Overcoming Anxiety and Personality Challenges: A Guide for Teens

Anxiety and personality issues?

Hello Dr.
Ding, I would like to ask you some questions.
Since middle school, I have been very afraid of crowded places.
I feel okay when I am with friends, but when I have to take the bus or MRT alone, I feel very uncomfortable and anxious, even to the point of experiencing slight breathing difficulties.
I am very afraid of other people's gazes and often wonder if I seem strange.
My situation improved a bit in my first year of high school, but recently it seems to have worsened again.
I feel extremely anxious when I see a large crowd while walking alone, which has led me to dislike and hesitate to go out by myself.
Additionally, I have personal issues; others often perceive me as someone who is easy to bully and doesn't have much of a temper.
Even with people I am close to, I find it hard to express my dissatisfaction.
For instance, my sister has often directly pointed out her grievances or my shortcomings since childhood, asking me to change.
However, when she does something I find excessive, if I tell her, she just brushes it off.
This leaves me feeling frustrated, and sometimes I get so upset that I cry or even resort to self-harm.
I feel like there are some emotional and psychological issues I need to address.
During my senior year while preparing for exams, I sometimes get very angry while studying, feeling useless and incapable of doing anything right.
I have become cynical, very emotional, and sometimes I yell and throw things out of frustration.
I even hate myself, my mood is poor, and I have no appetite.
I keep having nightmares and wake up startled in the middle of the night.
These problems have troubled me for a long time, and I don't know how to improve or resolve them.
Thank you, doctor.

I'm sorry, 10~19 year old female. Ask Date: 2016/05/18

Dr. Ding Shuyan reply Psychiatry

Hello, overall, it seems that you feel more anxious and suppressed in your interactions with others.
This may be due to being overly concerned about what others think, lacking confidence, and fearing that others may not accept our thoughts or behaviors, which could lead to losing their support and damaging relationships.
Fortunately, you are only 18 years old, and your personality is not yet fully formed, leaving room for adjustments.
First and foremost, we must accept ourselves as we are.
Individuals lacking confidence tend to overestimate others while underestimating themselves.
No one is perfect; we often magnify our flaws and, when we encounter others' strengths, we may feel even more inadequate in comparison, leading to fear and lack of confidence.
Try to view yourself from an observer's perspective and identify your strengths, giving yourself positive encouragement.
If this is difficult, consider asking your family or close friends for their input.
Secondly, practice expressing what you want to say in private, imagining that you do so smoothly and naturally, with positive responses from your listeners.
Practice this without self-doubt about whether it will be good enough.
Additionally, practice muscle relaxation and diaphragmatic breathing; you can find demonstration videos by professionals on YouTube to help with this.
If you tend to feel nervous in certain situations, doing relaxation training beforehand can help you feel more in control.
Gradually, you will build confidence.
Lastly, I want to share a thought with you: we often believe that others are constantly watching us, waiting for us to make mistakes or criticize us.
In reality, everyone is primarily focused on their own concerns and is not as attentive or critical of others as we might imagine.
Just as you are preoccupied with your own anxiety when interacting with others, they are likely more focused on themselves.
Often, we desire others to pay attention to us, but we may not achieve that.
In my work, I frequently notice that people may not even be fully listening to what we say!
If you find it overwhelming, seeking help from a doctor is also a good option.
I hope this information is helpful to you.
Sincerely,
Dr.
Ding Shuo-Yan

Reply Date: 2016/05/18

More Info

Dear Concerned Teen,
Thank you for reaching out and sharing your experiences. It sounds like you are facing significant challenges with anxiety, particularly in social situations, as well as difficulties with expressing your emotions and managing stress. These feelings can be overwhelming, especially during a time when you are preparing for important exams and navigating the complexities of adolescence.

Firstly, it’s important to recognize that what you are experiencing is not uncommon among teenagers. Many young people struggle with social anxiety, which can manifest as discomfort in crowded places or fear of judgment from others. This anxiety can lead to avoidance behaviors, such as not wanting to go out alone or feeling overwhelmed in social settings. It’s crucial to understand that these feelings are valid and that you are not alone in experiencing them.

Your description of feeling anxious in public spaces, particularly when you are alone, indicates that you may be dealing with social anxiety disorder. This condition can cause significant distress and can interfere with daily activities. Symptoms such as difficulty breathing, racing heart, and a sense of panic in crowded situations are common. It’s essential to seek help from a mental health professional who can provide a proper diagnosis and support.

In addition to social anxiety, you mentioned challenges with expressing your emotions, particularly when it comes to conflicts with close family members. It’s not uncommon for individuals to feel they cannot voice their feelings, especially if they fear negative repercussions or feel that their concerns will be dismissed. This can lead to bottled-up emotions, which may manifest in frustration, anger, or even self-harm, as you described. It’s vital to find healthy outlets for these feelings, whether through journaling, art, or talking to someone you trust.

Your experiences of feeling inadequate, having a lack of appetite, and experiencing nightmares are also concerning. These symptoms can be indicative of depression, which often coexists with anxiety. It’s crucial to address these feelings, as they can significantly impact your overall well-being and academic performance.

Here are some steps you can take to begin addressing these challenges:
1. Seek Professional Help: Consider reaching out to a school counselor, psychologist, or psychiatrist. They can provide you with coping strategies, therapy options, and possibly medication if needed. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety and depression, helping you to reframe negative thoughts and develop healthier coping mechanisms.

2. Practice Self-Compassion: It’s essential to be kind to yourself. Acknowledge that it’s okay to feel anxious or overwhelmed. Try to challenge negative self-talk and replace it with more positive affirmations. Journaling can be a helpful tool for processing your thoughts and feelings.

3. Develop Coping Strategies: Engage in relaxation techniques such as deep breathing, mindfulness, or meditation. These practices can help reduce anxiety and improve your emotional regulation. Regular physical activity can also be beneficial for mental health.

4. Build a Support Network: Surround yourself with supportive friends or family members who understand what you’re going through. If you feel comfortable, share your feelings with them. Sometimes, just talking about your experiences can alleviate some of the burden.

5. Set Realistic Goals: During your exam preparation, break your study sessions into manageable chunks. Set achievable goals for each study session, and reward yourself for completing them. This can help reduce feelings of being overwhelmed.

6. Limit Exposure to Stressors: If certain environments or situations increase your anxiety, try to limit your exposure to them when possible. Gradually expose yourself to these situations in a controlled manner, starting with less intimidating scenarios.

7. Consider Group Therapy: Sometimes, sharing experiences with peers who are going through similar challenges can be incredibly validating and supportive. Group therapy can provide a safe space to express your feelings and learn from others.

Remember, seeking help is a sign of strength, not weakness. You deserve support and guidance as you navigate these challenges. It’s important to take the first step toward healing and improvement, and I encourage you to reach out to a mental health professional who can help you on this journey.

Wishing you strength and resilience,
Doctor Q&A Teams

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