Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Hello I believe I can help you with your concern
I am so sorry that you are feeling this way, I can imagine how distressing this is for you
I would like to ask you some questions, so I can give you the best information possible, if that is okay with you?
May I ask, for how long have these feelings of not being good enough been present?
I have had them since I was 12.
And have you ever considered therapy or the use of an antidepressant medication before in the past?
And since 12, is this because of the comments by your family or other people as well?
I have therapy, I just can not afford the therapy session.
Mostly by my family
And what about your friends or co-workers, what do they say about you?
I don't have a lot of friends, and well my co-workers don't have anything negative to say. They are supportive, and what friends I do have are the same.
So may I ask then, if other people do not say negative things about you, why do you believe what your family has to say at face value, especially the negative comments they say?
It's not only their comments it is their actions, I have a mother who only wants to be my mother when it benefits her and my father tried to kill me, my grandmother well, she got stuck with me. They never let me forget that I am just in the way or a mistake that shouldn't have happened. My friends and co-workers may not have negative things to say, but I have heard nothing by negative things my entire life, and I don't believe what my friends and co-workers have to say
That is what I thought, I just wanted to hear you say it because that shows me you have good insight, which will be helpful. I definitely believe you have depressive and low self-esteem symptoms, most likely associated with a possible diagnosis of Post-traumatic Stress Disorder (PTSD) from the abuse you suffered from your family. This caused you to be sensitive to negative criticism, so that it effects very much, but it also causes you to ignore positive qualities as well. These are called automatic negative thoughts were you only focus on the negative and ignore the positive.
There is an effective treatment called Cognitive Behavioral Therapy (CBT) where I can teach you some techniques to help you and provide you with some helpful self-help books as well
So, its not just non sense, I knew I wasn't crazy
How do I me focus on the positive when there are negative people dragging me down
You are definitely not crazy, here let me give you an illustration of how depression makes you only focus on the negative thoughts and this just worsens your depression
Well to focus on the positive, you will have to look inwards, you cannot take what they say at face value anymore.
CBT is great this way because it will retrain your brain to focus on the present and you. It will help change your negative thought process to focus more on a positive and objective thought process
So this link may help you, it contains a technique I use with patients called a thought record. It will help you keep track of any negative thoughts you have. You put the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want you to come up with an alternative thought for the situation (more objective and plausible). This will help you change your way of thinking to be able to think more positive and not automatically go to a negative type of thinking.
Here is also a good link to replace your self-critical beliefs, with more positive self-beliefs
Also I imagine that you do get angry and frustrated by their actions and comments, but you may not be assertive to do anything and express that anger/frustration. This will worksheet will help a lot with that
I have been keeping a journal lately. I tend to pretend everything is okay when it isn't, I feel a lot of the times like a clown putting on his makeup with a panited on smile
Well do not pretend with this thought record. Look at it objectively and force yourself to at least consider alternative thoughts. You keep doing that over and over again, it will ingrain in your mind and your symptoms will start to lessen
This worksheet can help develop appropriate coping styles and reject any avoidance styles that you may have. Avoidance styles are usually hallmark with individuals that have depressive symptoms.
Also you mentioned that you thought that killing yourself would be the best option out, how strongly do you believe that? On a scale of 1-10, 1 being not strong at all and 10 being very very strong. What number would you put this suicidal thought?
So that is pretty high, have you considered seeing your primary care doctor or psychiatrist for a prescription of an antidepressant?
I can recommend some options on medications for you?
I haven't talk to my primary care doctor of psychiatrist.
I think you should. I would recommend a SSRI antidepressant as these are very effective and do not have a lot of serious side effects to them. Lexapro is usually considered the best in this class of antidepressants because it works very fast
In depression, is it normal to have highs and lows. For example : I can be fine for a couple of hours happy no worries, and then a few hours later I can't seem to control my thoughts, my emotions, un controllable crying
With symptoms of PTSD, this is not uncommon. But on most days and in most hours of the day you will feel depressed, and there will be some periods where you feel happy and normal, but these periods typically do not last.
No cause the negative always comes back
Exactly, and that is common with the depressive symptoms associated with a depressive disorder and PTSD
How do I cope when I have a grandmother who makes me feel guilty for things.
Well when she says something to make you feel guilty, put it in the thought record and analyze it and then you realize that what she was saying was not true. But also use that anger decision sheet to express your anger/frustration in an assertive way to help you feel more confident and put your grandmother on notice that you will not be passive anymore and that you will not take this anymore either
I also think these books will be very beneficial to you as well
Okay, but for example; Last night I was taking a test in my online course, and she was just chatting away and I could concentrate so I just said " grannie" was all I said, then today she won't even speak to me because supposedly I told her to shut up. She had walked around mumbling all day but won't say a word to me. I can ask her something and she just totally ignores me. Its like dealing with a child. But in the process she has made me feel guilty.
So objectively you did not do anything wrong. An alternative thought would be that your grandmother is very sensitive and needs to be the center of attention, so when you politely asked her to wait till you were finished, she took it as a rejection. Her interpretation of the incident is wrong, not what you did. You focus on that, then you cannot possibly feel guilty because you did nothing wrong
Okay. that makes sense
another question I have is, is it normal, to want to cut yourself so that you can feel pain somewhere else other than the emotional pain you are feeling
CBT is a gradual process of retraining your brain, it takes time for this to work. But if you keep practicing it over and over again it will start to become habitual in you and you will think this way automatically.
Yes it is. Cutting is a way of feeling physical pain so that you can see it and it is more tangible to you, while emotional pain you cannot see, so it confuses you sometimes. Also there is only so much pain a body and mind can take, so if you cut yourself you are distracting your mind from the emotional pain to focus on the physical pain
Are you cutting yourself?
Then you should make an immediate appointment with your primary care doctor or at least go to your nearest ER for some antidepressant medications, as these are signs that you need the immediate medical intervention
I stopped for a couple of years, but I have started back up again
That happens when your symptoms have become unbearable and overwhelming
I think I will be making an appointment with my Doctor.
I think that is very wise, the antidepressants in combination with the CBT techniques will be very helpful for you
Thank you for all the insight and advise
Anytime, is there anything else I can assist you with?
Not that I know of right now.
Okay, well I want to wish you the best of luck with everything and I hope your treatment is swift and successful. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.