During the day (even at school) I have a voice in my head. It tells me things like ; worthless, ugly, awful, not good enough etc. Is this normal?

A. You might be experiencing depression but I don’t have enough information to make that determination over the Internet. The inner voice that you have referred to, may be a form of negative self-talk and it’s quite common among people with depression or low self-esteem.

We all experience an inner voice that includes our conscious thoughts about ourselves. The thoughts can be positive or negative but among people with depression, the self-talk tends to be negative, self-defeating and unrealistic. Your inner voice is negatively skewed and thus may indicate depression or low self-esteem. It’s a definite concern.

Mental health professionals often attempt to assist their clients by challenging negative self-talk. In your case, you seem to be convinced that virtually everything about you is negative. If I were working with you, in one-on-one counseling, I would want to know what evidence you have to support these views. For instance, some people with depression are convinced of their incompetence yet have achieved many great accomplishments. Their logic is inconsistent with reality. They minimize their achievements and maximize aspects about themselves that they perceive as being negative. They struggle to see reality as it is. A therapist would help them align their self-perceptions with reality.

If you are unable to resolve this issue on your own, then you should consider seeking professional help. Your negative self-talk might be indicative of depression. The earlier that depression is treated, the better the prognosis. I would also highly recommend the books: Feeling Good: The New Mood Therapy and Turn Off The Negative Self-Talk, both by Dr. David Burns. Please take care.

Dr. Kristina Randle