Unexplained Crying and Negative Thoughts in Teens - Psychiatry

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Feeling inexplicably tearful and having negative thoughts?


Hello, doctor.
I am a third-year junior high school student who will be taking the entrance exams in May.
I have always been the top student in my class since childhood, and I have scored nearly full marks in several mock exams this year.
My parents have never pressured me about my studies, so academic performance has never been a source of stress for me.
However, starting about a week ago, I have been feeling an inexplicable urge to cry.
Whenever I am not engaged in other activities and my mind is blank, I begin to think negatively about various things.
I worry about whether my parents might encounter an accident, or if relatives in the south or friends around me might face unforeseen events.
As I dwell on these thoughts, I find myself crying—initially, it was just tears, but later it escalated to sobbing uncontrollably.
I am unsure whether I am crying because I am thinking of sad things or if I am thinking of sad things because I want to cry.
This has been happening frequently, almost 1 to 2 times a day.
Crying suddenly in public places (like school) is really embarrassing, yet I cannot control it, which is very distressing.
After crying, I experience a drop in body temperature and weakness in my limbs, but after a while, I can fully recover.
I have not faced any significant setbacks recently, and academic pressure is not an issue.
I have high expectations of myself, but that has been consistent throughout my life.
So why is this happening all of a sudden? This week has been really painful, and I feel like I am causing a lot of trouble for those around me.
What should I do? Is this a form of depression? Thank you, doctor!

Penny, 10~19 year old female. Ask Date: 2017/03/07

Dr. Dai Wanxiang reply Psychiatry


Hello Penny,
Based on your description, it seems that you are experiencing feelings of sadness, sentimentality, negative thinking, and excessive worry without any apparent life stressors.
I wonder if you are also experiencing symptoms such as memory impairment, difficulty concentrating, as well as changes in appetite and sleep patterns? Additionally, is this depressive state persistent most of the time, or does it resolve quickly? Has it affected your academic performance and interpersonal relationships? If you are experiencing the aforementioned symptoms, the likelihood of depression is quite high.
During adolescence, individuals face significant adjustments related to self-identity, interpersonal relationships, and the quest for independence, and occasional emotional upheavals can be a normal part of development.
Regardless, it sounds like these issues are causing you considerable distress, and I recommend seeking psychological counseling resources available at your school or professional assistance from a child and adolescent psychiatrist at a hospital.
Wishing you well.

Reply Date: 2017/03/07

More Info


It sounds like you are going through a very challenging time, and I want to commend you for reaching out and expressing your feelings. The sudden onset of unexplained crying and negative thoughts, especially when you have previously excelled academically and felt stable, can be quite distressing. It’s important to understand that emotional fluctuations can occur for a variety of reasons, even when there are no obvious external stressors.

Firstly, let’s explore what you are experiencing. The feelings of sadness and the urge to cry without a clear cause can be indicative of underlying emotional distress. This could be related to several factors, including hormonal changes, stress, or even the pressure of upcoming exams, despite your previous academic success. Adolescence is a time of significant change, both physically and emotionally, and it’s not uncommon for teens to experience heightened emotions during this period.

Your thoughts about your parents or friends encountering accidents or misfortunes suggest a level of anxiety that may be contributing to your emotional state. This kind of worry can lead to a cycle of negative thinking, where the more you dwell on these thoughts, the more emotional distress you may feel. It’s also possible that you are experiencing anticipatory anxiety, where the fear of potential future events causes you to feel overwhelmed in the present.

The physical symptoms you describe, such as a drop in body temperature and weakness after crying, are also noteworthy. Emotional distress can manifest physically, and it’s not unusual for people to feel fatigued or drained after an emotional episode. This can be exacerbated by the stress of academic expectations, even if you do not perceive them as a direct source of pressure.

Given that you have not experienced any significant recent trauma or stressors, it may be beneficial to consider the cumulative effect of stressors over time. Sometimes, even positive pressures, such as academic success, can lead to emotional fatigue if one feels the need to maintain a certain standard consistently.

Here are some steps you can take to help manage these feelings:
1. Talk to Someone: It’s crucial to share your feelings with someone you trust, whether it’s a friend, family member, or a school counselor. Expressing your emotions can provide relief and help you gain perspective.

2. Mindfulness and Relaxation Techniques: Engaging in mindfulness practices, such as meditation or deep-breathing exercises, can help ground you and reduce anxiety. These techniques can help you manage your thoughts and emotions more effectively.

3. Journaling: Writing down your thoughts and feelings can be a therapeutic way to process what you are experiencing. It can also help you identify triggers for your emotions.

4. Seek Professional Help: If these feelings persist or worsen, consider reaching out to a mental health professional. They can provide you with coping strategies and support tailored to your needs.

5. Physical Activity: Regular exercise can significantly improve mood and reduce anxiety. It helps release endorphins, which are natural mood lifters.

6. Limit Exposure to Stressors: If possible, try to limit exposure to situations or media that may heighten your anxiety or negative thoughts.

7. Establish a Routine: Having a structured daily routine can provide a sense of stability and predictability, which may help alleviate some anxiety.

It’s essential to remember that experiencing emotional distress does not mean you are weak or incapable. It’s a part of being human, especially during the tumultuous teenage years. Seeking help is a sign of strength, and taking proactive steps can lead to improvement. You are not alone in this, and there are resources available to support you through this difficult time.

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