Struggling with Mental Health: Emotional and Physical Symptoms - Psychiatry

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I'm feeling very down?


Hello, Doctor: I don't know what's wrong with me lately.
My mood is terrible, and my body has been experiencing various issues.
I have irregular menstrual cycles, constant dizziness, irritability, and fatigue.
When I get home from school, all I want to do is sleep, and I can't control it.
I wake up at 12:34 AM every night, and my sleep quality is poor.
I get up at 5 AM to prepare for school.
I can't concentrate, and I can't even read my books.
I'm so angry, and my exam results are poor.
I'm falling behind my planned schedule, and I really want to cry.
I have headaches, dizziness, constipation, stomach discomfort, chest tightness, weakness and soreness in my calves, and abdominal pain, all of which are overwhelming me.
I hate myself for not being able to study as hard as I used to.
I can't motivate myself to keep up with my schedule anymore.
I feel terrible, like I'm not doing anything right, and I can't present a good report card.
With these grades, my teachers will surely think I'm not putting in the effort like before, but I'm really, really tired.
My physical fatigue is worsening day by day, and I'm so sad.
However, I don't want my loving parents and teachers to worry about me, so I have to pretend that I'm doing well.
I also don't want them to see me weak and sick.
The thought of undergoing physical and psychological examinations terrifies me because I'm afraid of seeing a doctor.
I can't even speak when I'm in front of a doctor, and the examination instruments and procedures make me even more anxious.
I'm in so much pain, but I'm scared to see a doctor and I hate taking medication.
I don't know what to do; I feel like my hands and feet are tied, and I'm being choked, unable to move or breathe.
I don't want to admit that I'm sick, and I don't want to see a doctor or take medication...
I...
I just want to cry.

Ying, 10~19 year old female. Ask Date: 2006/05/11

Dr. Chen Wenyu reply Psychiatry


Hello, students today (and in the past) are truly unfortunate, facing academic pressure and competition for higher education.
Perhaps this is an inevitable part of growing up in our environment.
But how can one adjust their mood? How can one relieve stress? In your letter, you repeatedly mentioned "progress...
progress...".
Have you considered that you might be setting your own progress too high? Shouldn't you adjust your expectations? After all, if you can't achieve them right now, why not lower your goals a bit to at least feel more comfortable psychologically? Additionally, a balanced diet, a regular daily routine, and a habit of exercising are all effective ways to manage stress.
Before seeking medical advice, why not try these self-adjustments first? Thank you for your letter!

Reply Date: 2006/05/11

More Info


It sounds like you're going through an incredibly challenging time, and I want to acknowledge the depth of your feelings and experiences. Your symptoms—emotional distress, physical discomfort, sleep disturbances, and difficulties with concentration—are all interconnected and can significantly impact your daily life. It's important to understand that what you're experiencing is not uncommon, especially among young people facing academic pressures and personal expectations.

From a medical perspective, your symptoms could be indicative of a combination of anxiety and stress-related disorders. Anxiety can manifest not only as emotional turmoil but also as physical symptoms, such as headaches, gastrointestinal issues, and fatigue. The mind and body are closely linked; when one is under stress, the other often reacts. For example, your feelings of fatigue and dizziness could be exacerbated by anxiety, which can lead to a cycle of worry and physical discomfort.

Your description of feeling overwhelmed and unable to keep up with your studies is particularly concerning. This can create a vicious cycle where academic pressure leads to anxiety, which in turn affects your ability to concentrate and perform well in school. The frustration and anger you feel towards yourself for not being able to meet your own expectations can further exacerbate your emotional state.

It's also worth noting that sleep disturbances, such as waking up frequently during the night, can significantly impact your mental health. Poor sleep can lead to increased irritability, difficulty concentrating, and a general sense of malaise. The fact that you are experiencing physical symptoms like headaches, gastrointestinal discomfort, and muscle weakness suggests that your body is responding to the stress and anxiety you are feeling.

I understand that the thought of seeing a doctor or undergoing medical tests can be daunting. Many people share this fear, often due to anxiety about what the results might reveal or discomfort with the medical environment. However, seeking help is a crucial step towards feeling better. A healthcare professional can provide you with the support and guidance you need to navigate these challenges. They can help you understand your symptoms, explore potential underlying causes, and discuss treatment options that may include therapy, lifestyle changes, or medication if necessary.

You mentioned not wanting to burden your loved ones with your struggles, which is a common feeling among those dealing with mental health issues. However, it's important to remember that your loved ones care about you and would likely prefer to know what you're going through rather than see you suffer in silence. Opening up to someone you trust can be a significant relief and can help you feel less isolated in your experiences.

In terms of immediate strategies to help manage your symptoms, consider incorporating relaxation techniques into your daily routine. Practices such as mindfulness meditation, deep breathing exercises, or gentle physical activities like yoga can help reduce anxiety and improve your overall sense of well-being. Additionally, maintaining a balanced diet and staying hydrated can support your physical health, which in turn can positively affect your mental state.

Lastly, remember that it's okay to ask for help. You don't have to navigate this alone. Whether it's talking to a trusted friend, family member, or a mental health professional, reaching out for support can be a powerful step towards regaining control over your life and health. You deserve to feel better, and there are resources available to help you on this journey.

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