Long-Term Negative Emotions and Thoughts of Death - Psychiatry

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Prolonged negative emotions and thoughts of death?


Hello, Doctor: As the title suggests, I actually don't know how to explain my situation.
I feel that many aspects of my past, including my family, have contributed to my current state, but I often struggle to articulate it.
Since childhood, I've often been lost in thought.
Towards the end of elementary school, I began to feel depressed and engaged in self-harm (which my family later discovered; fearing being seen as abnormal, I became more cautious and did it less).
At that time, I was still young and felt I had to smile in front of everyone, even though I was much less lively than before.
The situation remained similar; in high school, the academic pressure was intense, and there were issues at home (the most vivid memory is the day before a major exam when my father threatened to commit suicide with a rope and a knife.
After I calmed him down, I sat on the stairs, too scared to sleep for a long time).
I continued to self-harm and experienced crying spells, headaches, and vomiting.
Later, I enrolled in a nearby university and returned home weekly.
During the summer of my freshman year, I worked a tiring job, and my father drove me (I have a complicated relationship with him; I know I love him, but I often feel a tug-of-war with resentment).
One day, while dealing with work issues, I pushed him when he called me, causing him to bump into a wooden chair.
I felt guilty and ashamed.
A few days later, while picking up my brother, he suddenly seemed weak (according to my brother).
After returning home, he collapsed in a chair, and my mother took him to the hospital.
This led to a series of events: he was critically ill, briefly regained consciousness, was transferred to another hospital, and I was balancing my studies with taking leave to visit him (I often felt irritable...).
Within a month, he suddenly became critically ill again, and I rushed to the hospital.
In a daze, I followed my brother's lead and signed a DNR order, but I couldn't even cry; I just felt choked up.
Later, I thought I could still feel him breathing and felt I had made the wrong decision, thinking perhaps my push had caused this (the doctors didn't explain clearly, only mentioning a blood clot in his brain and that he had liver disease).
I often felt angry with my mother for coming home the day before and angry with myself.
After that, I appeared more normal, but my situation remained similar.
I worked hard to graduate early, but a year prior, I felt I couldn't go on, no longer wanting to talk to my family, and only interacting with others out of necessity.
I returned home partly because my mother was also unwell, but I couldn't muster a smile for her.
I always felt that my mother thought I should do everything perfectly and that whatever I did was wrong.
I considered seeking psychological counseling at school, but I feared I wouldn't be able to express myself and worried that maybe I was just overthinking things.
Currently, my situation is similar to before (I still have occasional moments of feeling slightly better), but it's more outwardly expressed.
I often feel short of breath, and while I used to crave my favorite foods, my desires have diminished.
Recently, it got so severe that I felt nauseous at the sight of food, and I've started vomiting after meals.
I've been contemplating death, wondering if the balcony is high enough to jump from, and when I see cars on the road, I think about stepping in front of them...
but then I rationally consider the consequences of dying, how it would affect the driver, and what would happen to my mother.
Yet, I also find myself logically listing my savings, thinking that if something were to happen, it might be useful.
I often feel low over trivial matters, crying alone without much tears, feeling like I'm just making excuses for my sadness.
I have no particular expectations for the future; I feel exhausted but look forward to death...
I'm sorry for saying I didn't know how to express myself, yet I ended up writing so much.
I want to ask the doctor if this situation is just me being overly sentimental (as many people say) or overthinking, even though I don't want to feel this way but find it hard to control.

Zi Yin, 20~29 year old female. Ask Date: 2020/06/14

Dr. Wu Enliang reply Psychiatry


Hello, Ziyin: After reading your difficult life story, I can see that you are truly exhausted.
I am also concerned that long-term stress may have led to physical and mental fatigue, possibly resulting in depression.
Mental health issues require appropriate treatment, so I suggest you download the Mood Meter app to assess your mental and emotional state and look for nearby mental health resources.
Take care! Dr.
Wu Enliang

Reply Date: 2020/06/14

More Info


It sounds like you are going through an incredibly difficult time, and I want to acknowledge the pain and complexity of your experiences. Your feelings of sadness, guilt, and thoughts of death are serious and deserve to be addressed with care and understanding.
From what you've shared, it seems that you have been dealing with long-term negative emotions, stemming from various traumatic experiences in your life, including family issues, academic pressure, and the loss of loved ones. These experiences can lead to feelings of hopelessness and despair, which are often associated with depression. It's important to recognize that these feelings are not simply a result of being overly sensitive or thinking too much; they are valid emotional responses to the challenges you have faced.

The symptoms you describe—such as self-harm, feelings of guilt, difficulty in expressing emotions, and thoughts of death—are concerning and suggest that you may be experiencing a mental health condition, such as depression or anxiety. It's crucial to understand that these conditions are not a sign of weakness or a character flaw; they are medical issues that can be treated effectively with the right support and intervention.

You mentioned feeling overwhelmed by your emotions and struggling to communicate your feelings, which is common for many individuals dealing with mental health challenges. It can be difficult to articulate what you're going through, especially when the emotions are intense and complex. However, seeking help from a mental health professional, such as a psychiatrist or psychologist, can provide you with a safe space to explore these feelings and develop coping strategies.

Therapy can be particularly beneficial in helping you process your emotions and experiences. A therapist can guide you in understanding the root causes of your feelings, help you develop healthier coping mechanisms, and support you in building a more positive outlook on life. Cognitive-behavioral therapy (CBT), for example, is an evidence-based approach that can help you identify and challenge negative thought patterns, ultimately leading to improved emotional well-being.

In addition to therapy, medication may also be an option worth discussing with a psychiatrist. Antidepressants can help alleviate symptoms of depression and anxiety, making it easier for you to engage in therapy and other aspects of life. It's important to have an open and honest conversation with your healthcare provider about your symptoms, concerns, and treatment options.

You also mentioned feeling a lack of desire for things you once enjoyed and experiencing physical symptoms like difficulty breathing and nausea. These can be signs of depression and anxiety, which can manifest in both emotional and physical ways. It's essential to address these symptoms holistically, considering both your mental and physical health.

Lastly, I encourage you to reach out to trusted friends or family members about what you’re experiencing. While it may feel daunting, sharing your feelings with someone who cares can provide relief and support. You don't have to go through this alone; there are people who want to help you.

In summary, your feelings are significant and deserve attention. Please consider seeking professional help to explore these emotions further and to find a path toward healing. Remember, it's okay to ask for help, and taking that step can be a powerful move toward reclaiming your life and well-being.

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