Navigating Mental Health Challenges: Reflections on Academic Pressure and Self-Doubt

My condition?

Dear Doctor,
I previously sent you a letter confirming my impending expulsion, and I have decided to prepare thoroughly for my job search exams.
However, during this preparation process, I find it difficult to concentrate as I often think about the past.
I want to explain the situation to my teacher, who may have misunderstood me, and clarify why I feel I have let him down.
Every time I think about this, I feel sad and cry, worrying that my teacher may not believe me, or that he might say he doesn't care at all, which I fear I would find hard to accept (though I'm unsure if I should even explain).

I constantly ponder whether I truly did not commit myself to my studies, whether my mental health was genuinely affected, or if I simply lacked perseverance and used it as an excuse to avoid responsibility.
I also consider confiding in some friends about my feelings over the years and sharing what has happened to me (something I was afraid to do before).
I want their advice to analyze whether what I am doing now is correct, whether I have been responsible in my duties, and whether I can truly start anew and live authentically.

A multitude of fears and worries swirl within me, leading me to doubt myself and risk repeating past mistakes.
Is there something wrong with me, or is it just a temporary emotional imbalance? (During my time off from school to work, I was able to function normally, unlike now, when I can only think of these issues when I try to study.) The torment over the years has significantly impaired my memory.
If I truly had a problem, why was I able to endure for two to three years before losing interest in my studies? Was it due to avoidance or the effects of neglecting my emotions?

Qingkong, 20~29 year old female. Ask Date: 2006/04/23

Dr. Ye Yuki reply Psychiatry

Dear Qingsky user,
I regret to read in your second letter that you have withdrawn from school.
I must apologize for saying that I cannot definitively determine whether you are suffering from depression based solely on online information.
Even in cases of depression, each individual presents unique physiological, psychological, and environmental factors that lead to different courses and symptoms of the illness.
Therefore, it is essential to understand the individuality of each case to provide appropriate treatment.
It seems that you have many thoughts lingering in your mind, which may have troubled you for years.
The numerous questions you have written may have been self-posed and self-answered for quite some time.
Each of us has psychological mechanisms that help us cope with situations that cause emotional distress.
While these mechanisms can be beneficial at times, they may not always be helpful.
For instance, you mentioned that initially, you closed yourself off.
On one hand, this can be seen as a form of self-protection; however, while this approach may work in the short term, over time, when the resources available to us—such as friends, family, professionals, or personal growth—are no longer providing support against psychological stress, it can ultimately deplete our initial defenses.
Thus, it is not surprising that noticeable symptoms of depression appear after some time.
This is also why psychiatric treatment involves not only medication but also psychological therapy.
If I may suggest, now is not the time to question whether you have depression.
Rather, consider whether you are satisfied with your life, even if it turns out you do not have depression.
I believe the answer is likely no, which signals the need for help.
Sending this letter is a step forward, and I encourage you to seek consultation from a psychiatrist or a mental health professional as your next step toward recovery.

Reply Date: 2006/04/23

More Info

Navigating mental health challenges, especially in the context of academic pressure and self-doubt, is a significant concern for many young adults today. Your reflections reveal a deep struggle with feelings of inadequacy, anxiety about past decisions, and the pressure to meet expectations—both from yourself and others. These feelings are not uncommon, particularly in high-stress environments like college or during transitional phases in life.

Firstly, it's important to acknowledge that what you're experiencing is valid. The emotional turmoil stemming from academic pressures, coupled with the fear of disappointing others, can lead to a cycle of self-doubt and anxiety. This cycle often manifests in physical symptoms, such as difficulty concentrating, crying spells, and a sense of being overwhelmed. These reactions are not indicative of weakness; rather, they are signs that your mental health is being challenged by external pressures and internal conflicts.

The thoughts you have about wanting to explain yourself to your former teacher or seeking validation from friends are understandable. Many individuals grapple with the desire for closure or understanding regarding past experiences. However, it's crucial to recognize that while seeking external validation can be comforting, it should not be the sole source of your self-worth. Your value is not determined by others' perceptions or expectations but rather by your own understanding of your journey and growth.

In terms of your academic concerns, it’s essential to differentiate between genuine self-reflection and excessive rumination. While reflecting on past actions and their consequences can be constructive, dwelling on them to the point of distress can hinder your progress. It may be beneficial to set aside specific times for reflection, allowing yourself to process these feelings without letting them consume your daily life. Engaging in mindfulness practices, such as meditation or journaling, can help you manage these thoughts more effectively.

You mentioned the possibility of being "spiritually ill" or questioning your perseverance. It's important to understand that mental health issues can manifest in various ways, and they often do not have a clear timeline. Just because you managed to cope for a period does not mean that your struggles are any less valid now. Mental health is complex and can fluctuate based on numerous factors, including stress levels, life changes, and personal circumstances.

Seeking support from friends or mental health professionals can be incredibly beneficial. Sharing your experiences with trusted individuals can provide relief and perspective. Additionally, a mental health professional can help you explore these feelings in a safe environment, offering strategies to cope with anxiety and self-doubt. Cognitive-behavioral therapy (CBT), for instance, is an effective approach for addressing negative thought patterns and developing healthier coping mechanisms.

As you prepare for your job search and consider your future, remember that it's okay to take things one step at a time. Focus on what you can control in the present moment rather than becoming overwhelmed by the entirety of your past or future. Setting small, achievable goals can help build your confidence and provide a sense of accomplishment.

Lastly, it's crucial to practice self-compassion. Acknowledge that everyone makes mistakes and faces challenges; these experiences are part of being human. Instead of harshly judging yourself for perceived failures, try to treat yourself with the same kindness you would offer a friend in a similar situation.

In summary, your feelings of anxiety, self-doubt, and the desire for validation are common among individuals facing academic and personal pressures. It's essential to seek support, practice self-reflection without excessive rumination, and approach your mental health with compassion. Remember, you are not alone in this journey, and there are resources available to help you navigate these challenges.

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