Is It Stress or Depression? Your Mental Health Struggles

I would like to ask if it's due to excessive stress or if I have depression?

Hello, doctor.
I once experienced exclusion from my classmates, and male classmates would intentionally tease me (I’m not sure if it qualifies as bullying).
At that time, I felt exhausted and wished I could die.
In front of others, I could put on a smile, but at night, when I was alone in my room, my eyes would leak tears like a broken faucet.
I would silently stare at a utility knife, crying while blaming myself for being afraid of pain.
Every day felt like I was a walking corpse, forcing myself to go to school, feeling so tired and wanting to die.
In the second year of junior high, I made a few good friends and felt very happy, filled with hope for life.
However, in the third year, everyone suddenly left me.
I might have gotten used to being alone, so it wasn’t as painful as in the first year, but I still felt exhausted and wanted to die, and my memory started to decline since then.
Now I’m in my first year of high school, and I don’t know if it’s due to academic pressure or social stress, but my emotions have become unstable.
Sometimes I feel very happy, and other times I start to cry, feeling so tired of living.
I wonder why I have to suffer so much; I just want to lie down and space out or scroll through my phone (not really looking at anything).
When the pain becomes unbearable, I hit my legs hard, hoping that physical pain will alleviate my mental suffering.
At school, I can’t focus in class; I just zone out or doodle, and I lack the motivation to do my homework, leading to a significant drop in my grades.
Occasionally, I feel so anxious at school that I can’t catch my breath, and my body starts to tremble slightly.
I begin to feel immense pain and think about suicide.
Often, while going to school, I think, “I hope a truck will hit me.” In class, I feel like my classmates are constantly watching me and secretly talking bad about me behind my back.
Even though I can hear their conversations, I can’t help but think this way.
I previously discussed my depression scale results from a school assessment with the guidance counselor, who was originally a psychological counselor.
However, our conversation made me feel more anxious.
After talking for two sessions, he only taught me how to integrate into the class (which didn’t help), and we haven’t spoken since.
I felt he was dismissively handling my concerns.
Once, when I was so anxious at school that I could barely breathe and my hands and feet were trembling slightly, I went to find the guidance counselor, but I couldn’t locate him after searching for a long time.
So now, I don’t trust the guidance counselor much and don’t want to talk to him.
Doctor, do you think my current state is due to excessive stress or depression? Should I see a doctor? If I need to see a doctor, how should I approach my family about it? I’m very worried about how they will think of me and perceive me...
but my grades are really suffering, so I’m asking for your advice.
Thank you for your input.

Lin Tongxue, 10~19 year old female. Ask Date: 2022/06/15

Dr. Wu Enliang reply Psychiatry

It is indeed possible that the individual is experiencing depression.
It is advisable to talk to family members about the recent emotional instability, which is affecting learning.
If feelings of emotional distress persist, seeking treatment from a mental health professional is recommended.
Additionally, if possible, it is suggested to prioritize consulting a child and adolescent psychiatrist.
Dr.
Wu Enliang.

Reply Date: 2022/06/15

More Info

It sounds like you are going through a very challenging time, and I want to acknowledge the pain and confusion you are experiencing. Your feelings of sadness, anxiety, and the desire to escape from your current situation are significant and deserve attention.
From what you've described, it seems that you are experiencing a combination of stress and symptoms that could indicate depression. The distinction between stress and depression can sometimes be subtle, but there are key differences. Stress is often a response to external pressures, such as academic demands or social situations, and can lead to feelings of overwhelm, anxiety, and irritability. On the other hand, depression is characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities that you once enjoyed. It can also manifest in physical symptoms, such as fatigue, changes in appetite, and difficulty concentrating.

Your experiences of feeling exhausted, crying frequently, and having thoughts of self-harm are concerning and suggest that you may be dealing with depression. The fact that you have had moments of happiness in the past, but now feel a sense of hopelessness and fatigue, is also indicative of a potential depressive episode. Additionally, the physical symptoms you mentioned, such as difficulty concentrating and feeling anxious to the point of shaking, further support this possibility.

It’s important to understand that seeking help is a sign of strength, not weakness. If you are feeling overwhelmed and your academic performance is suffering, it may be beneficial to consult a mental health professional. A psychologist or psychiatrist can provide a proper assessment and help you understand what you are experiencing. They can also offer therapeutic options, such as cognitive-behavioral therapy (CBT), which has been shown to be effective for both stress and depression.

When it comes to discussing your feelings with your family, it can be helpful to approach the conversation with honesty and clarity. You might start by expressing that you have been feeling overwhelmed and that it’s affecting your daily life and studies. You could say something like, “I’ve been feeling really down and anxious lately, and it’s impacting my schoolwork. I think it would help if I spoke to a professional about it.” This way, you are framing it as a proactive step towards improving your well-being.

If you are concerned about how your family might react, remember that mental health issues are common, and many people seek help for them. It’s important for your family to understand that you are not alone in this, and that seeking help can lead to positive changes.

In addition to professional help, there are self-care strategies that can be beneficial. Engaging in physical activity, maintaining a routine, and practicing mindfulness or relaxation techniques can help alleviate some symptoms of stress and depression. Connecting with friends or family members who you trust can also provide emotional support.

Lastly, if you ever feel like you are in immediate danger or have thoughts of harming yourself, please reach out to a crisis hotline or emergency services. Your safety is the top priority.

In summary, it’s crucial to take your feelings seriously and seek help. You deserve support and guidance to navigate through this difficult time. Remember, reaching out for help is a courageous step towards healing and finding a path forward.

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