Mental Health: When to Seek Counseling and Support

Q: Mental Health: When to Seek Counseling and Support

Hello, user： Your condition is currently very serious, and you need to seek treatment at a psychiatric facility as soon as possible rather than just counseling. <br>Dr. <br>Wu Enliang

Psychological counseling

Hello Dr.
Wu, I am currently about to enter my sophomore year.
When I was in first grade, I joined the swimming team, and the coach was very strict.
Due to my insufficient skills, I was forced to be assigned to that coach's group.
The coach often splashed water on me and would make me practice rolling in the pool 50 times each way after all the other students had left.
If I choked on water or took a short break, I would be required to swim back and forth 50 meters 1-2 times, all in the name of helping me improve quickly.
Under this high-pressure training, my mother would occasionally come to observe, and the coach would allow me to finish early as an exception.
However, there was one time when the coach didn't notice my parent was present, and I was subjected to the same training regimen.
After practice, when my parent asked why I was the only one left, I could only say it was because I was weaker or that the other students left early.
After a few more classes, my parents watched from the sidelines, and after understanding the situation, they withdrew me from the program.
At that young age, I couldn't manage my emotions well, which led to a long period where I was afraid to go to school.

For a while, when I did return to school, I was bullied by older students, which made me even more reluctant to attend.
The teachers often asked my mother about my situation, but no one could help me, and I was too afraid to talk to my family about these issues.
I was generally quiet as a child, so when my family asked about school, I would try to say nothing was wrong.
I am unsure if I had psychological issues as a child; I was afraid to see a doctor and never sought help.
Recently, I was in a car accident four months ago, resulting in bruises and scrapes on my right leg, making it difficult to move.
After the incident, I started feeling unwell; I lost my appetite, often had diarrhea, and couldn't sleep well at night.
Seeing others live their lives made me start to curse myself, and I would cry at night, unable to control my emotions.
For a period, I couldn't attend school because I would cry for no reason.
About a month ago, as I began to handle club activities in my sophomore year, I felt like I had no friends or teammates to help me.
I would wait by my phone for replies, and if I didn't see a response, I would become extremely irritable.
Recently, I have also started to bite those close to me without controlling the force, and I have been experiencing insomnia, often not sleeping well at night.
Sometimes, I go an entire day without sleep.
My family asks what I want to eat at mealtimes, but I just don't want to eat.
If I don't eat, I get scolded, so I reluctantly suggest a meal, take a few bites, and then throw it away.
Occasionally, I binge eat, but I often skip meals.
I used to be able to finish an entire lunch box by myself, but now I only eat about a third or less and then throw it away.
Recently, I have found myself wishing for something to happen to me suddenly, like a serious car accident that wouldn't leave me paralyzed.
My daily routine is also irregular; if I don't see a message reply, I become very irritable, feeling like no one can help me, and I curse myself.
Sometimes, I can't control my emotions and start crying or getting angry.
At mealtimes, I either don't get up or skip meals, and sometimes I go 2-3 days without eating.
I also hear some auditory hallucinations, like my parents scolding me or other people cursing.
I struggle to sleep well, often staying awake all night or only falling asleep around 4-5 AM.
Occasionally, I wake up in the middle of the night with stomach pain or unexplained diarrhea, and I experience sudden abdominal pain.

I am unsure if I am mentally ill and would like to ask the doctor if I should seek treatment or counseling.
Thank you for taking the time to answer my questions!

Wangyou, 10~19 year old female. Ask Date: 2021/07/11

Dr. Wu Enliang reply Psychiatry

Hello, user: Your condition is currently very serious, and you need to seek treatment at a psychiatric facility as soon as possible rather than just counseling.
Dr.
Wu Enliang

Reply Date: 2021/07/11

More Info

It sounds like you are going through an incredibly challenging time, and I want to acknowledge the pain and confusion you are experiencing. Your situation involves a combination of past trauma, current stressors, and possibly underlying mental health issues that are affecting your daily life and overall well-being.
From what you've described, it seems that your experiences with bullying, high-pressure situations, and the recent car accident have contributed to a significant decline in your mental health. The feelings of anxiety, depression, and emotional instability you are experiencing are serious and warrant professional attention.

When to Seek Counseling and Support
1. Persistent Emotional Distress: If you find yourself crying frequently, feeling hopeless, or experiencing intense anger or frustration, these are signs that you may need to seek help. Emotional distress that interferes with your daily life, such as your ability to attend school or engage in social activities, is a critical indicator.

2. Physical Symptoms: The physical symptoms you mentioned, such as loss of appetite, gastrointestinal issues, and sleep disturbances, can often be linked to mental health conditions like anxiety and depression. These symptoms can exacerbate your emotional state and create a cycle of distress.

3. Thoughts of Self-Harm: The thoughts you’ve expressed about wanting to experience an accident or harm yourself are particularly concerning. It’s crucial to take these feelings seriously. If you ever feel like you might act on these thoughts, please seek immediate help from a mental health professional or a crisis hotline.

4. Social Withdrawal: The fact that you are isolating yourself and feeling that you have no one to turn to is another strong indicator that you could benefit from counseling. Social support is vital for mental health, and a therapist can help you build coping strategies and reconnect with others.

5. Hearing Voices: Experiencing auditory hallucinations, such as hearing voices that are not there, is a significant symptom that should be evaluated by a mental health professional. This could indicate a more serious condition that requires immediate attention.

Recommendations for Seeking Help
- Consult a Mental Health Professional: It’s important to reach out to a psychologist, psychiatrist, or counselor who can provide a safe space for you to discuss your feelings and experiences. They can help you understand what you are going through and develop a treatment plan tailored to your needs.

- Consider Therapy Options: Cognitive Behavioral Therapy (CBT) is often effective for anxiety and depression. It can help you identify negative thought patterns and develop healthier coping mechanisms. Additionally, group therapy might provide you with a sense of community and support from others who understand what you are going through.

- Medication: Depending on your evaluation, a psychiatrist may recommend medication to help manage your symptoms. This can be particularly helpful if you are experiencing severe anxiety or depression.

- Support from Family and Friends: While it may feel difficult to open up, sharing your feelings with trusted family members or friends can provide additional support. They can help you navigate your feelings and encourage you to seek professional help.

Self-Care Strategies
While seeking professional help, consider incorporating self-care strategies into your routine:
- Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing exercises, or yoga can help reduce anxiety and improve your emotional state.

- Regular Physical Activity: Engaging in physical exercise can boost your mood and improve your overall health. Even a short walk can make a difference.

- Healthy Eating: Try to maintain a balanced diet, even if your appetite is low. Nutritional deficiencies can impact your mood and energy levels.

- Establish a Routine: Creating a daily routine can provide structure and a sense of normalcy, which can be comforting during turbulent times.

Conclusion
Your mental health is just as important as your physical health, and seeking help is a sign of strength, not weakness. It’s essential to address these feelings and experiences with a professional who can guide you through this difficult time. Remember, you are not alone, and there are people who want to help you. Please consider reaching out for support as soon as possible.

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