From a young woman in Algeria: overwhelmed, anxious, stressed, panic attacks some times, not in the mood of doing anything from time to time, i like loneliness, i want to punish myself most of the time but never completely hurt myself (just beat myself in some parts of my body), i’d insult myself or evening say really bad things as if i wasn’t alone in my head (i’d feel like there is me and the other evil me telling me all of that), i never self harmed and cut myself but the suicidal thoughts are often here (for example if i’m driving the second after i’d think about crushing the car against the wall or to another car) the dark thoughts i have all the time are really haunting me,

i used to have friends now in college i talk to people but they just don’t care enough to stay and my old friends i barely see them but the thing is i don’t want to have friends and socialise i really don’t care about my old/current friends, i barely talk to my family,

the truth is nobody knows the real me, i have really low self esteem (i can’t help it), i hate changes but iv’e done some these past weeks, i’d freak out anytime someone (especially if i don’t know him/her) talks to me, i can’t deal with social activities or interactions, i believe i have social anxiety (just anxiety in general) but as i’m always searching for explanations

i  self diagnosed myself with some serious issues but i probably don’t even have them and maybe all of this is in my head and i’m completely normal since i tend to suffer alone and never tell people, i often have pain (by often i mean all day everyday and i’m not even joking) it could be tooth pain, back pain, headaches, stomachaches… but never something combined it’d be a specific area all day everyday for real, but i suffer in silence, i might have other things to add but for now i can’t concentrate enough to tell more.
thank you for reading

I’m very glad you wrote. This is a difficult way to live. As much as you say you hate change, you do need to change how you think and feel.

Normally, I would refer anyone who is suffering physical pains to their physician. In your case, the pain changes location day to day. That suggests that the “pain” is a way that your body is telling you that something is wrong but that it might not be physical. I’m guessing the body pains are like a “smoke detector” going off, telling you that you are in deep psychological pain that needs to be treated. You should have an exam by a physician just in case there is something medically amiss — just to be on the safe side.

I can’t make a diagnosis on the basis of only a letter. But your description of your thoughts and feelings does suggest depression and anxiety. Please make an appointment with a mental health professional for an evaluation. Self-diagnosis may be a place to start but once you label yourself, what do you do next? For that you need the expertise of a professional. A counselor will not only evaluate you for a diagnosis but will also make suggestions for what you can do to feel better.

Meanwhile, you say you can’t help it that you have low self esteem but that simply isn’t true. Self esteem isn’t something you have or you don’t. It’s a term that describes how people feel about themselves at the time. A positive self esteem can be built by interrupting negative thinking and setting positive thinking in motion. The way to do that is to start doing things that you believe are helpful to others. Doing good is what leads to feeling good. If you wait to feel good before you do good, it won’t work. It goes the other way around. I know. I researched this and wrote a book about it: Unlocking the Secrets of Self-Esteem: A Guide to Building Confidence and Connection One Step at a Time.

You made a very important first step toward feeling better by writing to us here. I urge you to take the next step and to make those appointments with a physician and counselor. You don’t have to live with these feelings. With the help and support of professionals — and with commitment on your part to work on it, you can again feel good about yourself and have friends.

I wish you well.
Dr. Marie