Anxiety: When to Seek Help for Mental Health Issues

Q: Anxiety: When to Seek Help for Mental Health Issues

Hello, Xiao-Hui： I feel that you are going through a tough time. <br>I wonder if you have been suppressing your emotions too much, which might have led to this volcanic eruption of feelings. <br>It would be beneficial to practice expressing your dissatisfaction more regularly, al

Is there an anxiety disorder or other physiological conditions?

Hello, doctor.
First of all, thank you for your response.
I have been troubled by the behaviors I will describe below for over two years.
I often suspect that I might have an anxiety disorder or other physiological issues, but since these episodes occur only once every 3-4 months, I haven't mustered the courage to see a psychiatrist.
I'm afraid of being perceived as overreacting or thinking too much.
I feel that although I am somewhat slow to warm up and hesitant to form deep friendships, I appear to be quite lively to outsiders.
Looking back at my childhood, it seems like I exhibited signs of anxiety.
I feel very insecure, and when I get anxious, I tend to pick at my nails until they bleed, and I don't spare my toenails either.
As I've grown older, I have forced myself to quit this bad habit due to my desire to look good, but I still can't shake off the anxiety.
Even when I'm very tired at night, I tend to stay up late because I feel reluctant to sleep, although I don't even know what I'm reluctant to let go of.
During this time, my emotions can fluctuate significantly over trivial matters, leading to uncontrollable outbursts where I scream loudly and hit the sofa or pillows frantically, often accompanied by chest tightness.
Sometimes I cry during these episodes, and sometimes I don't, but afterward, I wonder why I reacted that way and if I was being overly dramatic.
I often think, "Is it really that serious? It's laughable, right? It's just a small matter." These episodes tend to occur more frequently at night, yet I feel mentally clear and manage to hold it together until I'm home alone, where I finally lose control of my emotions.
I remember one time when I was on my way home and bought something at a convenience store, but I was given the wrong change.
When I got home, I had an episode.
I had a package that needed to be wrapped urgently, and while I was having an episode, I was looking for tape to wrap it.
I couldn't find any tape, so I put on a mask and went out to buy some.
At that moment, I was fixated on getting packing tape because it has a blade, and I felt an urge to cut myself with it when I got home.
Of course, I ended up buying regular tape instead.
This is also why I haven't seen a doctor yet; because after calming down, I realize that doing such things would leave scars and I would regret it.
I even knew that the package was urgent, and I understood that I could only scream when I was alone, otherwise, I would be seen as crazy.
But then I think maybe it's just that I'm under too much stress, which is why I often cancel my appointments on the day I'm supposed to go.
I'm not only afraid of being laughed at but also worried that such reactions in this environment are considered normal stress relief.
I have various contradictory thoughts; even my episodes are contradictory.
Sometimes I feel wonderful, and other times I think maybe I should just give up and that death would be better, yet at other times I feel incredibly happy.
This cyclical thinking leaves me feeling like I'm on the edge of being normal and abnormal.
Perhaps there are many more things I can't describe in detail regarding whether I have a physiological condition.
Today, I decided to seek help online because I had an episode today, which happened for no apparent reason, but it wasn't overly dramatic.
I know that although I really want to make an appointment, I might end up canceling it again.
So, I would like to ask the doctor if I should definitely see a doctor regarding this situation.

Xiao Hui, 20~29 year old female. Ask Date: 2021/03/30

Dr. Wu Enliang reply Psychiatry

Hello, Xiao-Hui: I feel that you are going through a tough time.
I wonder if you have been suppressing your emotions too much, which might have led to this volcanic eruption of feelings.
It would be beneficial to practice expressing your dissatisfaction more regularly, allowing for a small release of that pent-up energy.
If that doesn’t help, I recommend seeking individual psychotherapy to get assistance from a professional therapist.
Dr.
Wu En-Liang

Reply Date: 2021/03/30

More Info

It's understandable to feel hesitant about seeking help for anxiety, especially when symptoms seem sporadic or not severe enough to warrant a doctor's visit. However, your experiences and feelings are valid, and it's essential to recognize that anxiety can manifest in various ways, often leading to significant distress and impairment in daily life.

From what you've described, it sounds like you're experiencing a range of anxiety symptoms, including physical manifestations (like nail-biting until it bleeds), emotional outbursts, and a tendency to ruminate on negative thoughts. These behaviors can be indicative of underlying anxiety disorders, such as generalized anxiety disorder (GAD) or possibly even obsessive-compulsive disorder (OCD), given the compulsive nature of your nail-biting and the distress surrounding it.

It's important to understand that anxiety disorders are not just about feeling nervous or worried; they can lead to debilitating symptoms that affect your quality of life. The fact that you feel compelled to act out your anxiety in private, away from others, suggests that you are aware of the stigma surrounding mental health issues, which can further complicate your willingness to seek help. Many people share similar fears of being judged or dismissed when they express their mental health struggles.

You mentioned that your anxiety episodes occur every few months, which might lead you to believe that they are not severe enough to warrant professional help. However, the frequency of these episodes is less important than the impact they have on your life. If your anxiety is causing you distress, affecting your relationships, or leading to harmful thoughts or behaviors (like wanting to harm yourself), it is crucial to seek help. Mental health professionals are trained to understand these complexities and can provide a safe space for you to explore your feelings without judgment.

In terms of coping strategies, while it's commendable that you've tried to manage your anxiety on your own, it's also essential to recognize when professional help is needed. Techniques such as mindfulness, cognitive-behavioral therapy (CBT), and relaxation exercises can be beneficial, but they are often more effective when guided by a trained therapist. A therapist can help you identify triggers, develop healthier coping mechanisms, and work through the underlying issues contributing to your anxiety.

If you're worried about the stigma of seeking help, remember that mental health is just as important as physical health. Many people experience anxiety, and seeking treatment is a sign of strength, not weakness. It shows that you are taking proactive steps to improve your well-being.

In conclusion, I strongly encourage you to consider seeking help from a mental health professional. You deserve support and guidance in navigating your feelings and experiences. It may feel daunting, but taking that first step can lead to significant improvements in your mental health and overall quality of life. Remember, you are not alone in this journey, and there are resources available to help you find balance and peace.

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