Am I Sick? Anxiety and Social Struggles in Adolescents

Are you feeling unwell?

I feel so exhausted.
I can't understand why others don't feel this way, but I do.
I hate socializing; it drains so much of my energy.
I'm afraid that others won't like or accept me, but it's impossible to avoid social interactions in life.
Just the thought of going out with classmates makes me uncontrollably anxious and tense.
I'm scared that if I get so nervous I feel like vomiting, they'll see me and I won't know how to explain it.
I also dislike going to school because there are too many unpredictable and unpleasant things happening there.
However, I know I can't escape, which makes me hate myself for having these thoughts.
I have a personality that easily gets anxious and resists public speaking or any activities that are out of the ordinary, as they make me feel nauseous, cause my heart to race, and lead to dry mouth.
This discomfort is very painful for me, and I often feel like a weirdo.
My mood is frequently low, and I become impatient and irritable.
I've experienced symptoms of hyperventilation, and I've lost about 4 to 5 kilograms over the past three months.
I don't have insomnia, but I just want to sleep all the time and not wake up.
Sometimes, after class, I break down and cry because I can't understand the material.
Even though my grades have improved compared to before, I still can't feel happy about it; I blame myself for not being good enough.
Why can others be first, but I can't? When I'm nervous, angry, or sad, I engage in self-harm (mild).
I know it's wrong, but I can't control it, and I feel ashamed and guilty about myself.
These symptoms have been present for about six months, fluctuating between good and bad.
I'm soon facing major exams and interviews, and I'm terrified of messing everything up.
I'm even afraid that in the future, no one will want to hire me, and I feel lost and fearful about what else I might struggle to adapt to.
The internet says I need to adjust my mood before I can study well, but I don't know how to do that.
I don't dare to talk to my family about it; I've tried, but they think I have no reason to complain since I have everything I need, and I'm still a minor.
I also don't dare to take the step to see a doctor, fearing that if I go and there's nothing wrong, my family will think I'm overreacting.
But I'm really scared that if this continues, I might ruin myself.
I want to know if I'm sick.
If I am, it would give me the courage to seek medical help.
Thank you, doctor, for patiently reading this.

00, 10~19 year old female. Ask Date: 2020/08/28

Dr. Huang Xiaoxian reply Psychiatry

Dear Sandy,
It sounds like these situations are quite distressing for you.
The rational part of you and your family may think that it’s not a big deal and that you are overthinking it, but the emotional part of you struggles to ignore it.
Often, this is due to the areas of the brain that regulate our emotions being affected.
Research has found that fluctuations in neurotransmitters, such as serotonin, can lead to conditions like depression and anxiety (one of the causes).
Since your symptoms have persisted for about six months, simply adjusting your mood may not be sufficient for improvement.
I recommend seeking an evaluation from a mental health professional to receive appropriate treatment.
This can also help facilitate communication with your family about your condition through healthcare providers.
Wishing you all the best.

Reply Date: 2020/08/28

More Info

It sounds like you are experiencing a significant amount of distress related to anxiety and social interactions, which can be incredibly overwhelming. From what you've described, it seems that you are dealing with symptoms that are consistent with social anxiety disorder, as well as possibly some depressive symptoms. It's important to understand that you are not alone in feeling this way, and many adolescents face similar challenges.

Social anxiety disorder is characterized by an intense fear of social situations where one might be judged or scrutinized by others. This can lead to avoidance behaviors, such as not wanting to go to school or participate in social activities, which can further exacerbate feelings of isolation and sadness. The physical symptoms you mentioned—like rapid heartbeat, dry mouth, and feelings of nausea—are common manifestations of anxiety. These symptoms can make social interactions feel daunting, leading to a cycle of avoidance and increased anxiety.

Your feelings of frustration and self-criticism are also common among individuals who struggle with anxiety and depression. It's not unusual to feel like you are not measuring up to others, especially in a competitive environment like school. The pressure to perform well academically can add to your anxiety, making it difficult to focus and enjoy your accomplishments. It's important to recognize that your worth is not solely determined by your academic performance or how others perceive you.

The fact that you have been experiencing these symptoms for about six months and that they fluctuate indicates that you may benefit from professional support. Seeking help from a mental health professional, such as a psychologist or psychiatrist, can provide you with the tools and strategies to manage your anxiety and improve your overall well-being. Therapy, particularly cognitive-behavioral therapy (CBT), has been shown to be effective for social anxiety and can help you develop coping mechanisms to deal with your fears.

It's understandable that you may feel hesitant to talk to your family about your struggles, especially if you fear they may not understand. However, it might be helpful to approach the conversation by expressing how your feelings are impacting your daily life and academic performance. You could say something like, "I've been feeling really anxious and overwhelmed lately, and it's affecting my ability to focus on school. I think it might help to talk to someone who can help me." This way, you are framing it in a way that highlights your need for support rather than focusing solely on the idea of being "sick."
If you are concerned about confidentiality, rest assured that mental health professionals are bound by strict confidentiality laws. They cannot disclose your information without your consent, except in certain situations where there is a risk of harm to yourself or others.

In summary, it sounds like you are experiencing significant anxiety and possibly depression, which can be addressed with the right support. You deserve to feel better and to have the tools to manage your anxiety effectively. Taking the step to seek help is a sign of strength, not weakness. Remember, you are not alone in this, and there are people who can help you navigate these challenges.

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