Emotional Struggles: Navigating Mental Health Challenges - Psychiatry

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What is wrong with me?


Hello, doctor.
Three years ago, I saw a doctor and took medication due to persistent low mood, but I felt better afterward.
However, two years later, I experienced similar feelings during a major exam period, and now almost a year has passed since then.
After that incident three years ago, I often feel that my memory and concentration have worsened.
Now that I’m in college, living in a dorm on an outlying island, I initially thought it was great to live away from home, but I have changed.
I find myself crying a lot, often for no reason, and my patience has decreased.
In my class of 43 students, I am the only girl, and I am required to participate in almost all activities (the school mandates that each class must have a female participant).
I feel a lot of pressure and exhaustion.
I am not someone who easily talks or makes friends, and I definitely struggle to trust others.
I can talk to people, but it’s just surface-level conversation; I don’t share my true feelings or thoughts.
So far this semester, I have gone home twice, and both times I was scolded, which felt unreasonable.
My family doesn’t understand my school activities; they believe I shouldn’t participate in so many.
I have explained that if I don’t participate, I will receive demerits (I’m not the only one), but they still don’t understand, which makes me feel helpless and sad.
The pressure from home combined with school stress is overwhelming, and I don’t want to see a doctor again (because three years ago, my father called me crazy and said I shouldn’t marry in the future to avoid burdening others).
How can I get through this? Is there a possibility of relapse? Also, why have my concentration and memory worsened since that time three years ago? Is it due to the medication? Or could it be because of an overdose (I have previously taken pills)? Or am I just overthinking? I know this is a lot, but could you please answer my questions? Thank you!

~Xiǎng fēi de lántiān~, 20~29 year old female. Ask Date: 2008/11/03

Dr. Wu Peijun reply Psychiatry


Hello: It sounds like you have been going through a tough time lately, and I'm sorry to hear that.
The episode of depression you experienced three years ago may have been a major depressive episode.
If that is the case, full recovery is possible, but the risk of recurrence is high.
Increased life stress or even the absence of stress can trigger the re-emergence of depressive symptoms.
Regarding the decline in your concentration and memory, depression itself can lead to these symptoms.
Therefore, we emphasize the importance of seeking medical attention early and not waiting until the depression worsens to the point of cognitive impairment before consulting a doctor.
It is also possible that the side effects of sleep medications could be contributing to your symptoms.
I recommend that you promptly return to a psychiatrist or a mental health specialist for evaluation.
It would be best to have a family member accompany you, as the doctor can explain your situation to them, which may help them understand better.
Wishing you a swift recovery through this difficult time.

Reply Date: 2008/11/03

More Info


Navigating emotional struggles, especially in the context of mental health challenges, can be incredibly daunting, particularly for young adults like yourself. It’s clear from your message that you are experiencing a complex interplay of emotions, stressors, and past experiences that are affecting your mental well-being.
Firstly, it’s important to acknowledge that what you’re feeling is valid. Many young adults face similar challenges, especially when transitioning to new environments such as college, where academic pressures and social dynamics can be overwhelming. Your feelings of sadness, frustration, and anxiety are not uncommon, and they can be exacerbated by the pressures of academic performance and social expectations.

From your description, it seems you are experiencing symptoms that may align with anxiety and depression. The fact that you have a history of emotional struggles and have sought help in the past indicates that you are aware of your mental health and are trying to navigate it. However, the recurrence of these feelings, especially after a significant period of feeling better, can be disheartening. It's crucial to understand that mental health can fluctuate, and it’s not uncommon for individuals to experience relapses, especially under stress.

Regarding your concerns about memory and concentration, these can indeed be affected by various factors, including stress, anxiety, and depression. When you are under significant emotional distress, your brain's ability to focus and retain information can diminish. This is not necessarily a direct result of medication you may have taken in the past, but rather a reflection of your current mental state. Chronic stress can lead to cognitive fatigue, making it difficult to concentrate and remember things.

You mentioned feeling pressured to participate in school activities and the lack of understanding from your family regarding your situation. This can create a sense of isolation and helplessness. It’s essential to communicate your feelings to your family, even if it feels challenging. They may not fully understand what you’re going through, but expressing your thoughts can help bridge that gap. If direct communication feels too daunting, consider writing a letter or seeking support from a trusted friend or counselor who can help articulate your feelings.

As for your fear of seeking help again, it’s understandable given your past experiences. However, it’s crucial to remember that mental health professionals are there to support you, not judge you. If you feel comfortable, consider reaching out to a counselor or therapist at your school. They can provide a safe space for you to express your feelings and help you develop coping strategies.
In terms of managing your emotional struggles, here are some strategies that may help:
1. Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing exercises, or yoga can help reduce anxiety and improve your emotional regulation.

2. Physical Activity: Regular exercise is known to boost mood and reduce stress. Even a short walk can make a difference.

3. Journaling: Writing down your thoughts and feelings can be a therapeutic way to process your emotions and gain clarity.

4. Limit Overcommitment: It’s okay to say no to activities that feel overwhelming. Prioritize your mental health over obligations.

5. Seek Support: Whether it’s friends, family, or a mental health professional, having a support system can provide comfort and understanding.

6. Healthy Lifestyle Choices: Ensure you are eating well, getting enough sleep, and avoiding excessive caffeine or alcohol, as these can impact your mood and cognitive function.

Lastly, regarding your question about the possibility of recurrence, it is indeed possible for mental health issues to resurface, especially during stressful periods. However, with the right support and coping strategies, many individuals can manage their symptoms effectively.

In conclusion, while the journey through emotional struggles can be challenging, it is important to remember that you are not alone, and there are resources available to help you navigate this difficult time. Seeking help is a sign of strength, and taking proactive steps towards your mental health can lead to significant improvements in your overall well-being.

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