Depression: Breathing Issues and Emotional Responses

Psychological distress and difficulty in breathing?

Hello, doctor: Whenever I feel very depressed, it feels like my chest is being compressed, and the air I breathe in seems to be only half of what I usually get when I'm in a good mood.
It feels like there's something blocking it, and the air feels stuffy, like being in a sauna at the pool.
Additionally, when I hear my parents talking, I have a completely unwanted reaction.
At night, when I close my eyes to sleep, my mind keeps replaying their conversations, and I have to spend 1 to 2 hours reassuring myself that everything is fine before I can fall asleep.
I also get startled easily now, and I'm much more sensitive than before.
I have taken online tests for depression, and several times they indicated severe depression.
I have been expressionless for a long time, going through each day without feeling anything.
On good nights, I can fall asleep in about half an hour, but on bad nights, it takes about two hours or even longer.
Now, when I sleep on my right side, the position of my teeth or clenching them tightly affects my sleep.
If I lie down with my head on the pillow, the pillow slightly presses against my ear, and I can hear my heartbeat, which prevents me from sleeping—this never used to happen.
Could these behaviors and reactions indicate that I truly have depression? If I do have depression, are these behaviors and reactions related to it? Additional information: I have been subjected to increasingly frequent verbal bullying by my older sister since the sixth grade.

Miao Miao, 20~29 year old female. Ask Date: 2020/07/11

Dr. Peng Liyun reply Psychiatry

Hello, from your letter, it is evident that you are experiencing discomfort and distress.
The diagnosis requires discussion with a physician, and confirming depression necessitates a more in-depth evaluation.
However, it is important to ask yourself if you have coping strategies for these situations.
If you cannot find suitable ways to manage, or if these conditions are indeed affecting your life and interpersonal relationships, I recommend seeking further evaluation and subsequent management at a hospital.
Treatment options typically vary based on the severity of the condition.
Our clinic has outpatient services available from Monday to Friday in the morning and afternoon, as well as on Saturday and public holidays (excluding Sundays) in the morning.
I suggest considering a visit for an evaluation to discuss the best treatment options together.

Reply Date: 2020/07/11

More Info

It sounds like you are experiencing a range of distressing symptoms that are significantly impacting your daily life, and it’s important to address these concerns seriously. Based on your description, it is quite possible that you are dealing with depression, which can manifest in various ways, including emotional and physical symptoms.

Understanding Your Symptoms
1. Breathing Difficulties: The sensation of tightness in your chest and difficulty breathing when feeling depressed can be related to anxiety, which often accompanies depression. This can create a cycle where anxiety exacerbates feelings of depression, leading to further physical symptoms. The feeling of not being able to take a full breath is not uncommon in individuals experiencing high levels of stress or emotional turmoil.

2. Emotional Responses: Your heightened sensitivity to sounds and conversations, particularly those involving your parents, suggests that you may be experiencing emotional dysregulation. This is common in individuals with depression, where even minor stimuli can provoke strong emotional reactions. The fact that you find it difficult to quiet your mind at night and need to reassure yourself for hours before sleeping indicates a significant level of anxiety and emotional distress.

3. Sleep Issues: Sleep disturbances are a hallmark of depression. Difficulty falling asleep, racing thoughts, and the need to manage your emotions before you can rest are all signs that your mental health is affecting your sleep quality. The physical discomfort you describe when trying to find a comfortable sleeping position may also be linked to anxiety and muscle tension, which are common in individuals experiencing stress.

4. Long-term Effects of Bullying: The history of verbal bullying you mentioned can have lasting effects on self-esteem and emotional health. Such experiences can contribute to feelings of worthlessness and depression, making it more challenging to cope with current stressors.

Is This Depression?
Based on the symptoms you've described—persistent low mood, difficulty breathing, emotional sensitivity, sleep disturbances, and a history of bullying—it is reasonable to suspect that you may be experiencing depression. Online assessments can provide some insight, but they are not definitive. A thorough evaluation by a mental health professional is essential for an accurate diagnosis.

Recommendations for Moving Forward
1. Seek Professional Help: It is crucial to consult with a mental health professional, such as a psychologist or psychiatrist. They can provide a comprehensive assessment and discuss treatment options, which may include therapy, medication, or a combination of both.

2. Cognitive Behavioral Therapy (CBT): This form of therapy is effective for many individuals with depression and anxiety. It helps in identifying and changing negative thought patterns and behaviors that contribute to emotional distress.

3. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help manage anxiety and improve your ability to cope with stress.

4. Physical Activity: Regular exercise can significantly improve mood and reduce anxiety. Even light activities, such as walking or yoga, can be beneficial.

5. Social Support: Connecting with friends, family, or support groups can provide emotional relief. Sharing your experiences with others who understand can be incredibly validating.

6. Sleep Hygiene: Establishing a calming bedtime routine and creating a comfortable sleep environment can help improve your sleep quality. Limiting screen time before bed and practicing relaxation techniques may also be beneficial.

7. Avoid Substance Use: While it may be tempting to use alcohol or other substances to cope, these can exacerbate feelings of depression and anxiety in the long run.

Conclusion
Your experiences and feelings are valid, and seeking help is a strong and positive step. Remember, you are not alone in this, and there are effective treatments available that can help you regain control over your emotions and improve your quality of life. Please consider reaching out to a mental health professional who can guide you through this challenging time.

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