I once was a very athletic person running for miles every night and training hard for dreams of being a NBA player. My problems started during the summer before my senior year in high school. I was training hard at least 5 hours a day then, at night I would talk all night to my girlfriend not getting any rest.

By the time basketball season started my muscles were tired and in pain every time I did anything physical. I deeply resented the fact I let a girl keep me up all night and keep me from getting rest. I never really have been the same person since.

That was four years ago and I have gotten worse. Here are the symptoms :

1. Tired legs, Ex: Hurts legs to walk up house stairs or can’t lift weights due to muscle fatigue

2. Waking up still tired.

3. Headaches around 12 o clock everyday.

2. Angry and irritable when people are having fun around me.

3. Feeling anger or sadness for no reason when talking to someone.

4. Feels like im about to yell so I talk very low to control myself

5. Feels like there are tears or sadness inside me put if I do cry its like 2 tears and I can’t cry anymore. It does feel good to release some tears though.

6. Sweaty hands and feet when talking to people

7. Feeling disconnected from everyone, even people known for years.

A. You may be experiencing generalized anxiety and depression. Sadness, irritability, low energy, mood instability, and feeling disconnected from others are all signs of depression. Sweating when interacting with others may be a sign of anxiety. Sometimes people sweat in social situations because they are nervous and lack self-confidence.

We shouldn’t forget the possibility of a sleep disorder. Many of the emotional issues that you are describing can come from sleep deprivation.

At the time that you were dating your girlfriend four years ago, you were physically exhausting yourself. You physically exhausted your body during the day and didn’t rest at night. Without that much-needed rest, you didn’t function well. No one could function well in that situation. You resented your girlfriend for “keeping you up all night” but you should have insisted on rest.

You’ve noticed these problems becoming increasingly worse for the last four years. They are obviously degrading your life. I would recommend having a psychological evaluation and a physical exam. Remember, you wrote that you wake up tired. It could be caused by a sleeping disorder. Therapy could be immensely helpful to you. Depression and anxiety are very treatable conditions. Psychotherapy can be highly effective. Medication helps many people. You should not allow yourself to continue to suffer when there are effective psychological treatments available. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

Thank you in advance for your assistance. I have a very detailed long-term memory that stretches back to my first year of infancy. I can recall exact details from conversions, of my surroundings (from scents to background sounds). I can remember most of the very vivid dreams I had in my childhood, most being nightmares. Most of the dreams were recurring. One in particular strikes me as having deep meaning. In these dreams, I used to call them “the big bad wolf” dreams (as this was all a child could relate it to) – this large black humanoid wolf would always be trying to take me from my parents/other family. He would be nice around them (they seemed to know him = indicative of maybe a close friend or family member perhaps?) and they let him take me away. Normally to the basement of my house/my bedroom closet/or my grandma’s basement. Once alone with him, he’d try to attack me or keep me hostage. I was terrified of him. He wore clothing too, like a person. I just wonder if this sounds like I have repressed memories of sexual abuse or something of the like?

A. It is difficult to interpret dreams without having many details about the individual dreamer. There are very few generalized statements that can be made about dreams, which is why dream books are unreliable. One universal symbol in dreams is water. Water refers to the unconscious mind but that universal symbol may be overridden by a personal symbol. That is why one cannot interpret a dream without knowing the details of the dreamer’s life. Water may mean peace and security and not be a symbol of the unconscious mind. It depends on the individual.

You asked about whether this dream could indicate sexual abuse. That is a difficult question to answer. The fact that these dreams are vivid, memorable, emotional and reoccurring is significant and notable. Reoccurring dreams are essentially attempting to send us a message that we have yet to grasp. Dreaming of the basement and a humanoid wolf may signify sexual abuse but not necessarily.

The fact is that without a professional, skilled in dream interpretation, you may never know what the dream means. What can be said with certainty is that the dream is significant because of its vividness, repetitiveness and its emotionality. I would recommend that you keep track of this type of dream, being certain to record each detail, especially the way you feel during the dream. More details may be revealed in future dreams. It’s best to record the details of dreams as soon as you awake. You may also want to consider consulting a therapist who specializes in dream interpretation for further assistance. Please take care.

Dr. Kristina Randle

i have been dealing with insomnia and guilt. about 3 years ago i got caught cheating on a test i ncollege. i got an f for the class. i took the class over next quarter and passed. i didnt feel guilty then but i feel guilty now. what do i do? i cant take it anymore.

A: Please ask yourself how your life would be different if you weren’t obsessing about something that happened three years ago. If you can do that honestly, you will probably find some challenge in the present that is causing you anxiety and that you wish you didn’t have to face. You are spinning in old guilt instead of dealing with the present issue.

I suggest you consider a few sessions with a therapist to help you break throught the guilt and identify what’s really going on. You may also find comfort and some practical solutions with the support of a therapist.

I wish you well.
Dr. Marie

I am 50 years old, the age where loved ones get sick, need care, and die. I am currently caring for one relative in my home who has in curable cancer after having cared for a different relative (only a few hours per week) who died over a year ago. I also am dealing with a parent in a nursing home with dementia. I had cancer about two years ago but it was cured and I am slowing getting my strength back. My marriage has been on life support for several years now. Up until a few weeks ago I felt like I was coping pretty well with everything. Yes there were some moments during which I wasn’t exactly pleasant but all in all, I felt like I was doing okay, considering. So I decided to quite smoking. I hate being a smoker but staying quit is so hard and takes so much daily, minute by minute effort.

Two weeks ago I quit smoking and last week my husband lost his job, totally out of the blue. And that was the last straw. I just can’t take any more. I want to cry, but can’t. The tears form and then dissipate without falling. I think of crying and I feel shooting pains in the shoulders, chest, wrists and hips, but no tears. I want to scream and yell and stamp my feet but don’t have the energy and know it won’t change and darn thing. I try to grasp onto gratitude, thankful my children are healthy and are doing well, but then I’m consumed with fear that something will happen to them if I focus on them being healthy. I’m starting to feel like I’ve been cursed for having been a pathetic coward for so long, staying with a man I don’t love and being too afraid of the effort it takes to quit smoking. I don’t believe in curses or fate, really. Stuff happens in life, sometimes we caused it and other times we didn’t but in either case we gotta deal with it.

I’m not dealing very well right now; can’t sleep (have had sleep problems for a while but now its even worse) can’t cry, can’t gather enough energy to even plan ways to economize or get a job. I’m numb. I trust this too shall pass, but I’m afraid of how long it will take and how bad it will get before it gets better. I wonder if maybe right now is a bad time to also be struggling to staying quit. In the past few days I’ve cheated each day and smoked. It didn’t make me feel better but once I made the decision to go ahead and light up, that one little bit of stress fell away and then I was okay the rest of the day, comparatively speaking that is. I am taking Chantrix and I know there are some concerns about mental status changes, so I don’t know if the depth I feel right now is completely situational or has it been pushed deeper by the Chantrix?

I hope you can help because clearly, individual counseling is out of the question without insurance.

A: The safety information listed on the Chantix website states: “Some people have had changes in behavior, hostility, agitation, depressed mood, suicidal thoughts or actions while using CHANTIX to help them quit smoking” and advises that you call your doctor right away. I agree. I’m very concerned about your inability to cry and the pains you are experiencing.

Different people respond differently to medications. I realize you were trying to do something positive for yourself by quitting smoking but you may not be able to tolerate this medication. Yes, quitting smoking is good, but not at the price of your physical and mental health.

Please give yourself some credit for dealing with as much as you do. As my grandmother used to say, “Getting older isn’t for sissies.” She was right. You are dealing with multiple losses, changes in your own physiology, and now the financial and emotional stress that comes with your husband’s job loss. You may at times wonder why you are still standing up.

I understand that therapy may be impossilbe right now due to not having insurance but I do think you need some support. I hope you have some good friends or family members to talk to. Some mutually supportive whining is absolutely fine as long as you don’t get stuck in it and can balance all the stress with some good times. If you don’t currently have friends who can provide that, please consider finding a support group for caregivers. To locate one, contact your local hospital, senior service, or your doctor’s office for information.

Don’t give up on your goal of quitting smoking. Do wait until your life settles down and find a way to do it that doesn’t give you so much distress.

I wish you well.
Dr. Marie

I have always been an unhappy person. However, for about 3 years this feeling has become much more intense. I think of death and suicide almost every morning, with no concrete reason actually.

I have no friends. And although my boyfriend is the only person who I am comfortable with, I often treat him very badly and I actually break his heart. When I receive a bad grade or when we cannot see each other I blame him even though he is not guilty at all. Or even without any reason I just get angry and I tell him that I do not want to see him again (emotional fluctuations). In fact my relationship with the family members is the same. This may be the explanation of why I do not have friends.

The other thing is that when someone asks me a question I cannot answer it in a correct fashion, I make digressions into irrelevant topics. People cannot get useful information out of me. Even worse, I always forget the things that I want to tell someone. Often I stuck at the middle of a sentence, not to mention the amount of words I forget per day. These are actually quite ironic as I study mathematics and I am quite familiar with logic as well, but somehow I cannot pursue a logical conversation in daily life.

I do not hear voices but I talk to myself every time (I presume that everyone does?). And I do not see hallucinations either.

To conclude, I do not want to live because nothing makes me happy except for the dreams I imagine in my head. Am I in depression? Or in a worse situation? Thank you in advance.

A. Depression may be the problem. Several symptoms that may be indicative of depression include emotional instability, suicidal ideation and a marked increase in your unhappiness.

You described yourself as a generally unhappy person. Some people describe themselves as a pessimist and others as an optimist but it is relatively rare for a teenager to experience such a long period of unhappiness. It may be a sign of chronic depression.

You also described occasions in which you had difficulty with speech. Are these incidents related to nervousness? Did other people notice them? Have you been told that you “digress into irrelevant topics” or is it your characterization of the situation? The answers to those questions would help me to understand what’s wrong. People with depression often have a negatively skewed view of their skills and abilities. Depression increases the likelihood that you are incorrectly characterizing your speech problems.

If you are in fact having speech problems, then you should be evaluated by a physician to rule out a medical cause. Problems with speech are sometimes indicative of neurological problems.

My overall recommendation is to be evaluated by a mental health professional. You are clearly suffering and have been, for at least three years. Your unhappiness is intensifying and you’re often thinking about suicide. Those are all signs that help is needed and is long overdue. Please take care.

Dr. Kristina Randle

my bf who is bipolar expects me to stay up all night because he cant sleep. i have been up for 20 hours and have to be to work in 5 1/2 hours. i say i cant function on no sleep and need at least a few hours of rest before i have to drive to work, come home, and get kids off bus and everything else. he says this is not supportive and even though im exhausted if i really wanted to help him i would stay up 36 hours or more. am i wrong in wanting to get a few hours of sleep? am i not supporting him?

A: No. You are not wrong to want sleep. Contrary to what your boyfriend thinks, it is not being supportive for you to twist your life around his illness. He needs to get treatment for himself rather than insist that you join him in his manic state. When he is worked up, your boyfriend becomes a selfish bully. He wants his idea of support from you but isn’t willing to give you the support you need to be a mother and effective worker.

Put your foot down. Insist that he get some treatment. It isn’t healthy for him to be so wound up he can’t sleep. It isn’t fair or loving for him to demand that you do all that you do to maintain the family and also keep him company through the night.

Bipolar illness is a huge burden for those who have it. However, most people do respond to treatment. Those who have a healthy attitude toward their illness don’t try to drag the people they love into their spin. Instead, they develop a plan for how they and their partner can weather the next emotional storm in a healthy way. If he is unwilling to work with a psychiatrist so that the two of you can have a reasonable life, maybe you should reconsider this relationship.

I wish you well,
Dr. Marie

Over the past 6 years or so, I have experienced various symptoms of depression which i seemed to be coping with until recently. I have started to suffer from sleep paralysis and hallucinations which are affecting my desire to sleep and making me paranoid and fearful.The hallucinations started off small (e.g spiders or towels hanging from the ceiling) but the other day i was paralysed in my bed and saw a figure dressed in all white (similar to a KKK outfit but with no eye-holes). It was staring at me from the entrance of my room while i wasd paralysed and it was not going away so i tried my best to free myself from the paralysis to atack the figure but when i jerked myself out of bed the figure disintigrated. I casn not stop thinking about this and have started to sleep with the lights on or try and stay awake all night. Thanks for your help

A. Sleep paralysis might be an indication of a sleep disorder. Inform your primary care physician about your sleep problems. Your doctor may prescribe a sleep medication to help you sleep through the night. Being able to sleep through the night might make sleep paralysis less noticeable. We all experience sleep paralysis. It is protective to stop us from physically reacting to the content of our dreams. On occasion, we enter a state where we are in between sleep and consciousness. That is when we become aware of sleep paralysis. As we continue to wake up, the paralysis goes away. It can be frightening but it is harmless.

Your doctor will also likely suggest undergoing a sleep study. A sleep study entails your staying the night at a local hospital or clinic. While asleep, technicians will measure how well you sleep and closely monitor what is happening while you’re sleeping. A sleep study can identify whether or not you have a sleep disorder. Many sleep disorders are highly treatable.

I would also recommend being evaluated by a mental health professional. You stated that you have had depression for six years and you have recently noticed it becoming worse. There is likely a correlation between the worsening of your depression and your sleep problems. Effectively treating your depression symptoms will likely improve your sleep.

Sleep is very important to maintain emotional stability. Without sleep, it’s nearly impossible to able to function well or effectively. I hope this problem can soon be resolved. Please take care.

Dr. Kristina Randle

Last weekend I overdosed on nicotine. Sunday night I had a bad anxiety attack and shaking. It has gotten a lot better but today (4 days later) I still have anxiety over nothing (i feel that i’m going to die or i feel like i have to make myself breathe). I also have very bad insomnia (waking up 4-5 times a night) and I haven’t been eating much. My mind is not how it normally feels and I’m scared that this is a permanent thing. Is there anything to help me?

A. It would’ve been helpful to have had more details about how you overdosed on nicotine. How did that happen? Was this a one-time event or is this an ongoing problem that you struggle with?

I would highly recommend being evaluated by a mental health professional. The fact that you are heavily reliant on nicotine and experiencing insomnia and overeating likely means that you should receive a professional evaluation. A mental health professional could assess your situation and determine what treatments could best assist you.

You should also consider being evaluated by a medical professional. He or she could determine if there is any damage caused by overdosing on nicotine. The doctor may also provide a medication to assist with nicotine cravings and insomnia. Discussing your concerns with the appropriate professionals would help to reduce your fears. Please take care.

Dr. Kristina Randle

I am 12 years old and I think my best friends mom is being abused why I think this is that when ever I’m around them she’s always saying she’s sore and she wears scarves and sweaters in the middle of the summer. I overheard that he’s always makes fun of her. I have seen that she’s always scared when my friend is not around her and that she’s sad. I have heard arguments, screaming, and crying at night when I’m over there. Whenever I ask my friend what’s up she panics and makes up new excuses every day almost. Help me I’m so stressed over this I can’t sleep I’m so worried about her. Help me.

A: Thank you for having the courage to speak up about this to us. It is always a difficult thing to know what to do when you feel someone is being abused and yet don’t know for certain. But I would honor your instincts and talk privately to your school counselor about your concerns. He or she will know how to help. This is something that you need to talk to an adult about so they can help you and your friend’s mom.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

Hi there, My parents separated when I was 3. Was raised by my mom that was working all day so she could afford to raise me and help my grandparents. Was underweight since I was probably 4 maybe because I started growing super fast. Had a horrible acne so pretty much it destroyed my confidence so I was never going out or anything. Pretty much stayed home all the time and watch TV.

When was 18 moved to US so I could get a better life for my future kids. Had a great business… got screwed by my business partner + my apartment got completely robed of everything I had 2 years back. Was starving at first and barely survived everything that happened. It was a horrible time even used a plastic bag and tried to kill myself several times. I guess didn’t have it in me.
Finally got a job… and working 70 hours a week now. For all that time borrowed a lot of money so everything I do is just to pay back. So pretty much I work every day and when come home watch TV and go to sleep cuz I don’t have energy for anything. I can’t take a day off because my expenses are equivalent 70 hours of work. So here you go. Desperate unhappy and extremely lonely. Btw tried to kill myself couple month back but thanks GOD didn’t succeed cuz it would brake my mom’s heart. The thing is I am really social and fun to talk to at work but it’s just FAKE ME. I really don’t want to talk to anybody. So here you go. I know it’s a mess but the sad reality I will have to work like this for next 2-3 years just to get back up but I really don’t have the energy. Even thou I am 24 already got some grey hair and still super skinny, almost anorexic. Thing is that all my life I had something on my mind and I never really wanted to eat so maybe that’s an issue.

Anyways. I know it’s a mess and you probably wont answer. But I really do need help. Better to say a scream for help but I don’t know what to do and don’t have time for it. I can’t take day offs… just can’t. So I am trying to figure out what I should do to at least work on resolving my issues somehow. I hope for your help and thanks you very, very much.

A. You are most certainly welcome. You have endured many hardships. There was a time when you nearly ended your life. Thankfully you survived. Not only did you survive but you thrived. You began a successful business that eventually faltered seemingly through no fault of your own. Time and time again you have rebounded from difficult life circumstances. That makes you a very resilient person. Your resiliency is a major strength. Don’t minimize that important life-sustaining quality.

Having to work 70 hours a week makes you an extremely busy individual but your mental health is suffering. It’s vitally important to address the psychological issues that have been plaguing your life. As you noted, you’re not happy and you feel very lonely. Those unresolved psychological problems almost led to the end of your existence. That’s proof of how pervasive these psychological issues have become.

You, in all likelihood, would not ignore a potentially cancerous lump on your back and likewise you shouldn’t ignore your psychological symptoms. I would recommend seeing a therapist. You might be surprised at how quickly a competent therapist could facilitate a positive change in your life. Depression is highly treatable. There’s no reason for you to suffer when effective treatments exist that would greatly enhance the quality of your life.

The best way to find a competent therapist is to call at least four or five and ask detailed questions about how they would treat you. Choose the therapist with whom you feel the most comfortable.

You are working long hours. Your mental health is important but so is your physical health. Nutrition is important, as is rest. You should also see a physician to ensure that you have the physical stamina to continue your work schedule.

At this point, it simply a matter of choice. You must make the decision that you want help and then make the effort to receive it. You deserve to be happy. Please take care.

Dr. Kristina Randle

I’ve been having nightmares for two years now… At first it was the same two over and over every night for about a month. Then I wrote it down and one of them stop but now I just get new ones. At first, I thought I had these nightmares because of The Crash, but I’m pretty much over it, I don’t cry when I talk about it anymore. Plus, the recurring one I can’t get to stop have nothing to do with the crash.
All of my nightmares have something to do with it except that one. It’s about sexual abuse and it’s the same guy every time. I’m scared it’s real, but I don’t have a memory of anything or anyone like that. Any advice on how do get rid of these or find out why I have the weird one?

A: I am sorry you are going through so much turmoil with these nightmares. Nightmares, particularly recurring ones, can be hard to cope with and difficult to curtail, but you have done well with the one. Now let’s see what we can do with the other.

The fact that it isn’t about the movie and has an invasive sexual element must be very uncomfortable for you to manage. While it does not mean you were abused, the nightmare is trying to get your attention. What we don’t know is why.

I would ask your parents to set up a counseling session for you with someone who has experience working with people your age. He or she has experience in working with these kinds of nightmares and may be able to help.

In the meantime you may want to talk to your counselor at school. It is likely he or she can guide you, or recommend someone who can help figure out what is going on.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

Hello. I am having some issues trying to differentiate between reality and dreams. I have become increasingly suspicious, especially of my boyfriend, when he leaves the house pretty much accusing him of doing something wrong. I have had severe depression. I am oversleeping the majority of the time, but go through bouts of insomnia which makes me feel crazed even further. I find myself forgetting where I am going while driving, and end up somewhere I dont know. I’ve been hostile lately as well but will cry at the drop of a dime. All this has been occuring over the past month or so. More recently (last week or two) I have started having internal conversations with myself and talking out loud during these conversations while I work alone at nights and singing. Trying to find out what could be wrong with me. Any insight would be helpful. Thanks!

A. You have described a pattern of emotional and psychological instability. Your irregular sleep patterns may be contributing to many of your symptoms but to what extent is unclear. It is common for individuals who are sleep-deprived to have difficulty managing their mood. A lack of consistent sleep may not be the root cause of your problems but it’s likely contributing to your current emotional instability.

Severe depression is also an issue but without having many more details about your current symptoms and your psychosocial history, it is difficult to know what may be wrong. Your symptoms are concerning and are degrading the quality of your life. I would recommend being evaluated by a mental health professional.

Medication can improve your sleeping patterns. Medication and psychotherapy can also help to help stabilize your mood. Do not ignore your symptoms or assume that they will simply go away on their own. Typically, untreated mental health symptoms become worse over time. I hope that you will consider my suggestion of seeking professional help. Please take care.

Dr. Kristina Randle

Hi. I am a mother of 4 teenagers ranging from 14-18. My 16 has always had a strong will power, but lately she has been getting worst. She has gained a lot of weight has poor self esteem, doesn’t feel like doing anything (very lazy) Has periods where she is very excited about the future (wants to be an OB), but then doesn’t want to do anything. Example last yr she started out good in school, very enthusiastic but after a few months she gets sidetracked. Doesn’t want to do anything, very lazy, always tired, seems depressed, angry, moody. She disobeys me, very sloppy, unorganized, but when she tries she could be the sweetest most helpful girl. Always thought she had a problem with anger management so I have taken her to 2 psychologists in her life, but she gets tired and bored. They tell me there is nothing wrong, but she tells me she tells them what they want to hear. In other words she is not open with them. I am concerned that there might really be something wrong with her? or is it that I am exagerating? I feel she is getting worst. At times she does not respect me at all much less obey me. Won’t do chores all she wants to do is be on computer and TV which I have taken away for the summer. Is it just teenage behavior? Help? Don’t know what else to do or where to get help?

A: She sounds like a typical teen to me. But I never want to make that judgment without covering all bases. Please take her for a complete physical checkup. Ask that her thyroid and other hormone levels be tested. Sometimes weight gain, fatigue and problems with concentration are related to hormonal imbalances. It’s important to check.

If everything checks out medically, then maybe family therapy (you, your husband, and your daughter) instead of individual therapy for her will be helpful. Tell her how important it is for the two of you to work on your relationship. Assure her that you aren’t convinced something is “wrong” with her but that maybe you and her dad need to learn ways to be more supportive. If she won’t go, go yourself. A few sessions with a therapist who has expertise with adolescent issues and who can hear the whole story will be far more helpful than I can be.

I wish you well.
Dr. Marie

Well I have been suffering from severe mood swings. I will go from being happy to being sad for no apparent reason. I can’t stand to be alone because it makes my mind wonder and I start to have suicidial thoughts. I have recently harmed myself. I have the worse mood swings and its gotten out of hand. Im not sure if its maybe bipolar disorder or Im depressed. My sleep patterns change every week and so do my eating habits. I get angry over little things. I recently got a negative counsling because I talked back to my commander, which is out of character for me. Im not sure whats going on with me or whats happening in my head but Im not sure who I should talk to because Im not sure whats going on with me. Ive had a severe background with abuse physically and verbally. Ive had a drinking problem and a drug problem. Ive self harmed and had a eating disorder. I have also tried to kill myself. Can you help me figure who I need to see to help myself probably before I end up getting into a lot of trouble.

A. I would encourage you to see a mental health professional. Your behavior is endangering your career in the military.

Many people in the military would like to seek the assistance of a mental health professional but are worried about how it may affect their future career. If that is a concern, then I would suggest seeing a mental health professional outside of the military. You must do what is necessary to properly address your mental health concerns.

Given your mental health status at this time, I would encourage you to see a mental health professional, whether inside the military or outside, as soon as possible. Don’t ignore these problems or believe that they will simply go away on their own. Ignoring these problems will only make them worse. I hope that you will take the appropriate action and see a mental health professional immediately. Please take care.

Dr. Kristina Randle

It feels like NOTHING is real, but…that doesn’t depress me. Shouldn’t it? For the past few months (and nothing I can think of significant has happened in the past few months, at least nothing out of the ordinary) i’ve begun to feel as if the world around me wasn’t real. But it’s not…depressing or scary…and the fact that its not scary, is a little bit odd to me. I don’t feel particularly unhappy or unsafe, in fact, you could even say that recently I’ve been happier than normal. But even sitting down in the living room typing this seems like it isn’t really happening. It’s like i’m just thinking really hard about things happening or watching some odd 3d projection of information pretending to be physical matter or light or whatever. Shouldn’t I be depressed? Why do I feel so strangely…I don’t even know how to explain it. Not euphoric, because that’s too extreme, just…disconnected. A sort of happy isolation. Am I crazy, or am I like…SUPER CRAZY? What’s wrong with me?

A. I would need many more details about your symptoms to know what, if anything, may be wrong. For instance, it would have been helpful to have answers to the following questions:

• Do you have a recent history of substance use?
• How often do you feel as though nothing is real?
• When did these feelings begin?
• Are you able to distinguish between what is real and what isn’t?
• Are you engaging in any particular activity when these feelings occur?
• Did you recently began taking a new medication?

There are several general possibilities that may explain your symptoms: a significant lack of sleep or the use of drugs or alcohol. If you have used drugs or alcohol recently, your symptoms may be a side effect of those substances. I receive many letters from individuals who have recently “smoked something” and subsequently feel similar to what you have described.

It’s also possible that you are experiencing symptoms of a mental health condition. Depersonalization disorder is characterized by feeling detached or estranged from oneself. Sometimes individuals with this disorder describe feeling as though they are in a movie or living in a dream. Some individuals who experience depersonalization worry that they are “crazy.”

On some occasions, individuals with depersonalization disorder experience derealization. Derealization is the experience of feeling as though the external world is strange or not real. Depersonalization disorder typically develops in adolescence or early adulthood (average age is about 16) and can be exacerbated by a traumatic event. Depersonalization disorder is categorized as a dissociative disorder and may be associated with other conditions such as schizophrenia, panic disorder, acute stress disorder, another type of dissociative disorder, drug use, or a general medical problem.

My recommendation is to have an evaluation by a mental health professional. An evaluation could determine if you should be concerned about your symptoms, if your symptoms require treatment and if you have a mental health condition. It is advantageous to receive an objective opinion from a trained professional when experiencing unusual psychological symptoms. Please take care. I wish you the best of luck.

Dr. Kristina Randle