From a young man in the U.K.: A few years ago I noticed a strange tic-like symptom had appeared, it seems whenever my mind wanders to something embarrassing or uncomfortable in the past, no matter how significant or otherwise – I often tense up for a second and am unable to control myself from blurting out the words “Kill yourself” or “you should die”, “shoot yourself”; often rather loud and violently directed at my own self. I have a harder and harder time trying to squash these outbursts in public.

This has often put me in awkward positions when this happened when around people at work or out and about. Strange, and whats stranger is that I do not feel particularly suicidal despite my situation.

I’m 27 years old currently living with mental health issues, maybe depression but I don’t want a diagnosis to tarnish my medical record. I feel intense loneliness most of the time and do not feel remotely like a member of the human race, isolated and sad. I feel I often reek of desperation and this doesn’t help my case haha.

I’ve always had low self esteem from severe bullying in primary school and my younger brother sadly passing away during this time. I have a hard time connecting with people recently and have had paranoid outbursts (usually under the influence) which has destroyed any relationships or friendships I once had.

But despite all this I have hope, I would never try to kill myself. I use mindfulness and meditation along with plenty of thinking to get through my days, and believe it will get better.

But seriously.. What’s the deal is with these “tics”?

Please help me.

Thank you so much.

A: It’s note-worthy that you direct all your “tics” at yourself. It suggests that your frustration with yourself is huge. In a way, you’ve taken over the bullying that others used to do to you.

I don’t understand why you think a diagnosis would tarnish your “record”. Your medical record is confidential. I suspect that a diagnosis or at least an understanding of what is happening would give you enormous relief.

I can’t offer a diagnosis on the basis of a letter. But I can suggest that intense bullying and the trauma of the death of a younger brother may have triggered feelings and thoughts that you have yet to deal with effectively. Your “tics” may be a way that you are telling yourself that you really do need some treatment in order to have a productive and happy life.

I do hope you will take care of yourself and get the help you deserve.

I wish you well.
Dr. Marie