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Social Anxiety

Can’t Figure Out What’s Wrong with Me

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I’m 19, I don’t know what’s wrong with me. I almost always avoid social situations, or any situation where I feel like I won’t have a way to leave if I start feeling overwhelmed. I don’t feel comfortable being around more than one person at a time, whether it is close family or a friend since childhood. I have carried my backpack almost everywhere with me for about 6 months. I keep my laptop, chargers, random stuff that I wouldn’t want to lose. I have worn the same beanie since I was about 16. I can’t leave home without it on. It makes me feel more hidden from everyone. I can’t bring myself to see a psychiatrist.. I want to know what might be wrong with me. I have been searching what seems like forever for an answer, how to be myself again. I care about everyone a lot, I’m not able to show it/tell them though. I can’t talk to anyone about what’s troubling me. Last time I tried talking to a close friend, we were never as close again. I haven’t heard from her in months. Im constantly thinking about the past. After I hang out with a friend, I’m thinking of all the things I could have done wrong, or said that sounded odd. I hear voices of friends occasionally. Sometimes I think I hear them quoting everything I am doing in a sarcastic voice. I don’t talk to them. Most of the time I can tell if I am mistaking a sound for someone talking. No matter where I am, even in my own room, I feel like people are watching me or have set up a camera to record what I’m doing. I haven’t taken a picture of myself in years because I’m afraid that someone is getting copies of everything I do (pictures, internet browsing, text messages, etc). Usually when I go somewhere new, I look around for video cameras set up or people watching what I am doing. I am almost always listing off all of the possible negative things people could be thinking/saying about me. Whenever someone laughs, I automatically think that they are laughing at my awkward walk. I’m currently prescribed Amphetamine Salts (Adderall IR) 30mg 3x daily. I have been taking anywhere from 2-5 a day though. I can barely get out of bed in the morning until I take one. I think I am just putting everything into my head, and convincing myself that something is wrong with me. Even if I am, it is definitely taking it’s toll on my life. Im pretty sure, if anything, I have something similar to Social Anxiety.. I was abused from newborn, up until 16. Then my mom divorced my dad because he wouldn’t stop the mental/physical abuse. The fact that it was my fault has stuck with me to this day. I also went through one of the worst tornadoes in history May 22nd, 2011. Since then, I’ve lived in a FEMA trailer park. I’ve started smoking up to a pack a day. I’ve never done anything like this before, so I’m sorry if it was too long, too much personal information, or anything like that. It’s 4 in the morning, work in 5 hours. Any advice would help so much.

Without interviewing you in person, it is difficult to know precisely what may be wrong. There are two main possibilities. The first is that you have social anxiety. The second possibility is that you have schizotypal personality disorder. Individuals with schizotypal personality disorder characteristically have a great deal of social anxiety, tend to be loners, misinterpret situations, experience paranoia and have paranormal or peculiar beliefs.

A complicating factor in your situation is that you have been displaced from your home. Not being able to live in your home may be contributing to your anxiety problems.

You also mentioned that you have a history of abuse. That further complicates the situation and it may also be contributing to your current psychological symptoms. You blamed yourself but it is important to know that you are not to blame. The adults are to blame; you were an innocent victim.

In your letter, you stated that you have been prescribed medication. That means that you have likely been evaluated by either a mental health or medical professional. I would encourage you to speak to that person about the symptoms you have described in your letter.

The fact that you’re taking a medication that is not working is also important information that the prescribing physician needs to know. Ideally, you should be evaluated by a mental health professional and referred to a psychiatrist for psychiatric medication, if necessary. My main suggestion is that you need to contact the proper mental health professionals so they can properly assist you with your psychological problems. Please take care.

Dr. Kristina Randle

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I Don’t Know What Is Wrong

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From a teen in the Netherlands: I feel so confused.Since I was 10, I have been an anxious person. I was bullied around that time, and I have always been made fun of. I feel like that never really affected me. Then, when I was 12, I remember feeling horrible sensations inside me. I don´t know if those feelings were sadness or anxiety, I just remember being in mere pain. Then, after I turned 13, those feelings were decreasing in intensity. I was definitely still anxious, but I guess I was used to it, so I really cannot remember my emotional experience at that time.

What worries me is that, now, most of the time, I feel numb. That is the first of the only three feelings that I can experience, and the one I feel the most: plain numbness. My teachers have always said that I have a nonchalant attitude, and I used to disagree, but now I do not. There are periods of time (which are very long) where I could not care less about anything in my life. During these, feel restless, cannot concentrate, and often find myself thinking of death, generally, or just full of pessimistic thoughts, but I cannot feel anything positive. I cannot even enjoy activities the way I used to.

Sometimes I feel a second, different feeling: I feel stupid or ashamed. I don´t really know how to describe this one. I feel like this when little, simple and insignificant events affect me tremendously for hours, but then I tend to just ignore them, and when I remember stupid things I have done in the past.

The third feeling is a mixture of hopelessness and abandonment, but I rarely experience it. When this feeling comes, I fantasize about being friends with people I know (most of them have only seen me, or know me but despise me) and talking to girls I am attracted to, begging them to stay with me for a minute. Then I feel truly sad, start crying and realize that I will be alone during all my meaningless life.

By the way, I am feeling so stupid right now, just because I am writing this to you. I lately also fear being a victim of crime when the second and third feelings come; most of the time I just visualize myself dead in a corner after being robbed.
P.S: I have high-functioning ASD.

Thank you for writing. Although I can’t make a diagnosis on the basis of a letter, I can tell you that the feelings you describe are consistent with depression. As you probably know, people with high functioning autism are often anxious. The isolation due to difficulties with social interactions and communication can also trigger feelings of depression.

If you are not already in therapy, I hope you will consider seeing someone for an evaluation and recommendations. Look for a therapist who is experienced in working with teens on the autism spectrum. Such a therapist will help you make sense of your feelings and also learn some compensatory behaviors so you can be more comfortable with other people.

I also suggest that you read some of Temple Grandin’s books. She is an articulate and helpful member of the community of people on the spectrum. I think you would find her story helpful. There is also an excellent made for TV movie that was filmed in 2010 about her life. Do check out her website as well: http://templegrandin.com/. I think her articles will be very reasssuring.

I wish you well.
Dr. Marie

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Humiliated

by Holly Counts, Psy.D.
written by Holly Counts, Psy.D.

Hello. I am a 15 year old girl. Since I was a little girl, I never really went outside. I always stayed at my home most of the time. I only had one friend with whom I would talk to most of the time. I was terrified of what people thought about me, and I still am. And because of that I avoid people, even my classmates. A humiliating incident happened today. After tuition, my tuition sir’s small girl who is about six years younger than me was playing with me. She then suddenly took a leap on the double-swing seat’s edge and was standing and swinging. I was worried she would accidentally fall and hurt herself. So, I went over and playfully hit her leg and told her she might fall. After that she did something which really humiliated me in front of my friends. She slapped me. I was speechless and I walked away. What’s worse is that I didn’t even tell her anything. What’s even more surprising is the fact that I didn’t even get angry. When I went home, I was only thinking what my peers would say about me after that embarrassing and humiliating incident. I still wasn’t angry on the girl.

Here’s the problem: #1 – I always, ALWAYS fail to stand up for myself. I always think the other person is always correct. Not me. I am really pathetic. #2 – I am always worried about what people might think about me. Because of that, I don’t even speak to any people except for my best friend. Even when I actually speak to people, I get really shaky and fail to form proper sentences. I can’t even think properly and because of that, I blabber out stupid stuff. (age 15, from Saudi Arabia)

I’m sorry that you are feeling humiliated by this experience. It may be that the girl slapped you because she did not take your behavior of hitting her on the leg as playful and she was striking back. In the future, it may be best to keep hands off and just let her know that you are worried that she might hurt herself. I’m not saying that what she did was ok or justified, but she may have just reacted without thinking, not realizing you were trying to help.

Nonetheless, even though you felt humiliated by the experience, I doubt it really caught that many people’s attention and even if it did, they will move on and forget about it. I’m more concerned that you feel so uncomfortable around others and yet care so much what they think of you. What really matters is how you feel about yourself. If you like yourself, others will like you too.

In order to build up your confidence socially, it may be important to slowly work on making new friends and specifically seek out those whom you have things in common with, be it school subjects, hobbies, or even just a similar sense of humor. You don’t have to have a lot of friends, just focus on having a few good ones. This will go a long way in helping you feel comfortable.

It may also be beneficial for you to speak with your school counselor, a therapist or perhaps even a trusted teacher or other respected adult. Getting an adult perspective at this difficult time of your life might help you make progress faster. Furthermore, you can do some reading on self-esteem and assertiveness. There are many good workbooks available, as well as some helpful online resources.

You began the process of sticking up for yourself by writing in and reaching out. Keep up the good work!

All the best,

Dr. Holly Counts

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Why Can’t I Keep Healthy Friendships?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From a teen inthe U.S.: I’m 14 now. When I was in 7th grade I had two best friends. During that school year I didn’t have many classes with them, they had more classes with each other. I began to feel very left out and I got very depressed for some reason. I would always cry and feel worthless because I always felt left out and thought they were getting closer to each other and they were going to leave me behind. Right now I’m a freshman in high school. Now that I look back on that I see that I was overthinking and that it was all in my head.

Nowadays I find it so hard to keep friendships. If I’m really close to a friend or if I’m just always with them I get very attached to them and I don’t know why. I always feel jealous and insecure if that person I’m attached to hangs out with other people because I’m afraid they will take them away from me. I’ve noticed that I’m always jumping from person to person and getting attached, but it only ever happens with one person (I don’t get attached to more than one person.) I get so much anxiety at the idea of them finding someone else and leaving me behind. Please help me. I know feeling like this isn’t healthy and it kills me inside. This really affects my relationship with other people, please help me.

First — and this is very important — I want you to know that you are not at all alone in this. Many teens are insecure. Even kids who look secure are often as anxious as you are inside.

You have been trying to “cure” your insecurity by limiting the number of people who can reject you to one person at a time. As you have discovered, it doesn’t work to do that. Why? Because the teen years are a time when people sort who they are most comfortable with, who they want as friends, which friendships are healthy and which are not. This leads to a lot of rejections along the way. Kids like you who are sensitive often take this sorting personally, when it is often just about not being the right “fit” for someone else.

The “cure” is to decide to take some risks and to broaden your circle of friends so you can do some sorting of your own. You will only figure out who are the right friends for you by experimenting with different relationships and by comparing how you feel (and even how you are) with a variety of people. It’s just true that sometimes people we think are a perfect match when we first meet them don’t turn out that way. This isn’t heartless. Sorting (which does involve some level of rejection) can be done kindly.

Kids who successfully navigate the peer group are people who find ways to get to know lots of others before settling on a few besties. You can do that by joining teams or clubs or activities that interest you. People who share an interest (whether it is softball, a theatre production, making music or work on a service project) already have something in common. Slow down with trying to get close. Resist the temptation to cling to one person. Instead, do things with the group. Invite a few people to do something like go to a movie or go shopping or something you know will interest them.

As you gain confidence and become a more active participant in the life of your school, you will naturally find your own group. Yes, you will be “rejected” now and then by someone you think might be a friend. But you will also be accepted by others. That’s a normal part of the process.

I often wish there were a way to magically get young people through the struggles of the teen years. But I also know it is those very struggles that are necessary to help you develop maturity and sophistication about relationships. It’s difficult. But I suspect you have what it takes to manage it and become the sensitive, strong woman you are meant to be.

I wish you well.
Dr. Marie

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I Don’t Know?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

This feels kinda stupid but I know I need help? I’ve slowly lost touch with everyone in my life, including my whole family. I have exams coming up and everyone expects me to do amazing but I can’t. I can barely find energy to get up in the morning. there are times when I feel like crying, even though there’s nothing wrong. I’ve always got a headache, or stomach ache, or just generally feel ill. I think I hate myself and this makes me hate everyone else too. I feel like I’m ‘digging my own grave’. I talked to someone honestly, and she basically told me to ‘suck it up’. Sometimes I wonder if she’s right though, maybe its just me being a twat. Recently, I’ve buried myself in all the fantasy worlds in tv shows. My whole family seems more complete without me, and just generally happier. The friends I used to have got left behind as I moved schools, and I ended up with the popular kids. I just don’t wanna cry anymore. I’m just so tired. and I can’t talk to anyone. my parents think I’m crazy, and I’m making stuff up. they’re too busy with my siblings to even notice me half the time. sometimes I wonder if they wish they didn’t have me. I’ve also gained a lot of weight. it sucks. I’m taller than my own dad like is that even possible? and fat. I’ve tried working out… I look like an idiot. I just want to leave everywhere, but that isn’t possible. I’ve been brought up as a Christian, but sometimes it feels like even god doesn’t want me. I went to a retreat, and came back happy and refreshed. no matter how much I pray I cant get it back. it seems like whatever I do now I always wrong. I’m so sick of being here. sometimes I wish I could just sleep till I’m old. talking to people makes me feel like an attention seeker, begging them to notice me. but I need their help, I don’t know how to ask for it. Everyone keeps asking me if I’m alright, apart from my parents. I thought they were the people who were meant to notice you and know you the best? I always say sure I’m okay but I literally don’t know. I wanna leave home. (From England)

 At 16 years old I can say that many of your feelings are shared by others you age. It isn’t easy trying to figure out where to fit in and how to choose a direction in life. I admire the fact that you are trying different things to feel better even though you don’t feel supported by your family. This takes courage and resilience and isn’t easy.

The sadness you are describing can be coming from many sources. I would just tell your parents that you are not feeling well and ask to go to the physician. Your parents may have an easier time if they believe you need medical attention. When you talk to the physician explain to him or her that you are having these thoughts and feelings. The physician can do two things. One, he or she can check out if there is anything physical that may be causing your symptoms. Secondly, if it is time for some counseling he or she can talk to your parents about the need and help make a referral.

Wishing you patience and peace,
Dr. Dan

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I Often Pretend to Be Someone Else

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From a teen in the U.S.: So I will often either when bored or stressed (from anxiety) or just for fun  head out on a walk (or home) and there is a couple things i might do. Either play a trailer and pretend like im the director and people are reacting to it while i play out the characters in the trailer or play a rap song and be the rapper or me (and I often have a little backstory when I do). Or alot of times I might just pretend I’m me singing or playing guitar and being amazing at it while family members or school mates are watching.

I do this almost everyday and ive done something similiar like this when i was around 11,12 but the thing is i only do it when i have my eaphones on and im playing music.

And the thing is I honestly havent had any friends all my highschool years, maybe 1 or 2 but i would isolate myself alot in my room because of my social anxiety and never really would go out unless at night for a walk.

Now the thing is in all my times ive pretended like this im almost the center of attention or i did something great or have some talent. Similar to this I would also go on walk where I would play bits either from radio segments or podcast that were really funny and pretend i was that person being funny or in that group.

I also want to add when im doing any of this i can stop at any moment like if i have something to do i can just stop and I dont actually believe its real and i know its pretend. I just want to know why it brings me so much joy and relieves stress when I do it cause after not doing it for a while I start feelin the urge to do it again why is this?

 You use your imagination because you are lonely and isolated. It’s as simple and as complicated as that.

You told me that you have social anxiety, that you haven’t had friends, and that you’ve been doing this for a very long time. When you were a young child, you discovered that the world of imagination was much friendlier for you than the social world. You therefore spent more and more time developing it. That gave you a way out of your loneliness and it felt wonderful. A pretend world as complicated as yours usually is the mark of an exceptionally bright and imaginative kid.

I’m not worried about your delight in music or your pretend fame. It’s the stuff that great novels and songs are made of. What I am worried about is your continued isolation. If you continue to retreat to your imagination, you will not learn the skills you need to make friends, find a partner, or be successful in a job.

As painful as it will be at first, you do need to get out into the real world. For that, you may need the support, encouragement and guidance of a therapist — at least for a while. Please don’t put it off. A therapist can help you learn to use that intelligence and imagination of yours to find ways to get comfortable with other people.

I wish you well.
Dr. Marie

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Am I Avoiding People or Do I Just Like Being Alone?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

It’s like that I always being alone everywhere. I’m comfortable with being alone. In school or going to some places, it’s really okay for me to be alone. Some people in school sees me weird for it, but I think it’s them who always need accompany just to go to toilet or canteen while they can do it their self. I have two best friends and don’t like to be in group.

I avoid those people who talk so loud and cant control their laugh. My interest aren’t the same like any other girls. I don’t like gossiping or talking about make up or love life. Yet, I like games, comics, breaking the rules, and I draw a lot. I don’t want to pretend I like their interest just so I can talk with them. I like being who I am and they see me weird for it. I turned down guys who flirted with me indirectly like three times because I don’t know what topic should I say.

When I was a kid, I’m a shy and quiet girl but gets talkative with my close friends. But, I turned really quiet when I’m a junior in middle school because my friends and someone who I think my best friend avoided me. Middle school was the worst time for my relationship with people. I ruined many of it and got avoided by my classmates twice. I’m starting to think my like of being alone because of that, plus my mother passed away and I was really close with her and one year later my dad married again.

Lately, I began to love being alone in my world and don’t like to talk to someone. I love being in my world with my imagination and it bothers me when someone start talking to me because I don’t know what should I say, I’m not good at making joke and I really often miss pronounce words and speak with low voice. Lately, I also feel empty and often daydreaming. Am I avoiding people or love to be alone? Because it really sucks to know people sees me weird for it. (From Indonesia)

 

A:  I really appreciate the way you have articulated this question. There’s a fine line between needing alone time and avoiding people. Susan Kane has written about this in her book Quiet. I recognize that being alone has commend this value many people and groups, and group interaction me be counterproductive for them. Susan Cain writes about this with clarity. Being shy or quite isn’t a disease — but systematically avoiding new or challenging situations isn’t healthy. Give yourself a goal of trying something new — talking to someone new once a week. Challenge yourself regularly as it will help you grow — but watch Susan’s Ted Talk for more insight into embracing your quiet nature. You will need to balance both as you move forward.

Wishing you patience and peace,
Dr. Dan

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My Older Brother Has No Friends & I Am Extremely Worried, How Can I Help Him?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

My brother (19) has always loved video games and spent most of high school playing online with his friends. However, I believe that this has seriously stunted his social growth. He went to a different high school than all of his middle school friends and remained friends with them but wasn’t able to make any new friends at his high school. His high school was a catholic all boys school with extreme athletic pressure and was known for being mostly “alpha males.” My brother did not fit in at all and I think that this isolated him from social interaction throughout high school. I assumed that in college he would be able to make friends because there would be a wider variety of social groups, but it is now his sophomore year and he has made absolutely no friends. He is very uncomfortable in social situations and avoids eye contact with people, but when he is around people he is comfortable with he’s completely normal. He mentioned to our mom that he wanted to go out one night but he didn’t have anyone to go with. I have had him hang out with me and my friends before but he is extremely awkward and finds it hard to talk to them. It is almost as if he hasn’t developed any personality due to missing out on social interaction in high school and I am extremely worried (as are my parents) about him because I can’t really help him be more confident and put himself out there. I think that he is struggling with confidence issues as well as SEVERE social anxiety but there is no way for me to help him. He is an engineering major so he has little time to socialize and this has not helped him meet new people at all. How can I help him? How can someone regain confidence and build a personality after such a traumatizing high school experience?

You mentioned that his high school experience was “traumatizing.” That may be how you see it, but that may not be how he sees it. It would be interesting to know if he considered it traumatizing. Many people have similar experiences with peer pressure in high school and don’t perceive it as traumatizing. Maybe it wasn’t as traumatizing as you perceive it to be.

Also, you are assuming that his personality growth was stunted because of his limited social interactions in high school but the reverse may be true. His limited social skills may be the reason why he interacted so little with others. Deficits in social communication can prevent people from connecting with others.

One possibility to consider is that he may have autism spectrum disorder (ASD). ASD is a developmental disorder that primarily affects communication and behavior. There are two core elements of ASD. These include a deficit in social interaction and the presence of repetitive and restrictive interests and/or behaviors.

Your brother is showing a potential problem in the area of social interactions. His interest in video games may qualify as being a restrictive or repetitive interest and/or behavior.

One other element of ASD is that problems with communication and behavior interfere in an individual’s ability to function properly in life. According to your letter, the problems you have described with his communication and behavior do seem to be interfering with his ability to function in life. In fact, that is your major concern and reason for writing.

One other aspect of your brother’s behavior is his avoidance of eye contact. Individuals with ASD often have problems with visual attention. They often report having extreme difficulty looking others in the eyes. People with ASD say that it is a stressful experience. Some have said that “it burns.”

In our culture, it is considered disrespectful not to look someone in the eyes. If you’re speaking to someone who is continually looking away, people might be offended by it or even frightened by it. The reality is that sometimes individuals with ASD are overwhelmed and are not intending to be offensive or to show disrespect. Too few people in our culture understand this.

Obviously, I cannot diagnose your brother on the basis of a short letter. I’m simply pointing out the fact that he may be demonstrating some of the characteristics of ASD. You can read more about ASD. There are many great resources on the internet.

You might speak to your parents about the possibility of your brother undergoing a psychological evaluation. The evaluation could shed light on what might be wrong, if anything. If ASD is a possibility, then your brother should consult a professional who has experience with ASD.

Once he undergoes an evaluation, you will have a better understanding about what may be wrong. Hopefully he will be open to having an evaluation. That would be a great place to start. Good luck and please take care.

Dr. Kristina Randle

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Should I Compensate for My Past Failures?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

From Bangladesh: I am 34, married, have a daughter who is eight years old. I love her a lot. I probably have very low self esteem and also obsessions/compulsions. In the sanityscore.com I scored 75 in self-esteem and 56 in obsessions/compulsions. Although, I am sure I didn’t answer a lot of questions correctly.

I graduated in 2006. But for the past 10 years I was employed for only 22 months in 2 different jobs. The second job was worse than the first one and barely covered my expenses. I am currently unemployed and pursuing a Master of Science degree in IT. I have been living off of my father’s house rent for most of my adult life.

I have been abused by my parents since the age of 4. Both my parents used to beat me a lot but my father used to emotionally abuse me more. My mother expressed her love and appreciation for me sometimes but my dad never did so (except for 3 occasions) because ‘that would spoil me’. Constant criticism, name-calling, belittling, ridiculing, verbal threats was a daily routine in the name of education up until 2012. I was thrown out of home twice before the age of 12. When I was 20, I escaped from home for fear of my dad after failing in 2 courses but returned home after 3 days. I was and am very fearful of my dad. I can never speak to him normally and mostly keep silent whenever he is around, I feel like walking on egg-shells. In 2012, at the age of 30, I first came to learn what emotional abuse is. At one occasion in that year, I confronted him and yelled at him for the first and last time. The abuses lessened ever since. But I am still afraid of him and want to move away but I need a decent job first.

I procrastinate a lot. I have no friends since the age of eight. I am afraid of facing job interviews (despite having well qualifications) and making friends for the fear of being judged negatively. I know I need therapy.

I am not legally/financially indebted to anyone. But I feel I should compensate for my past unemployment by earning more in the future. Some people I know are trying to do so to compensate for their ‘forgiven debt’. Should I do it? Everyone in society seems to believe that consuming more than you have earned in life is disgraceful and nobody deserves to live on the food that he hasn’t paid for. But I don’t want to do so. I want to be happy but want to ‘deserve’ it too. But I don’t want to go abroad to earn more. I just want to live away from my parents with my family, learn more of what I love, connect with people, raise my kid and have a good life. I don’t want to pursue more money or burden myself with more responsibilities or pains than that is required to have a healthy self-esteem. What steps should I take?

 Thank you for your question. I appreciate the courage it takes to write about the emotional abuse, and understand your desire to compensate. However, unless there was a specific agreement made between you and your father for compensation, I would not invest your time, energy and future in repaying something that your father needed to give. Let the “forgiven debt” be just that. It may be one of the ways your father is trying to atone for his poor parenting. Let this be.

Your university should have a counseling program on campus and it’s likely to be well equipped in helping you with social and professional skills. Make an appointment with one of the counselors. They will help you to envision a future of learning more of what your love, connecting with others, raising your child, and having a good life.

Wishing you patience and peace,
Dr. Dan

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My Life Is Taking a Turn for the Worst It Seems

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

For a while now, I have shown symptoms of depression as well as social anxiety. I talked to a therapist about whatever I could. I told him about some other things like the repetitive tasks I must perform out of fear, my derealization experiences, etc. All he told me was that I was experiencing a lot of anxiety. I’m not sure if I explained myself too well or if he doesn’t necessarily want to tell me about what may be going on. This is quite frustrating, because I need help. Terribly!

I feel as though I will be taking my life soon. I think about this everyday. I have quite a lot of breakdowns but I keep this to myself. I have suicidal fantasies and they are quite a relief. I am always extremely sad and become angry very quickly. I feel so lonely and I feel like a burden. I am just another failure. When others talk about the future and ask me what my plans are, all I can think about is death. Along with these suicidal thoughts and fantasies, I have quite a lot of homicidal fantasies which all have to do with mass murder. It seems as though I have this hidden goal of becoming an infamous mass murderer. I want to be at the top of a ranking chart for mass murderers and how many they have killed. I would like to write a manifesto and some other separate paperbooks that would explain my motives, my worldview, societal views, me as a person, etc. Of course this is all part of an elegant fantasy. I am filled with rage and hatred. I feel powerful and in control when I think about mass murder.

Overall, I really just want to know how to deal with these thoughts and fantasies. Living doesn’t seem like the best option currently.

It seems as though you have spoken with your therapist about your social anxiety but not your suicidal or homicidal thoughts. You should not keep those from your therapist. It is very important that you discuss those thoughts with your therapist. It should be the very first thing you discuss in your next therapy session.

You’re not alone in your homicidal fantasies. These fantasies often involve becoming an all-powerful, entity of destruction. Desire for infamy is a desire to be seen as important, to get attention. People feel this way when there are suffering and they lack power in their own lives.

It’s difficult to tolerate all the negativity in your world, especially when you’re in pain and don’t have the power to stop it.

But you have a choice as to how you move forward. You can choose to seek help or to act on your strong emotions, which in all likelihood, are temporary and will eventually subside.

Many, many people at 14, the teenage years, have difficult lives. The world can seem oppressive but that changes as you age, mature and grow. It’s best to seek help during this turbulent time.

Even without help, many people learn that eventually life gets better in time. That’s the core message from people who have attempted suicide and who have survived. They discovered that their lives got better and thankfully, were alive to see it happen.

Killing, mass murders, etc., are as much a form of suicide as homicide. The consequence of murder is, for all practical purposes, the ending of your own life. You will be killed during the homicide or perhaps executed, after being caught, or live a nearly unimaginable life of degradation in prison, until you commit suicide or your heart naturally stops beating.

Damien Echols, of the West Memphis Three, spent 18 years incarcerated for a crime he did not commit. He was eventually released and described prison as “the coldest, most empty place…you’re dealing with some of the most sadistic elements of humanity there… I can’t even articulate how bad it is, how vile and revolting it is.”

I don’t think you want that kind of life.

Ronald Siegal, Assistant Clinical Professor of Psychology at Harvard Medical School, is right when he says you are not our thoughts. “We think our thoughts actually mean something. In fact we think we are our thoughts and our thoughts are us… Sometimes [your thoughts] are downright ridiculous. Just because you think it, doesn’t make it true.”

He’s exactly right. Many people have irrational, ridiculous thoughts but they don’t necessarily mean anything. They might be evidence of suffering and a sign that an individual should seek help but they should not necessarily be thought of as important. Fantasies are meant for exploring thoughts and ideas without having to do them in real life. Most fantasies are never carried out.

I hope that you will ask your therapist for help with your homicidal and suicidal thoughts. I hear from many teenagers who don’t have access to any mental health treatment and who would be envious of your opportunity. You have that access, use it for your benefit. Your therapist can help you but not if you withhold important information from him. I wish you well. Please take care.

Dr. Kristina Randle

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My Mother Is So Depressed and Doesn’t Want Help

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From Greece: I’m an only child living with his mom. My mother has had a very harsh time. Mostly a bad husband who wasted 30 years of her life in verbal fights. My parents are divorced now, so since my father literally tossed us out, my grandmother is taking care of us, as my mother always took care of the household and no one hires her in her 50s.

Today she has put on too much weight, she never goes anywhere without car, she goes out (though very rarely she does) with my grandma and no one else, and she avoids seeing other people as much as possible, making me say cheap excuses as to why she won’t be at home. She barely sleeps 1 or 2 hours at night. I am totally devastated by the way my mother is ruining herself.

She has been through a lot of course, not just my father (who was a psychological nightmare during all our lives), breast cancer (almost sure created by the anxiety my father caused all the time) and psoriasis. I am glad she survived through cancer, but she is so not caring for herself. She eats cookies and chips almost every night, and the only thing she cares about is buying food from the super market. Also, she behaves in a way my father used to. If provoked a bit more, she starts shouting angrily, and she always says that she answers to no one, and no one will tell her what to do, as if we remind her of my father,

when my grandma and I tell her to stop eating at night, etc. She gets angry SO easily. She has closed herself inside the house and all she does is household stuff, cooking, eating and watching silly stuff and news on facebook.

I feel like dying every day I see her decline like this. She has promised me several times that she will start taking care of herself, but somehow my father always comes forth and she forgets every promise, going back into her vicious circle she calls life. I have asked her to visit a psychologist, but always says she won’t give money to crazy people when she is fine. But she has told me sometimes how useless she feels but that’s all.

I’m writing details to justify, but I’ve been incapable of helping her…I need some advice…

This kind of situation is terribly difficult. However concerned you are, you can’t “make” your mother take care of herself. Although I can’t offer a diagnosis on the basis of a letter, it is probable that you are correct, that she is depressed.

What saddens me most is that she is letting her former husband “win”. She may think she is making him feel bad by behaving in this way, but she is incorrect. From what you shared in your letter, he probably doesn’t care.

There is a famous quote by a British poet named George Herbert. He said “Living well is the best revenge.” The way to recovery for your mom is to reclaim her self-esteem and to show her ex that she is fine. She can do that by taking care of herself, by finding something to do that gives her life meaning, and by generally moving forward in her life.

Even if your mother refuses to see a counselor, I encourage you to do so. You are a sensitive and loving son. You would probably benefit from getting some practical advice from someone who can hear more of the details as well as some on-going support in this difficult time.

I wish you well.
Dr. Marie

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Tried Everything & Feel There Is Nothing Else that Can Be Done

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I have agoraphobia, social anxiety and depression. Had loads of help to work through these problems, different therapies, different medications but still struggle a lot with all of them and the agoraphobia I have never really got on top of it.

I am an adult living with my parents for many years due to my mental illness. I work a lot, have no friends (mainly by choice as it is very hard for me to enjoy spending time with people due to the social phobia) and stay home over the weekend mainly. I feel I am at the end of the line, that nothing can help me. I have got to the point I am over trying to get better, I am tired and feel defeated. I want to die, but I am an only child and I am worried for my parents, but I cannot cope with them dying, and one has COPD and the other a bowel cancer.

Most normal people, would just deal with the illness of their parents and their death as inevitable, but I have always had this terrible fear of them dying, as my life is really nothing without them and I feel that when they start to get really sick , I will simply lose it and not be able to cope anymore and would end up committing suicide. I saw a movie when I was a young girl called Night Mother and felt a profound connection with the main character, I was only 17 at the time I did not know about mental illness or how my life would turn out, but to this day, over 20 years later, I feel that this is how my life is, like that character, you get to a point where you have had enough.I would like to possibly die before my parents, but I am so scared of getting it wrong and ending up worse off. I would like to talk to my parents about my wishes, but it would crush them, but I dont know how long I can keep pretending that I will be okay when they become ill. I feel I should have the right to choose to die if my life is so unhappy or that I am going to suffer considerably mentally by the deaths of my parents.This is not something that would happen in the very near future.

You may not be doing everything you can to help yourself. You seem to have essentially given up. The evidence? You choose not to have friends because of your anxiety. You could have friends, but you’d rather not because you consider your anxiety to be insurmountable. You are thus making a choice, the wrong choice in my opinion.

Anxiety is unpleasant, but it’s not insurmountable. No one likes unpleasant emotions, but avoidance only makes them worse. Avoidance reinforces and increases your anxiety and the stranglehold it has upon your life. Instead of choosing to avoid unpleasant emotions, choose to endure them and learn to work through them. In concrete terms, that means having friends even if the thought of interacting with them frightens you. If you face the problems that frighten you, rather than run from them, those problems will eventually not frighten you. With the assistance of a competent therapist to guide you through the process, you can prevail.

Anxiety and depression are highly treatable disorders. You should never stop searching for help until you find a treatment that works. It is especially important to find help because of your suicidal ideation. When someone is suicidal, it’s evidence of their suffering.

Regarding your parents, it is true that they will eventually die. Everyone who walks the earth will eventually die, but while we are here we must make the best of our time. You mustn’t allow it to be a torture. With therapy it needn’t be that way. There are many support groups and counselors that can assist you.

Call 5 to 10 therapists and speak to them over the phone. Choose the one with whom you feel the strongest connection. You might also try connecting with friends and family, members of clergy or anyone else who you think could help. Don’t stop trying until you find relief.

Finally, you might also try reading the book The Road Less Traveled: A New Psychology of Love, Traditional Values and Spiritual Growth by M. Scott Peck. He discusses many of these issues in his book and provides suggestions for solutions. You might find it beneficial. Please take care.

Dr. Kristina Randle

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Why Should I Change for a World that Makes No Sense?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

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

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Afraid That I Have Avoidant Personality Disorder

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I’ve always been very shy and it seems to have escalated into social anxiety. In elementary school I had many friends and joined teams and got involved. In middle school, the same thing. I’ve always been viewed as the “nice, quiet one”. Around grade 10, I started cutting myself off from people, thinking that they wouldn’t want to be my friends anymore. I’m not sure where this came from. Nevertheless, I withdrew myself and my social anxiety increased. It’s strange, but I seem to have become more confident in myself yet I cannot seem to make relationships anymore. One side of me wants to, but this other stronger side does not want to expose myself or get involved in anything because of fear of rejection. I’ve stopped joining clubs. I spend my lunch hour alone. I have one close friend who I cam be myself around. But I cannot approach her at school if she’s surrounded by other people because they intimidate me. I have trouble looking people in the eye or saying something as simple as “hi.” I work at McDonald’s as a cashier where I do not find it hard interacting with customers. I actually enjoy it. But when it comes to talking to my coworkers, that’s a lot harder for me. I am a very hard worker and make a good employee except for the communication part. I try very hard to please people. I can talk one on one with people but cannot approach a bunch of people and join in conversation. I have stopped getting involved in anything except school and work. Every time I go to work I feel anxious, even though I’ve been working there a year. I remember dreaming about my high school years, and they were not like this. I dream about getting married and having children and a good job where I have lots of friends, but I’m so scared that this will never happen for me. I haven’t told anyone about this and people (even my family) just describe me as shy. It’s killing me and I don’t know what to do.

You may or may not have avoidant personality disorder. You match many of the symptoms. It is a realistic possibility. The good news is that many effective treatments exist for anxiety.

You mentioned that you try to be a people-pleaser. Perhaps you do this because of a desire to be liked or as a strategy to avoid confrontation. Nothing good comes from people-pleasing. The most unfortunate aspect of it is that you abandon your true self and essentially become whoever anyone else wants you to be. It is a very inauthentic way to live. No one could be happy living as someone they are not.

Now is the time to get help. Consult a therapist. Anxiety typically becomes worse if not treated. This happens because people with anxiety often attempt to manage it by avoidance. This short-term approach has been found to make anxiety worse in the long term. Many people have overcome anxiety disorders and live psychologically healthy lives. Millions of people have done it and so can you. You have the power to make positive changes in your life and it begins with deciding to get help. Please take care.


Dr. Kristina Randle

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I Feel as if Something Is Missing, Something Everyone Else Has that I Don’t

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I’m prone to overreacting every once in a while, I’ll usually throw a fit in my room at night and try to be quiet (hitting pillows, crying, screaming into pillows) which I’m sure is ordinary. The real problem is I seem to be missing something. I’m too…open-eyed, I guess. I sit around with a stupid smile on my face. At school, I feel uncomfortable if people try to sit next to me at lunch, so I sit on my own and read, and this doesn’t bother me at all! But my mother thinks I’m hurting myself (socially), but she doesn’t seem to understand how strained I feel when I’m put into a situation I don’t like. On the other hand, when I do feel chatty, I always seem to mention topics that aren’t related, or I steer the conversation towards me, or I’m unintentionally mean. I try to remind myself not to behave that way, but every time I talk it seems like I mess everything up. I think about things no one else really cares about. I’m not sure if my personality is weird or if something is actually going on with my brain that doesn’t happen with everyone else, because even introverts (i think) have their own little group of friends to sit with, even if they don’t talk, but I feel stifled and nervous when I haven’t started talking on my own terms. I’ve started noticing that I take nudges and pushes a little too seriously, and when I try to replicate that playful atmosphere with my siblings I end up hurting them or angering them. Everyone gives me a hard time because of it. My siblings make me feel guilty. Once I had politely declined an offer from a nice girl who wanted me to come and sit with her and her friends, and when I later on related it to my mother, she was upset that I didn’t accept the offer and told me that I wasn’t going to make many friends if I was rude like that. There’s also the fact that I act a lot like a child and can be loud and annoying, and I feel like I interrupt people all the time. I just love being alone and feel agitated if someone, like one sibling of mine often does, impedes my private space unannounced. Thank you for listening.

Being a teenager is difficult, much more so than many people realize. Most teenagers can relate to your experiences. All of the things that you have written about have probably been felt and are being felt by teenagers across the world. They worry about fitting in. They want people to like them. They worry about embarrassing themselves in front of others, and so on.

Your mother seems to be concerned about your wanting to be alone. Her concerns may be valid. The key to knowing if there’s a problem is determining the reason you want to be alone. If it’s because you want to collect your thoughts or read a book or focus on a project, then those are normal and healthy reasons. If it’s driven by nervousness or fear, then that’s a problem. It might suggest that your avoidance of people is due to anxiety. It would be unhealthy to avoid social situations because of fear. Doing so would reinforce your fear and could make your anxiety worse.

It’s normal to want to be alone, sometimes, but not all of the time. It’s expected that you would want to socialize and make friends. You might try talking to your mother about this issue or better yet, consulting the school guidance counselor or a therapist. Therapists specialize in understanding relationships and social interaction. You could greatly benefit from their professional advice and guidance. Please take care.

Dr. Kristina Randle

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Factitious Disorder

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I think I might have factitious disorder. I don’t want to self diagnose myself but I’ve been struggling for a few years trying to figure out what’s wrong with me. I was diagnosed with social anxiety when I was 16 but it wasn’t good enough wanted to be worse, to have bipolar or schizophrenia. I tried to imitate the symptoms of them to get diagnosed and be put on stronger meds. I always want pity and attention from people. The minute something goes good in my life I hit the self-destruction button and do something to wreck it. I’ve been to the same rehab 3 times. I keep messing it up for myself looking for attention or pity. I’ve been drinking more and more to show people I have a problem. Its as if I want to be an addict. Its crazy it drives me mad. I hate myself when I lie or exaggerate. Is there something wrong with me? Am I just a horrible person, looking for attention and pity? I hate this how can I stop destroying myself. Any advice would be much appreciated. I’m off to rehab again soon and I’m terrified I’m going to do this again. Am I mentally ill? Just curious. Nothing has made sense to me until I heard about this disorder; maybe I’m wrong I don’t know I hope someone does though.

I think the answer isn’t about the diagnosis. It is to realize that you sabotage yourself on a regular basis. Forget about the diagnostic terms. You know the pattern and process and you know it causes you pain. That is enough. What is the difference what we call it? The bottom line is that there is a dysfunctional pattern, it brings you a great deal of grief, and the good news is that your distress has prompted a very healthy desire in you to change. Let’s work with that. All too often the emphasis is on the diagnosis, of what is wrong with us. Let’s start in a different place. Let’s ask what is happening in your life that is right. In other words, what are your strengths?

I would find a local therapist to work with (see the find help tab at the top of the page) and see if he or she can help you identify times when this destructive pattern occurred — but more importantly, try to find out when it isn’t operating, or when good things are happening in your life. Often there are positive patterns that emerge alongside the negative ones. Let’s see what they are.

In preparing for this you may want to look at the character strength survey. It is free and can help you identify what your strengths are, and how to build on them. If we don’t look to amplify our strengths, then all we are left with is a battle to stop symptoms.

Wishing you patience and peace,
Dr. Dan

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Why Am I This Way?

by Holly Counts, Psy.D.
written by Holly Counts, Psy.D.

Well, let me make this very short. When I was younger, I used to isolate myself a lot. I had a computer, so I was addicted to it. I couldn’t spend a single day of my life without it. It was similar to a drug addiction. I was 11 when I got it and 17 when my grandma sold it. Which means I spent 6 yrs of my life in virtual life. I was 17 when I looked in the mirror for the first time and realized I was obese. I became anorexic at 17 and also started self harming, had a suicide fail and had social anxiety. I was so self conscious about myself and my body that I just isolated myself even more. It was like that until I turned 19.I no longer cut or starve, but I still have constant thoughts of suicide. The problem now is that I’m 20 and I still have to face consequences of the past. I never had a job cause I’m terrified of working. I ran away from all my job interviews. I stutter when I’m on the phone. I can’t even order pizza myself. I don’t know how to interact with people. I had a very lonely life and I still do, I have literally no friends and never did, and I feel like no one likes to be around me. Why am I such a coward? Why can’t I just go out and get a job like everyone does? (age 20, from Brazil)

A: You ask “why am I this way,” and yet you explained why in your letter. It sounds like you are really asking “How can I get better?” You already have insight into your problems but you need some guidance in correcting the mistakes from your past. This does not make you a coward, it just means you have some work to do.

Our developmental years are extremely important in helping us form our personality, learn coping skills, learn socialization skills, etc. You missed some very important steps along the way, but you can start catching up now. Good thing your grandma finally broke the habit and sold your computer. Virtual reality doesn’t really help us much in the actual reality of everyday life.

I think you would benefit greatly from therapy. A therapist can help you build social skills, confidence, self-esteem, communication skills, as well as treat the depression and eating disorder issues. Although it might be scary at first, you would also be a great candidate for a therapy group. Being part of a group could help speed up your learning curve.

Once you start feeling better about yourself and interacting with others more confidently, then you can focus on finding a job or enrolling in college. You are still young enough that you can change the path you are on and lead a full, successful life. It is time to start living!

All the best,

Dr. Holly Counts

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Sometimes I Get the Urge to Hurt Other People

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Sometimes, normally when I’m with a small amount of people (1-5) my hands will start to sweat and tingle a little on the inside. They feel itchy but I can’t scratch the itch away. I will get a similar feeling in my abdomen. I start to feel that the only way to get the feeling to stop is to hurt someone but I know it’s wrong so I try to hold back. Sometimes it’s hard though. A lot of times I end up hugging someone and squeezing them really tight until I have to force myself to stop. Sometimes in order to prevent myself from doing this I have to dig my nails into my palm. Other ways I try to stop this urge is by biting my lower lip and ripping up paper. Sometimes I get the urge to hurt others even when I’m by myself. A lot of times this results in gruesome murder stories.

I’m not sure if this will help or not but… I have ADD and Dyslexia. I see floaters all the time and have problems with hearing ringing in my ears. I have a Swiss Army Knife and for some reason take it to school with me. It never leaves my side. I also carry a box of matches with me everywhere. I love weapons especially Hatchets, small knifes, Riffles, and Chainsaws. I love reading and writing scary stories. I hope that helps.

To be entirely honest I don’t know if this is just my personality or if there is some disorder out there that matches up with those symptoms. I would really like to know if something truly is wrong with me and if there’s something I can do to fix it. I don’t want to end up killing someone and going to prison forever.

There is no disorder that I am aware of in which the main symptom is having the urge to hurt others.

When you’re around people, you experience a particular set of symptoms. You sweat and “tingle a little on the inside.” You feel it in your abdomen. You may be describing social anxiety.

Perhaps your social anxiety makes you feel out of control, fearful or frustrated. In an attempt to suppress those unpleasant emotions, an urge to hurt people arises.

Being in the presence of others is not the only time you feel the urge to hurt people. It also happens when you’re alone. You indulge those feelings by contemplating gruesome murder stories. In addition, you carry a bladed weapon. That all increases the possibility that you might harm someone.

It’s important that you do what is necessary to control your urges. In my opinion, what is necessary is therapy. Therapy can help you to understand the origin of your urges and more importantly, develop effective coping strategies for your strong emotions. Therapy might also help you to manage your ADD and dyslexia.

By your own admission, you are worried that you might kill someone. That recognition should prompt you to seek help; it is the most responsible course of action.

Killing would also destroy your life. You could be sentenced to the death penalty and face execution. Prison is hell on earth. Seeking help could prevent a great deal of suffering for both you and for others, and it would ensure a better quality of life. I hope that you make the right choice and seek help. Please take care.

Dr. Kristian Randle

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Scared To Tell My Mom about Social Anxiety

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I think I might have a social anxiety disorder. I get embarrassed very easily and of mostly everything. I cannot speak in front of an audience, when I have to in school I usually just don’t do it. I’ve been told I take criticism way too personally (by my mom). I get nausea when something I’m nervous about is going to happen (e.g. when I’m going to gym class because I’m not very athletic and I don’t like people watching me attempting to play a sport). I don’t like crowds, when I’m offered to go to the mall, or a restaurant, or even a relative’s house (that I’m not close to), I usually decline. I’m aware that I’m a very shy person, and should work on my confident issues. But I don’t though if I’m being dramatic about this. I’m scared to talk to my mom about it because I don’t want her to think that I’m being dramatic. And I don’t know why I’m scared because she’s a very good mother, and I’ve trusted her with a lot of secrets. One time she commented on me never wanting to go out with the family and said that I never want to spend time with them. But I do want to spend time with them, I think maybe I’m scared.

It is possible that you have a social anxiety disorder, but you may not. Many of your fears are very common. It may be that you lack the skills to deal with difficult or anxiety-producing situations. The good news is that these skills can be learned.

I do not believe that you are being dramatic. It seems that you are truly having difficulty with the situations outlined in your letter. As I mentioned above, many people have similar fears. For example, many people become nervous in front of an audience. In fact, surveys repeatedly show that public speaking is the number one fear.

The trick to reducing the anxiety that accompanies public speaking is to be yourself. Many people try to pretend to be someone else when they are giving a speech. For instance, in the case of a student assigned a topic to present to the class, he or she often erroneously believes that they have to be an “expert” on the subject matter. They believe this is what others expect from them. In reality, no one expects the student to be an expert. Students are in class to learn. You aren’t a professional speaker or a television anchorperson. You are just a student in class and no one expects you to be a professional. That is the reality of the situation. If you hold yourself to higher expectations you will feel anxious because you simply are not a professional and won’t be ready to be a TV anchor when your class has finished and cannot yet perform as a polished professional.

I would encourage you to speak to your mother. Here’s an example of how you may want to present your problem to her: “Mom, I become very nervous in a number of situations (name some examples from your letter) and I would like help to change this. My fears are very real and they are making it difficult for me to feel comfortable in many situations. I have even been worried about bringing this problem to your attention. I was concerned about your reaction. This is a problem that really bothers me. I have considered the possibility that I might need to see a mental health professional. Is this a problem that you can help me with?”

You need to be honest with your mother. It seems as if you may be worried that by bringing this problem to her attention you would be in effect saying that she has failed to help you. Your mother probably would not come to that conclusion. She most likely would react with concern and a desire to help but she first needs to know that a problem exists. Your job is to tell her the truth and to be detailed about the problem. Her job is to assist you in correcting the problem.

I hope this answer helps you. Please consider writing back after you speak to your mother to let me know how the conversation went. I hope to hear from you. I wish you well. Thanks for your question.

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Social Anxiety Tied to Prior Manic Phase Activities

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

My wife has been diagnosed as Bipolar since her induced menopause from 7-8 years ago. Her behavior has changes sporadically during that time, culminating in a serious manic phase earlier in the year where her Xanax use and alcohol abuse resulted in some very troubling actions. I had to file for divorce in order to protect myself it got so bad. Eventually we were able get her to agree to committing herself to a Mental Health program in southern FL that took about 2-3 months to complete followed by 6 weeks of group therapy locally. She is now back home, on the proper medications and actually doing well. My concern is I cannot get her to reach out to family and friends. I really believe this all stems from being ashamed of her manic behavior earlier, which really was out of control. She is fine with me but hardly ever leaves the house or talks to anyone. Her doctor says to give it time but I think she needs therapy to address this. Do you have any suggestions? She has come so far but cannot seem to move forward.

You mentioned that she had engaged in some “very troubling actions” so much so, that you needed to file for divorce in order to protect yourself. It would’ve been helpful to have included more details about her troubling actions for context. More information would have made it easier to understand why she is now reluctant to reach out to friends and family.

You are pushing her to do something that she is not comfortable doing. Again, without more information about her history, it’s difficult for me to know whether or not you are doing the right thing. The fact that her doctor does not endorse your idea leads me to believe that it may simply be too soon for her. Her doctor knows all of the facts of her case and is still advising you to “give it time.” People are ready when they are ready and no sooner. You might be prematurely pushing her to do things that she’s not ready to do.

She might feel a great deal of shame and embarrassment about what happened. That can be difficult to get over. You mentioned that she had been in treatment, but it’s not clear that she’s in treatment now. She obviously has a doctor but it’s not clear whether she also has a therapist and is in counseling. You might encourage her to undergo counseling to examine why she is reluctant to connect with friends and family. Counseling is the ideal place to deal with these types of issues.

One potential risk of pushing her to do things too soon might be her having another episode. You would never want to jeopardize her mental stability by pushing her to do something she’s not ready to do. It might be best to follow the doctor’s orders.

Talk to your wife. Voice your concerns but don’t push her too hard. Ask her why she’s reluctant to reach out to friends and family. You might already know or think you know but it wouldn’t hurt to ask her to expound upon her reasons and to share her feelings. She might need more time to overcome whatever it is that she’s feeling as a result of that difficult time in her life.

If you’re uncertain about how to proceed or are struggling with your relationship, you might consult a therapist, for individual counseling. There you might learn helpful strategies for supporting your wife. It can be difficult to love someone with mental health issues. That’s one of the primary reasons that advocacy groups such as the National Alliance on Mental Illness (NAMI) exists. It was started by family members who struggled with their lack of support for their loved ones with mental illnesses.

I hope this issue can quickly come to a resolution. It may simply be that she needs more time and you need more patience. A therapist could assist you in making a determination about how best to proceed. Thank you for your question. Good luck and please take care.

Dr. Kristina Randle

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