Do I Need Therapy? Mental Health Struggles in Teens

Q: Do I Need Therapy? Mental Health Struggles in Teens

Hello： Crying without reason at night, not wanting to interact with others, and having suicidal impulses can be very distressing. <br>However, it seems that having a clear life goal has helped alleviate these feelings. <br>Recently, though, it appears that these feelings have res

In such a situation, it is uncertain whether psychological counseling or medical treatment is necessary?

Hello, doctor.
I am currently a high school student.
During my third year of junior high, the pressure was particularly intense as I prepared for high school entrance exams.
Initially, I felt disconnected from my family and friends, doubting their love and concern for me.
I would cry uncontrollably in the middle of the night, shaking all over, and I didn't want to interact with anyone.
Whenever I did have contact, I would experience nausea, vomiting, and stomach pain both psychologically and physically.
Eventually, I even had suicidal thoughts.
At that time, I felt completely drained, as if I were the only person left in the universe, yet I was still breathing.
At first, I felt a bit lonely and scared, knowing that no one would come to rescue me.
But as I was gradually consumed by self-loathing, I realized I had completely lost my emotions.
There were moments when my feelings fluctuated, but it was still a heart-wrenching pain.
I eventually began to heal (though I'm not sure if it can be considered healing) because I had dreams and life goals, and more importantly, I had entrance exams to focus on.
I constantly reminded myself that I absolutely could not get sick, and as the exams approached, my mental state gradually returned to normal.

However, recently I have noticed that my inner self has become particularly sensitive again.
A glance or tone from others can affect me deeply, and I often feel lonely, experience insomnia, and have vivid dreams.
The instances of crying uncontrollably have also increased.
I feel that these are beyond my control.
I believe I have become mentally stronger since that episode, but for some reason, I am starting to show signs of relapse.
You might tell me, "Think about your life goals; you still have dreams, right? Just go do what you love, and things will get better." But it's precisely because I have dreams that every time I experience this state, the guilt and pressure become overwhelming.
I have a clear vision for my life, which makes me somewhat easygoing and a bit isolated at school (I don't view school or exams as my entire world, so academic pressure doesn't affect me much).
Yet recently, I have increasingly lost the desire to go to school.
I feel a strong need for solitude, but when I am alone, I become lethargic and don't want to do anything.
Why do I feel so lonely when I am the one pushing people away? I take simple mental health tests online every month (like the SCL-90), not to rely solely on these measures to assess my severity, but to reflect on my immediate feelings and think about how to improve my negative thoughts.
Since I have been able to manage so far, I wonder if I need to seek psychological counseling.

Niming, 10~19 year old female. Ask Date: 2016/12/08

Dr. Liang Sunyuan reply Psychiatry

Hello: Crying without reason at night, not wanting to interact with others, and having suicidal impulses can be very distressing.
However, it seems that having a clear life goal has helped alleviate these feelings.
Recently, though, it appears that these feelings have resurfaced.
You have your own thoughts about the future, but you feel lonely when alone.
It looks like you have been trying very hard.
I encourage you to be kind to yourself and cherish yourself.
I also agree with what you said about working towards your dreams, little by little, accumulating progress every day.
The speed of progress doesn't matter; it's okay to take breaks and catch your breath.
Be a little kinder to yourself.
When we are alone, we are our own company.
It's important to feel comfortable in solitude and to first like and appreciate yourself.
It's okay to have imperfections; embrace and accept them.
If things still don't improve, seeking psychological counseling or medical help can be beneficial.
Wishing you all the best.

Reply Date: 2016/12/08

More Info

It's commendable that you are reaching out to understand your mental health struggles, especially as a high school student facing significant pressure. Your experiences of feeling isolated, overwhelmed, and struggling with self-worth are not uncommon among teenagers, particularly during challenging transitions like preparing for high school entrance exams.
From what you've described, it seems you have been navigating a complex emotional landscape. The feelings of emptiness, anxiety, and the physical symptoms like shaking and nausea you experience during social interactions are serious indicators of distress. It's important to recognize that these feelings are not just a phase or something you can simply "snap out of." They can be signs of underlying mental health issues, such as anxiety or depression, which are prevalent among adolescents.

The fact that you have experienced suicidal thoughts is particularly concerning. This is a serious matter that should not be taken lightly. While you mentioned that you felt a sense of recovery due to having dreams and goals, the resurgence of these negative feelings suggests that the underlying issues may still be present and need to be addressed. It’s crucial to understand that having goals and aspirations is beneficial, but they can also create pressure that may exacerbate feelings of inadequacy or anxiety when you feel you are not meeting those expectations.

You mentioned that you often feel a sense of loneliness despite pushing people away, which is a common paradox in mental health struggles. This can lead to a cycle where the desire for connection conflicts with the fear of vulnerability, making it difficult to reach out for help. It’s important to remember that seeking support is not a sign of weakness; rather, it is a courageous step towards healing.
Regarding your question about whether you need therapy, the answer leans towards yes. Therapy can provide a safe space for you to explore your feelings, understand the root causes of your distress, and develop coping strategies. A mental health professional can help you process your emotions and experiences in a constructive way, which can be particularly beneficial given your current struggles with sensitivity to others' perceptions and feelings of isolation.

You also mentioned using online mental health tests like the SCL-90. While these tools can be helpful for self-reflection, they are not a substitute for professional evaluation and support. Mental health professionals can offer a more comprehensive assessment and tailor their approach to your specific needs.

In summary, it would be beneficial for you to consider seeking therapy. A therapist can help you navigate your feelings of loneliness, anxiety, and self-doubt, and assist you in developing healthier coping mechanisms. Remember, you don’t have to go through this alone, and there are people who can help you find your way through these challenging emotions. Taking this step could be a significant move towards understanding yourself better and improving your mental health.

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