A: There’s a lot going on for you, and I can tell that the stress is really getting to you. It sounds like you are a really good student and work hard at everything you do. But the perfectionism and anxiety are starting to take a toll. Perfectionism can be a tricky thing to deal with because many times it reinforces itself. For example, you over-study for an exam and get a good grade so the message you send yourself is that you need to do that every time. However, this pattern will ultimately lead to exhaustion and burnout.
Furthermore, you are not just describing perfectionism, you also include many descriptions of anxiety and obsessive rituals. I have found that these things tend to go hand in hand. Throw in a good dose of feeling “not good enough” and you have a pressure cooker situation. I’m sure you have studied the statistical principle of the bell shaped curve in college. As anxiety increases, performance increases, but then if it continues, performance begins to decline.
Your main question seems to be about whether or not you should speak to your doctor about adding another medication to address the anxiety (you already mentioned Adderall). By all means, I suggest you speak with your doctor, but you may get to a point that it might be better to speak to a psychiatrist because they specialize in these areas.
You mentioned that you spoke to the school psychologist but didn’t find it helpful. I highly recommend that you try again. You might not have had enough sessions to make a difference or you might not have found the right therapist for you. Remember, medications only address symptoms. The underlying problems will not go away unless you also address the thinking patterns and behaviors that create the symptoms. This is where therapy is most helpful.
There’s a lot you can do on your own too, such as learning to relax and meditate, take some “fun” classes, and read some self-help books, such as Brené Brown’s work. I would also suggest that you look into the concept of Adrenal Fatigue to more fully understand the long term effects of running on “adrenalin,” not to mention that it may be helpful knowledge for your future patients.
Finally, you are concerned that your mom won’t be supportive of medication or counseling. Typically, if you receive services through your school’s counseling center, she wouldn’t have to know. But, yes, she may find out if you use your health insurance benefits. This will be good practice as an adult college student. You need to do what is right for you, not what you think others want for you. You can be the one to break the family patterns and learn to prioritize psychological health, rather than continuing to “pretend” the problems don’t exist.
All the best,
Dr. Holly Counts