From a teen in South Africa: So from what other people have told me, I’m not exactly considered normal. People often seem to find my behaviour odd. I’m very introverted. I spend days at a time sitting in my room without anyone else, and I’ve had full blown conversations with myself for hours on end while doing so. I tend to talk to myself very often, even in public without realising it. Usually I recite the numbers “1 2 9 10 5 9” if I realise that I’m talking to myself in public because I start to panic and think people are going to think I’m strange even when no one has noticed. It’s something that’s been happening for a long time now where i will suddenly just say something out loud and realise that I said it and a sudden panic comes over me so I recite those numbers to calm myself down, sometimes I add other random numbers between 1 and 10 as well.

Anyways, so I’m going to summarize a bit because I seem to be babbling again.

-I was diagnosed as Bipolar when I was 16 after being stuck in a lock downward for 4 weeks straight and going basically crazy
– I’m a very fidgety person, I can’t sit still for very long and do nothing and I can’t stay in one place for more than a couple of days without getting a very aggressive mind set, and a short temper.
-I’m often finding myself intrigued and entertained by blood, gore, and the ideas of killing people, I find death fascinating and I have contemplated suicide on several occasions.
-my mother died when I was 10
-I crave human attention constantly, yet as soon as I’m around people, all I want to do is be alone again.
-I tend to get into an extremely depressed state if I get into any form of trouble with anyone. I have a thing about being yelled at by people, if I get into trouble then I end up getting super depressed for days and being barely able to get out of bed. The closer I am to that person, the worse it is.
-I hate authority, I can’t stand anyone telling me what to do or making themselves seem more important than me in any way. I can’t stand people who are in a position of authority and ended up clashing with basically every teacher I ever had because of this.
-I talk to myself a lot; in public places, alone, and I tend to even scream in my sleep according to my dad.
-I have a lot of nightmares. Whenever I have one, the root of the fear is always my brother (he has anger issues, temper lobe epilepsy, he’s a lot bigger and stronger than me, and he used to bully me and sexually harass me while we were growing up by grabbing my breasts randomly and sneaking into my room when he thought I was asleep.
-I tend to take on the personality of other people at random. If I watch a certain show or hang out with a certain person long enough to learn their characteristics, the way they speak and act, then I end up talking, acting, and even thinking in a way that mimics that person for the next few days.
-I was bullied a lot in school
-I only had one friend from 1st-7th grade. 7th grade I made friends with my current best friend who is currently in a completely different area of the country 2 hours away from me.
– I live in a town where I literally know no one other than the people I live with, no friends, no outside connections, no job, etc. Yet for some reason i feel perfectly content to sit here alone for hours every day
-I sleep excessive amounts. Anywhere between 12 hours in one day to 32 hours within two days. I’m also constantly tired and ready for another nap.
-I like to torture bugs. I have two Carnivorous plants and my favourite pass time if I haven’t been active for too long is to hunt bugs, pick them up with tweezers, make them scared, then force them into the Monkey cup or Venus fly trap alive and watch them desperately try their best to get free even though they’re going to die.
-I have hygiene issues. I don’t bath very often or brush my teeth, or hair, and I never shave or wear a bra. It’s not that I have anything against bathing or brushing my teeth, or being clean, I just don’t do it for whatever reason. I’m not sure why but I’ve always had an issue with hygiene.
-I’ve been questioning myself for a long time as to who and what I am. I feel uncomfortable when referred to as a girl, and more at home being referred to as a boy. I like male fashion a lot more than woman fashion and I even wear male deo because I like the smell better than the female deos. I created an online persona called “Zack” where I’m a male, and spend a lot of time talking to people who only know me as Zack (I do tell them what the situation is so I’m not catfishing them or lying to them) but at the same time, I can’t bring myself to discuss this with anyone in my family, or talk to anyone at all in irl about this. I also don’t know if I can consider myself a trans or if I’m just a girl who likes to act like a boy. It’s something that’s confused me for a few years now.

I’m sorry, I’m ranting. My real question, now that I’ve given you a bit too much information, is how do I stop these bad habits, and what should I do to be more connected and more successful socially? Because at the moment I literally have no social life and the last few people I hung out with all thought I was very weird.

A: ¬†If you could stop your “bad habits” you would have done so long ago. I can’t diagnose you on the basis of a letter, of course. But I can tell you that from what you wrote, you do have serious problems that 1) need to be addressed if you are to have a satisfying and happy life and 2) that are treatable.

Although your behaviors meet the criteria for several different diagnoses, I do wonder if maybe you are on the high functioning end of the autism spectrum (either instead or or in addition to whatever other diagnoses have been assigned to you). If that has not be explored, please do get an evaluation.

I think you already know that therapy would be helpful. I also encourage you to get involved with group, as well as individual, treatment. Group therapy provides a safe place to talk about your issues with others and to get feedback from other members of the group about what you do that distances you from others and how to correct that. A good group becomes an important support while the members learn more about themselves in interaction with others and rehearse new behaviors.

Please take care of yourself. Stop obsessing about all that is “wrong” with you and get the treatment you need to discover and bring out all that is “right.” As a starting point, you might find it reassuring to take the Strengths assessment at http://www.viacharacter.org/www/Character-Strengths-Survey. Once you know your personal character strengths, you can build on them to improve your outlook and your life.

I wish you well.
Dr. Marie