I used to love everything about life. I was so happy and ready to show the world who I was. I started college and during my junior year everything changed in one night. I got home from work and started feeling terrible. I felt like nothing mattered and that life had no point. Since then I have had difficulty with suicidal thoughts, depersonalization and derealization. Sometimes I feel like part of me is watching over me, and that it wants me to join it in heaven. Other times I get scared when I’m around loved ones because I know they are going to die one day, and that I’ll be left without them. I also get scared that I’m going to die, that I could end my life without realizing I’m doing it. How I feel seems to vary by the day, but they are not mood swings from high to low, just low to lower. When I’m walking around sometimes I feel like I may be in heaven already, especially when I’m walking through scenic environments. If I see something especially pretty or out of place I feel like I may be imagining it. Even going to the lake is enough to make me wonder if I’m real. This feeling doesn’t ever go away. I get overwhelmed extremely easily, and sometimes feel like I’m in a fog. Situations as simple as having a conversation at work or going to the store can make me feel like there’s too much going on, and that I’m about to wake up from a coma or a dream. I always feel like I’m about to hear my alarm clock go off and I’ll wake up. I’ve seen several therapists, talk therapy hasn’t been very helpful. I’ve been on and off Lexapro a few times. I’m on it now and this has been the only successful time. My dad, his parents and my other grandpa are alcoholics and my sister and aunt are bipolar type 1. I feel like a freak and honestly don’t understand why this is happening to me. I have never had real issues in my entire life. (From the USA)

A:  I appreciate the courage it takes to discuss this and try to change it. It sounds difficult and your resilience and persistence in managing it so far is extraordinary. I think it may be time to add group therapy to your recovery process. Group therapy — when done effectively — can give you a support forum for change, while challenging your perceptions. Spend some time looking for a good group therapist. Here is one organization that can help you find someone in your area or you can use our Find Help tab at the top of this page.

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