Mental Health: A Teen's Struggle with Anxiety and Gaming

I think I am sick?

Hello doctor, I am a third-year junior high school student.
I often feel unwell and want to go home or don’t want to go to school; I just want to sleep and rest.
However, every time I’m at home, I only think about playing video games.
Every morning before class, I try to find ways to go back home, but after getting home, I just play video games.
You might say it’s a gaming addiction, but that’s not the case.
I rely on gaming to gain confidence and escape from life.
It started in elementary school when I was bullied.
I felt a sense of fear during recess when I had to play with classmates.
In elementary school, I had thoughts of wanting to end my life, but I never acted on them.
I still gained confidence through gaming, so I didn’t think much of it.
However, by sixth grade, I was really bullied to the point where I was scared because no one would play with me during recess.
I didn’t want to go to school, but I still did because I didn’t want to worry my parents.

In the first year of junior high, I met a sixth-grade girl through a mobile dating app.
She was very nice to me, willing to listen and chat with me.
After the second year, perhaps because of her, my social relationships improved a lot.
I started to make friends and was no longer afraid of interacting with others.
During the summer before transitioning from second to third year, I still kept in touch with that girl, but after we had a fight, we lost contact.
After that, I started to feel emotionally low, and all the accumulated pressure exploded.
I began to cry at night, feeling anxious and inexplicably fearful.
Gradually, my life faced obstacles, my grades started to decline, and I felt like I was failing at everything.
Naturally, I began to play video games even more.
I started to feel frustrated and disgusted, and I couldn’t find anyone to talk to.
I dated a girlfriend, but she didn’t really understand how to listen.
I began to teach her how to play video games and hoped she would play like me.
I needed to hear her voice every night to fall asleep.
Later, her parents disapproved of our relationship.
According to my dad, it was because I used foul language, and my girlfriend said her mom thought people who curse aren’t good people.
After learning this, I became more irritable and my emotions continued to decline.
I started playing games all the time.
About 2-3 months ago, I realized I was mentally unwell.
I confided in a friend, and she suggested I see a psychologist.
However, I didn’t want to worry my parents, so I hadn’t mentioned it until this morning when I wanted to rest and didn’t want to go to school.
I started to pretend to be sick, and my mom couldn’t take it anymore and started scolding me.
Later, my dad said I was acting this way because I didn’t want to go to school.
I began to feel that I shouldn’t continue like this.
I want to be strong, but I can’t.
I’m afraid of many things, especially not doing things well.
I don’t know if I should talk to my parents about these issues, and I’m unsure if I’m ready.

I want to ask:
Q1.
Should I talk to my parents about these issues?
Q2.
What is the typical process for a psychiatric consultation?

Jie, 10~19 year old female. Ask Date: 2015/12/22

Dr. Song Chengxian reply Psychiatry

Hello, junior high school student.
Your analysis of the psychological motivations behind your refusal to attend school and your obsession with video games is quite insightful.
However, you mentioned that you do not want to bring up the issue of seeking medical help because you don't want to worry your parents.
Have you considered whether your current situation would actually put their minds at ease? If you have concerns about seeing a psychiatrist, you might want to first talk to a guidance counselor at your school.
The counselor can assess your situation to determine if medical intervention is necessary.
If going to a hospital is inconvenient, you can also be referred to the counseling center for secondary schools in your city or county, where a resident psychologist or psychiatrist can conduct a further evaluation.
The process of seeing a psychiatrist differs from that of a general physician in that the psychiatrist will spend more time listening to the individual's subjective experiences and thoughts, which is quite similar to the discussions you would have with your guidance counselor.
It might be worth trying to start with your school.
Best regards, Dr.
Song.

Reply Date: 2015/12/22

More Info

It's clear from your message that you're experiencing a complex mix of emotions and challenges, particularly related to anxiety, social interactions, and your reliance on gaming as a coping mechanism. Let's break down your concerns and questions.

Should You Talk to Your Parents?
First and foremost, it is crucial to consider whether you should talk to your parents about what you're going through. While it’s understandable that you don’t want to worry them, it’s important to recognize that your current situation is likely causing them concern already. Parents often sense when something is wrong, even if their child doesn’t openly discuss it. By sharing your feelings and struggles with them, you can open a dialogue that may lead to support and understanding.
Talking to your parents can also help them understand your needs better and may encourage them to assist you in seeking professional help. They might be more supportive than you expect, and having their backing can make a significant difference in your journey toward better mental health. If you feel comfortable, you could start the conversation by expressing that you’ve been feeling overwhelmed and anxious, and that you believe talking to a professional could help.

Understanding the Process of Seeing a Mental Health Professional
Regarding your second question about what to expect when visiting a mental health professional, it’s important to know that the process is designed to be supportive and non-judgmental. When you first meet with a psychiatrist or psychologist, they will typically conduct an assessment to understand your situation better. This may involve asking you questions about your feelings, thoughts, behaviors, and how they affect your daily life.
Here are some common aspects of the initial consultation:
1. Background Information: You may be asked about your personal history, including any significant life events, family dynamics, and your experiences with anxiety and gaming.

2. Current Symptoms: The professional will likely inquire about your current feelings, such as anxiety, sadness, or any thoughts of self-harm. They may ask how long you've been feeling this way and how it affects your daily life, including school and relationships.

3. Coping Mechanisms: They will want to know how you currently cope with stress and anxiety, including your reliance on gaming. Understanding your coping strategies can help them provide tailored advice and support.

4. Goals for Therapy: You might discuss what you hope to achieve through therapy, whether it’s managing anxiety, improving social skills, or finding healthier coping mechanisms.

5. Treatment Options: Depending on your situation, the mental health professional may suggest various treatment options, including therapy (like cognitive-behavioral therapy), medication, or a combination of both.

The Impact of Gaming on Mental Health
Your reliance on gaming as a source of confidence and escape is not uncommon, especially among teens. While gaming can provide a temporary sense of achievement and community, it can also lead to avoidance of real-life challenges and social interactions. This cycle can exacerbate feelings of anxiety and depression, as you may find it increasingly difficult to engage in the world outside of gaming.

It’s essential to find a balance. Consider setting limits on gaming time and exploring other activities that might bring you joy or fulfillment. Engaging in sports, arts, or social clubs can help you build confidence and develop social skills in a less pressured environment.

Seeking Help
Ultimately, seeking help is a sign of strength, not weakness. It shows that you are taking proactive steps to improve your mental health. Whether you choose to talk to your parents, a school counselor, or a mental health professional, remember that you deserve support and understanding.
In summary, yes, you should consider talking to your parents about your feelings, and when you see a mental health professional, expect a supportive environment where you can discuss your concerns openly. Taking these steps can lead to a healthier mindset and a more fulfilling life.

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