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Social Anxiety

Mother Ruining My Mental Health

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP November 2nd, 2023
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

The relationship between me and my mom is quiet difficult to describe and understand. At one point we often laugh and talk together, when I want a hug she’s the first person I’m going to, but at the same time she’s the only person that I actually fell deep hatred towards. For already 4 years now she’s been slowly damaging my mental health and I can’t do anything about it.
When I was 13 I started being completely unmotivated for an unknown reason which led to me laying in my bed for 90% of my free time, not studying etc. The only thing she said was: ‘You’re acting like you’re depressed. I have to warn you – no child of mine will be mentally ill, so I hope you’ll get out of that immediately’. I never spoke to her about my real feelings, only some minor things, like stuff that happened during day, a book or a movie. She doesn’t know how I feel, at all, but I’m sure she can somewhat sense that I’m not doing okay.

In middle school when all the girls started wearing makeup, shopping and doing all the stereotypical things I was still kinda stuck mentally as a 10 years old – video games, not caring about my appearance, spending my time at the playground etc. That made her angry, too – not to add that I cut my hair in a ‘boyish manner’ and rarely wear skirts/dresses (I just find them uncomfortable). My grades are still low and I rarely do house chores nor do I have any friends in school. She started calling me a weirdo, insulting me, telling me I’m not normal and that I’m ruining her life because she wanted a beautiful and smart daughter – just like my sister. She always says that she treats both of us equally but even a blind person can see who’s the ‘disappointment in the family’.

I became completely emotionally cold on the outside and use only fake and nervous laughs sometimes. Meanwhile, inside I feel like I’m slowly dying (how cliché) and I can’t even get any help. School just ended, but they’d still need to call my parents if I went to the counselor. By my own observations I think I might have depression and social anxiety (at least) and lately I’ve been experiencing dissociation a lot. (From Poland)

I would go directly to the source of the problem by asking your mother if she would help you by going with you to a counselor. Tell her you want to make certain you keep yourself of in a good place mentally — and she could help by going with you. But if she doesn’t want to go, tell her that you would be willing to go on your own. The strategy will both show her how important it is for you and keep her directly in the loop and involved.

If she comes I’d explain the issue to the counselor the way you’ve explain it here. If she doesn’t go, then explain what you have said here — with an eye toward how you can use the counseling to change how you feel.

Wishing you patience and peace,
Dr. Dan

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I Realized I’m Not Being Myself

by Holly Counts, Psy.D. May 17th, 2023
written by Holly Counts, Psy.D.

2 years ago I developed social anxiety out of the blue, and it was truly something I had never experienced. I had all of the symptoms of social phobia during the summer after 9th grade, and after weeks of experiencing it, I became depressed and really angry. When school started, I developed some ways to help deal with it, such as convincing myself that nothing was wrong with my face, and I reduced my social phobia significantly. However, I also began to have OCD alot more, fearing that I would get anxiety if I didn’t perform my rituals. Eventually my mother helped me get treatment for my OCD, and for the past 4 months (I am 16 and a half right now) I have had little to no OCD (compulsions and obsessions). These past 2 months, however, I have realized that my life hasn’t felt the same since my social anxiety. I still don’t speak as wittily and on command as I used to, and I notice that I ask obvious questions and that I mimic what other people say. I used to have my own way of speaking and thinking, and I feel like its hiding somewhere, but I don’t know how to bring it back. I don’t get scared around people like I used too, but I know that my social phobia is still there, and its blocking me out. However, I feel like its been so long since I’ve been myself (about 2 years) and I don’t know who I am anymore. I keep thinking that i have lost all my opinions and that I am a fake and I’m worried this is something bigger. I wake up several times at night, and sometimes the center of my head, around where the hippocampus is, feels heavy and I get sad. All my life, until I was 15, I got all A’s and B’s, but my grades dropped during that intense OCD phase and now I feel like an idiot and worry about my future. Everyday I think about how I have lost my personality and identity, and life feels unfamiliar to me. I don’t feel the need to hang out with friends or make new ones because I hate the way I talk, and how not-genuine I have become. I used to love to hangout with friends and even my parents, but nothing feels the same anymore and I don’t know who I am. I used to have interests and think about the future but all I do is think about the past and how good it was. I feel as if I mimic others and that my thoughts are infected with other peoples. I just have no idea how I became so lazy in school and I feel as if my developement is being hindered as a result. Can this all be anxiety, or is it something else? (age 16, from US)

Thank you for writing in with your question. Yes, everything you are struggling with can be related to anxiety. Anxiety disorders can affect our functioning a great deal and can take a long time to fully recover from. Even though there are distinct diagnostic differences, such as the ones you describe here with Obsessive Compulsive Disorder (OCD) and Social Anxiety, the lines can also be blurry and cross over.

I’m glad that you are getting treatment but you didn’t say whether it was medication or therapy. Receiving both forms of treatment would be ideal in this situation and you may need to remain in treatment for a while. Please be very open and honest with your therapist about all your symptoms because they can’t help you with aspects they don’t know about. Tell your therapist about your social anxiety, about your grades dropping, about your sadness and worry, your sleep difficulties and so forth. You might also benefit from finding a support group for adolescents coping with depression or anxiety. It can be very helpful to be around others who understand.  There are usually many support groups offered within a community but you can also find them online.

Don’t worry if you don’t fully feel like your “old” self. You are still at an age that you are continuing to develop and grow. Be open to new experiences and be proud of yourself for fighting back. Don’t give up hope. Things will continue to get better.

All the best,

Dr. Holly Counts

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Is This Anxiety or Maybe Something Else?

by Dr. Marie Hartwell-Walker March 3rd, 2023
written by Dr. Marie Hartwell-Walker

From a graduate student in the U.S.: I have been in constant stress and feeling worried for the last 3 years. I have constant chest pain and extreme depression episodes where I cannot get out of bed or stop crying. I have no friends because I am embarrassed of myself and my decisions and dont want to expose myself as a fraud to anyone. I am also deathly afraid of being judged by others about my decisions. I have worked a little but struggled in that environment because i cannot concentrate because i feel others are saying or thinking bad things about me.

I am doing a graduate program and although i find it interesting i have not manage to get any relevant research or work experience because fear of exposing myself.I also taken just easy way out of getting credits and bullshit. I did this because I just want to go home and do an easy job to reduce the stress in my life. I dont go to classes because of fear of having to talk to other people. I dont take the classes i want because of fear that I am not smart enough due to my mental state. oh and Im undecisive.

I have anxiety since I can remember. At 13, I suffered from episodes of panic attacks and feelings of detachment from my body. I thought that life wasnt real and that I was in some sort of Simulation. Nowadays I think about this as a source of comfort as I wish to escape the situation I am in.

I also feel constant disorientation and confusion. I constantly get lost going to places,i dont notice things,i forget what i am doing as i am doing it(while driving i can get lost in my thoughts), losing things, breaking things(extremely clumsy), forget peoples names that I have known for years. Its like im almost always zoned out and mentally slow yet I cannot seem to turn my brain off. My thoughts even disturb me through in nightmares.

I want to know if there is a way for me to get rid of these symptoms. Am I simply an airhead or is my anxiety somehow related to my inability to think logically? Is there something else that could be causing the problem? Would medication help me with my anxiety/panic? I am to afraid of going to the doctor.

The feelings you described are consistent with a diagnosis of social anxiety. It can be debilitating — something you know only too well. You wrote an articulate and organized letter which tells me you can probably do fine with graduate work if you could only get your anxiety under control.

I do understand why you are afraid to go to a doctor. Most people with social anxiety are afraid of interactions with just about everybody and a doctor is no exception. But doctors are exactly who you need to see. In fact, you need to see 3 different helpers to get the help you need. Please have some optimism. Most professionals are just that — professional. They don’t want to judge you. They just want to help you.

First, if you haven’t had a complete medical check up in awhile, do get one. You want to be sure that there isn’t something medical going on as well as the anxiety. Once that’s been done, you need to see a psychiatrist for some medication to settle things down enough that you can start to use some therapy. Right now, you are just too, too anxious. Finally, you need to make an appointment with a cognitive-behavioral therapist to learn how to cope with social situations, including classes, and to manage your intense feelings. There is nothing at all wrong with being a bit anxious. Everyone is. But your anxiety is so intense that it is getting in the way of your life. You need to learn some skills for toning it down — and for feeling more in control.

While waiting for appointments, I do suggest you get a copy of Feeling Good by Dr. David Burns. Read it carefully. It will give your therapy a jump start.

You have suffered in isolation for far, far too long. You deserve better. Please, let the helpers do their job and do your part. You can get much better.

I wish you well.
Dr. Marie

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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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I Scare Women Away

by Dr. Marie Hartwell-Walker February 6th, 2023
written by Dr. Marie Hartwell-Walker

From a U.S. soldier: First off… I would specifically like this question to be answered by a woman, if possible. I am 34 years old, and have been struggling with a mental thought for years now (since I was 15). It drains me of my self esteem, it causes me to breath heavily when I encounter it, I’m afraid to travel, or even go on vacation. It’s my encounter with women.

I always seem to get either a horrible beastly face, or like they purposely look away from me. Its worst when there are a group of them. Im not an ugly man, in fact I am pretty hansome, and a beautiful body. Im married to a very beautiful woman who tells me almost everyday that I’m beautiful, but I still struggle with this, because I’ve travelled all over the world, and I get the same reaction from women.

Can you please once and for all, explain this for me, or even give me some exercises to overcome this, as Im tired of living like this. I need freedom from this, it is really starting to drain me.

Have you ever heard the expression “You get what you expect”? I have a guess that is what’s going on here. It’s impossible to know when this started or why. But I think you may have run into a couple of tactless women who weren’t interested in you and then you developed an idea that you aren’t attractive. The cause is now lost in the mists of the past. But that cause, whatever it was, doesn’t have to inform the future.

First. Listen to your wife. Hers is the only female opinion that matters anyway. She thinks you are beautiful inside and out. Please take a hard look at why you find it necessary to be attractive to other women when the woman you love thinks you’re the best thing going.

That being said: If you need to feel like you can attract women in order to feel good about yourself, here are a few surefire steps:

  1. Observe people who seem to be what you want to be. Note how they stand and move, what they talk about, their facial expressions, and generally how they make themselves approachable.
  2. Copy them. That’s right — be a copycat. Imitation is a form of flattery. It’s also a way to “try on” different behaviors. Try it and see whether being more approachable is really what you want.
  3. Practice makes permanent. Practice those skills at least a couple of times a day. At first it will feel artificial but you will get the hang of it.

Please — Be careful about what you wish for. Think about what you will do if a woman responds to your new persona. Take care of your marriage.

Frankly, I think there are better attributes to hang your self-esteem on — like being kind, honest, a good husband and father, and a positive member of your community. Beauty is, after all, only skin deep.

I wish you well.
Dr. Marie

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How Do I Tell Someone about My Possible Depression & Social Anxiety?

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

I am fourteen years old. I’ve been experiencing severe depressive symptoms with terrible suicidal thoughts for weeks now. I have also been experiencing all symptoms of social anxiety since grade five. I can’t stand it. There are many different physical and mental tasks i must repeat in order to ensure the safety of me and others. I seem to always have the urge to break something or kill someone. I overeat way too much. I eat when I’m not hungry. I have gained fifty pounds in the last year. My academic performance is suffering. Suicide seems like the best option now. I’ll be starting my plan soon. I feel so trapped!

When I am out in public or in social situations, I tend to believe that people know what i am thinking and feeling. To push these people away mentally, I think about death and destruction so that they stop they’re doing. I also have different voices in my head that i have conversations with in social situations. They encourage me to kill all who look at me or read my thoughts. I gain a sudden hatred for all I see in public as I feel they are constantly judging me and planning to do me harm. When everything gets too overwhelming, everything becomes dream-like as if what i sense is simply not there. I believe this is derealization. I think about mass murder quite a lot and i take great pleasure in it. I do not plan on killing anyone, but it gives me a confidence that i can’t explain. I feel I am able to project these fantasies on to other people when they are reading my thoughts, scaring them away and feeling victorious. I am quite paranoid about everyone and everything. To the point of angry outbursts when someone has found out something about me like my full name. It is hard for me to trust anyone.

I am too afraid to tell anyone about any of this. There are people who are much worse off than I am which makes me feel quite pathetic. I don’t want to appear as an attention-seeker or ungrateful. I do want help though, really bad. I just want to know how to go about telling someone. How should I approach my mother and what should I do to make this whole thing go smoothly?

I see this letter as the first step in your getting help. You have clearly articulated some of the issues with which you are struggling.

Your next step should be speaking to your mother. I don’t know what your relationship is like with her but if you feel comfortable, openly discussing these matters, then you should do it. You want to be as honest and sincere as possible. You might even consider reading her the letter that you wrote to me. It’s incredibly insightful and it will help her understand what’s wrong and how sincere you are about wanting help.

Another strategy is to write her a letter. Sometimes people feel more comfortable writing than they do speaking. Do what’s most comfortable for you.

In cases where parents are not open to mental health treatment, I commonly recommend speaking to the school guidance counselor. Guidance counselors know how to talk to parents about these kinds of issues. Think about which approach would work best with your mother.

There’s no reason for you to feel “pathetic.” Treating mental health problems is a learned skill. Mental health professionals receive years of rigorous training and education to learn those skills. Their training is what gives them expertise. You should have no expectations about knowing how to solve your own psychological problems.

No one feels “pathetic” about having to consult a dentist for a bad tooth or a dermatologist about a misshapen mole. Laypeople don’t have expertise in dentistry or dermatology and that’s well understood but for some reason, many people feel that they should have innate expertise in the field of mental health. Innate expertise in mental health, is no more realistic than innate expertise in carpentry or physical therapy or radiology or engineering. Expertise in those areas involves many, many hours of specialized training and practice.

Consulting a mental health professional for psychological problems is no different than consulting a plumber for a clogged drain or a physical therapist for rehabilitation. With any problem, it’s most efficient and most reasonable to seek an expert.

Your writing this letter and your openness to seeking treatment makes you anything but “pathetic.” It makes you brave and insightful and it significantly improves your likelihood of a good prognosis. All of the problems you described can be resolved with mental health treatment. I hope you are able to receive the help that you desire. Please take care.

Dr. Kristina Randle

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Diagnosed with Anxiety & Depression But Is It?

by Kristina Randle, Ph.D., LCSW January 1st, 2023
written by Kristina Randle, Ph.D., LCSW

I don’t want to go to see a doctor in person, because that means I have to look at them. When I am around others I can’t help but act completely normal and ‘happy’. I hate being judged, so I don’t tell them anything that’s going on. I am afraid of people. I would feel like an idiot and I always have whenever I have opened my mouth about something. I know how to act perfect in social situations- Smile, laugh, converse at all the right ques. I’ve been told by my parents that I am extremely manipulative. I act normal around them now too. The only persons feelings I care about are my Mothers. That’s it. Couldn’t care less about any other. I hate being touched, Don’t care about others feelings or what they are doing, Will always assume I am being lied to. I always question if this is actually my personality. Is this actually me or is my mind just telling me that? I like to be alone all the time, don’t want to sleep, cant sleep. I like others misfortune and often go deep into thought about killing/harming others I see/know or myself. I have acted upon myself often. It makes me happy. Given the opportunity I would consume a human. I tried to strangle my sister once. I wanted to kill her. Don’t touch me, don’t talk to me, don’t look at me- I know you’re thinking about me or talking about me. Leave me alone. I have myself screaming in my head SSSHH! I tell myself to shoosh all the time-out loud I don’t know why. I want to smash everything! I don’t desire a partner-How annoying!Anything sexual is absolutely repulsive! I just want to think. I often will ramble- what I want to say, what I think in my head, never comes out how I want it to- It never makes any sense I hate it!
I don’t know if we are real. Are we actually real? Why? We’re so minuscule, why should I care? You are always being watched, even alone in my house I am being watched- Everyone knows, always assume. I scream at people in my head, but I would never actually do it..I think I would need quite a push. I don’t intend to have a very long life. why would I?

I’m not sure what your exact question is, but it seems like you want to know if you have depression and anxiety. Without an in-person evaluation, a diagnosis is impossible.

You said that you don’t want to visit a “doctor in person” because you don’t want to “have to look” at them. The fact that you been diagnosed with depression and anxiety would suggest that you have already visited a doctor in person. He or she seemed to think that depression and anxiety were the most fitting diagnoses. The professional who had the opportunity to meet with you in-person would have been in the best position to offer a diagnosis. Perhaps depression and anxiety are accurate diagnoses.

Your not wanting to be around others or be in a relationship, your desire not to “have a very long life,” and your engaging in self-harm, are consistent with depression. People with anxiety are afraid of people. They’re very self-conscious about how they are perceived by others and will often avoid social situations because of their anxiety.

The symptoms that are inconsistent with depression and anxiety include your desire to “consume a human” and your belief that you are being watched. Those symptoms may be related to depression and anxiety, but I would need more information to know with certainty.

Maybe you don’t have a strong desire to change but none of the symptoms you have described seem pleasant. They seem to be degrading your life. If you want to improve your quality of life, then you should be in treatment. The symptoms you have described are treatable with therapy and medication.

Depression and anxiety are two of the most common mental illnesses in the world. Many people who have symptoms just like yours have recovered with treatment.

If you’re willing to go to treatment, then you can expect a positive change. If you’re unwilling to go to treatment, then these problems could worsen. I hope that you choose treatment. There’s no reason to live with curable problems. Please take care.

Dr. Kristina Randle

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Suicidal and Need Help

by Kristina Randle, Ph.D., LCSW December 17th, 2022
written by Kristina Randle, Ph.D., LCSW

I’m not sure what to do. I’m severely suicidal and have attempted to kill myself 7 months ago and can’t stop thinking about doing it again. I did see a therapist before but didn’t find she helped me at all. She told me my problems weren’t that bad and when I told her I wanted to kill myself and that no one would care she said, why don’t you try it and find out. She also said she didn’t want to see me anymore until I had a job, so that’s why I stopped going to her. I’ve been unemployed for over 3 years now and the job I did have was the first job I ever had, and they fired because of my depression. I’ve been trying the last few months to get another job and I did have an interview and almost had the job, but they hired someone else. I am finding it very hard to deal with being suicidal, unemployed, depressed and I also have social anxiety. Another thing is when I was between the ages of about 3 or 4 until I was 12, a relative who was 2 years older than me used to do sexual things to me and I’ve always had a hard time dealing with that. I’ve never really talked about it before, it did come up once in therapy but my therapist said that it was normal for kids to do that. I won’t go into details of what he did, but I know it was not normal behaviour. I want to start therapy again with a different therapist, but it scares me because I feel and always felt like my problems aren’t bad enough to warrant going to therapy. I just don’t know what to do besides trying to kill myself again.

It is completely unacceptable and unethical to tell a client who is considering suicide to “try it and find out.” I do not know of an instance of that ever happening with any therapist that I personally know or know of.

It is wise to consider seeing a new therapist. The fact that you have suicidal thoughts is concerning and a sign that help is needed. Suicide is never the answer. There are many competent therapists who could help you.

Depression, in the past, was more difficult to treat. Today it is treated with great success. You are going through a difficult period in your life. It is quite common for each of us to have these difficult, troublesome periods. While we are having these painful times in our lives, it is common to assume that they will never end. Please remember that they do end. I have written here before about survivors of suicide attempts. The overwhelming, vast majority are very happy that their attempt failed. They realized the value of life and found the happiness that had been denied them.

I often advise those searching for psychological help to call at least four or five therapists. You want to essentially interview therapists over the phone to find out how they would help you. Discuss your problems and ask specific questions about how they would help. Make an appointment with those with whom you feel the most comfortable. It might take some time to find a good therapist but it is worth your effort. Please take care.

Dr. Kristina Randle

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Unreal Memories, Unreal People, Voices, Trouble Talking?

by Kristina Randle, Ph.D., LCSW December 2nd, 2022
written by Kristina Randle, Ph.D., LCSW

I’ve been having trouble for the past 3 years with various things like hearing strange voices tell me to do things and once in awhile seeing strange things that no one else can see. For a while I thought they were messengers sent to me and I was terrified of them but couldn’t get away. Now I’m doing a bit better. I think this is some type of psychosis? But what is even more confusing to me are these clear memories I have of events that never happened. In these memories I am a different person entirely, but they feel so real. I don’t know what’s going on, and it’s kind of freaky.

Another thing which I can’t account for is that sometimes I feel certain person, let’s say “Bill,” is angry with me. I’m really distraught for a while just to realize later that I don’t even know the “Bill” I was thinking of. It seems I make people up to be mad at me or otherwise have things against me. All these things put together make me wonder if I don’t have Schizophrenia. I’m horrible at expressing myself and often say things that my friends tell me don’t make sense at all, or, if I’m really nervous, just a sentence put together with random words. I don’t realize I’m doing it at the time though. I also struggle with sudden thoughts of seriously harming myself. I’m able to control them, and my family is helping me through a lot. I am depressed a lot, and I think maybe I struggle with anxiety…is that all this is, or do you think I may be struggling with something more? Is this something medication may help? I don’t want to seek help if all they can do is diagnose me and then leave me. I hate talking to people as it is, so if all they can do is talk to me I’d rather not get help. The only reason I think schizophrenia is because my friend thought I had it. Do you think she’s right?

 

 Your symptoms are unusual and could indicate psychosis but I do not have enough information to provide a diagnosis. It is possible that you have schizophrenia or another mental illness, but you would need to have an in-person evaluation with a mental health professional to determine what may be wrong.

The idea that you would be diagnosed and then forgotten is more fear than reality. That is not how mental health treatment works. Mental health professionals don’t diagnose and then discharge their clients. They first conduct an assessment to identify the problem. Then they develop a comprehensive treatment plan to correct the identified problem. True professionals work with you, to get better, for however long it takes.

Mental health problems are treatable but not if you avoid seeking help. It would be a mistake not to seek help. It could make your symptoms worse. Please consider consulting a mental health professional. It will be worth your time and effort. Both medication and therapy could help you tremendously. Please take care.

Dr. Kristina Randle

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What’s Wrong with Me?

by Kristina Randle, Ph.D., LCSW November 14th, 2022
written by Kristina Randle, Ph.D., LCSW

I was just wondering if somebody could possibly give me an idea of what an official diagnosis would be like for me. I’ve been raped, abused, etc… My mother was an alcoholic my entire childhood and she was never there. She exchanged alcohol for pills and now uses those instead. My father randomly had a stroke and a seizure last August and it caused an aneurysm to burst, so he passed away two days later. I feel rejection with even the slightest thing (like, “I need to get off the phone” or “I’m talking to my friend”), I get extremely paranoid that somebody (especially people I know) watch me in odd ways (through my phone screen or my computer screen), I don’t love any member of my family nor do I want to, I am very antisocial, I get angry easy and just about anything can cause me to feel bad or depress me. I try to do anything I can to make people happy with me. I never say no to anybody and always try to agree with anything peolpe say. Unless I know them personally, then I generally have issues with arguing way too much and thinking I am always right or should always be right.I have problems maintaining friends. I can just see somebody and immediately want to be with them and try to be with them. Then something as simple as them not saying much the first time I talk to them makes me feel like they hate me and don’t want me and I get upset. I could go on and on…Do you have any idea?

It’s always difficult to provide a diagnosis over the Internet since I don’t have the ability to interview you and ask follow-up questions. You named a number of symptoms that don’t necessarily seem to fall into any one particular diagnosis.

You may be experiencing some of the elements of schizotypal personality disorder. Individuals with this personality disorder are described as odd or eccentric. They have difficulty maintaining close relationships. They tend to misinterpret the motivations and behaviors of others and become distrustful of them. Paranoia-associated social anxiety is linked with this particular personality disorder.

You may have elements of schizotypal PD but not everything matches. You described never being able to say no to friends and always agreeing with what people say. Those characteristics are not necessarily associated with schizotypal PD or with any particular disorder which again makes diagnosis, especially over the Internet, quite difficult.

Having difficulty saying no and being agreeable may mean that you are a people pleaser. People pleasers go along with the crowd to avoid confrontation. They also want people to like them and feel that being agreeable helps to accomplish that goal.

You had a difficult childhood. You experienced trauma multiple times over. Your mother was unavailable and you lost your father. Those seminal events could be and likely are contributing to your psychological problems. The most efficient way to deal with psychological problems and to receive an official diagnosis would be to see a mental health professional. The problems with which you are struggling are correctable. Therapy could greatly assist in the process of correcting psychological problems. Click on the “find help” tab at the top of this page to locate a mental health professional in your community. I wish you the best of luck. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice

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Do I Have Schizotypal Personality Disorder?

by Kristina Randle, Ph.D., LCSW October 10th, 2022
written by Kristina Randle, Ph.D., LCSW

Hey, firstly, I have already been diagnosed with having mild Social Anxiety (by a psychiatrist) and am definitely an introverted person anyway. I came across schizotypal personality disorder having seen it mentioned and being curious as to what it was and upon googling, discovered a few aspects that sounded very similar to my own personality!

– I feel like I have unusual thinking patterns. I genuinely find the following interesting; I think a LOT in general and find it rewarding and enjoy it. I tend to wonder about the afterlife (NOT in a suicidal sense, but just in a ‘I-wonder-what-happens’ sense) and also have a great interest in the universe and natural world around me. I also find I think a lot about the history of the world and aspire to be an Archaeologist. I’m not sure if these are classified as unusual patterns, but I don’t feel like any of the people I know at school would dwell on such things. (Having said that, I do keep up-to-date with pop culture and so on, and I have pretty similar tastes in music & T.V. to everyone else in my year level at school.)

– I have a lot of magical thinking. I suppose when I say this, I mean that I am very curious as to the existence of magic and whether or not there are any forms of it in the world today; what, I have no idea. I tend to wonder about this a lot and I have a desire to travel the world and experience different cultures in order to discover whether or not magic exists. I do have career & future family aspirations, for the record, so I am not suggesting I plan to make my travels my whole life. I am not particularly religious as I have not yet made a decision where my beliefs lie. Having said all this, I do not believe that I MYSELF have any magical abilities, nor anyone around me.

– I do not believe I have ever experienced unusual perceptual experiences, though if a more detailed explanation of what this exactly means / involves would be helpful, if that’s able to be given??

– I tend to find myself very uncomfortable in social situations. Mostly, I feel I do not know what to say that would be interesting to the other person and I am constantly wanting to impress and be liked by those around me. I DO have around five close friends, with whom I spend my time at school with and catch-up at other times. However, I don’t have much to do with the rest of my year level, though I would like to. My excessive social anxiety doesn’t seem to diminish with time though in my case, it has completely to do with negative judgements of myself; e.g. I’m not funny enough / interesting enough / what I think of to talk about isn’t good enough, rather than having any mistrust of my friends or paranoia. ~~< I am not sure if these symptoms are just more to do with my previously mentioned diagnosed anxiety than anything else??

I just wanted to ask online, before jumping to conclusions. Thanks in advance for your help!

You’re very welcome. While I can’t know with certainty if you have a disorder, I don’t believe that you meet the criteria for schizotypal personality disorder. Most of the symptoms that you mentioned are either normal or more characteristic of an anxiety disorder. Further supporting my contention is the fact that you were evaluated by a psychiatrist and he or she diagnosed you as having an anxiety disorder rather than schizotypal personality disorder.

With regard to being interested in the afterlife, this is not an unusual interest. The majority of individuals, at some point in their lives, will contemplate what happens after we die. It is a normal and healthy interest. All religions, philosophers, and great thinkers have considered what happens after death.

The type of “magical thinking” that you experience is not the same type of “magical thinking” that is being described by the Diagnostic and Statistical Manual of Mental Health Disorders (DSM), the guidebook that mental health professionals use to diagnose mental health disorders. You described wondering if magic exists in the world. It’s normal to wonder if a particular phenomenon is real. The type of “magical thinking” that the DSM is describing is more in line with whether an individual believes that he or she is being controlled by or influenced by a paranormal phenomenon. You explicitly stated that you do not believe that you have magical powers. In my opinion, your interest in whether magic exists in the world is inconsistent with the type of magical thinking that is characteristic of schizotypal personality disorder.

The social anxiety that you described seems more characteristic of a social anxiety disorder rather than schizotypal personality disorder.

It seems as though the diagnosis your psychiatrist has provided is likely accurate. Also consider the fact that he or she presumably conducted a full-scale psychiatric and social history and after having done so concluded that you have a social anxiety disorder rather than schizotypal personality disorder.

It is wise to conduct research on other possible related mental health disorders. It is also wise not to jump to conclusions. My recommendation would be to learn as much as you can about social anxiety disorder and use that education to help with the disorder. Fortunately, you are in treatment. With treatment, you can expect the elimination of social anxiety from your life. Please take care.

Dr. Kristina Randle

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I Always Worry about My Relationships

by Dr. Marie Hartwell-Walker October 3rd, 2022
written by Dr. Marie Hartwell-Walker

From Eqypt: I always worry about my relationships with my friends and other people and always conclude things about other people’s actions or thoughts causing me to act upon somethings or situation then regretting acting that way afterwards or act in the wrong way. That issue makes me afraid of starting any kind of conversation with my friends and makes me nervous of making a mistake whenever I talk to anyone which may seem to other people on the outside that I hate them or I’m not sociable and boring.

Also I’m not the type to ask for help even when I might be failing in the subject I’m studying or even ask about an advice about a situation that I’m in, I would sit for hours searching for a solution on the internet.

Another Issue is that I’m always emotionally unstable, My mood changes so quickly that almost all the people that I know ask me what’s wrong or if there is something that makes me angry, and for some reason I hate being asked that question a lot.

Lately, I running away to my house quickly once I’m done with my classes in my university; I don’t wait enough to make any conversation with anyone, my friends always tell me where are you? we don’t see you often! and then I would invent any kind of an excuse.

I had many fights with my friends which is due to my over sensitivity and feeling that I’m always ignored and that my friends don’t want someone like me who may be dull and not funny enough or good enough or not intelligent. Always belittling myself and my work, which caused me to be lazy and hate studying because I always think that no matter how much I do, I will always get a not good enough grade.

I’m tired of being like that and I don’t know where to go to or what to do or whom to ask for help…
Please help me

Although I can’t make a diagnosis on the basis of a letter, what you are describing is consistent with Social Anxiety Disorder. Social Anxiety Disorder is extreme fear of being judged by others in social or performance situations. That and a low self-esteem are getting in your way of being all you can be. As you have already found, it is a very hard way to live.

The good news is that you have made a start in asking for help by writing to us here at LifeHelper. Ideally, you would benefit from some cognitive behavioral therapy. But if that isn’t available in Egypt, a place to start is at the “Find Help” tab on our homepage. Click on “Community”. Go to the Anxiety forum to learn and get support from other members.

I packed everything I know about self-esteem (and how to improve it) in my latest book, “Unlocking the Secrets of Self-Esteem”, published by New Harbinger Press. You might find it useful to get a copy and work on the activities.

I wish you well.
Dr. Marie

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My Boyfriend Dislikes Me Being Very Anti-Social

by Dr. Marie Hartwell-Walker September 26th, 2022
written by Dr. Marie Hartwell-Walker

Hello! So recently, I had been shut down by my boyfriend because he feels that me being extremely distant in social situations is idiotic.

I loathe social gatherings and situations like parties because I constantly fear of interacting with people. I never understood why. I always thought this be a small phase for me but it never went away. I’m an 18 year old high school senior. Being my age, I figure it should be normal to be outgoing but i’m the complete opposite.

A few weeks ago, my boyfriend and I; along with my best friend and her boyfriend had attended a party thrown by another friend. I didn’t want to go cause I constantly worried about how I would look. (I’m quite large in size. I do struggle with my weight so I feel this adds on to my anxiety.) After some discussion with NY boyfriend, I decided to go, regardless of my worries.

When we got there, I began to cling to my boyfriend because I didn’t know anyone else there. He eventually left me behind for some of his friends so I didn’t know what to do. I eventually just sat somewhere and remained there for a good 30 minutes. My boyfriend noticed and looked annoyed with the fact that I wasn’t talking to no one. He eventually introduced me to his friends. I didn’t say much at first but I eventually forced myself to talk. My boyfriend got pulled away by a few of his other friends and that was when one of his friends decided to rudely compare my boyfriends size to mine. He mentioned how big I was compared to him, how I should lose weight and how I wasn’t pretty enough for him. His friends only laughed and backed him up. I sat there frozen stiff, feeling completely humiliated, embarrassed and just overall broken.

Eventually, his friends had left to join my boyfriend again and I quickly had locked myself in the bathroom only to cry for an hour. After, I had quickly grabbed my belongings and left without saying a word.

The overall experience was completely dreadful and I can’t stop thinking about it. It has impacted my social life even more. I haven’t talked to my best friends or boyfriend since then and they desperately have been trying to reach out to me. I haven’t eaten for about a week and do not wish to eat anytime soon. I don’t wish to socialize with anyone, not even my parents. At this point, idk what’s up with me anymore.

It may be that you are naturally more introverted than your boyfriend, or it may that, lacking support, you are developing social anxiety. It sounds to me like you have now fallen into a negative cycle that is making things worse, not better. It goes like this: You aren’t comfortable with people, so you withdraw more and more, which means you don’t develop the skills you need to get comfortable with people, which makes you withdraw — and so it goes.

The incident at the party only confirmed your worst suspicions about being out in the social world. You ran into some bullies. Yes, bullies. Your boyfriend’s so-called friends were terrible to you. But that doesn’t mean that they represent the whole world. Clearly your boyfriend doesn’t care about your size. Neither does your friend. Why should the bullies’ opinions count more?

You can learn how to be comfortable with people. You can learn how to handle bullies. But you probably can’t do it on your own. Your fears have become too great. I therefore strongly urge you to find a therapist who specializes in anxiety disorders. With guidance and support, you can overcome your fears.

I wish you well.
Dr. Marie

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Close Friend’s Social Phobia Off The Charts

by Kristina Randle, Ph.D., LCSW September 23rd, 2022
written by Kristina Randle, Ph.D., LCSW

A close friend told me in March that she has had social phobia/anxiety for over 4 years. I was stunned by her revelation. She has always been reserved in general. She is in the medical profession with advanced degrees and is generally a pleasant, but very driven person. She had started some therapy due to becoming physically ill before some meetings, even if she knew the attendees. Since January, she has taken about 30 days of sick time, which isn’t a problem as far as work goes. This is unheard of for her! She travels a great deal with her work and last Saturday started to become unhinged. I drove over an hour to meet her since we now live a couple of hours apart. Saying she was distraught doesn’t do it justice. I literally held her for hours, getting her to a place where she could let it out. This went on all night at a hotel. The next day, she was more herself and we went our separate ways and I felt okay with that. I was prepared to follow her back to her city if need be.

On Monday morning, I get a call from her brother that she has taken scores of Adderall tablets. REALLY? She doesn’t have ADHD that I know of, but the RX had her name on it I’m told. There was a strangely written note and after reading it, I can’t say it’s a traditional suicide note. This is all so out of character and it’s nearly overwhelming. I have healthcare POA for her and she for me along with access to bank accounts and some other account types when she travels. I now have everything business-related under control, but I am now processing my own feelings about what was a very real attempt at ending her life. I feel empathy and love for my close friend, not anger. We have never let each other down. She is done with observation and will go to another place for at least a couple of weeks- by choice. Another first and I’m happy for that. Besides being supportive and meeting with her Psychiatrist soon, is there something I should or shouldn’t do? There was a situation for me in 2001 where I could have given up my survival skills also. It was a specific event that triggered that thought process in me and she helped get me through it. This is far different for her. I just want to be loving, supportive and empathetic, but I’ve never dealt with a suicide attempt of someone close to me. Any suggestions?

Thank you.

Your friend is fortunate to have someone in her life who cares so deeply about her well-being. There are several ways that you can assist your friend in this situation. You could offer to drive her to therapy appointments or attend the first several with her, if she allows or believes that it would be helpful. You could also encourage her to attend a support group for individuals who are experiencing severe anxiety.

Psychoeducation about severe anxiety may help you to better support your friend during this difficult time. The more you know about anxiety the better able you can empathize with her situation.

Finally, being able to empathize, love, care, and support your friend during this difficult time are some of the greatest gifts that you can offer. Focus on providing your emotional support and don’t feel obligated to offer psychological advice. Suicide is a very complex matter that requires the treatment of mental health professionals. Though friends and family mean well, they’re simply not trained to deal with the complexities of mental illness and suicide. I hope this helps. Please take care.

Dr. Kristina Randle

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Crying Is Causing Me to Avoid All Social Interactions

by Dr. Marie Hartwell-Walker September 10th, 2022
written by Dr. Marie Hartwell-Walker

From the U.S.: For about 7 years now I can barely get through a conversation without crying. It’s humiliating and is uncomfortable for everyone involved. Anything can trigger it but I seem to have narrowed it down to three general triggers. All of these triggers are things that I normally would never give a second thought let alone burst into tears about. 1) Any large group activity – baseball games, choir performances, kids school performances. If a group is together and I’m part of it, at some point I cry. 2) When anyone shares anything the least bit sentimental. For example – a friend of mine was talking about her son’s kindergarten graduation. His teacher taught the kids the sign language sign for “I love you” so that the next year that would be their secret signal around the school. Cute right? Cute. She was telling me this and I burst into tears! To the point I couldn’t speak. This happens all the time. 3) Anytime I have to speak about anything spiritual. I’ve almost stopped going to church. I can’t talk about any of it – not even planning a simple kids activity without crying at some point.

I have searched for an answer. I’ve never been one to be sentimental or publicly emotional. In fact, I used to be a pretty decent public speaker and enjoyed training large groups, teaching in my church and social situations. I avoid all of these situations at almost any cost. I am however, a mother, a wife, a friend, an employee – I have a life. I feel like I’m losing it though. I have to figure out what is going on before I turn to total isolation.

I don’t cry a lot otherwise. If I’m truly sad about something I do cry and feel that I cope pretty well with stress. I can’t think of anything that’s happened that I haven’t dealt with. I love my family and my friends. I used to be really secure with myself until this started. I feel like my anxiety and depression are a result of this – not the other way around. I’m at a complete loss and just don’t know where to start to find answers.

It must feel terrible to feel so out of control of your feelings. It appears that you feel the most vulnerable around the things you care most about.

When a glass of water is already full, it takes only a drop to make it overflow. It’s as if your nervous system is already just about overloaded and then these important issues push you over the top.

I do suggest that the first thing to do is to see your medical doctor to determine if there is an undiagnosed medical issue going on. There is sometimes a link between emotional symptoms and medical problems. Take a look at this article here at LifeHelper: #/lib/involuntary-emotional-expression-disorder/

Another possibility is a medication side effect or medication interactions. If you are taking any medications, you should also talk to your doctor about whether they are contributing to your emotional sensitivity.

If you are medically fine, then an evaluation by a mental health care professional is in order. Emotional symptoms are often the result of untreated anxiety and/or depression.

I wish you well.
Dr. Marie

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I’m Tired of Thinking My Life Is a Waste

by Dr. Marie Hartwell-Walker September 4th, 2022
written by Dr. Marie Hartwell-Walker

From the U.S.: Well, here it goes:

I hate myself and don’t like most people. I’ve pushed my friends away/out of my life. I feel I can’t talk to my own family about my real feelings. I haven’t been in a romantic relationship in 20 years (since high school), which only magnifies my self-loathing. I have zero self-confidence. I’m in a career that pours machismo, which I have none. Most every day I have thoughts of the “s” word, and this has been consistent since Jr. High.

My social anxiety has spiraled to the point where I never leave the house (I peer through the window before I even get the mail or take out the trash). No social media because my heart beats out of my chest making a simple comment. It feels like the universe throws every possible obstacle in my path. I always end up feeling worse.

These are just a few of a long list of issues I grapple with every day. I tried to drink away my feelings during my 20’s which culminated in a 30-day stint in rehab by age 32. I have not had a drink since and I don’t take drugs, other than smoking weed since age 13.

I fear antidepressants because I don’t want to become dependent. On past doctor visits, even though it was on the tip of my tongue, I was too embarrassed to ask about depression. But I feel I’m at my wits end, which has led me to create an account and “ask a therapist”. The only thing I feel is in my favor is an incredibly strong sense of empathy towards everything, especially animals. Crazy, right?

Nope. Not crazy. Probably you are suffering from depression as well as social anxiety.

Stop kidding yourself, please. Yes, you are taking a drug. The weed isn’t helping you one bit. In fact, although it may make you feel a bit better, it is probably contributing to the problem.

You already know that you need help. That’s why you wrote to us. Now please follow your own good instincts and get the help you need and deserve. Start with a complete medical check up to make sure there isn’t an undiagnosed medical issue that is part of the problem. Do be honest about how often you are smoking weed.

Then ask your doctor for a referral to a licensed therapist. The first thing that will happen is a thorough evaluation. Then you and the therapist will talk about the therapist’s recommendations.

Medication may or may not be recommended, but it is at least something to talk about. (A course of prescribed medication will probably do more for you than marijuana.) But even more important will be getting to the root of your feelings and providing you support to take the necessary steps to change your life.

Please follow through. You are only in your 30s. You can have decades of good life ahead of you if you take care of yourself by getting the help you need.

I wish you well.
Dr. Marie

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A Woman Is Missing from My Life

by Dr. Marie Hartwell-Walker September 3rd, 2022
written by Dr. Marie Hartwell-Walker

From Pakistan: I am not in the habit of writing about my problems to total strangers but sometimes things become so complicated that it is much better to seek help.

I am 27 years old and to say that the concept of girl or a woman is missing from my life might be an understatement. Shy as a young boy, I found it impossible to talk to girls and belonging to a conservative family in Pakistan, that did not help, not one bit. The touch of a woman’s body was a longing that nearly made me mad. I went into depression and could not concentrate on anything.

I created a paradigm where I thought I was a moral guy and I will get the woman when I will get married (unlike the States or most countries, marriages in Pakistan are decided by elders).

I turned 27 and still, there is no chance of me getting married. I do not have any girlfriend. This made me mad, crazy and threw me into depression. My work, my daily life struggled. And I did something which I always believed to be the worst ever thing that one can do.

I ended up losing my virginity to a prostitute from Russia. The actual act was so surreal that I just cannot describe the feeling. Now instead of feeling guilty, I am feeling something else entirely. I want more. And this is making me crazy.

I need some advice on how to make rational decisions because I am losing my mind. I am acting weird, speaking weird, all is going down the drain. I want to stop and ask for help before I do something which I regret for the rest of my life.

Your advice in the matter would be highly appreciated. Have a great day.

 Of course you want more. You are a healthy young man who wants love and sex in his life. There’s no shame in that. It’s regrettable that in your desperation you turned to a prostitute. But it’s not the end of the world. It’s something to learn from. As you discovered, anonymous sex isn’t what you want and need. I suggest you forgive yourself for a lapse in judgment and focus instead on what you are going to do to find the right woman.

Unfortunately, I simply don’t know enough about how young people in Pakistan meet. You indicated that your elders would ordinarily be helpful. If that is the case, why not ask the elders in your family who know you well to help you find a woman to love? Arranged marriages can and do work if there is a commitment to it from both people. It is one option to explore.

If you are more western in your thinking, then it’s time to take more responsibility for your own growth. Often people find that the best way to meet potential partners is to get involved in an activity or organization that they and other people their age care about. Working on a project together takes some of the pressure off of relating to someone who is new. Over time, friendship and sometimes romantic relationships form. Even when romance doesn’t happen, making more friends will help you meet other people — who might introduce you to others. The challenge is to get into social activities and to develop the courage to show people your good qualities.

Some people think that finding a relationship shouldn’t take work. But I don’t agree. If you were unemployed and wanted a job, you would figure out how to actively look for the job. Relationships are just as important. I think it’s fine to put the same amount of effort into finding a partner as you would if you were looking for a job.

If shyness continues to get in your way, I hope you will consider seeing a counselor to help you work on it.

I wish you well.
Dr. Marie

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Transgender Issues

by Holly Counts, Psy.D. June 16th, 2022
written by Holly Counts, Psy.D.

I know it’s a bit of a cliché, but for as long as I can remember, I have felt very different. As a child, I didn’t have many friends, and could not really relate very well to others around me. Aside from this, I was a happy child who grew up in a loving and stable family. However, from a very young age, I felt very feminine. I could not really understand it at that age though, and was acutely aware of what was expected of my behaviour, so for the most part suppressed any overtly female characteristics. I would always play as a female character in video games, and would admire strong female characters in movies and tv shows. I felt very embarrassed when asked about why I did these things, which just made me try and push these desires and behaviours further down. As I reached the age of puberty, I felt something very bad looming, almost predicting the torment that was about to arrive. And as expected, my journey through puberty was highly traumatic, to the point where my parents barely knew what to do with me. I was withdrawn, depressed, angry and apathetic towards all areas of my life – including my studies. Nothing gave me any sort of relief, I just felt (and still do) like a freak who doesn’t belong anywhere. I started anti-depressants at the age of 14. My doctor initially was reluctant to prescribe them to someone under 16, but saw how desperately I needed help and agreed to begin a low dosage. I began to realise at around 16 that I was experiencing thoughts of being transgender, and at that point many things in my life began to make more sense. Despite this revelation, I didn’t feel any better or sure of what I wanted to do with this information. I am now 19 and am still struggling with my life, and have effectively become a hermit – too nervous to even step out of my front door most of the time. I do not know how to go about regaining my life, as every direction I could take feels hopeless. The reality is that I don’t want to have to change anything, I want to be happy as and where I am – but I can’t see that happening any time soon. Any advice would be greatly appreciated, as I am at my wit’s end here.

A: Thank you for writing in with your question. I wish I could ask you more questions to clarify your situation but hope that I can still offer some help. I’d like to know if you have sought out any support regarding the transgender realization and if you feel your depression and tendency toward becoming a “hermit” seem related to your gender identity or feel like separate issues altogether. My best guess is that both might be true. Depression and anxiety is common with gender identity issues and is quite understandable. Surviving all the typical struggles of adolescence can be difficult enough, but it can be exponentially more complicated when your physical body doesn’t match what you feel inside.

I would first suggest that you reach out to others in similar situations for some support. No one else can understand better than someone also going through it.  There are online forums and support groups and there may even be one in your local community. There are lots of resources online to help educate you and get you connected with the appropriate resources. Here are just a few examples:

http://www.nhs.uk/Livewell/Transhealth/Pages/Transoverview.aspx

#/a-primer-on-transgender-care/005870.html

http://www.apa.org/monitor/2013/04/transgender.aspx

I recommend therapy for addressing the depression, anxiety and isolation.  The safety and confidentiality of psychotherapy is also an excellent place to explore deeper levels of your identity, sexuality and plans for the future. In the United States you have to participate in therapy before you can begin hormone treatment or gender reassignment surgery, although you did not mention these in your letter.

Finally, it is important to find a family doctor who has experience with gender identity issues. You need to feel comfortable when you go to the doctor, whether it is because of an illness or because you decide to pursue medical interventions in the future.

You are not a freak, your situation is not hopeless, and I think that once you surround yourself with support, happiness will be just around the corner.

All the best,

Dr. Holly Counts

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Why Do I Isolate Myself So Often?

by Dr. Marie Hartwell-Walker May 29th, 2022
written by Dr. Marie Hartwell-Walker

From a teen in the U.S.: For as long as I could remember I liked being alone. I think it’s starting to really effect me though as I start to get older and enter the adult world. Every time I’m out with friends I feel uncomfortable and awkward. I always feel like I’m putting a front or an act in front of everyone I speak to and I could only feel at ease when I’m at home by myself. When I’m alone I feel as though I don’t think. Like I’m just alone in my room for hours imagining a better life and different scenarios of my pretend life when really I’m just laying in bed doing nothing. Is that normal?

I feel like something is wrong with me but I don’t understand what or how I could fix it. Sometimes I feel brain dead like I can’t even find words to describe how I feel or communicate with other people. The only phrase I always find myself saying is “I don’t know” I don’t know what’s wrong with me, I don’t know how to explain what I’m feeling, and I don’t know how to communicate or create a genuine connection with people.

All I ever do is pretend like I’m living in my own daydream and in this daydream I have personal connections with people I can hardly keep a conversation with in real life. Even when I go out with friends or family all I could think about is going back home to be alone. Like having conversations with people drains me and I need to be alone resting to stop feeling on edge.

Please tell me if this is normal or if any other person feels this way because a huge percent of the time I feel like I’m the only one who feels exactly what I’m feeling.

No, you are not alone in this. At 17, you are aware of the increasing expectations (by yourself and others) for you to enter the adult world as a fully functioning adult person. Those expectations can be daunting. Since you find them overwhelming, it make sense that you retreat to daydreaming as an alternative to dealing with the difficult reality.

However, this is a problem that only spirals downward. The more you retreat, the less comfortable you will be in the company of others. Instead of getting practice in communicating well and developing confidence in yourself, you are becoming convinced you can’t do either.

It may be that you are developing the symptoms of social anxiety. Everyone has some degree of worry about how they will be received by others and whether they can manage the multiple demands of a social situation. But symptoms of social anxiety are not just a momentary case of “stage fright”. When social anxiety reaches a clinical level, the person becomes so fearful of the judgment of others and so convinced that she can’t fit into the social world that the stress is just too much to handle. People with social anxiety dread being in a variety of social situations. This can severely limit a person’s life.

People tend to see those with social anxiety as shy or aloof or even snobbish. But the truth is that the client really does want to have positive relationships and to be included. The social anxiety has become a huge barrier.

The physical symptoms of social anxiety are individual. Some people feel dizzy or lightheaded. Or they might feel tension in the body. Some people develop stomach pain and diarrhea or a racing heart, blushing or sweating. Meanwhile, the person perseverates about their fear that they will do or say something that will offend someone else or humiliate herself. Basic social skills dessert her.

Such clients develop a variety of strategies for managing life. Some will only go anywhere if they are accompanied by someone they trust. Many significantly limit their contact with others. Others develop a full blown phobia and never leave their house.

The good news is that social anxiety can be treated. The success rate is high. Research has shown that the treatment with the best results is active, structured, cognitive-behavioral therapy. This type of therapy has been shown to to change the neural pathways in the brain permanently.

The earlier you get treatment, the less of your life will be wasted by holing up in your room. I urge you to make an appointment with a therapist who specializes in anxiety disorders as soon as you can.

While you wait for your appointment, you might find it helpful to read “Feeling Good: The New Mood Therapy” by Dr. David Burns. In it, he explains social anxiety more fully than I can here. He also describes a number of techniques you can use to help yourself feel better and more self-confident.

I wish you well.

Dr. Marie

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Staying in Touch with Therapist after Termination?

by Dr. Marie Hartwell-Walker May 27th, 2022
written by Dr. Marie Hartwell-Walker

I had been seeing a female Greek counsellor for social anxiety and I really miss her. I have just found out that firstly, she was exactly the same age as me; we are both 21 and secondly, that at our final appointment I was perfectly within my rights to ask if we could stay in contact with one another. Prior to our final session I had told myself that it was a necessity that I ask her that question. However, after looking on the internet to find out if I was allowed to make a relationship with a counsellor so soon after cutting our professional ties, I read that I was not allowed and I believed this; it turns out that it was pure lies. In retrospect I cannot believe why I did not just take the risk and ask her; I don’t see what harm it could have done. I am absolutely beating myself up about this.

My friends all gave up on me a couple of years ago because I didn’t want to socialise with them and this was the perfect chance to make a new friend which I have missed the boat on. She was such a friendly, likeable person that I got on really well with both within the counselling room and outside where we would chat and joke together.

My brother and sister often ask each other how many friends they have on Facebook and my brother will say “479”. My sister will then reply by saying “Is that all? I have 517”. I just wish that I could say that I have one friend and I hate myself for the fact that I can’t say that. It is likely that I will never see her again and that chance will never come back to me. i am not very good at all around people and I have no idea how I am going to find anybody else my age who I feel I could make a friend.

I have asked my new counsellor whether she would be willing to give me her phone number and she replied by saying “I am afraid it is not possible for me to help you with this, it would be completely contrary to our governing body code of ethics, however it was perfectly ok for you to ask [my Greek counsellor about maintaining contact]. Sorry I can’t be more helpful”. She was my only link back to her.

It was four months ago and already I am baffled and it is beyond any words of mine as to why I didn’t just ask her that simple question; I hate myself for it…

I desperately want to speak to my new counsellor about it but I only see her once a month now and in the weeks in between seeing her it eats away at me.

You certainly could have asked. But it’s unlikely your counselor would have encouraged a friendship. The counseling relationship is based on a helper/helpee dynamic. It’s very difficult for the two people involved to change their roles to ones based on equality. Right now, you have an idealized view of your counselor. This is natural and normal because all your conversations were one-sided. The hour was spent focused on you. If you did start to learn more about her, you might find that you don’t have as much in common as you think. Still, if this is eating at you, write her a note and see what she says. Many counselors are happy to get a note from a former client now and then but usually it stops with that.

As for your siblings’ “friendships:” I hope you don’t think a gazillion “friends” on Facebook means all that much. These are not intimate relationships. They are largely acquaintences. If you want facebook “friends,” all you have to do is start “friending” people and then updating your status with interesting comments and material. You too can have 100 friends on that basis. But I think you are looking for something more satisfying.

To get friends, you have to put yourself out there. That means doing the very thing you didn’t want to do to keep your former friends. If the idea of socializing is painful, I hope you will work on that with your new counselor. Friendships require maintenance. They require regular contact. You have to be interested in the other people and you have to find ways to enjoy each others’ company.

Please stop spending your time berating yourself about your idea that you missed an opportunity with your counselor. It’s just keeping you stuck. Instead, start looking at what you do and don’t do that makes having a social life so difficult and then make some changes. I’m sure your new counselor will be happy to help you with that.

I wish you well.
Dr. Marie

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