Overcoming Mental Struggles: Finding Purpose and Direction in Life

After careful consideration, I couldn't come up with a solution?

Hello, doctor.
I apologize for bothering the online consultation physicians at Taiwan e-Hospital again.
This time, I have chosen you, Dr.
Li, to be my mentor and to provide me with consultation advice.
My relevant information should be under the name Jason, where you can find the issues I previously mentioned.
I truly apologize; my psychiatrist at the hospital only provides outpatient services and does not engage in detailed discussions—just a few words, really.

Additionally, I recently had a falling out with my brother, and we are currently in a cold war.
My father is getting older and is not very involved in my life anymore.
My mother passed away fifteen years ago.
I don’t have any friends—only former classmates and teachers who bullied me.

I would like to ask the following: I consider myself somewhat timid, often feeling scared of death and anxious about flying.
In my last job, I worked in a cleaning service and was excited about the idea of becoming a civil servant, even taking private tutoring to prepare for the exams, but the results were not ideal! I realize that I am not cut out for studying; for me, it seems easier to find a part-time job to earn extra money rather than studying in my spare time.
Studying requires thorough understanding and mastery of the material, which is difficult for me! Moreover, these are national exams! Although I did take the mental health exam, the money I previously invested has gone to waste, and my time has been wasted as well!
I genuinely cannot think of anything useful I can do.
I want to succeed, but I am already 43 years old! If my mother had not passed away, perhaps we could have discussed this together.
Vocational training might help, but I have assessed that it won’t make a significant difference! I know I cannot expect everything without putting in the effort.
Even if I want to find time to study, my daily life and responsibilities disrupt me.
Furthermore, I currently have a job but am not taking any tutoring classes.
I cannot become a full-time student!
In terms of daily life, I am really trying hard! I work diligently and also manage household chores, trying to balance both sides, but studying? I really cannot do it; I can only study sporadically.
Sometimes after work, I feel so exhausted that I just crash into bed—where is the time to study? And when I am tired, how can I manage a part-time job? I sincerely ask for your help.

Jason, 40~49 year old female. Ask Date: 2023/08/13

Dr. Li Guanying reply Psychiatry

Dear Sir/Madam,
From your letter, it is clear that you are experiencing distress regarding your ability to continue working and contribute value, which is commendable.
Here are some suggestions:
1.
In the face of an uncertain future, psychosomatic disorders, such as depression, are common in modern society.
These are chronic conditions that require long-term treatment for recovery.
2.
Psychosomatic disorders are chronic illnesses characterized by episodes of exacerbation, remission, recovery, and relapse.
More than half of patients may experience a recurrence of symptoms even after they have improved.
Due to individual differences in physiology, it may take time to identify the most suitable medication, so please be patient and collaborate with your physician.
3.
Regarding pharmacological treatment, each primary medication typically requires 4 to 6 weeks to assess its efficacy.
If you experience any discomfort, please keep track of the duration and frequency of your symptoms.
Some medications can be monitored through blood tests to check their concentration, so discuss this with your physician.
4.
In addition to medication and psychotherapy, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive treatment that does not require anesthesia, has a high safety profile, and does not necessitate hospitalization.
It can improve anxiety and depressive symptoms, and patients with treatment-resistant depression or poor medication response often show significant improvement after rTMS therapy.
Please discuss any psychosomatic issues or difficulties with concentration during your follow-up appointments.
Our clinic offers consultations from Monday to Friday, both in the morning and afternoon.
I recommend considering a visit to allow your physician to personally assess your symptoms and collaboratively determine the best course of action for you.
Wishing you mental and physical well-being.

Reply Date: 2023/08/13

More Info

Hello Jason,
Thank you for reaching out and sharing your thoughts and struggles. It sounds like you are going through a very challenging time, and I want to acknowledge the courage it takes to express these feelings. Your situation is complex, and it’s understandable to feel overwhelmed, especially given the loss of your mother, the strained relationship with your brother, and the lack of supportive friendships.
Firstly, it’s important to recognize that feeling lost or struggling to find purpose is a common experience, especially during difficult life transitions. Many people face similar challenges, and it’s okay to seek help and guidance. You mentioned feeling like you have no friends and that your family dynamics are strained. This isolation can exacerbate feelings of loneliness and despair, making it even harder to find direction in life.
In terms of your career aspirations, it’s commendable that you have ambitions to become a civil servant. However, it’s also crucial to be realistic about your current situation and capabilities. You mentioned that studying for exams feels daunting, and it’s understandable given your work commitments and the fatigue that comes with them. It might be beneficial to explore alternative paths that align with your strengths and interests.
Consider looking into vocational training programs that focus on practical skills rather than academic qualifications. These programs can often lead to fulfilling careers without the pressure of extensive studying. Additionally, part-time work in areas that interest you could provide both financial support and a sense of purpose.
You also expressed a desire to find meaning in your life. This can often be achieved through small, incremental changes rather than drastic shifts. Reflect on activities that bring you joy or fulfillment, even if they seem minor. Engaging in hobbies, volunteering, or joining community groups can help you connect with others and foster a sense of belonging.
Moreover, it’s essential to address your mental health. The feelings of hopelessness and the pressure you place on yourself can be overwhelming. Seeking therapy or counseling can provide you with a safe space to explore these emotions and develop coping strategies. A mental health professional can help you work through feelings of inadequacy and guide you in setting realistic goals for yourself.

In terms of your current job, it’s great that you are working hard and managing household responsibilities. However, if you find that your job is draining you to the point where you cannot study or pursue other interests, it may be worth considering a job change. Look for positions that offer a better work-life balance or that align more closely with your interests.

Lastly, remember that it’s okay to take things one step at a time. Life is not a race, and finding your path may take time. Be kind to yourself and recognize the efforts you are making, even if they feel small. Celebrate your achievements, no matter how minor they may seem.

In conclusion, I encourage you to explore vocational training, seek mental health support, and engage in activities that bring you joy. Surrounding yourself with positive influences and gradually working towards your goals can help you find a sense of purpose and direction in life. You are not alone in this journey, and there are resources available to support you.

Take care, and I wish you all the best on your path to finding fulfillment and happiness.

Best regards.

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