Anxiety, Emotional Distress, and OCD in Teens

Anxiety disorders, emotional distress, obsessive-compulsive disorder (OCD)?

Hello, doctor.
I am currently a high school junior, and over the past two years, I've noticed that my emotions have become increasingly anxious.
I often feel overwhelmed with many things I want to do, yet I can't seem to do them well or correctly.
This leads to a feeling of tightness in my chest, and I become easily angered.
I find myself wanting to keep doing things while feeling angry until I think I can stop, but if I can't achieve satisfaction, I feel like throwing things, yelling, or hitting hard objects, believing that if I get hurt, my mood will improve.

Sometimes, I can't stand the actions of my classmates and feel the urge to scold them, even though I know it’s not my business.
I can't help but want to say something to them, which might explain why I only have one or two friends I can truly call friends.
I once talked to my homeroom teacher about this issue, and they mentioned that I have a moral obsession and look down on being with them.

I have trouble falling asleep at night, and sometimes the more I lie down, the more awake I feel.
Recently, I often feel drained and fatigued, lacking motivation for anything I do, and I can't perform well.
I initially wanted to focus on studying, but I get distracted easily, or I find myself staring at a line of text trying to digest it.
During exams, I often have to read questions three or four times, which only makes me more frustrated.
Now, just seeing anything related to schoolwork makes me feel tight in my chest, and my body is often tense.
My grades have been declining, and I'm falling further behind my teachers.
My family is very unhappy with my academic performance, and I am terrified that I won't be able to perform well in next year's exams.

I feel like I'm on the verge of a breakdown, and no matter how much I try to fix things, it feels like a leaking bucket that can't hold what I put in.
I would like to ask the doctor if I should see a physician.
If I talk to my family about this, they might think I have poor stress tolerance or that I'm just making excuses.
Can I secretly see a doctor? Thank you, doctor, for taking the time to read my concerns.
I appreciate your help!

Xiao Ya, 10~19 year old female. Ask Date: 2017/07/23

Dr. Zhang Fangrong reply Psychiatry

Dear [Recipient's Name],
From your letter, I can sense the changes and discomfort you are experiencing.
I believe that the pressures of high school life, especially regarding academic demands, can be quite significant.
It is commendable that you have already spoken with your homeroom teacher.
I would also recommend that you consider speaking with the school’s counseling psychologist to receive some guidance and advice, including whether a medical evaluation is necessary.
It is also important to communicate your current emotional state and situation clearly to your family.
If you are feeling extremely uncomfortable and on the verge of an emotional crisis, seeking a physician's evaluation and discussion is essential.
Therefore, having a family member accompany you to the doctor would be a better arrangement.
Wishing you mental and physical well-being.
Sincerely,
Dr.
Fang-Rong Chang
Department of Psychiatry

Reply Date: 2017/07/23

More Info

It sounds like you are experiencing a significant amount of anxiety and emotional distress, particularly as you approach a critical time in your academic career. The feelings you describe—such as chest tightness, irritability, frustration, and difficulty concentrating—are common symptoms of anxiety disorders, including Obsessive-Compulsive Disorder (OCD) and generalized anxiety disorder. These symptoms can be exacerbated by academic pressures, social dynamics, and personal expectations, which can create a cycle of stress and negative emotions.

From your description, it seems that you are caught in a cycle of anxiety that affects your ability to perform academically and socially. The feelings of frustration when you cannot meet your own standards or those set by others can lead to outbursts of anger or self-destructive behaviors, such as wanting to break things or harm yourself. This is a concerning sign that your emotional distress is becoming overwhelming.

It's important to understand that seeking help is not a sign of weakness or an inability to cope. Many people experience similar feelings during stressful periods, especially in high school, where academic and social pressures can be intense. Talking to a mental health professional can provide you with the tools and strategies to manage your anxiety and improve your emotional well-being. They can help you understand your feelings, develop coping mechanisms, and work through the underlying issues contributing to your distress.

You mentioned concerns about how your family might perceive your need for help. It's common for individuals to worry about being judged or misunderstood when discussing mental health issues. However, your well-being is paramount, and seeking help is a proactive step towards taking care of yourself. If you feel comfortable, consider discussing your feelings with a trusted family member or friend who might support your decision to seek professional help. If you prefer to keep it private, many mental health professionals allow for confidential consultations, and you can seek help without your family's knowledge if that feels safer for you.

In terms of immediate strategies, here are a few suggestions that might help you manage your anxiety:
1. Mindfulness and Relaxation Techniques: Practicing mindfulness, deep breathing exercises, or meditation can help reduce anxiety and improve your ability to focus. These techniques can help you ground yourself when you feel overwhelmed.

2. Structured Study Time: Break your study sessions into manageable chunks with scheduled breaks. This can help reduce the feeling of being overwhelmed by large amounts of material.

3. Physical Activity: Regular exercise can significantly reduce anxiety levels and improve mood. Even a short walk can help clear your mind and reduce tension.

4. Limit Caffeine and Sugar: These can exacerbate anxiety symptoms. Try to maintain a balanced diet and stay hydrated.

5. Journaling: Writing down your thoughts and feelings can provide an outlet for your emotions and help you process what you are experiencing.

6. Reach Out for Support: Whether it's friends, family, or a counselor, talking about your feelings can help alleviate some of the burdens you are carrying.

In conclusion, your feelings are valid, and it’s crucial to address them before they escalate further. Seeking help from a mental health professional can provide you with the support you need to navigate this challenging time. Remember, you are not alone in this, and there are people and resources available to help you through it.

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