Depression, Self-Harm, and Emotional Instability in Adolescents

Q: Depression, Self-Harm, and Emotional Instability in Adolescents

Hello Nana： You have clearly articulated your situation and described the potential negative events that may arise, as well as your emotional changes. <br>The past cannot be changed, but we can alter our perspective on past events and their impact on us. <br>You have come this fa

Depression, self-harm, emotional instability?

Hello, Doctor.
When I was a child, I lived abroad with my parents and changed schools multiple times.
In elementary school, a teacher once said in front of the whole class, "I've never seen someone so stupid." A classmate replied, "Well, now you have." I never told my parents about similar experiences at school and always hid my other side (depression, hesitation, feeling hurt, and being under pressure) from them.
Additionally, a tutor once told me, "You are very hypocritical." My parents often scolded and hit me for my poor academic performance.
Due to my introverted personality, I had no friends at the new school, and my old friends seemed unwilling to meet me for some reason.
In fifth grade, I first had thoughts of wanting to die and considered jumping out of the window from the 12th floor of my home.
When my parents scolded me, I began to fantasize about revenge (imagining stabbing my parents, hoping someone would kill them, researching curses and various poisons, and thinking about how to get back at them when I grew up).
After returning to Taiwan for middle school, I again had no friends for three years due to my personality (not liking to talk) and endured pressure from my parents and school.
I started imagining various ways to die (looking down from a building and picturing myself lying below after jumping).
I was once sent to the counseling room by a teacher, but I didn't speak the truth (I couldn't bring myself to say it).
Teachers have always thought I had issues.
There was a significant difference between how I behaved at home and at school.
In high school, I self-harmed for the first time (cutting my wrists, drinking cleaning fluid) and felt a sense of calm afterward, almost becoming addicted to it.
I wanted to fall into despair and thought about dying every day, feeling anxious and being mocked by classmates and parents.
I wanted to shut down all my emotions (both happiness and sadness) and cried until I briefly lost my vision.
My parents sensed I had problems but didn't express much concern.
I once went to see a psychologist alone and received medication, but afterward, my parents often made fun of me for it.
I began to experience verbal abuse and wished to be cruel and heartless.
Even with classmates I was closer to, I wouldn't share these issues (as if exposing my weaknesses in front of others).
Sometimes, both my parents and I felt I was overly excited, which I didn't want but couldn't control.
At times, I would cry until I experienced tinnitus, feeling exhausted from living.
There was a period when these issues didn't occur, but after a conflict with my parents, I started self-harming again.
Doctor, do I have a problem? What is it?

Nana, 10~19 year old female. Ask Date: 2017/03/03

Dr. Liang Sunyuan reply Psychiatry

Hello Nana: You have clearly articulated your situation and described the potential negative events that may arise, as well as your emotional changes.
The past cannot be changed, but we can alter our perspective on past events and their impact on us.
You have come this far, and although it has been difficult, you should recognize your ability to coexist with adversity and commend your efforts.
Self-harm can indeed become addictive, and developing alternative coping skills is essential to break this vicious cycle.
Each person in the world is unique, and it is challenging to explain all conditions through a single diagnosis.
I recommend that you continue your treatment, and in addition to medication, incorporate psychotherapy and lifestyle changes for better outcomes.
The principle is to treat yourself kindly and improve your present and future.
Wishing you all the best.

Reply Date: 2017/03/03

More Info

Dear [Name],
Thank you for sharing your experiences and feelings so openly. It takes a lot of courage to discuss such personal and painful matters, and I commend you for seeking help and understanding. Based on what you’ve described, it sounds like you are dealing with a complex mix of emotional distress, self-harm behaviors, and possibly symptoms of depression and anxiety.

From your account, it appears that you have faced significant challenges throughout your childhood and adolescence, including bullying, emotional abuse, and a lack of support from your family. These experiences can have a profound impact on mental health, often leading to feelings of worthlessness, hopelessness, and isolation. The thoughts of self-harm and even suicidal ideation you mentioned are serious and indicate that you are in a place of deep emotional pain.

Understanding Your Feelings
1. Depression: The symptoms you describe, such as persistent sadness, feelings of worthlessness, and thoughts of self-harm, align with what is commonly recognized as depression. Depression in adolescents can manifest in various ways, including irritability, withdrawal from social interactions, and a loss of interest in activities that once brought joy.

2. Self-Harm: Engaging in self-harm, such as cutting or substance ingestion, is often a coping mechanism for emotional pain. It can provide a temporary sense of relief or control, but it is not a healthy way to manage distress. It’s essential to recognize that self-harm is a signal that you need help and support.

3. Emotional Instability: The emotional highs and lows you experience, along with feelings of anger towards your parents and thoughts of revenge, suggest that you may be struggling with emotional regulation. This can be common in individuals who have experienced trauma or significant stress during formative years.

Seeking Help
It is crucial to talk to a mental health professional who can provide a safe space for you to express your feelings without judgment. A psychologist or psychiatrist can help you understand your emotions better and work with you on coping strategies. Therapy can be particularly beneficial in addressing the underlying issues related to your past experiences and current feelings.

1. Cognitive Behavioral Therapy (CBT): This type of therapy can help you identify and change negative thought patterns and behaviors. It can be particularly effective for depression and anxiety.

2. Dialectical Behavior Therapy (DBT): If you are struggling with intense emotions and self-harm, DBT can provide you with skills to manage your emotions and improve interpersonal relationships.

3. Medication: In some cases, medication may be necessary to help manage symptoms of depression and anxiety. A psychiatrist can evaluate your situation and determine if this is a suitable option for you.

Building a Support System
While it may feel challenging, reaching out to trusted friends or family members about your feelings can also be beneficial. Having a support system can help you feel less isolated and provide you with the encouragement you need to seek professional help.

Conclusion
You are not alone in this struggle, and there is hope for recovery. It’s essential to take your feelings seriously and seek the help you deserve. Remember, reaching out for help is a sign of strength, not weakness. You have already taken a significant step by sharing your story, and I encourage you to continue on this path toward healing.

Please take care of yourself, and I hope you find the support and understanding you need.

Warm regards,
Doctor Q&A Teams

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