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I am completely falling apart. I am overwhelmed with guilt because many of my problems are self-induced. I feel I am completely incapable of making any correct decisions and I only make things worse.

I choose a college based on their acceptance rate into law school, neglecting the financial cost under the assumption I would become a lawyer and wouldn’t have to worry about the stress of student loans. I made the poor decision to defer law school for a year to work at a non-profit attempting to save the world, which only served to put me in severe debt. My student loans got deferred and then defaulted as a result of my low paying job and negligence. I met someone at 23 who I thought I would spend the rest of my life. Consequently I gave up graduate school, took an even further pay cut to so I could move with him to another city. After being together for 3 years, I found out he was in love with an old flame from college and had decided that I was too much of a burden for him.

This April my little sister took her own life, the night before she was coming to visit me. She had so many things going for her. I can’t even begin to describe the guilt I feel associated with her passing. All of my poor decisions, asking her to come visit me, being self-absorbed in my own problems and not being as great of a sister to her as she was to me.

I work at an insurance company reviewing death claims. I spent 8 hours every day looking at autopsy reports and death certificates. Because we are paying out large amounts of money our work is critically reviewed and scrutinized. I feel like a complete failure in my job. I feel sick walking into work every morning because I am terrified to make a mistake or to face a mistake I made before. I just can’t get anything right.

I’ve made poor relationship decisions. I can’t perform in an entry level job. I am overwhelmed with debt. And I miss my sister. Is there something wrong with me that I am just hardwired to mess everything up? Maybe I’m just self-destructive? Is there a mental disorder that is associated with my incompetence or am I just a failure?

First and foremost, I am sorry for the loss of your sister. It is difficult to lose a family member to suicide, especially someone with whom you were so close. It is important also that you know that your sister’s suicide is not your fault. You may feel guilty but that guilt is misplaced.

When someone is suicidal, it is a sign that they are severely suffering and likely have a serious mental illness. Most mental health professionals struggle immensely with how to appropriately deal with suicidal clients. For the layperson, knowing how to appropriately deal with a suicidal individual, even when it is a family member, is nearly impossible. Love cannot cure mental illness nor can it prevent someone from committing suicide. Family members simply do not have the education and training that is necessary to deal with the complex problem of suicide.

With regard to poor decision-making, the fact that you are aware of your problematic decisions is very insightful. Many people make poor decisions and remain completely oblivious to those mistakes.

You can’t change history but you can make better decisions in the future. No one can be free of mistakes but it is important that going forward, you recognize the importance of being correct in your thinking. To be correct in your thinking you need to think critically about every decision. Critical thinking skills can be learned.

There are two main ways to develop critical thinking skills. The first is to study the characteristics of self-actualizing individuals. Self-actualizing individuals have the ability to see reality clearly. The more accurately you can judge reality, the fewer mistakes you will make in life. It is important to make as few mistakes as possible because you will pay for all of your mistakes, financially, psychologically and so forth. Read Abraham Maslow’s work regarding the characteristics of self-actualizing individuals.

The second way to develop critical thinking skills is to enter cognitive therapy. Cognitive therapy can assist you in examining your past mistakes and the associated faulty thinking process that accompanied those mistakes. Cognitive therapy can also assist you in assessing your ability to be logical and will challenge you to make the most rational decisions.

You may have made mistakes in life but you can positively affect your future by learning critical thinking skills. You asked about whether or not you have a mental illness. Though I cannot know with certainty, I do not believe that you are mentally ill. It is most likely the case that you made decisions without utilizing the proper critical thinking skills. The good news is that these skills can be learned through research or by entering therapy. Please take care.

Dr. Kristina Randle

I realize that around my age and older is when symptoms of schizophrenia begin to show. I am extremely concerned that I may have it. I hear voices and see things all the time. The voices in my head introduce themselves to me, and sometimes speak in different languages. I have a friend that has Schizophrenia and she said it is usually obvious, and that it looks as if I am showing early signs. I feel as if I can read other people’s minds. The voices in my head tell me things. Sometimes good, more often bad. It’s affecting my school work because they will shout things at me in Italian. I have done extensive research on schizophrenia, and I have many of the symptoms. Such as delusions and disorganized speech. So far I’ve counted 29 voices in my head. Do I need to check in to a mental hospital? Or do I not even have Schizophrenia. Please help.

I do not believe that you have to “check in” to a psychiatric hospital at this point but you should have a psychiatric evaluation. You can do this several ways. One way is to go to the hospital and request a psychiatric evaluation. Generally, an individual would utilize this option if he or she is experiencing significant or severe distress or there is an emergency. Typically, an individual would be admitted to the hospital if the evaluators suspect that they are a danger to themselves or to others.

Another way to have a psychiatric evaluation is to make an appointment with a psychiatrist. You would choose this option if there was no immediate psychiatric emergency. Your parents can call the local community mental health center and schedule an appointment with a psychiatrist. Your parents can also speak to your primary care physician who may be able to recommend a psychiatrist. Another option, if you have health insurance, is to call the telephone number on the back of your insurance card. The insurance company typically has a list of mental health professionals they recommend and who are “in network.”

As I mentioned above, it is imperative that you are evaluated as soon as possible. Auditory hallucinations are not a common occurrence. It is a symptom that should be investigated very thoroughly. Hallucinations, both visual and auditory, are associated with schizophrenia but they can also be brought on by drug use, fever, organic brain disorders, dementia, and on rare occasions, parasitic infection.

Please speak with your parents immediately about having a psychiatric evaluation. It is best not to assume that you have schizophrenia or any other condition. You will not know what, if any, disorder you have until you have been thoroughly screened by medical and mental health professionals. In the meantime, it is important to remain calm. To the best of your ability, try to engage in activities that are stress-free and that you find relaxing. If the voices are worse during certain times, for instance when you are alone, try to distract yourself either by watching television, listening to music or by being in the presence of others. Other stress reducing activities include physical exercise, deep breathing, meditation, and yoga. I am not suggesting that you engage in these activities as a way to treat a possible diagnosis of schizophrenia. I am simply recommending that you reduce your stress levels as much as possible because increased levels of stress might exacerbate your symptoms.

The next step for you is to speak your parents and to be evaluated. I know it may be difficult but please try not to worry. Worrying increases stress and at this point, you want to focus on stress reduction. Effective treatments exist for virtually every mental health condition. Please do not hesitate to write again if you have any additional questions. I wish you the best of luck.

Dr. Kristina Randle

Insurance Company

Incapable of Making Good Decisions

Schizophrenia At My Age?