Depression & Anxiety With Academic, Cultural and Familial Pressures

Hello, My Young Friend:

Thank you very much for writing.  I am so very sorry to hear of your pain and difficult circumstances, and I will certainly do what I can to give you some guidance.  Although very distressing, the feelings and thoughts you are having are not unusual, and are QUITE treatable and changeable.

It does indeed sound like you are experiencing symptoms consistent with a major depressive disorder combined with features of generalized anxiety, and that these conditions have been persisting for some time.  It also sounds like these conditions and their symptoms have played a significant role in the the deterioration in your academic performance (feeling overwhelmed, fear of not performing up to expectations, difficulty concentrating, etc.), as well as in your overall distress. 

I do understand that the pressures imposed by your parents, regarding your future professional direction, and by the cultural norms in your country for adhering to and respecting these expectations, have played a significant role in your ongoing struggles.  It is like true, also, that your own habits of interpretating and responding to these external events have also exacerbated your condition.  I am not able to know if you do possess any attentional difficulties, or other challenges to learning, but that might be worth looking into as well.

My most important recommendation for you is to get the help you so badly want and need, in the form of treatment for the conditions I have described above.  When depression and anxiety are impairing your functioning, and causing you to think of ending your life, IT IS TIME TO SEEK TREATMENT, WITHOUT FURTHER DELAY! 

You may begin by showing your parents the letter you wrote me as well as my response and see if they are willing to help you access mental health treatment.  If they do not respond positively, then I would advise you to speak with another trusted adult family member, with a spiritual leader in your community, or with your primary care doctor.  If none of those steps work, you can investigate the availability of a low cost or free clinic in your area, or seek guidance from your school about such services.  I know that seeking such help may be feel stressful, scary or embarrassing, but the act of helping yourself is actually a sign of great STRENGTH AND COMPASSION toward yourself. 

The main point here is that you need to begin receiving treatment for your symptoms first, before you can expect yourself to constructively address the other challenges you are facing.  It will be all but impossible to make any well-informed decisions or major steps in the the professional or academic realms while you are still burdened with these symptoms.  Treatment will ideally consist of psychotherapy, and that may be combined with psychotropic medication, if that is deemed acceptable or necessary. 

You can also help yourself a great deal by doing some reading about depression and anxiety and beginning to learn techniques for helping yourself.  Therefore, I suggest you obtain and read the book, "The Feeling Good Handbook" by David Burns.  Many people are able to obtain significant benefit from doing this reading on their own.  This should not be viewed as a substitute for treatment, but as something you can do while awaiting treatment, or as a supplement to treatment.     

Once your symptoms begin to dissipiate, with treatment, you can then begin to address the life challenges you are facing in regard to your schooling, your professional goals, and the pressures imposed by your family and culture.  By that time, you will have the energey, clarity of mind, and increased confidence to better address these issues.  For now, you need to regain your sense of well-being, and internal peace. 

I wish you the very best of luck in facing this common (but painful) set of human challenges, and I hope my advice has been of some help to you.  Please do write back to keep me posted on your progress, or to ask any additional questions you might have.

Sincerely,

Richard E. Schultz, Ph.D.