I don’t leave my room and apartment unless I have to (school, for example). I do speak to and know people at school, but I don’t view them as “friends.” The only “person” I feel is a true friend is my stuffed animal — a puppy. I’ve created a personality for him, and he’s the only one I trust enough to talk to. I don’t talk to my parents. There have been times where I feel suicidal and Puppy always comforts me and tells me everything will be okay. I do have an exit plan in case things get too rough for me to handle or if something happens to Puppy. I do not think I can live without him.

I’ve been told I’m witty, clever, and humorous. The jokes I make are usually self-degrading but made in such a way that does not raise any red flags. I justify my lonliness by telling others “Disregard females; acquire currency.” But in reality, I hate being lonely. I devote 100% of my time to my studies in hopes of earning enough money to maybe give me more self esteem.

When I have too much free time, I think. I look back on my life and analyze different events that shaped me to who I am. Here is what I have concluded: I was constantly being picked on during elementary school because I was Chinese and because of the way I dressed, and people called me “chino.” Even other Asians picked on me for no apparent reason. I remember thinking to myself “Why don’t people like me?” My mom taught to not fight and just take insults as they come, and I did. Every day I just sat there and took insult after insult. One day I read in a book that the word “chino” meant “chinese” in spanish. When the next person called me chino at school, I said to him “Yea? so what?” I saw the confused look on his face and that’s probably how my sense of humor started. I realized I had the power to throw their insults back at them by turning them into a joke. Over time, this turned into self-degrading jokes and acts such as spitting on myself in order to gross out and scare away the bullies.

In middle school, I got in trouble for a joke I made and I was forced to see the counselor for a week. My parents didn’t know. After that, I toned down my jokes. In the 7th grade, I had just gotten a haircut (I hated every single one of my haircuts.) and was feeling more self-conscious than I usually was. On my way to band class, and to my surprise, this random girl came and gave me a hug. I didn’t know what to do, or what to say. I just stood there with my arms by my side like a statue while she hugged me. I didn’t hug her back. Over time, I had grown to like her. I was infatuated with her, but I didn’t know at the time, silly me thought it was “love.” A year later, overcoming my fear of rejection, I asked her out. Instead of giving me a solid yes or no, she said maybe. This “maybe” kept me in her grips for the better half of the year before my infatuation ended and I was able to rationally think again. By that time, the hugs have stopped. As the year went on, I noticed that she did what she did to me with every guy. Hug them, get close to them, a few months later move on to others. Rinse and repeat. After that, I promised myself to never get close to another female again. The emotional hell and drama just wasn’t worth it.

After graduating middle school and starting High School, I had become very cold and logical. Or atleast I tried. I acted like an a**hole for lack of a better term. I justified pushing others away by saying it was more trouble than it was worth; love is just a bunch of chemicals being pushed around in my brain. By Sophomore year, I let down some of the walls I built up and attempted to socialize. I still didn’t do the whole hanging out thing and my weekends were spent in front of a computer as always, but my social network got bigger. We helped each other when in need, but I still didn’t view them as friends and I certainly didn’t trust them enough to tell them what I’m wrting here now.

I am now a Junior, and my workload has more than tripled when compared to Freshman year. I’m majoring in Computer Science and am pushing myself with 3 college level courses and a monday-friday after school program doing computer work. I’ve become stressed out this year and I find myself indulging in my fantasies a lot more. The summer before my Junior year began, I found an anime on the Internet called Spice and Wolf. I was never much of an anime fan, but I watched a few episodes and became infatuated with the female character, Horo. Every time I lay on my bed, I retreat into my fantasy world where I’m holding her in my arms and everything is perfect.

I know she’s not real and a relationship with a cartoon character is impossible, but I feel happy when I’m in my fantasy world. Also, I think I may be addicted to self-loathing and the happiness feeling generated when I’m in my fantasy. Whenever I feel depressed and begin contemplating suicide, there’s this weird feeling I can only describe as black goo starting at my heart and spreading to the rest of my body. As it spreads, I feel a rush and I begin crying. As I cry, those mental images of self-hurt mentioned in the beginning come back again and I feel worthless. Those images and feelings trigger another “black-goo rush.” and it lasts for almost an hour. I feel the same rush when I’m in my fantasy cuddling with Horo except instead of black goo, I feel a light, “brown” sensation that spreads from my heart. Then, instead of crying, I feel an overwhelming sense of happiness and I’m actually smiling. I fear I may be addicted to these two feelings of intense sadness and intense happiness. I fear I may be wh*ring for attention and feeding my ego when this happens. For example, something bad but insignificant might happen and I’ll start beating myself up over it until I feel an overwhelming feeling of sadness and dread which will trigger the black goo rush. As for the intense happiness, I find myself saying “Horo and Puppy will always be here for you” whenever I feel lonely and I begin to dive back into my fantasy.

No one knows anything of what I just wrote. There are only 2 people on the planet that I trust enough to say this to while not anonymous like I am right now; myself and Puppy.

One last thing, whenever I’m in my depression cycles I analyze my life and what I wrote about my early life leading up to this point is what I have concluded to be the cause of my social awkwardness and loneliness.

Please help me. I don’t know if I’m coming off as arrogant or attention seeking, but I really can’t see myself being capable of having a girlfriend, or even being alive to see my High School graduation to be honest. I need help.

A. It must be frightening to not be able to trust anyone enough to ask for help. Not only is that frightening but it is a very lonely feeling. Clearly, you are struggling with multiple issues, most notably depression and suicidal ideation. I am glad that you decided to write because it gives me a chance to possibly shed light on your situation and to offer you hope.

Please know that this is not a hopeless situation. Actually, the opposite is true. You can be helped. Yes, there are issues to deal with but as you mentioned, this is the first time you have let anyone know that you need help. The fact is that by writing this letter you have begun the process of seeking help. In the grand scheme of things, writing an anonymous letter is only a small step in the process, but it is a step nonetheless.

You seem to be experiencing depression and suicidal ideation. You feel that there is little or no hope for you. You have a great deal of difficulty interacting with others, to the point where you completely avoid it and have created a fantasy world. In this fantasy world, you feel safe. You can be yourself without fear of what others might think of you. It’s a freeing feeling, which may even be addicting. That might explain why you increasingly find yourself reverting to the fantasy world. Psychologically, it’s a safe haven for you and thus you allow yourself increasingly more often to enter this realm. The increase in frequency may be psychologically preferable to you but it is problematic. It’s okay to daydream; we all do it from time to time, but the fear is that eventually you will not be able to “bring yourself back” from your fantasy world and that you will lose touch with reality completely. To lose touch with reality is to be psychotic.

I do not want to alarm you, but I would strongly advise you to seek help from a therapist immediately. This is the next step in the process. Writing a letter is the first step. Asking for help and presenting your situation to a mental health professional, face-to-face, are the next necessary steps. I strongly recommend therapy because you are struggling with serious issues and your way of handling the situation is to slip into a fantasy world. The danger is, as I mentioned above, that you will be unable to return to reality. I worry this might happen to you and that is why you should consider talking to a therapist about these issues. He or she could address these issues and teach you new skills that will equip you to live in the “real world.” Remember, the fantasy world is not real. It is made up of imaginary people, places and ideas. It is okay to fantasize and to use your imagination, but not to the point where you feel compelled to escape into fantasy because you fear reality.

The biggest concern, of course, is that you are depressed and suicidal. That makes it all the more important that you seek help immediately.

If you are not sure how to speak to your parents about this, then give them this letter and my response. If you do not want go to your parents, then give this letter to a school counselor or school official. If you believe that you might harm yourself or someone else, call emergency services immediately or take yourself to an emergency room. Lastly, if you are feeling overwhelmed or confused, call 800-273-8255 to speak to a counselor trained to deal with suicidal thoughts. It is the number for the National Suicide Prevention Lifeline. It is a 24-hour, toll-free suicide prevention service available to anyone in suicidal crisis.

One last thing: you wrote at the end of your letter that you know you need help. You have a strong sense that something is wrong. The good news is that everything you wrote about is treatable, but it requires that you ask for help. I understand that you may be frightened but please know that getting help is nothing to fear. Millions of people are helped by mental health professionals and it changes their lives for the better. Good luck.

A: What are you waiting for? Please. Take this woman back to her physician immediately. I suppose she could be having an adverse reaction to her medication or to the mix of medications. It’s also possible that she is so overwhelmed by all the hard things that have happened to her recently that she is having a breakdown. I’m glad she has a loving relative like yourself who is keeping watch. She shouldn’t be left alone until she has been evaluated and treated. I also hope that someone has helped her daughter find a counselor to help her cope with the sexual assault. What a terrible time for this family!

I wish you well.
Dr. Marie

My parents have always told me never think of your self, because your a christian and that you have it so much better than everyone else in the world. I could never talk with my dad, inside I still remember when he used to beat me, when I was 5. I didn’t even do anything wrong and when my dad came home from work, he used to get infuriated over the smallest things and he used to beat my sister and me.

My dad had so much problems with his dad. My grandfather used to beat his kids for absolute reason. My dad hated his dad for beating my grandmother and he made her blind. I hate my grandfather so much.

Even though my dad had such a painful childhood of working from such a young age, child abuse, there’s this anger that runs in my family. I hate everyone in my family and when I see them, I can’t take it anymore, they always depressed about something. My sister hurts me just as painful as my dad, she said if I wasn’t born, here life would be better. On a regular basis, we would fight and when we get into a fight, she would throw things until i get seriously injured.

She blames me that it wasn’t for me, there would be no problems. When I was 5, my sister left me at the park and I think i know the reason why.

My mom is suffering the most in our family. I feel so bad for her, I can’t tell her anything about how I feel sometimes because I know in my mom’s side, cancer runs pretty badly. I don’t know what to do, one time, I told my mom about one of my problems, she cried herself to sleep.

At church, I grown so distant from everyone, I just hated everyone at the time and its so hard to go back to a church I’ve been going to church for 11 years. I have no friends, and at school and I always smile so that no one sees whats really going on in my life. About 2 years ago, i was shy but now it got to the point, when I look at someone for the long, I look away and just away. I can’t hold a conversation with anyone. I’m distant away from GOD.

What should I do?

A. I am sorry you are experiencing so much distress. Unfortunately, your family may not be able to focus on your issues because they may have too many of their own. That may be why they dismiss you and your concerns. Also, if they are unable to solve their own issues, then they may feel helpless to deal with yours. Having no help or support from your family makes the prospect of tackling your issues doubly difficult. I can understand why you’re overwhelmed.

I have two suggestions for you. One is that you speak to a guidance counselor at school. There are many teenagers in similar situations and they feel that no one at home can help them. Utilize the guidance counseling service at your school, if it is available to you. My second suggestion is to seek guidance from a clergy person. You said that you are Christian. Perhaps there is someone at the church who can assist you with not only the family issues, but also with the fact that you feel distant from God. I would advise you to consider both, speaking to the guidance counselor and a clergyperson.

Not having support from your family can be a barrier to treatment, especially for teenagers. I would encourage you to keep trying to find help from a teacher, a therapist, guidance counselor, mentor, or any other respectable adult whom you like or trust. Don’t stop trying until you find someone who can offer you help. You should also consider joining a school program or extracurricular activity, or any other social gathering or support group. I suggest this because you could benefit from a support system. I believe that if you had friends or a circle of support then you would feel less overwhelmed. It could act as a “buffer” for the stress you feel at home. Ideally, individual or family therapy would be the best type of treatment for you, but if you are unable to access that, a supportive friend or social group could help you considerably.

Thank you for your question and I wish you the best of luck.

My boyfriend and I have been going out for two weeks, ever since homecoming. He is my first boyfriend and I am his second. We weren’t much before we started going out (i.e. we talked about 30min-1hr a day at school [we are freshmen in high school] although we both liked each other) but now that he’s asked me out, he seems to be talking to me less and less, little by little.

He is never the one to text me or start the conversation, but when I start it he engages in the conversation very well. I feel like I shouldn’t have to talk to him and tell him that he should talk to me more. When you like someone you should /want/ to talk to them more, you shouldn’t have to be told. If I do talk to him, I feel like, if he changes, that him talking to me more would be because I told him too.

He did this exact thing with his last girlfriend, and she broke up with him. I feel like this may be the right option, because everyone deserves to have someone that likes them back. I also don’t want to be waiting around with someone who doesn’t like me as a girlfriend.

I still really like him still. He hesitation on breaking up is that he may not have the same idea of what a relationship is or how to act in one (although that doesn’t explain why he’s been talking to me less).

Should I break up with him? Or should I talk to him about this? If so, what should I say? Is there something else I could do?

A: One of the unfairnesses in life is that girls tend to be ready for romance before the boys. I think you may be right that he may not have the same idea you have about what a relationship is and how to behave in one. He may believe that asking you out tells you everything you want to know.

It sounds to me that you had a better friendship with this guy when you were just friends. 30 - 60 minutes a day is a lot of talking for most guys. As you have increased your expectations, he has backed off.

Instead of breaking up, why not start with backing up? Make the friendship part of your relationship more solid by appreciating his good qualities and enjoying the conversations he has with you. As he gets more comfortable, he may start to have more to say. If you stop working so hard to get him to talk, he may find the space to initiate a conversation.

I don’t know if this will work for you or not but I do think that giving up on someone after only 2 weeks is rushing it a bit. I susggest you give it more time and less pressure and then see what you both think.

I wish you well.
Dr. Marie

My brother-inlaw has been taking depression medication and has been removing car sideview mirrors and urinating outside in planters? His has been arrested for this and has been sent to the hospital a couple of times for evaluations but no one can help and they just release him out. He denies that he does anything like that and will not talk about it. He does not want help and will not stay in a facility. Sometimes he will walk to a local 7/11 and steal a beer. He will not get drunk but must have a beer or two each day. He also will mumble a few words if he does not think anyone is watching. We are uncomfortable around him and feel he might start doing something worse or act out with anger. How can we get him help or find a facility to keep him longer and find out if he has other problems than just depression? We need help, please.

A: I’m very glad you wrote. Since you are 60, I’m guessing your brother-in-law may be somewhere close to your age. I’m also guessing that he has been taken to a psychiatric hospital for his behavior. It’s very possible that the problem is medical, not psychiatric. The way the American health care system is currently organized, a psychiatric facility probably didn’t check him out medically. Their job is to stabilize someone, review his psychiatric medications, and get him home.

Your brother-in-law may be less resistant to seeing his doctor than going back to a facility. My best suggestion is that you get him to his doctor for a complete physical. Believe it or not, there are a variety of medical issues that can cause this type of behavior. Problems with the heart or bowel, for example, sometimes show up as delusions and depression. A sign of early dementia is erratic behavior. I’m not an M.D. and I don’t have anywhere near enough information to tell you what the diagnosis may be. I only mention those possibilities to demonstrate that psychiatric symptoms sometimes have medical origins. As for the beer: He may be self-medicating. The alcohol makes him feel better so he goes for it.

You will get a better assessment if the family keeps careful notes of exactly what your brother-in-law does, how often, and with what intensity for a few weeks prior to the appointment and present the information to the doctor. Otherwise, the doctor will only have what his patient reports - which you already know is unreliable.

Your brother-in-law may not appreciate it but he is a lucky man to have concerned family. Whatever the problem may be, early diagnosis makes a difference. By getting him to a doctor, his family may well give him the chance for a much better - and longer - life.

I wish you all well.
Dr. Marie

I’m a 34 year old housewife. I’ve been married 8 years and have 2 children. I’m not too sure how long I’ve been feeling empty. I do remember having a terrible time in December 2008. I spent a lot of time in bed. I only got out of bed to take my child to school and feed my other child throughout the day. I cried a lot and slept even more. I thought of running away all the time. Somehow I got over it and moved on. I still feel sad and empty. I don’t have any friends I hang out with. I visit with my husbands family sometimes but I am usually home, on the computer. I’m tired all the time. My energy level is so low. My family has a history of Thyroid issues and I thought that was my problem but the tests come back negative. I don’t enjoy sex anymore. I only do it when my husband stresses the issue that we haven’t had sex in a long time. I don’t enjoy him touching me anymore either. I tried to explain that I’m going through something I can’t really describe and if he could just take his time maybe I can warm up and want it again. It doesn’t work. I sometimes hope he has an affair so I don’t have to be bothered. I want to stay with him but I don’t feel its fair to make him go through this. Can this be a medical condition? What can I do to fix this?

A: My goodness. This sounds awful. Yes. It could be a medical condition. It could even be a problem with your thyroid. Sometimes the tests for thyroid problems produce false negatives. I hope you saw an endocrinologist, not just your primary care physician, to have this checked out. If a more sophisticated test still comes back negative for thyroid, there are a number of other physical conditions that can produce the symptoms you describe. Among the possibilities are anemia, vitamin deficiency, eletrolyte imbalance, urinary tract infections, chronic fatique syndrome, Lyme disease, and even a brain tumor. This list isn’t intended to be inclusive or to scare you but merely to point out that there are many medical conditions that can look like depression. The first step, then, is to get a complete medical workup.

If you find you are medically fine, then please get yourself to a psychiatrist or psychologist for an evaluation. The symptoms you describe are also consistent with a diagnosis of depression. Depression often makes people withdraw from the people and activities they love. Fortunately, it can be treated. A combination of medicine and talk therapy can get you back to your usual self.

Please don’t wait to make these appointments. You’ve been feeling miserable for far too long. You, and your family, deserve to have a happier life.

I wish you well.
Dr. Marie

The worst though is that I found out that last year when my mom put me on homebound and she didn’t see me for months, she tried to slit her wrists. So if I leave she might do something stupid…especially if she’d never see me again. I wouldn’t even have a way of contacting her. On top of losing all that Im losing by moving, I’m moving to a new town and going to a new school- we all know what happens to the new kid in high school. I just don’t know what the hell to do or why I should live anymore, why I shouldn;t just off myself. I just cant take any more stress or heartache or I might do something stupid because I dont know how to deal with this.

A. I understand that you are experiencing a great deal of stress. Nothing in life seems to be going your way. Please understand that life has its ups and downs. At this point in time you are experiencing several unfortunate and unpleasant situations. Yes, it is undoubtedly a difficult time for you but it is important that you realize that your situation will likely improve. You’re assuming, for instance, that you’re not going to like moving. Assumptions don’t always turn out to be true. The truth is that there’s no way to know if you will like or dislike your new town or school. Yes, there are some individuals who when they move have a difficult time adjusting, but you may surprise yourself and like it. Your move may not be as negative as you are predicting it will be. My advice for you regarding this matter is to stop assuming the worst outcome and to keep an open mind.

As for the girl that you like, there is no denying the fact that leaving her may be difficult. It will likely not only be difficult for you but as you mentioned it may be very upsetting to her, to the point where she might harm herself. Given the situation, it is advisable that you do one or all of the following: speak to your mother, her parents, or consult the school guidance counselor about your concerns regarding your girlfriend. The fact that she may harm herself is a very serious concern and not something you should be dealing with on your own. Perhaps if you and she had a constructive way to deal with the inevitable move, then it could help ease the transition for you both. I hope you will strongly consider informing an adult about the fact that she may harm herself.

I am also very concerned about the fact that you are considering suicide. As mentioned above, life has many ups and downs. It will not always go smoothly. That is the case for everyone. You need a better stress management strategy in place for when life gets tough. You may be considering suicide because you’re not sure how to handle difficult life circumstances. Please know that you can learn alternative methods for handling stress that do not involve harming yourself or ending your life. You can do this through counseling which has been shown to be very effective for many people. Millions of people are helped by counseling. If you’re not sure how to access counseling, then you should speak to your mother about how your feeling or go to a school counselor immediately. If you feel that you cannot keep yourself safe, then you should go to the emergency room and inform them about your plans for suicide.

Your life is likely going to change upon moving but don’t assume that there is going to be a negative outcome. It may turn out to be the best move of your life. The point is you don’t know what the outcome will be and you should not make assumptions. The smartest thing you can do now, as a mentioned above, is to speak to your parents or a school guidance counselor.

If you’re suicidal then call emergency services or go to the emergency room immediately. It’s also important that you have in your possession a number to a suicide hotline. Please call 800-273-8255 in the event that you feel overwhelmed. This is the number for the National Suicide Prevention Lifeline which is a 24-hour, toll-free suicide prevention service available to anyone in suicidal crisis. Thank you for your question.

A. There may be many possible explanations regarding why you are engaging in attention-seeking behavior. It may be related to your chaotic history, none of which is your fault. Generally, people attempt to gain attention when they feel they are not getting enough of it or they need or want assurance that they are loved or liked. Learning why you engage in a particular behavior may not be very helpful. I believe that what’s most important for you is to focus on not necessarily why you lie for attention, but how you can stop. In the future, you may revisit the issue of “why” the behavior developed and conduct an in-depth analysis, but for now, I think your energy is better spent on how you can stop.

I also want to point out how perceptive I think your question is. Some people lie for attention and they have no real idea that they shouldn’t be engaging in that type of behavior. Others may know that they are engaging in negative behaviors but they simply don’t care enough to change. That isn’t the case with you. You realize that it’s wrong and you want to change. To me this is a sign of an insightful person. You desire to change but you are not sure how. I find this very encouraging because there is help available and it’s just a matter of finding it. One caveat is important to mention. I do not want to give you the wrong impression. Changing your behavior isn’t usually an easy or emotionally painless process. In fact, it will likely be challenging but half the battle has already been won. Your already know you need help. At this point, it’s a matter of accessing competent mental health professionals.

Given your age any treatment that you undergo will likely require your parents’ approval and involvement. This means that you will need to tell them that you need and want help. In your letter, you have listed several things that you have done to get attention. I do not know whether your parents know that you had lied to them about those situations. If they don’t know, then you may have to tell them the truth and by doing so, it may demonstrate to them that you need and want help. If they already know the truth, then they may sense the fact that you need help. Because I don’t know the specifics of your situation, I can only give you general advice.

Generally speaking, the best way to approach this situation is to be honest with your parents. Tell them what you wrote in this letter, which is that you feel compelled to lie to gain attention. What you wrote in your letter was very succinct and to the point. In addition, I would highly recommend counseling. Individual counseling could be very helpful as well as family therapy. Ideally, that would be the best way to proceed. Lastly, I would also advise you, especially if you’re not comfortable speaking to your parents about this situation, to print out the letter you wrote to me and my response and give it to your parents.

I hope that you’re able to find help. I think you would greatly benefit from counseling. Thank you for your question. Good luck.

My boyfriend and I are having problems because he says my jealousy and insecurity have pushed him away. Here is what has happened. We have been together for 2 and a half years and have a daughter together. He refuses to move in together. Currently he is living un his own home on property that he rents from his exgirlfriend. The ex that he rents from was married while he was sleeping with her and her husband knew and was ok with it! And she goes out to his house whenever she feels like it and he told me there’s nothing he can do about it because its her property. He has went to her house in the middle of the night when her husband wasn’t there and then got mad at me when I got upset about it and accused him of having sex with her. When I became pregnant with our daughter I asked him to move in with me and said he didn’t want to move off the property he lives on cause he didn’t want to leave his landlord/ex girlfriend with money problems. Then he accused me of being jealous and insecure when I got mad about that. He is always telling me there is nothing between them anymore and that I’m over reacting but he is constantly putting everyone else and everything else ahead of me. He also told me, when I was 8 months pregnant, that a girl at work, who is very young and pretty, offered him sex. Then he proceeded to ask me that if we broke up could we still be friends. Then accused me of being too jealous when I got angry by this. He also invited his ex and her husband on a camping trip and told me I wasn’t invited and when I got mad he called me insecure. He has recently broke up with me saying he can’t deal with my jealousy and insecurity and accusations. Was I over reacting? And how can I stop being so jealous and insecure?

A: No. You’re not overreacting. What people do is far more important than what they say. This guy has never put you first. Why do you think he will start now? He likes the life he is living. You’re the one who is unhappy. I’m puzzled why you hang on to the idea that he is going to make a life and a home with you. Your “jealousy” is your own good sense telling you that staying with him will probably mean constant disappointment.

You didn’t mention how he relates to his daughter. She may be the only glue that is holding you two together. On the other hand, if he is as casual about his relationship with his little girl as he is with you, even that “glue” isn’t holding.

If you want a stable and more traditional married and family life, it doesn’t look to me like this guy is a good bet. I hope you will find the strength and the resources to stand up for yourself and your child. There are good men in the world who would be happy to make a family with the two of you.

I wish you well.
Dr. Marie

A. Two possibilities come to mind: you may be experiencing a state of disassociation or there may be a neurological explanation. Disassociation is characterized by a loss of the connection of an individual’s thoughts, memories or their sense of identity. People can experience disassociation on a continuum. For example, a minor to mild case of disassociation may be experienced when a person becomes “lost” in a book or a movie. This is a common experience that many people can relate to. A more severe and concerning level of disassociation may occur when an individual begins to believe that they are someone else and has difficulty “coming back to” who they are. It’s also concerning if an individual has difficulty deciphering reality and finds themselves increasingly living in a fantasy world.

I also mentioned above the possibility of a neurological disorder. It is important that you rule out a possible medical cause. My advice is to make an appointment with your primary care doctor, speak to him or her about your symptoms and ask to be referred to a neurologist. Neurologists are essentially brain doctors. Brains are their specialty. I would highly recommend that you be examined by a neurologist to be certain that nothing medical is causing the shaking of your hands and the accompanying disassociation. Seeing a neurologist to rule out a medical cause is the best place to start.

It would also be advisable that you speak to a professional therapist about this issue. You can do this while you’re undergoing medical testing or after a medical cause has been ruled out. I suggest professional counseling because as I mentioned above, this problem may be an issue of disassociation. If you choose to see a therapist, then you’ll want to choose one who specializes in dissociative disorders. I’m not suggesting nor could I know if you have a dissociative disorder, but if you are experiencing disassociation then it’s helpful to have someone who’s specifically trained to treat those types of issues.

It is important that you take action and be evaluated by both a neurologist and a mental health professional. The obvious concern is that you may have a medical condition that needs to be treated. As you noted in your letter, it does seem that this problem is increasing. I hope you will take my advice and be evaluated. Thank you for your question. Good luck.

Lately I feel like I’ve been getting kicked around and going nowhere. I was released from the psych unit at the hospital on Wednesday following a 12-day involuntary stay. My preceptor (psychiatrist) thought I might be a danger to myself and had me admitted against my will. Although I was having suicidal thoughts, I’m bipolar. This honestly happens to me all the time, and I was never in any acute danger. Obviously she didn’t believe me.

While I was in the hospital, I dealt with two separate psychiatrists who had totally different opinions of me and completely different treatment plans. The first guy didn’t even want to bother with me. He brushed me off in such a callous way that I was very hurt, even crushed. The second guy was more open-minded and thought it would be worthwhile to try me on an MAOI, which I have never taken before. He discontinued the wellbutrin I was taking on the assumption that my outpatient psychiatrist would go along with that plan (he even talked to him about it). On Friday, my outpatient psychiatrist said that he didn’t like the MAOI idea and that I should go back to the meds I was taking prior to hospitalization, except without the antidepressant. (Take a depressed person and remove the antidepressant… good plan.)

So what did my hospitalization accomplish for me? Well, it screwed up my schooling. Now I have to take a leave of absence, repeat my psych rotation, and delay my graduation by months. It also did nothing to change my mood. I’m just as depressed as I was before, but with an altered set of stressors now. There have been no promising changes in my treatment plan. I gave the docs over a week of my cooperation as an inpatient in the hopes that they could help me, but it now seems that the entire ordeal was a complete waste of my time and a rather disruptive/destructive force in my life. I can’t think of anything good that has come of this. Nothing.

I’m going into medicine. I’ve always had an interest in psychology. However, this experience has done nothing but leave me disappointed and disheartened. Disappointed that those who are providing my care can’t agree with each other. Disappointed that I would be callously brushed off when I am in genuine pain. Disappointed that one would get my hopes up, and another would put me right back where I was before. Disheartened because when I finally made myself vulnerable and accepted a need for help (like frequent suicidal ideations maybe aren’t normal or healthy), I received three different responses and have made no progress whatsoever. Disheartened because I’m starting to feel like I can’t be helped (or at least no one wants to try). Now THAT’S depressing.

A recommendation has been made for therapy, and I’ll agree that I need it, but I don’t want to put all of my eggs in that basket. I’ve done therapy before. Years’ worth, and it has only been a moderate help. I know I don’t handle stress well, but my history includes bouts of major depression even when everything in my life is going well. Can therapy fix that? Really?

Obviously I’m venting, but I need to know - how do I overcome this frustration, discouragement, and newly-found skepticism as I try to pursue care from the people who I feel have let me down so badly, and who seem to be tired of dealing with me? I haven’t quite given up on myself yet, but sometimes I think I’m really close to throwing up my hands and calling it quits too. That’s when suicide starts to sound so inviting again, because sometimes I think I would rather die than live like this for another 50+ years. I need a reason to hope.

Thanks.

A: Thank you for writing. I hope you won’t give in and give up. You obviously are thinking hard about options and trying to take charge of your life. I’m very, very sorry that you seem to have been caught in the gaps of the current health care system. Each doctor was undoubtedly doing what they thought best. But it’s frustrating that there wasn’t more collaboration among them. I’m not surprised if at times you want to throw up your hands in dismay. It may be a small comfort to know that many people with a bipolar diagnosis try for years before they get the right providers and the right strategy to manage their illness.

The good news is that it can be managed. Yes, talk therapy helps. I recently attended a reading by David Lovelace who is the author of Scattershot, My Bipolar Family. He also has bipolar illness. He joked that his mechanic takes longer to change the oil in his car than his psychiatrist takes to review and prescribe his meds. Psychiatrists often have to see 3 or 4 people an hour; not exactly a pace where they can dig in and understand what is going on with someone. That’s why the talk therapy piece is so important as a long-term strategy. Your therapist can help you understand your illness better and learn strategies for coping with it and even using its positive aspects. Ideally, there should be a partnership and good communication between your psychiatrist and your therapist and you. Learning how to live with bipolar illness is a process of self-discovery; not just a matter of popping the right pills.

I think you might find it helpful - even inspiring - to read the books by Kay Redfield Jamison and the previously mentioned book by David Lovelace. You are indeed in very good company. Many people with a diagnosis of bipolar are extremely bright, creative, and productive people. Once they learn how to live with the illness, they become their best versions of themselves.

I wish you well.
Dr. Marie

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Much to her dislike, however, the way she acted never once got in the way of “CS” and I’s friendship. In fact, by the time May came near, we could not be separated. Unfortunately, this closeness with “CS” also meant I had to spend more time with “JL”. This time spent near her allowed us both to figure out just how similar we were in terms of our emotional health. “JL” and I both self-injured, felt depressed, suffered from paranoia, had family issues and wanted to kill ourselves. This common struggle would become the building blocks of our friendship.

Now, fast forward to the beginning of Summer. I was in the midst of a very serious depression. It had gotten to the point where I couldn’t get myself out of bed 99 percent of the time and had written out a detailed plan for suicide. The day before I was going go through with it was the day “CS” called asking me to sleepover. I saw the visitation as a way to say goodbye, so I built up the strength to go. To make a long story short, while over there she introduced me to a band whose music would be the thing to give me hope to keep going. This group became my reason to get up every morning and I felt the need to tell everyone about how much I loved them: including “JL”.

That phone call with “JL” telling her of my new musical discovery would be the start of our friendship. I learned that she too had been significantly impacted by this band and found their music to be of great comfort. We began discussing favorite songs, how the lyrics related to our lives and other fan-like topics. By the end of the conversation, however, we had spilled our life stories out to each other.

That spilling out of stories and many conversations that would follow made me realize just how hard things have been for her. Both of “JL”’s parents were heavy drinkers through her early years and her two older siblings abused drugs in high school. She told me that those two sisters, when their parents were at the bar, would lock her younger sister and her up in a small room while they partied with friends. If “JL” refused to go into the room, one of the sisters would chase her with knives. Things were getting worse in the household, and – after many years of heavy drinking/smoking - the mother developed terminal cancer. She passed away when “JL” was seven.

After her mom died, everything fell apart within the family. Unable to deal with the similarities between “JL” and the mother, her father got “JL”’s hair cut short, bought her only male clothes and refused to let her play with “girl toys” (all this in an attempt to make “JL” seem less like her Mom). The oldest sister got arrested after “accidentally” (she says) burning her youngest child and ended up being sent to prison (she is still there). The other older sister got deep into drugs, gangs, etc and was kicked out of the house. In the midst of this, “JL” locked herself in her closet for weeks and started blaming the younger sister for the mother’s death (and family problems that followed).

According to “JL”, she has felt angry and depressed ever since. Events that have happened since then - such as the drug addicted/gang involved sister joining the army and one of her father’s girlfriend’s kids sexually harassing her for a short period of time - continue to make this worse. Most recently, her father got remarried and punishes her for so much mentioning life before this new step mom (even the good memories). “JL” feels unloved, unheard and alienated in that household. There have been multiple times where she’s tried to overdose on Advil, thankfully never taking enough to do any damage.

This all brings us to the present. For the past couple years (basically, since I became friends with her), “JL” has been rapidly going downhill emotionally. She is reckless, doing things such as crossing the road when it is not safe; goes into destructive (self-injurious, ripping apart paper, throwing things, etc) fits constantly; acts quite violent at times; and, is more suicidal than ever before. To make all this harder for her, she has very few friends left: her moods, thoughts and destructive actions all make it very hard to be around her. Not to mention that when she gets like that, she will literally run away from you and not let you even talk to her. She keeps pushing everyone away.

At the start of this school year, she began acting up so bad one time that one of her friends called 911, in fear that “JL” would kill herself (she was threatening). Luckily, she went to the hospital somewhat willingly and cooperated with all the tests (ex: hair sample) and questions. When I first heard she was there, I felt so relieved. For the first time in ages, I didn’t have to worry about her safety or if she would be alive by time I next spoke to her. For once, I could breath easy when thinking about “JL”.

Unfortunately, that peace of mind didn’t last. Her step mother arrived a few hours later, yelling and cursing at both “JL” and the hospital staff. She was pissed off that she had to drive all the way there (about 30 minutes) to pick “JL” up and argued with the hospital’s psychiatrist until they allowed her to go home. In the end, “JL” was punished and nothing ended up being solved. For me, this instance was the last straw in my tolerance of her parents. They now clearly knew she was suicidally depressed and yet refused to seek any treatment for her. Even after “JL” begged to see a therapist, they did nothing: not even bringing her to the free support groups close by.

I feel completely and utterly helpless. My friend needs treatment of some sort and even she knows this (heck, she says she’s jealous of the fact I have a psychiatrist). Today, when I asked her if she thought she could keep herself from severely inflicting harm on herself, the answer she gave was “No, I don’t think so.” In school, they tell us that if our friend is in crises we should tell an adult. But what do you do when the adults already know and yet refuse to help correct the problem? I’m so desperate to help her that I have even considered calling Child Protective Services (CPS), reporting that psychiatric-related medical neglect is putting “JL” in danger. I know this will probably make things harder on the family, but I feel it’s all I have left to help her.

As you all know much more about these things than I do, I’m asking what my options are. Is it best if I call CPS reporting her parents? Or, instead, are there are other things in place to help in these situations. Maybe a law allowing her to be kept at a hospital until she is stabilized, despite the fact the parents would rather bring her home. Even if there’s nothing I can do, any advice would be welcome at this point.

Thank you for reading.

PS: I’m sorry I made this so long, I just wanted to be as detailed as possible.

A. This is a very difficult situation. Your friend’s life is at risk. This is not a situation that you should be dealing with in isolation. I understand that adults and mental health professionals have been involved in the past and that there has been no positive resolution. Is there anyone else you could speak to? For example, what about school counselors or other school officials?

My advice for you is to immediately go to someone at the school who could assist you with this issue. You could tell that individual about your friend’s personal situation. School professionals are trained to deal with these issues. They are in a position to call Child Protective Services if they had reason to believe that your friend was being abused. Take some of the pressure off of yourself and tell a teacher, a school nurse, school counselor, the principal, or anyone who will listen to you at the school, so that they can take action. Another option is to call Child Protective Services and ask them for their advice. That is one way to handle this situation but I think the best approach is to do what I said, which is to tell someone at the school who is in a position to take the proper action. If you feel that your friend is suicidal and you have reason to believe that she is going to kill herself, then you should call emergency services.

This is a very complicated situation which should be brought to the attention of an adult at the school. I know it is difficult to see your friend in so much pain and anguish and to feel that there’s not anything that you can do to help her. She needs professional help and she may need to be taken out of her home and placed into a residential treatment facility so that she can receive the proper treatment. Please immediately go to a school official and tell them what you know. If they can’t help then call Child Protective Services. At that point, there is little more that you can do. Even if it was your mother or sister, there would be little more that you could do. You are not alone. There are many friends and family members who have done all that was possible for a loved one and now they must simply hope for the best. You are a good friend and person. I wish you and your friend the best of luck.

About 7 moths ago i got seperated from my 7 year marriage because i wasn’t happy and i dont love him. i started to go out with my friends and i really wasn’t looking for someone. two months later i met a guy at a club at first i just wanted to dance i was attracted to him. so he asked me for my phone and i dont know why i gave it to him because other guys had asked me and i didn’t give it to them. So he called me the next day but i didn’t answer because i didn’t recgize his numbr. He send me a text the following day and i replied cause i was wondering who that was. Then he kept on calling me a lot and i wouldn’t answer but he was so annoying and finally i agreed to go out with him. We went out that night and i had fun and he was always so sweet to me he would tell me the prettiest things and made me feel special. We started to go out but i was the one going to his place all the time because i didnt want my family to know.

Everythng was good he would even tell me that he wanted to me to move in with himm whcich i said no and at the beginning i also told him not to fall in love with me because i didnt wanted anything serious. So we were together fot 4 moths

but about a month ago he started to change he would get irritated really fast. I asked him if he didnt love me anymore and he would say yes and one night after makig love he told me that he didnt love me that he needed sometime to think about what he wanted. That he didn’ wanted to hurt me. I told him that why he had said the he loved me if he didnt ad he sad that he thought he loved me but he did’t.

Now i feel real stupid like he just played me and only wanted the sex. He has been my second sexual partner and i feel so bad. Like how could i be so stupid to beleve him. I did fall in love with him he made me feel thigs that i didn’t feel about my husband. Now i can’t stop thinkng about whether i should just go back to my husband because i dot want to be hurt again. Now i know that most guys only want sex and i know that my husband loves me and he would take me back anytime. Of corse i would not tell him what hapend but i would feel very guilty. Please help me think better. Was this guy only playing me?

A: I don’t know if he was playing you. It’s true that some guys are only interested in the thrill of the hunt. Once they have the object of their desires, they lose interest. On the other hand, it could be that this fellow was genuinely interested in you initially but lost interest as he got to know you better. Courtship is about getting to know someone more and more and sorting out whether or not the person is for you. There are many decision points along the way.

My biggest concern is that you decided you were “in love” just a few months into a new relationship and very quickly after leaving a long marriage. It makes me wonder if you needed to convince yourself that you were in love in order to try out a new relationship. It’s been a long time since you dated. For many people, this is a scary time. You may have tried to skip over dealing with the anxiety by getting too close too fast.

Instead of trying to analyze the guy, I think you need to do some work on yourself. The question isn’t whether you should go back to the security of a man who loves you but who you don’t love. I think you need to be working on discovering who you are as an independent person and what you want in life. If you could do this by yourself, you would have done it. For that reason, I strongly suggest you get into therapy and work through why your marriage failed, how you may have contributed to it, and what you want and need in a relationship. If you do that work well, you are less likely to make the same mistakes and more likely to find the soulmate you are looking for.

I wish you well.
Dr. Marie

At school, I used to be very smart. I am in the gifted and talented program at my school. However, recently my grades have been dropping very rapidly. I haven’t gotten a single A in subjects I used to excel in. Also, I was very interested in theatre and now I am not even auditioning for a solo in the public choir at school. Mostly because my self-esteem has plummeted. There is another singer at my school and she is amazing. People say we are as good as one another, and I used to believe them, but now I don’t think so. My “friends” (I’ll mention them later) always go up to her and tell her she’s great and write her name down for solos and everything.

I am in a complicated relationship with my friends. I am in the “popular” crowd at school. They always exclude me and I feel like whenever they are together and I am not, they are talking about me. I know that they talk about me, I just know it. I also can’t just hang out with the other girls, because they aren’t as fun and they have complicated plans and mostly just don’t invite me as often as my group. It’s not like they’re excluding me, because lots of people don’t come when they have plans. But still.

My family is horrible! My sister is a redhead and the rest of the family is brunette. Whenever people see my family they instantly see her hair and are always like “Oh, you’re so beautiful!” Meanwhile I am sitting there, all fat and ugly and freckly with mouse-brown hair and clothes that don’t fit because my parents never take me shopping. (Literally, if I’m lucky twice a year. And I’m the oldest so I can’t get hand-me-downs.)

I’m probably so fat because I don’t do any sports because I am bad at all of them. I also spend most of my life on the TV and computer, which my mom always yells at me for.

My mom is the worst. This is copy-pasted from the Word document I use to vent my feelings: Mom is horrible. She is constantly mood-swingy. She used to be my best friend, someone I could talk to about the fact that I have no friends. But now I feel even more lost because she is growing closer and closer to my brother (the Yankees) and my sister (God knows) and farther and farther away from me. We have absolutely nothing in common now, except for trivial things like brown hair and freckles. We used to talk together, watch TV together

but then (After she started her business) she has grown constantly angry, mad at everything I do, always glancing at her iPhone, and then yelling at me for glancing at my computer. She yells at me to buy things with my own money, though she has none of her own money, she gets it all from my dad. She doesn’t spend time with me and yells at me for things I don’t do. She applauds my sister for 82% on tests, and whenever I get a 105% she jokingly says, “You couldn’t do any better?” She thinks of it as a joke, but by not saying anything supportive, she makes me feel worse about myself. Once again, she is constantly grouchy and doesn’t do anything besides yell, go places without me, look at her iPhone, do business stuff (it isn’t even a real business!!! it isn’t started yet!), and go on her computer. She’s like a robot with her switch broken and switching between working, not caring, gossiping, and angry.

When I do something good, she brushes it off and thinks I am “fishing for compliments.” She’s always telling me to hang out with my friends, though she promised she wouldn’t the last time my friends were horrible to me. She obviously wishes her dream child were someone who looked and acted like (kid in my grade who thinks she’s the best), with (the girl who can sing)’s brains and talent, (her best friend’s daughter)’s humor, and (my friend)’s hair. (Notice that I am not anywhere in there because she hates me.) She is always watching the Yankee game with my brother or talking with my sister, though she used to talk with me and watch TV with me. Why is she suddenly watching Yankee games? She never watched the game, but now suddenly my brother shows an interest and it’s, “I’ll drop everything else and watch the Yankee game! Oh, (my name) wants to watch something? Too bad, I’m going to the restaurant to hang out with the people I DO care about!” She doesn’t remember things I need/want (a haircut, deodorant, to go shopping, books, to watch TV with her) and then she gives my sister those things. It is obvious that my sister is her favorite. She ignores me and curses at me for nothing. I am the oldest and when I don’t do anything I get yelled at. She tells me I have no friends and that I have no life. So does my dad.

My dad is horrible. He constantly criticizes me, and says things about how great my sister is in front of me just to make me mad. He thinks it is funny to point out my flaws, which I have enough trouble with as it is. I am afraid to bring up these things, afraid to say that I wish he loved me more, because I know he’s just going to say that he gives me food, clothes, etc. and that is more than enough to show his love. Or, he might say that I wouldn’t be here without him and that is more than enough; probably the former. Dad doesn’t spend much time with me, and when he does, we are either eating dinner, watching Sci-Fi (which I don’t like), or on a “family bike ride.” However, these “family” bike rides don’t include the whole family, which is unfair. Dad doesn’t know the year I was born, often forgets how old I am, doesn’t go to many of my recitals, criticizes my every move, and only knows 5 of my friends’ names. Sometimes I’ll just be doing my homework and he’ll walk in and be like, “Look at my (my name). I wish she was still the kind girl she was when she was little.” I don’t even do anything!

My siblings throw things at me and throw things in my room. Last week my sister put an apple core in my room’s garbage can and the next day gnats were all over. My mom yelled at me. When I tried to explain, she told me to be more like my sister.

Whenever I think about when I was a little baby (like just-born baby) I cry. I also cry whenever someone tries to say something like, “You’re special! Your family loves you. People care about you.” I don’t know if it’s tears of joy or sadness, or if I am just denying what they are saying. I guess I want my life to be that way again, the way it was when I was a baby, when my parents loved me and everything was simple. Or that people would actually think I meant something. I don’t feel appreciated or anything. I know this sounds like nothing, but I wish I was never born. I want to die but I am too scared to be in physical pain. I know I probably won’t kill myself but I hate my life more and more every day. Please help. I am the only one who feels this way and I have mood swings and I hate it. Please help me.

A: Whew! Nothing seems to be going right, does it? Sometimes life can be like this for awhile. At 13, you know that it’s past the time when mom can kiss it and make it better. But you’re also not quite at the point where you can figure out what to do on your own. I’m glad you wrote.

The hard part about growing up is coming to terms with the fact that the only one who can change things for us is ourselves. It’s time you made a shift in how you look at things. Your letter only talks about how things seem from your point of view. Let’s try to see things from where your parents sit:

Has it occurred to you that maybe things are really complicated for your mom right now? She’s trying to handle 3 kids who are growing up and she’s taking the personal and financial risks to start a business. She seems on edge and distracted and anxious. Things may be more tense with the business than she is sharing with you. She may be extra irritable with you because, as the oldest, she expects you at least not to need her as much. It’s not necessarily fair but it is understandable.

It sounds to me like your dad is trying. This is a matter of seeing the glass as half empty (your way) or half full (my way). From my point of view, he does watch TV with you. He knows 5 of your friends’ names. He invites you on bike rides. He gets to some of your recitals. From his point of view, your little girl self was a whole lot easier to deal with than this moody adolescent who has come to live at your house. He could certainly be more tactful and supportive, it’s true. But it sounds like he doesn’t quite know how to relate to you and his awkward attempts just make you mad.

You are not powerless to change things. If you want your life to be better, you’re going to have to start taking some action. You have so much more to work with than other kids. You’re smart, talented, and you have friends. You even have friends who aren’t necessarily friends with each other. This is an important strength.

Focus on getting your grades back up. Stop comparing yourself to the other singer and sing from your heart. There’s room in any place for several good singers. Not satisfied with your looks? Give yourself a makeover. Get in shape and get your hair styled in a way that makes you feel good. Take an interest in clothes and figure out how to make a fashion statement with what you’ve got. Maybe get together with some of those friends to trade some clothes and give each other some fashion tips.

Not happy with family relationships? Instead of complaining, maybe you could ask your mom if she needs some help. Learn more about her business dreams so you can understand what is stressing her. Compliment your dad when he gets things right and he’s more likely to want to try harder. As for the siblings: Well, siblings are siblings. You’re all struggling to grow up. Every now and then try to reach out to them and things might get a bit better.

I suspect this isn’t what you wanted to hear. But I know that sitting around blaming other people for our troubles doesn’t improve the situation. Self-pity, even when we’re right, doesn’t make change. Your teen years are when you begin to take charge of your life and decide who you want to be. Only you can set your goals and work toward them. A bright, talented girl like you will go far once you get started.

I wish you well.
Dr. Marie

A. Unfortunately, your story is not uncommon. I am aware of other individuals who have had a similar reaction, which is that they developed mental health symptoms, specifically feelings of depersonalization, after using drugs. We could never know if it was the use of marijuana that caused you to develop the mental health symptoms but it is a realistic possibility. One thing to keep in mind about marijuana is that it is technically considered a hallucinogenic drug. I understand that some individuals use medical marijuana for severe pain associated with disorders such as cancer or glaucoma. Medical marijuana, for those purposes, is a highly controlled substance. With the marijuana bought on the street (or any other illegal drug), it is difficult to know precisely where the drugs come from or who creates them. It leaves one to wonder “what exactly did I smoke?” or “was what I smoked laced with another drug? Angel dust? PCP? Heroin? Arsenic?” It is theoretically possible that you unintentionally smoked one or several harmful or dangerous substances in addition to the marijuana. This is one of the many hazards of drug use.

It would be interesting to know if you experienced mental health symptoms prior to your use of drugs. For instance, did you ever have a panic attack prior to smoking marijuana? Did you have feelings of anxiety prior to marijuana use? Knowing that information might help me to better understand how or why your mental health symptoms developed.

It’s also important to consider the fact that you are currently taking several psychiatric medications. You said that you feel emotionally numb. I wonder if you were feeling the emotional numbness before you started the psychiatric medication or if it’s a recent development, something that developed after you began the medicine. I mention this because some individuals report feeling emotionally numb while on psychiatric medication. It is a commonly reported side effect of antidepressant medication, in particular. For some individuals, the emotional numbness that accompanies some psychiatric medications is considered beneficial, particularly for those experiencing extreme depression. The emotional numbness might shield an individual from the deep depths of depression, but the flipside of this is that they don’t feel happiness either. In your specific situation, it may be difficult to determine precisely what is causing the emotional numbness. This is because I don’t know if you felt that way prior to psychiatric medication or if it was the result of the depersonalization you have described. It may be difficult to untangle the truth.

You’re currently being treated with psychiatric medication but you’re not feeling any better. Because of this I would highly recommend that you consider seeing a therapist. A therapist could help you deal with anxiety and depression by teaching you coping skills. He or she may also be able to assist you with your feelings of depersonalization. Some individuals who experience depersonalization benefit from hypnosis. That’s a treatment approach you might want to consider.

Keep in mind that something is causing you to feel extreme anxiety. As I mentioned above, we don’t know if it’s the drug use or a psychiatric symptom, but no matter the cause psychotherapy may be the solution. If your only treatment at this time is psychiatric medicine, then you’re probably not receiving comprehensive care. If you’d like to search for a therapist please consult this directory. Thank you for your question.