Last Straw Archives

I am writing to you for help. Almost every day, I am overcome with feeling of doom. A dull, gray doom in my belly. And with good reason– I’m 24 years old and I just can’t get the hang of life.

I’ve had severe social anxiety since I was a little girl– this feeling of intense aversion to social interaction has been with me literally since pre-school. I’ve been treated with medications of all sorts for 8 years now. I’ve had 2 regular CBT therapist with whom I had regular meetings, but that ended when I lost my health insurance. Additionally, I have been hospitalized for depressive episodes, and gone to in-patient clinics, as well as a 4-month long “dialectical behavior therapy” program.

But every time I think I might be getting better, it all comes crashing down. I’ve enrolled in and dropped out of 4 different colleges. I couldn’t find a way to fit in or summon the energy to go to class, and I could not life my mood enough to succeed.

Now I have a job that I generally enjoy, at a small business run out of my boss’s home. There could not be a less stressful job, I make awesome money, and I love my boss… but I keep not showing up to work for weeks at a time. This happened once last December (2 weeks absence), then again in March (1.5 weeks absence), and now last week I could not go in either. God knows how I still have the job– I think my boss bad for me, I know she cares about me, plus, as I said, it’s a really small place with no real attendance policy.

But I feel so guilty I’m sick about it. I know this is unacceptable, but I just feel.. doom.

But this time I think it’s the last straw with work. I just could not go to work. I don’t understand it– when I skip work, all I do is wallow and watch game shows, but at the time it feels like that small amount of solitude and peace is worth the trouble of yet another unexplained absence.

I could not blame her for firing me, if she does, but I’m terrified of confrontation. How can I just show up on Monday knowing there’s another “talk” waiting for me? I cry at the slightest negative remark about my behavior, even if I’m guilty of it. I am so timid it’s embarrassing.

I have a boyfriend and we live together and I love him, so that’s good. I have a supportive family. But I just feel like it’s really time for me to come into my own– I’m already 24! Yet I remain paralyzed and ashamed, anxious and unhappy. I can’t give up and quit my job, but I might have to, but I’ll never be able to get another job, especially in the public sphere, even though I have in the past… I’m so embarrassed because I was a top student in high school, I was supposed to have a bright future. But for some reason, I totally crumbled.

I know you will say that I should get back into therapy but what about in the short term? I am on antidepressants, my psychiatrist really listens to me, but they just don’t help– I can’t stop this lethargic, shameful, self-centered lifestyle. Please don’t think ill of me or that I am being whiny and that I need to grow up– I know I do. I just can’t quell this behavior; I’m not even sure I know what’s going on.

Please help me. Your words would mean so much. Thanks for reading.

I would characterize the way you describe yourself and your situation as harsh and hypercritical. It is unlikely that you would think this harshly of a friend or a family member in a similar predicament. You most likely would have more sympathy for others than you have for yourself. I have sympathy for the fact that you are truly suffering; I would suggest adopting this personal attitude towards yourself.

It is important to understand that having a mental health disorder is not your fault. It does not make you “self-centered” or “whiny.” You also should not feel “shameful.” Just like people do not choose to have cancer, people do not choose to have a mental illness. You are clearly not choosing your way of life. You are desperately trying to improve your life but are having difficulty. If you could help yourself out of this distressful situation, you would.

It also seems as though you are comparing yourself to other individuals your age and concluding that you are in essence a failure, “a 24-year-old deadbeat” to use your words. This is an unfair comparison. As you mentioned, you have been struggling with a mental health disorder since you were a child. You are comparing yourself to people who likely do not have depression or anxiety. Everyone’s situation is unique to their specific life circumstances. No two people have the same set of life circumstances, therefore a comparison of this nature will always be inaccurate.

You are having difficulty identifying the problem and knowing how to treat it. You correctly speculated that I would suggest returning to therapy. You have tried counseling on several occasions without success but that doesn’t mean you should give up trying. Finding the right therapist could make a major, positive difference in your life. The alternative is to do nothing and to continue suffering. Those would not be wise choices. Knowing you have a mental illness and deciding not to treat it is akin to learning of a cancer diagnosis and refusing chemotherapy.

What can you do in the short term? Ask for referrals and recommendations from friends and family. Ask your psychiatrist to recommend highly qualified therapists that have a track record of successfully treating depression and anxiety disorders. Another idea is to call at least 5 to 10 therapists and speak to them about your problem. Ask them specifically how they would help you and in addition ask if they have treated others in similar situations and to describe the outcomes of those cases. Make an appointment with the therapist who you feel the most comfortable with over the phone.

You should also surround yourself with supportive individuals. Fortunately you have supportive friends and family. Do not hesitate to utilize their support during this difficult time. Spend as much time with them as possible.

As for your job, you may want to speak to your boss about this situation. It seems as if she is an understanding individual. She may sympathize with your situation and suggest a short leave of absence. Your honesty with her may help to save your job. A leave of absence would afford you time to focus on your treatment. You may also be eligible for family medical leave. The Family Medical Leave Act (FMLA) is a federal law that allows employees to take a leave of absence for up to 12 weeks (usually unpaid) to care for an ill loved one or to “take care of one’s own serious health condition.” You could read more details about FMLA here.

I hope this answer is helpful. Please consider writing back and letting me know how you are doing. I hope to hear back from you in the future. I wish you well.

I’m looking for a little advice for my mother who may have Borderline Personality Disorder. Long story short, I feel like this is the last straw and I’m starting to lose patience.

Issue: We’ve been bearing with her, but it there doesn’t seem to be a light at the end of the tunnel without professional help. My mother seems to be too proud to accept any type of ‘weakness’ even if it’s a medical illness. She has attempted to take medication in the past but that resulted in suicidal episodes and she became zombie-like at times. There seems to be communication barriers as well.

About her: My mother is an extremely proud woman who is hard on accepting the possibility that she is ever wrong – in fact she is almost always right in her eyes. She is extremely irritable and her temper rises as fast as a moving train. For instance, if my father is late because of work issues, she will throw a tantrum and start to mumble about his irresponsibility. Depending on the situation she will run through a wide range of emotions starting with anger, sadness, depression, and then rise back to anger.

She experiences periods of extreme mania and depression. We believe these swings may be tied to her eating habits and that she is extremely self-conscious of her self-image. Her mood tends to swing in a 1-2 month cycle, after 2 months we can expect an outburst, tantrum, or cry for attention. She has attempted to take her life in the past by ingesting a full bottle of Advil followed by a bottle of wine. At earlier stages she would bring herself to a haze with alcohol, but that has subsided and she now drinks on special occasions.

She has extreme anxiety issues. For example, she will ask if the stove has been turned off a few times before leaving the house, again once we’ve left the house and fear that the stove hasn’t been turned off even after we’ve assured her. The same scenario can be applied to closing garage doors, icy weather conditions, family/friends safety, and a belief of a cheating husband.

She grew up with a bit of verbal abuse in her family and she felt like she could never measure up to the expectations set. She’s always been placed on the side since in older traditional Chinese families, if you’re not a male child, you’re just an outsider. She rarely had a father figure. She’s worked the majority of her childhood and continuously feels like her worth has diminished because she never finished college.

There is so much more, but I can’t seem to put thoughts into words. My father has been attempting to ease every one of her episodes, but I fear that may not be enough. My brother seems to avoid all issues, acknowledges there is a problem, and pretends all is well with the world as long as we don’t stir the hornets nest. I’m not sure if it’s the right thing to do, but I’m seeking any and all advice, help and references I can get.

Thanks in advance for your help.

It is very difficult to watch your loved one suffer and refuse to seek help. It is additionally challenging and understandably frustrating when a loved one’s problems negatively impact the family and everyone suffers as a result. This seems to be the case in your situation.

Undoubtedly you are faced with a very challenging situation. There are no easy solutions. When someone refuses to seek help, then it is the others around them who have to make the adjustments. That may mean limiting your interaction with your mother. If she won’t modify her behavior, then you may need to modify yours. You have to protect yourself. Self-preservation is not a selfish act; it is a necessity. It is important to do your best to help your mother in every way possible but it is also important that you do not let her problems destroy your life.

I have three main recommendations for you. One would be to consider family therapy or individual therapy. Family therapy may be an option if she is willing to go with you to counseling. Even if she isn’t, therapy could teach the family the necessary tools that are needed when caring for a loved one with mental illness. It could also facilitate consistency. Working together as a family may also provide the leverage needed to gently urge your mother into treatment.

There are other possible advantages of family therapy. If the rest of the family is open to counseling, then she may be more willing to go to treatment. If everyone else is willing to make adjustments to their behavior, then she may be open to doing the same. It also sends the message that she isn’t “the problem” and that the family unit as a whole could benefit from a positive intervention.

Individual therapy could teach you how to better and more effectively interact with your mother. The therapist could help you to understand the importance of boundaries and teach you the logistics of how to achieve this important step. In addition, he or she can also help you deal with the psychological and emotional aspects often associated with caring for a mentally ill family member.

The second suggestion involves contacting a local National Alliance on Mental Illness (NAMI) support group. NAMI is an advocacy group that is dedicated to helping individuals with mental illnesses and their family members. They are particularly well-versed in the challenges of having a family member with a mental illness. Most communities across the country have a local NAMI support group. Visit their website for more information.

My third suggestion involves psychoeducation about borderline personality disorder. Pay close attention to educational material designed for the family members of individuals with borderline personality disorder. There are many resources available. One popular resource is The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Egg Shells by Randi Kreger. You may also want to try the Family Connections program.

I hope these suggestions are helpful. I wish you the best of luck. Please take care.

Dr. Kristina Randle

Last Straw

Feeling Like a 24-year-old Deadbeat

Mom May Be Borderline But Refuses Help