Phobias

From the U.S.: I haven’t been doing too well the past few years. I’m 20, I have GAD, social phobia, depression, ADHD, and OCD, and I feel like I’m just getting worse.

Normally, I don’t feel bad enough to do things like this, but I recently watched the last season of BBC’s Sherlock (I know it sounds silly but hear me out), which has always been a nice escape, and heard one line that’s just made everything worse. It goes: “‘You’re high above us, all alone in the sky, and you understand everything except how to land’ […] ‘Every time I close my eyes, I’m on the plane. I’m lost, lost in the sky and … no-one can hear me.’”

The way this person on turned out — alone and sad and utterly confused — it’s been depressing me to no end, I don’t feel ‘high above’ anyone per-say, but I feel isolated just the way it’s described here, like there’s no one who can understand. The only people I remotely relate to are in books and movies, even those are far and few between, and they always seem to be characters everyone else hates. I don’t have friends and my family doesn’t like who I am.

My therapist has all these plans for who I should be and how I should change to fit in with the world, but I really do like myself and I don’t want to change for a world that makes no sense to me. It’s just that, though being alone with my thoughts is the only thing that feels comfortable, it also hurts more than anything. I wonder if there’ll ever be a time that I don’t feel isolated and abnormal and if I’ll ever be happy in a world thats both excruciatingly boring and miles beyond me.

My mind sometimes makes incredible things and sometimes it makes the stuff of nightmares, and I worry I will have to deal with its creations by myself because I don’t have the emotional intelligence to convey it to others, even if I wanted to. I too am in the sky and alone, and I can’t seem to grapple with it. Please help.

Although I can’t make a diagnosis on the basis of a letter, what you report is consistent with depression. You feel hopeless and helpless to change anything. You are isolating and you are terribly unhappy.

Without talking to your therapist, I can’t make a judgment about how she is treating you. I can only ask if she is specifically addressing your symptoms and your resistance to change. Like many people who are depressed, you may want to change but feel hopeless about the possibility for success. You may need some medication for awhile to take the edge off so you can benefit from whatever is happening in a therapy hour. That’s not necessarily a recommendation. Since I haven’t talked with your therapist, it’s just a thought.

Meanwhile, you need to get on your treatment team. Instead of working hard, you are justifying your distance from others by claiming that the world is boring to you. Therapy only works if the client is willing to work on making a change. If you trust your therapist, you need to do your part by sharing your innermost thoughts and by trying out what she suggests. If you don’t trust your therapist, you need to step up and talk about it. If you can’t get to a position of trust, you may need to look for another therapist who is a better fit for you.

Therapy does work. But it only works when a client partners with the therapist. I hope you will find it in you to join with your therapist in the goal of defeating your symptoms instead of sinking into depression and defeating your therapy.

I wish you well.
Dr. Marie