

Dr. Kristina Randle

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