Lack of focus, anxiety, depression

By Kristina Randle, Ph.D., LCSW

Q. I feel this started picking up around 7 to 8 years ago and is just now where I’m not really sure what to do anymore.

I’ve always had a mild issue with concentration. I have a habit of getting sidetracked etc. I’d be in class and notice that I was thinking of something totally unrelated to the lecture and mentally shake my head and try to pay attention (to things I was genuinely interested in to begin with). Some minutes later I’d notice I had dazed off and again wasn’t paying attention. This would happen pretty much constantly through my lectures.

At first, it wasn’t too big of a deal. I was capable of only half paying attention and doing well anyway. It tends to take less effort for me to get most things than it does other people, or so it had always seemed.

However, I’ve gotten to the point where it’s a real effort to even read anymore. I used to read all the time: fantasy, various fiction, textbooks, science books, and even encyclopedias. I always just loved reading (which is probably the main reason I even did well in school to begin with). Now, when I read a book (and this is something that has gotten progressively worse over the years), I can’t focus. I find myself reading the same paragraph (or lines) over and over again. I’ll be reading and notice, I have no clue what the last sentence just said. When I look back I realize I haven’t really read anything for the last couple of paragraphs. This happens repeatedly. I’ve almost completely given up reading for enjoyment which is something that used to take up a great deal of my time, and I have decreasing ability to read for my classes. I’ve also been a horrible procrastinator my whole life. Again, this used to not be as much of an issue. Even procrastinating, I was able to do well. I’ve also been forgetful most of my life (which also seems to be getting worse). I can be thinking about asking someone a question, go to the kitchen to get some water, then completely forget I was going to ask them something. I had one student (I tutor for Java programming) apologize to me by email for saying “horrible” things to me, and I had no clue what she was talking about. All of this combined has now equated to doing poorly in college. I was doing quite well at computer programming, and now find even that difficult. It was something I used to very much enjoy doing. I dread going to class. I dread taking tests. Sometimes I get so worked up over it, I can’t do anything but sit there feeling so sick to my stomach I feel like I’m getting an ulcer or going to vomit.

So, I wind up having to drop a class. But then I can’t show face in class the next time around, because I’m so obsessed with how stupid I look being in a class the second time around. I’m also aware that it’s stupid to be so nervous/upset about such a thing, but it doesn’t change anything. So, I don’t go to class… If I go back to class, I’m “the guy that never attends class” so I don’t go again… and so on.

So, of course now I’m disgusted with myself, because I’m doing poorly in school. And not because it’s too difficult for me… I’ve never felt it is. I just can’t seem to stay focused and motivated.

I’ve always had a poor diet, and when I got out of highschool, I had very little exercise. (On a perhaps unrelated note, I started losing my hair at 18-19.) So, I’ve recently been eating better… and exercising… lifting weights and walking… taking vitamins… but I still feel… I don’t know… dull. At least, when I’m not feeling anxious. This isn’t to say I don’t ever enjoy myself, just that it’s definitely not the norm.

I also started becoming aware that I had kidney stones around that time (19-20). Not actually passed them; just had bad back aches from them (they could be seen on an xray). I didn’t finally pass one until a few years ago (3-4). I was prescribed hydrocodone (narcotic analgesic) for pain relief. That was pretty much useless, so I stopped taking them. I had always been funny about drugs. I get that from my mother. People that used drugs were weak and anything that altered your mentality was detestable. I took it to a further level than she did and abstained completely from alcohol as well. Probably 6 months to a year later I was working on a directed study that required more programming than normal. So, between surfing the web (which I tend to do more and more… you can be doing 10 things at the same time and never really have to pay attention to them all) and programming, I was getting severe headaches. So, scrounging around for some ibuprofen, I found the old unused hydrocodone. I figured it’d at least work for a headache even if it did nothing for my kidney stone pain. Sure enough, not only did the headache go away, but I felt more energetic and able to concentrate. I’d program for hours until it wore off and my headache came back, then I’d take it again and program for hours. It was the first time I felt “normal” in a long time. There was definitely a buzz… but I didn’t care about that. It just felt so good to be able to read and program for hours like I used to and not be unable to focus or feel like I had no energy.

So, here I am now. Today I had a midterm. I woke up early to study some more for it after barely sleeping (I failed to mention throughout all of this drivel that I have a hard time going to sleep which is also something that has progressively gotten worse over the years), but was so anxious about the test, I felt overwhelmingly sick to my stomach. I had plenty of time to study, but couldn’t. 8 hours later and I’m still a little sick. I missed the midterm. So… I’ll have to drop the class… again.

I don’t know what to do at this point, but I know I need to do something. I actually called three psychiatrist offices this morning (which, considering my almost sub-conscious long held views of psychiatry and people that go to psychiatrists, is actually saying something) but none were taking patients. (I hate talking to people I don’t know on the phone, and was getting sick over that as well while calling.) I have always chalked up anything going wrong to laziness/procrastination and figured I just need to “try harder”, but that’s not really solving anything. I guess, after all this, what my question is: how do you go about starting to work towards a solution in this vein? I used my insurance co’s website to look up psychiatrists and was just calling asking if they were taking new patients. I assume that’s kosher? If they ask “what’s the purpose of the visit?” what do you say? It feels like any answer to that question is whiny. Are you supposed to be referred by a dr, or is just calling normal?

A. Instead of trying for the psychiatrist at this point, why not try a therapist. Just as you were looking for psychiatrists through your insurance company website, go back to the website and look for therapists in your area. If you ended up at a psychiatrist, he or she probably would refer you to therapy anyway. I am not exactly sure what medication could do for you at this point. Start with therapy and then, if your therapist believes medication would be helpful, then see a psychiatrist.

Since you are in school, you can also try your college counseling center for help. Most universities have an entire counseling centers staffed with well trained psychologists, social workers and psychiatrists with services specifically designed to help with student problems exactly as you are describing.

It sounds like you are at least partly depressed, it’s getting worse and it is affecting your school work and other areas of your life. It sounds like the way you have lived for years, just is not working for you now. Doing poorly in school is very real. You are not whining. The problems you describe are very real and you should seek help and not put this off.

When you call for help, whether it’s to a therapist, psychiatrist or at the college counseling center, just say that you are having trouble with procrastination and depression. It does not matter very much what you say when you make the appointment, it just matters that you make the appointment. You should keep all of the follow up appointments and get the help you need to live a more productive, efficient and more stress free life. Good luck and don’t let this problem snowball anymore than it has already. Don’t wait another 7 to 8 years to seek help. The sooner you get started solving your problem, the less stress you will experience.

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Last reviewed: By John M. Grohol, Psy.D. on 2 Nov 2005

APA Reference
Randle, K. (2005). Lack of focus, anxiety, depression. Psych Central. Retrieved on September 2, 2014, from http://psychcentral.com/ask-the-therapist/2005/11/02/lack-of-focus-anxiety-depression/