Do I Have a Mental Illness? My Emotional Struggles - Psychiatry

May I ask if you are feeling unwell?

---

Hello, Dr.
Ding.
I would like to describe my situation and ask if I might be ill.
My life has been relatively smooth; I have a happy family, no trauma, no significant losses, no end to close relationships, and no experiences of bullying.
However, I feel unwell.
Since childhood, I have had trouble sleeping.
My family says that even as a baby, my sleep was unstable, shallow, and I had difficulty falling asleep, which led to frequent illnesses during my childhood.
Around the fourth grade, my insomnia became more severe, often unable to sleep until three or four in the morning, but I had to wake up at seven for school, resulting in long-term sleep deprivation and poor mental state.
In fifth and sixth grade, I experienced episodes of chest tightness and difficulty breathing, but I didn't pay much attention to it at the time.

During the winter break of my first year of junior high, I inexplicably became very depressed, feeling sad every day without any apparent reason.
I also lost 10 kilograms due to a lack of appetite, became withdrawn, refused care, self-harmed, and had suicidal thoughts with plans.
This situation lasted about a year, during which I did not seek any professional help, but it inexplicably improved.
In the third year of junior high and the first year of high school, I became very lively, talkative, and fast-paced; my classmates described me as passionate and a "crazy woman," although my original personality was quiet and introverted (possibly hypomanic?).
I struggled to focus on my studies, resulting in poor grades, so I repeated my first year of high school.
After that, my high school life was relatively stable, but my sleep remained very unstable.
My mind was always racing, making it hard to sleep, and I frequently experienced headaches and a heavy head, sometimes feeling very anxious and confused inside.
Now in my second year of college, I started feeling emotionally unstable again at the beginning of last year.
I often feel confused and uneasy without any specific reason, and I can't articulate what that confusion feels like.
In the second half of last year, I felt very uncomfortable physically and mentally, experiencing chest tightness and pain, weakness, lack of motivation, irregular sleep patterns, binge eating, and sometimes not eating at all.
I always feel tired.
My sleep is still terrible; I am always tense and unable to relax, have shallow sleep, talk in my sleep, and feel very fatigued during the day, causing me to skip many classes.
I also engage in self-harm, which has become a habit.
Additionally, I have experienced feelings of losing touch with reality and a sense of self, feeling as if my soul has detached from my body.

So far this year, I still feel strange and uncomfortable.
I feel irritable and uneasy without any particular reason.
I often have the urge to throw things or break glass.
Although I have a gentle personality, I can't stand feeling irritated and sometimes want to lash out at others.
I have frequently experienced moments of daydreaming and lack of focus throughout my life, often feeling inexplicably anxious.
During junior high and high school, I struggled to concentrate on studying.
Recently, random violent incidents in Taiwan have saddened me because I used to fantasize about committing random acts of violence and then committing suicide.
Sometimes I feel very low and seriously contemplate suicide, but usually, I feel better after a few days; it’s a constant cycle of ups and downs.

I do not experience hallucinations or delusions; it’s just my imagination.
Socially, I have always found it difficult to trust people for some reason, keeping my distance and not daring to form deep connections, resulting in few friends and no romantic relationships.
I usually prefer to be alone.
I struggle to adapt to groups and feel uncomfortable and a bit fearful in group settings, often retreating.
My classmates describe me as cold, distant, and aloof.
Sometimes I think about harming others, but I have never acted on it.
I consider myself quiet and reserved, not wanting to conflict with others, but I sometimes imagine harming them.

Regarding self-esteem, I have very low confidence and dislike myself, feeling worthless and a failure, worrying that I will be uncompetitive in the future and quickly eliminated.
My sleep is still poor, and I often feel mentally drained during the day.
I also struggle to identify my emotions, so when I feel uncomfortable, I resort to self-harm, often feeling tightness in my chest.
Additionally, I do not cry; I have heard that some people with depression cry frequently, but while I feel like crying, I cannot.
I haven’t shed tears in many years.
Sometimes I have suicidal thoughts, but I don’t genuinely want to die; I just feel unworthy of living or can’t think of other ways to cope with my discomfort.

Doctor, do you think I might have bipolar disorder or borderline personality disorder? I fear connecting with people (worried about not being able to separate), so I connect with objects, having unique feelings towards them, and often feel empty.
I feel exhausted every day, but this has been the case for many years.
This is what I have to share; could you please tell me if there is something wrong with me? Am I ill? Thank you for your patience in reading this.

---

YY, 20~29 year old female. Ask Date: 2016/06/01