Q: If something was to happen to me my brother would not be able to survive.  I need help. My mother adopted my brother at 13 whom is 21 now.  He had been foster care since he was 2 years old.  They labeled him as mentally ill.  We would hit is head on the wall, get upset and not talk for hours, and walk with his head shaking and hand dangling.  He was in LD classes in school and had visited 33 different schools in his lifetime.  Growing up he moved to main stream classes and currently he is in his 3rd year in college but just started taking regular classes.  My mother passed away in 2007 and it was left to my dad to raise him.  My dad tried to get him help and was told that he could take care of himself.  My dad could not handle it any longer so I took him in.  It took him 7 times to pass his test to get his license.  He does maintain a dish washing job.  The best I can discribe him is he can do things but needs to be reminded and has no sense of reasoning.  Only follows directions but will follow them exactly.  Just yesterday he didn’t understand that if he couldn’t make it to work that he had to let them know.  He thought he could just go in the next day and tell them.  I have remind him to clean his room, and he isn’t apart of the household.  He just stays in his room all the time.  I have realized he needs someone for a lifetime and I can’t provide it.  I am a single mother of three girls and need help.  He needs help with his finances.  I didn’t realize that til he was 500 dollars in the hole and wasn’t paying any bills.  I just don’t know where to start to get him the help that he needs.  Please help.

A: Thanks for writing in for help. I want to commend your for taking in your brother. That is very courageous. It sounds extremely difficult to see no end in sight, and to know how vulnerable he would be in the world without someone to guide and support him. I believe that there are two things that need to happen at this point: 1) access additional support for your brother and 2) find  help and relief for you so you don’t completely burn out.

Does your brother have an official diagnosis? If not, I recommend that you take your brother in for psychological testing and evaluation. Depending on his diagnosis, he may be eligible for additional resources and care through your state, and may qualify for disability benefits. Please consider contacting NAMI (National Alliance for Mental Illness) in North Carolina and inquire about advocacy and support services in your area, and contact your community social services agency here. Your brother may be eligible for some type of supervised housing situation, occupational therapy for life management skills, and other services. Putting some long-term help in place for your brother will hopefully alleviate some of your current burden and decrease your concerns about him if something should happen to you.

In the short run let’s get you some additional help. Can your father take shifts caring for your brother to give you a break on a regular basis? Are there any adult day care services in your area where you could know he was safe? There are resources available. Please reach out for support for both of you.

Take good care of you and yours!

Julie Hanks, LCSW

Q: I have acknowledged the fact that I have an anger problem, but I have not been able to find a way to deal with it. When I get angry I scream, curse, and get verbally abusive with the person that I am angry with. I have broken objects by throwing them across the room or by simply breaking them myself. I have injured myself by punching and kicking walls and random objects. Whenever I try to control my anger I feel light-headed, weak and shaky. After my anger passes I feel frustrated because I couldn’t control myself and break down in tears.

I have seen a therapist before for my anger issues and it only helped me for a couple of days before I was my old self again. While in therapy the therapist handed me a paper with a list of questions, one of the questions being; “have you ever been sexually abused?” I answered no, even though I experienced sexual abuse as a child. When I was 7 I started being abused by a close family member, it lasted until I turned 11 1/2 years old (when I started puberty.) I have never told anybody about it because I feel embarrassed and ashamed of the fact that the abuse lasted for so long. I know that the abuse was not my fault but I find myself constantly blaming myself for it because I never told anyone about it. I’m now 21 years old and I am afraid that I will hurt someone due to my anger. The relationships that I have been in before have not lasted long due to my anger and I’m tired of not being in control of my emotions.

I am seeking advice for what I should do to try and resolve my problem. I know that by talking about my abuse with someone I might be able to let the emotions that I have locked inside out, but I know that I will never be able to talk to someone about it due to the embarrassment that I feel. So I’m kind of at an edge here. Any type of advice would be helpful and greatly appreciated. Thank you for your time.

Click the arrow below to listen to the therapist’s response…

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To find a therapist who can help resolve your abuse issues click Find Help.  Please visit www.malesurvivor.org for more resources to heal from male childhood sexual abuse.

Take good care of yourself!

Julie Hanks, LCSW

*This is my first Ask the Therapist AUDIO response. What do you think? Like it, hate it? Let me know your thoughts.

I was abused as a child, have no sex drive and the one true love has left me (he doesn’t know about my childhood) I want to know if there is any hope for us at all-we never had sex often (twice in a year) he won’t discuss sex as he gets embarrassed and never ever made the 1st move, told me he loves me but not the way a boyfriend should? We both work long hours and shift work, and I have a dog that gets jealous even if we kiss!! but I feel such a failure, and I know we were soul mates, can i get him back? He wont answer my calls, and I was constantly accusing him of having an affair.  I’m absolutely devastated as I feel like I’ve lost the one true love of my life.

A: Click arrow to listen to response from Julie Hanks, LCSW.

Additional childhood abuse resources:
Find a therapist resource
PsychCentral’s Survivors of Abuse Community Forum

Take good care of yourself!

Julie Hanks, LCSW

Q: Hi…My problem is that my boyfriend broke up with me 2 weeks ago. we already planned to go to Hawaii and I have to go because I can’t pay him back since it’s really expensive. We decided to be friends, when I’m around him I want to be his friend and that’s the only thing I think about but when I’m not around him, I start missing him so much. I keep telling myself that I want him to be my friend nothing more, I don’t want to go to back to him and he doesn’t either but I miss him so much and want to be around him all the time. The trip is in 2 weeks and were gonna spend 10 days together there. I’m scared that I will get hurt and after we get back from Hawaii, I will start missing him more and get hurt even more. Please help me, I seriously have no idea of what to do and no one can help me out. I have finals coming in a week and I really don’t want anything to affect my studying.

A: Don’t go to Hawaii with someone who just broke up with you, even if you have to forfeit money. Focus on your studies and on moving forward with your life. This is a chance to learn how to tolerate missing him, and process the grief. You may want to talk with a counselor through your college.

Click the arrow below to listen to my audio response.

photo credit: janineomg

Q: I was with my ex girlfriend for a year and half.  A few months before our breakup she moved a few states away and we tried to maintain a long distance relationship.  I did not go with her, because I was nearly finished with college.  At the time it seemed like a spur of the moment decision on her part to leave the area, but she really wanted to move out.  When she was away, we talked about moving in together and other promising things about our future with one another.  Ultimately, she met someone out there and left me for him.  I was angry and upset and we talked about the situation at length. She said didn’t want to be with one person for the rest of her life.  I told her we should stop talking and said maybe we could be friends down the line.  A couple of months passed and she contacted me telling me heart felt things and insulting her own actions in regards to how we split.  I was excited to hear from her, but I told her it wasn’t a good idea for us to be talking to one another being that I still had feelings and she was still with her new boyfriend.  But, to my fault, I ended up contacted her a few times; sending casual “hi, what’s up?” emails.  She came back home to visit for two weeks and we ended up hanging out a lot.  She told me she still loved me and we were intimate and sexual with one another.  Emotionally though she seemed very back and forth about me and her current boyfriend.  Also she seemed guilty one moment for hanging out with me and then was alright about it the next.  Obviously she is confused and giving off mixed signals, and I feel like I’m being led on.  We have talked openly about the situation before but didn’t really come to a conclusion.  She told me she is uncertain if she is going to continue living there or if she is going to live back in this area.  Either way, I know this situation isn’t healthy for me and I should definitely disengage from it.  But I don’t know what I should or shouldn’t say or if I should even say anything at all and just walk away from it.  Thanks for your help.

A: Thanks for your email. Letting go of a past love relationship can be very difficult, especially when you felt a strong emotional and sexual attachment. I’m glad that you can see that holding on to this relationship isn’t good for you and that it’s time to take responsibility to change.

The underlying question for you to answer is why you are reaching out to and trying to engage in a relationship with a woman who moved away from you, found another boyfriend, clearly states that she doesn’t want to be with one person, and is willing to cheat on her current boyfriend with you. Are you afraid you won’t find someone else to love you? Are you trying to get her to choose you over her current boyfriend?

She isn’t the only one who’s confused and sending mixed signals. You have both sent mixed signals to each other. From what you’ve described, you aren’t far enough down the the road to “be friends” without becoming intimate, so I suggest that you set strong “no-contact” boundaries with your ex and stick with them. No contact means no contact. It’s time to start spending your time developing yourself and seeking a relationship with a woman who wants to be in a committed relationship with you, instead of holding on to an unhealthy past.

Take good care of yourself!

Julie Hanks, LCSW

I am 14 and recently my parents have discovered I struggle with self-injury. After discovering this, they are going to send me to see a therapist to help with the issue. They, of course, know I struggle with self-injury, but I would prefer if they did not hear about it if I tell the therapist when I self-injure. Is this possible, or is it required that they inform my parents when I cut? As a minor, do I have any confidentiality from my parents?

A: First of all, I’m glad that your parents are going to take you to a therapist to address your cutting. Your cutting is a warning sign that something in your emotional life needs to be addressed. While there is confidentiality between client and therapist, there are limits to that confidentiality.  Therapists are required ethically and by law to intervene when a client is threatening serious harm to self.  Since cutting can  range from minor surface scratches to life threatening wounds, and I don’t know how serious your self-injurious behavior is, I am not able to fully answer your question. Your question can be best answered by your specific therapist when you meet with him or her. At your first session, I suggest that you ask your therapist how he or she will handle your disclosure of self-injury.  Because you are a minor, it is likely that your parents will be involved in some way in your treatment. Many therapists will require family therapy  when working with minors because family dynamics often play a part in a child’s distress, and because parents play an important role in the healing process.

My biggest concern regarding your question isn’t whether or not your therapist will tell your parents, but why you don’t want your parents to know the full extent of your self-injury. Is it because you are embarrassed of what they will think? Is it because you don’t want to upset them? Is it because they will be angry with you? Is it because they will overreact? I hope you will address this important question with your therapist.

The fact that your parents are taking you to therapy to get help tells me that they are concerned about you, that they care about you, and that they acknowledge that you are in pain and need professional help. Consider that they may be able to help and support you through this difficult time as you sort through your emotions and resolve the pain underlying your self-harming behavior. You are 14 and it’s their job to make sure you are safe.

Take good care of yourself, and let your parents take good care of you, too.

Julie Hanks, LCSW

This includes my low-stress job, friendships, even parenting.  I feel that I don’t belong and it’s only a matter of time before others find out, which scares me. I believe that this has been going on for several years, but I only recently became aware of it. I know that I felt this way the entire time I was in college, but I thought that it was because I hated my major. I don’t feel like my child is really mine, even though I remember giving birth to her. I’m afraid that if I talk to anyone about this that they will take her away.  I’m currently being treated for depression, but I feel like I’m going to explode trying to bottle everything up. What is going on?

A: Thanks for writing in for help. I imagine it’s incredibly painful, confusing, and frightening to wonder if  you’ll be exposed as a fake.

There is a name for the experience you’re describing — “imposter syndrome” or “imposter phenomenon.” While imposter syndrome isn’t an official mental health diagnosis it has been studied and written about by many psychologists. It’s the inability to “digest” and internalize your own life and accomplishments. Several famous individuals, like Jodie Foster, have expressed similar experiences of feeling like they don’t belong,  they don’t deserve the life they have, and that they will be exposed as a fraud. The imposter syndrome is also commonly experienced by many graduate students. It is a stressful way of feeling about your life and may be connected to or contributing to your depression.

You mentioned that you’re currently being treated for depression. I’m unclear as to whether that means you’re taking medication or you’re in therapy. If you’re not in therapy, please look into individual and group therapy, in particular. I think it would be very helpful to hear that other people experience similar feelings. You may enjoy reading this PsychCentral article Feeling like a fraud, and the book “How To Feel As Bright And Capable As Everyone Else Thinks You Are” by Dr. Valerie Young available at her website ImposterSyndrome.com. Thanks again for writing in and best to you on the road to accepting that this is your life, you’ve created it, and you deserve it.

Take good care of yourself!

Julie Hanks, LCSW

Q: I’m in the first year in university, my story started when I finished high school with high grades but due to money problems I couldn’t attend medicine faculty and now I’m studying pharm.d.

But since I started to study this all people keep asking me why I’m not studying medicine and they feel sorry about me, now I can change my major to dentistry and I’m thinking about attending it because anyway it’s higher than my current major, simply I can just throw off all the people’s talking about me if I do that, actually I’m more interested in practical studying offered in dentistry but I will lose a semester and I will be late, actually I don’t know what I want!
PS: sorry for my language being bad because I’m not a native speaker

A: Young adulthood and the huge decisions that come along with it can be overwhelming. You are not alone.

Your struggle to find your academic and career path are shared by many I’ve seen in clinical practice. There are so many factors to consider and so many people influencing major life decisions that it can be hard to find yourself in the process.

I know it’s difficult, but try to remember that most of the people who are giving you input aren’t going to be in your life forever. The most important person to please in your academic decision is you! You are the one who’s going to be doing the graduate work. You are the one who is going to be going to your job and finding fulfillment or regret, not them.

Have you spoken with a counselor at the university to help guide you through this decision-making process? If you haven’t, I suggest that you do. An academic counselor can help you sort through which educational and career path will be the best fit for you and can help you identify possible financial resources that you may not have considered.

I also recommend talking with professional pharmacists, dentists, and physicians and doing some job shadowing to get a feel for what they do. If you are really having a difficult time deciding, it’s all right to take time off from school to decide, or to switch majors if you find that what you’re doing doesn’t suit you. Yes, you will have lost some credits and it will take longer to graduate, but doing something that you enjoy will be worth it.

Take good care of yourself!

Julie Hanks LCSW

photo credit: /kb

A: Click on the arrow below to hear my response…

Podcast: Play in new window

Here are a few additional anxiety resources on Psych Central:

Find a Therapist Here
Information on Psychotherapy for Anxiety Disorders
Psych Central Community Forum for Anxiety, Panic, & Phobia

Take good care of yourself!

Julie Hanks, LCSW

Originally appeared in my PsychCentral.com column

photo credit: spaceodissey

Q: I’m a 25 year old male. I’ll just start off by saying that opening sentences take me sometimes hours to write (this one took ten minutes).  The same goes for my life – I just can’t seem to get anything started:  Job applications, writing routines, relationships with the opposite sex, you name it.

The only thing is, I usually succeed once I get started.  So, I’m trying to figure out why I can’t get things moving.  I graduated college almost a year ago and have only applied to about 5 different districts (I’m a state-certified English teacher) out of the hundreds in my state.

I also still live at home with my parents, and although they have threatened to kick me out, I usually find temporary work just in time to save myself.  Although I used to get 95% of my college schoolwork done here, I can’t seem to get focused when it comes to applying for jobs or keeping in touch with love interests or former colleagues.

Home-wise, there’s no major problems.  I’m comfortable here, and I don’t have to pay rent.  I don’t always have the sense of independence I want, but I’ve learned how to deal with it, just like I have learned how to deal with sadness, anger, guilt, and anxiety.  I focus on something else.  But I feel like it’s starting to get trapped inside, to a point where I will never be able to express myself.  I feel like this will cause me to regret everything later in life.

The main thing is that I know exactly what I have to do in life to move forward, but I just can’t seem to do it.  I don’t even have a logical explanation why – I just don’t.  Same goes for relationships. I was talking to a female friend who I have liked for over a year, and we mentioned our feelings for each other because we’re currently seeing other people (so it was means for conversation).  She asked if I had liked her, and I said yes.  When she asked “Why didn’t you tell me?” My honest answer had to be “I’m at a point in life where I’m just not acting on anything.” Tension followed, and I felt a little regretful afterward, but then I told myself not to dwell on it.  So, I don’t.  I’m not really feeling anything about it right now – that has all passed.

Do you think that my outlook on life (not to dwell on my past) is affecting my future?  I feel like the more I say the past doesn’t matter, the more I’ll act exactly like I have been, and I’ll only end up stuck.  I want to be 100% independent, not because of man pride or anything, but because I’m ready to live my own life.  How do I start?

A: Yes, I do think that your pattern of not examining the past IS affecting your future, but the real question is what are you most afraid of finding if you do look back and if you do feel?  Are you afraid of failure? What is your biggest fear if you did openly express yourself to your parents?  If you don’t have healthy ways to process emotions that come up in life they will likely build up over time and manifest in self-destructive ways. My guess is that this pattern is a large part of why you are feeling so paralyzed in your life.

Look for healthier ways to deal with your emotions. Consider journaling your feelings, joining a men’s therapy group, or talk with an individual therapist to help you get to the emotional root of why you’re feeling reluctant to start your adult life. Cultivate encouraging and supportive male friendships. Exercise to relieve stress, improve mood, and feel a sense of accomplishment and power. You mentioned that you don’t have the sense of independence that you want but you’ve “learned to deal with it.” Your sense of independence is paramount at this stage of life so I encourage you to foster that desire, not to relinquish it. It is important to take action, even if it’s clumsy and things don’t turn out perfectly. Ask out the woman that you’re interested in, send out 5 job applications every day, speak openly with your parents about your feelings, start paying them rent or pay them by contributing to the care of the home and yard. If usually feels better to act, even when you don’t feel like it, than to feel powerless in your own life.

I have a few questions about your parents. Why are your parents letting a capable 25-year-old adult son with a college education live in their home rent-free? Is it possible that they are enabling you to stay “stuck” at home because they are afraid of you leaving? Are you a buffer or a distraction that keeps them from dealing with marital problems? There may be some family issues contributing to your current dynamic.  Again, consider seeking help from a therapist to help you understand and resolve your internal struggle and understand any family dynamics that may be adding to your difficulty “growing up.”

Take good care of yourself!

Julie Hanks, LCSW

Originally appeared in my PsychCentral.com column

Well, I’m 15 and I’m really sad because my brother always gets everything he goes and sees my dad and gets £30 or more of him every time he gets money for stuff as well everyday and when I go and see my dad all i get is a £5.  My brother also got a xbox connect of my dad. I asked my dad for a xbox 360 and he said he has no money but he always gets my brother stuff and when my brother comes home he brags about it and I’m getting fed up of it. My birthday comes and all he gets me is a little ornament I don’t want to seem ungrateful its just he treats my brother different to me he should treat us both the same but he don’t. I think its favouritism.

A: I can see why you are so confused and sad about not being treated fairly by your father. Dads are the most important male figure in an adolescent daughter’s life. Consider talking with your dad about your hurt. Start by expressing gratitude to your dad for what he has provided for you. Then, gently call his attention to perceived differences in the way he treats you and your brother. Be sure to use “I” statements as much as possible and avoid using accusations like “you always…” and “you never…”. An example of this is “Dad, I feel sad when you give my brother more money than you give to me because I’m afraid it means I’m not as important to you.”

Another issue here is the competitive relationship with your brother. I can’t help but wonder what’s behind his bragging. It sounds like neither of you live with your dad, right? Do either of you have a fear of losing touch with your dad or of not being important to him? Is your brother exaggerating the gifts from dad so he feels more secure about dad’s love for him? I have more questions than answers here so feel free to write back.

It sounds to me like the core issue behind the money and gifts is your hurt and fear about not being as valuable to your dad.  The first place to start is sharing those feelings with your dad and asking for reassurance of his love.

Thank you so much for writing in and asking for help. Please let me know how the conversation goes.

Julie Hanks, LCSW

Originally appeared in my PsychCentral.com column

The problem that I have is that I’m not sure what’s wrong with me. Last summer, I tended to wake up without any emotion at all, then I would be all depressed and thinking I’m fat. Around 1-4 in the evening, I would become apathetic and it would feel like I didn’t have any more feelings. Then, around 6 or so, I would have emotions again. I don’t know if there is anything wrong with me. Sometimes I feel like I have no emotion at all and then out of the blue I start to have emotion. It feels like I overreached my limit to how much I can feel at one point and then I have to wait for my emotions to heal or something. Is there a limit to how much I can feel? Is there a limit to how much I can feel one thing? I feel really bored a lot of times but I still have a lot to do. Sometimes, though, it feels like I have to force myself to feel feelings and emotions. I don’t know if there is a problem or something.

A: It does sound like there is a problem, but I need more information before I can provide an answer for you. I suggest that you get in to see a therapist for a mental health evaluation for depression. Feelings of emptiness, lack of enjoyment in life, and focusing on negative thoughts such as “I’m fat” may be symptoms of depression.

I’m curious what was happening around you or inside of you when you’d start to feel again. What activities were you engaged in? How would you describe the transition from “not feeling” to “feeling”? I also have questions about what it felt like to have “no emotions at all.”  Also, I’m curious about your relationships with family and friends and how you’re functioning in other parts of your life, like school or work.  Please write back with more information if you’d like additional advice. Until then, I urge you to seek therapy to help you get to the bottom of your confusing emotional patterns and start working toward enjoying your life.

Take good care of yourself.

Julie Hanks, LCSW

Originally appeared in my PsychCentral.com column

Q: I had naturally been apprehensive to meat when I was younger. I liked to eat, but I didn’t really like meat (aside from the taste). Then, 6th grade came along, and I started having problems: depression, (the past, not now) suicidal and many other things. Along with that, a lot of changes were entering my life: I was about to enter junior high, and I had insomnia. Then, I decided to become vegetarian and anorexic. To tell you the truth, I wasn’t a complete vegan at first. I was “98% vege”, meaning that I ate hotdogs/hamburgers/chicken nuggets/bacon/top ramen soup. In seventh grade, I became full-fledged vege, and continued to have problems. In eighth grade, I turned my life around, and was the food nazi: no food additives, no meat, healthy as you can be.

Then I started running in 9th grade, that brought problems of enough energy, so I just ate more. (Oh and I have ran ever since in xc and track up until senior year 2nd semester, now I am training for a marathon). 10th grade came, and I found out that cheese had rennet….so I stopped eating it. 11th grade came, and I learned about gelatin….stopped eating it. 12th grade 1st semester: (btw, I was slower this year), I have stopped eating yeast (they eat things unlike plants, they seem too much like an animal).

Now, I am scared to eat eggs (not because anyone told me anything which I DON’T WANT TO KNOW), or anything with them in it: bread, pasta, brownies….Right now I am reduced to potatoes/rice/beans and some fruits/veges. I want to eat yeast again, and I might want to eat the things with eggs in it (because I used to LOVE pasta and bread)….thing is, I can’t. I am not that caring of a person, I am just slightly autistic and I have sensory issues and images get burned easily in my mind…. What should I do? Oh, and is this more of a mind issue or food issue?

A: Thank you so much for reaching out for help The short answer is that your food issues aren’t really about food. From what you describe, 6th grade was somehow a turning point in your emotional life and you developed depression, insomnia and anorexia. I’m curious about what happened that year. Was there an event or situation that triggered your symptoms? Were there changes in your family or environment?

You mention that in 8th grade you “turned your life around,” and yet you continue to become even more strict about your diet. Controlling what you eat and the size of your body can be a way to gain a sense of control when other parts of life seem out of control.  Focusing on food can be a way to manage intense emotions or a way to numb your emotions in general. I encourage you to get into therapy with an eating disorder specialist in addition to meeting with your doctor for a thorough physical evaluation. To find a therapist in your area click Find Help at the top of this page.

Your food obsession is a sign that you have intense unresolved emotional pain that needs attention, and that you are likely suffering from an eating disorder. Please, seek help so you can heal from your food obsessions and learn healthier ways to cope with the difficulties that you’ve experienced in your life.

Take good care of yourself.

Julie Hanks, LCSW

Originally appeared in my PsychCentral.com column

Q: I’ve been sitting here for 30 minutes trying to formulate my thoughts into a paragraph but I can’t do it so I’m just going to list feeling as they come to mind.

1. I feel nothing on a regular basis. For example if I got a call saying that my mother died, I don’t think I would even cry.
2. I’m irritable beyond belief. If someone asks me to do something I get pissed for them even asking me.
3. I’m not suicidal, but I constantly question why I’m living and try to come up with reasons to continue on.
4. I don’t see people as individuals. I see everyone as a mammal, which leads me back to number 3.
5. I want to ask my parents, or anyone for help, but I’m afraid of being laughed at.
6. I don’t even try to interact with girls. I’m not homosexual at all, I’m still attracted to girls, but the effort I need to put in to get an outcome is unbalanced.
7. I observe everyone’s actions with relationships and reasoning and feel like everyone is, for lack of a better term, retarded.
8. I bite my fingers all the time, not just the nails, but the skin around it. After searching the internet I found over-focused ADHD which I believe I fit all the symptoms of.
9. I smoke weed. I’m not addicted to it, but it is the only thing that makes me happy. When I’m high my constant racing thoughts calm down allowing me to live normally.
10. Sometimes I get stuck on negative thoughts and experiences. For example, if I call a friend and they don’t answer I immediately think they are ignoring me and go into a downward spiral of depression until I hear back from them.
I’m sure there is more but as it is it took me an hour just to get those 10 down. Please help with some kind of advice.
Thanks – Lost Teenager

A: Please reach out for help from your parents as soon as possible. Ask them to take you to a psychotherapist or psychiatrist to get a mental health evaluation.

Though I can’t diagnose you without seeing you in person, I can tell you that what you are describing sounds to me like depression — the empty feeling, the extreme irritability, and the difficulty finding a reason to live, social withdrawal, and negativity. The good news is that there are several very effective treatments for depression, including cognitive behavioral therapy, psychodynamic therapy, and medication treatment. If your parents have generally been supportive of you in the past, they will likely respond positively to your request for help. If for some reason they aren’t supportive, please reach out to another adult, like a school counselor, for help. You don’t have to live the rest of your life with this much emptiness and disconnection.

Take good care of yourself.

Julie Hanks, LCSW

Originally appeared in my PsychCentral.com column

Q: I am a 17 year old High School student and I have felt this conflict my entire life, but only now can I ignore it no longer.

Amidst all of the discussion about college and ‘finding the right fit,’ I have realized that the major internal problem I have is that I lack an identity, lack interests, lack emotions, and therefore have trouble with social interaction. I am hopelessly apathetic at heart, and I don’t know how to reconcile the true ‘me’ with the image others expect–that of a ‘normal’ person who has passions and desires. I care about nothing–not politics or current events, not my friends or family or other people, not sports or music or art. Outwardly, I am a high-achieving, well-rounded student. I do well in every subject and participate in a variety of extracurricular activities, some of which I hold leadership positions in. However, none of them truly interests me, and I only continue them to get into college. Nothing ‘outside’ school much concerns me either. The various problems of society don’t matter to me, even when I’m affected. Occasionally a particularly poignant tragedy or example will make feel like helping out, but on the whole, I am completely apathetic. The same goes for the social aspects of my life. My childhood, family, and friendships were and are normal, but I do not have emotional connections to anyone; if somebody ‘close’ to me died, I would only be concerned with how it would affect my own convenience. I don’t have any academic, athletic, or arts-related interests either, and I do not believe the problem is lack of exposure. The only things I like to do are things that make me forget my existence and consciousness–playing games or reading a book or watching television, but the appreciation I have for those things is completely aesthetic and surface-level.

Left alone, I would be fine with this situation and content with engaging myself in passive activities for the rest of my life. However, society demands interaction. I sometimes have difficulty projecting the ‘right’ appearance in conversations and social interactions because I never feel anything (happiness at a friend’s success, sadness at someone’s death, gladness when someone praises me). Most days I do not have trouble interacting with people, but the times when I ‘mess up’ cause me great consternation because I am somewhat of a perfectionist and do not want people to think of me badly. I do not believe I have a social disorder because I understand what people mean and what kind of reaction to give–I just cannot act out that reaction because I do not truly feel it and I do not have enough acting prowess to express that emotion believably. People occasionally comment that my expression is too serious (that’s my default expression–blankness that is misinterpreted as seriousness, sadness, etc.), that I do not smile–in fact, I barely move, because I have trouble acting out body language as well even though I know what the proper response is. The emotions I do feel in social interactions are solely derived from self-consciousness–did I smile enough just then? Do I look relaxed? Most of all, do I look NORMAL? This kind of nervousness impedes my acting and therefore my daily interactions. Because I want to look what ‘normal’ is in any situation, I project different personalities to different people, causing conflicts when I deal with them together. I cannot just ‘let things go’ and be who I am–silent, still–in public; I want to look normal, but I can’t seem to force my body to comply.

What should I do? I want to make my social interactions normal so that I can live more conveniently–’conveniently’ in this case means in a state where my physical needs are attended to and I am left alone and not thought about much by others, where I fit in, so that when alone I can drown myself in fiction and escapist activities. If I have a disorder or psychological problem with this lack of emotions–perhaps a refusal to recognize them?–I want to be able to deal with it. However, I don’t think I could deal with speaking to a counselor in real life because my guard would always be up, always trying to act and never expressing what I truly mean. I won’t be trite and say that I am spiraling down into darkness, but this problem truly does bother me.

A: It sounds extremely exhausting to be constantly on guard worrying about the appropriateness of your social interactions, especially when your internal state doesn’t match your behavior.

I’m so glad that you are reaching out for help to find your way through this confusing situation. Yes, it does sound like there is a problem going on, either psychologically or medically. I recommend that you seek help from a counselor to get an evaluation, and to get a thorough physical exam from a physician. There are many medical and mental illnesses that can cause the blank feelings that you’re describing and the feeling of disconnection and despair. While I can’t diagnose you based on an email, the emptiness that you are describing sounds like severe depression. To learn more about the symptoms and treatment for different types of depression click here.

You mentioned that you’re not sure you can put your guard down with a counselor, but keep in mine that psychotherapists are trained to help you lower your guard over time, to help you get to the root of the problem, and to help you develop skills to live a more fulfilling life. Additionally, a therapist can help you resolve any life events or relationship problems that may have contributed to shutting down your emotions and help you to reconnect with who you are, how you feel, and what you want.

I have seen many clients in my clinical practice develop the disconnection that you are describing after experiencing trauma or loss as a way of protecting themselves against further pain. If you need help finding a good therapist in your area click the Find Help link on PsychCentral. Don’t wait. Life and relationships can be much more rewarding than what you are currently experiencing and there are many, many resources available to help you. Please let your parent, guardian, or school counselor know that you need help so they can support you and help you.

I urge you to get professional help so you can reconnect to your emotions and find joy and fulfillment in your life.

Take good care of yourself!

Julie Hanks, LCSW

Originally appeared in my PsychCentral.com column

Three days ago I found out that a year ago my husband sexually abused my daughter. I don’t know what to do I love my daughter very much and I love him I will protect her at all costs, I have put locks on her door locks on the bathroom and she is not left alone with him. I confronted him but he denies it stating he loves our baby very much and would never hurt her. I want to believe him but I could never not believe her. I want to know if our family unit is savable would therapy help what should I do. I don’t want to be a bad mother and I don’t want to lose my family.

A: I can’t even imagine how painful and confusing it is for you to hear that your husband sexually abused your daughter. In spite of your overwhelming feelings and confusion about who to believe, you are required by law to report the suspected abuse. Here is a link to the Florida Abuse Hotline so you can report it immediately and they can begin investigating. As your daughter’s mother, you must protect her first, over your husband and over your marriage. How you handle this situation, and whether or not you believe her, support her, and protect her will largely determine how well she recovers from the trauma throughout the rest of her life.

I strongly suggest that you immediately ask your husband to find a temporary place to live until the abuse investigation has been completed in order to protect your daughter, and that you get your daughter into treatment with a therapist specializing in sexual abuse as soon as possible. Click the Find Help link at the top of this page or ask for some recommended therapists from the department of children and family services when you call to report.

I have so many questions for you. How did you find out? How old is your daughter? Is your husband your daughter’s father or stepfather? Does your husband have any history of sexual offenses? But all of these questions are secondary to protecting your daughter and to reporting the alleged abuse. Reporting and protecting will likely require you to put your own fear of losing your marriage and family on hold temporarily so you can take the necessary steps to protect your daughter.

I don’t know whether your family is salvageable because at this point there are too many unknowns. If your husband did in fact abuse your daughter, he will need to participate in intensive treatment, face the legal consequences for his abusive behavior, and take responsibility for his abhorrent behavior. Even then, a large determining factor will be whether your daughter wants to have any kind of a relationship with him.

The most important and immediate factor here is protecting your daughter and doing what is in her best interest. So again, here is my recommendation for your course of action:

1. Report the alleged abuse to Child Protective Services
2. Ask your husband to live elsewhere while the facts get sorted out by the authorities
3. Get your daughter into treatment

I wish you well in this extremely difficult situation. Take good care.

Julie Hanks, LCSW

Q: Hello, I am a 16 year old Sophomore in high school. For the past 5 years I have struggled with addiction to self injury, depression and ADHD.

My parents refuse too believe anything is wrong with me and every day scream at me and break things as well as insult me about how useless I am and how I am always ruining their lives! My friends all say that I’m amazing and such a good friend but I have a hard time believing them when my OWN parents seem to hate me…My grades have gotten a lot worse because my parents deny that I am ADHD even though my doctor has said I need therapy and medication.

I failed three of my classes and the fights and insults got worse, my parents took away nearly everything I had and I almost committed suicide twice, My doctor finally told my mother I NEED to get therapy so she did reluctant, and told me the entire way about what a failure I am.

I went to therapy for about 3 months and stopped, my therapist was ignorant and treated me like a little kid. She blew off how I was upset about my parents and my hair falling out due too PCOS and being diabetic. I hate my parents but I love them at the same time… they always yell at me and get angry and things I don’t do and forget… I have ADHD and it’s not my fault! but they just yell a me about how I use it as a crutch. Right now I am not allowed to go out with friends and am constantly threatened that if I don’t start getting straight A’s they will take away my desktop and my books… I’m scared because I just keep hating myself even more! I can’t sleep at night and I can’t concentrate in school, I keep having mental break downs and freaking out and am nearly ready to start cutting again because it makes me feel amazing, I’m scared but my parents don’t care! I’m tired of working my butt off just to get yelled at and I really don’t know what to do anymore…. My school even won’t do anything when I talked to my teachers, I am really lost.

A: Thanks for reaching out for help to figure out how to manage your feelings of loneliness and hopelessness and stop your self-destructive behavior.

It’s not uncommon for adolescents to love and hate their parents at the same time when they feel invalidated or misunderstood. It sounds like you and your parents aren’t sure how to help you. My guess is that they’re very scared and are trying to motivate you by grounding you from friends and threatening to take away privileges, which in turn makes you feel punished and hopeless.

Don’t let the fact that you didn’t connect with your therapist before discourage you from seeking therapy again. If you don’t want to go back to the therapist you’ve seen previously, ask your mom, your physician, or a school counselor to help you find another therapist who you feel more comfortable with. Self-injury, suicide attempts and failing grades are all signs that you need professional help as soon as possible. Please don’t wait. To find specific therapists in your area, please click the Find Help link at the top of this page.

In addition to individual therapy, I highly recommend family therapy. Your family can learn new ways of relating with each other and dealing with conflict, and healthier ways to manage emotions. The therapist can also help your parents learn options to support and motivate you other than putdowns and punishments, and can help you understand and express your deeper feelings and needs to your parents in a way that your parents are more likely to hear.

It sounds like you’re trying to tell your parents, through your symptoms, that you’re in a lot of emotional pain, and instead of hearing your pain they’re seeing your choices as “bad behavior” instead of as a desperate cry for help. A family therapist can help you and your parents understand what’s going on below the surface for you, and help you understand your parents’ fears and intentions. The fact that your mom was willing to take you to therapy before is a sign that she recognizes that therapy can be valuable, and that is a good sign. Please talk to her and get the help you need as soon as possible.

Take good care of yourself.

Julie Hanks, LCSW

Originally appeared in my PsychCentral.com column

Q: My son is now 13 and had been diagnosed ED / ADHD since he was 3. I was a single mom the first 4 years of his life, and married when he was four.

I now have two other boys, 2 and 4, and my husband and I are struggling to deal with the oldest’s behaviors. It is actually causing me to be very depressed at times and it is straining our marriage. I’m not sure what I can do, to help him and us. I feel like I’m going to literally lose my mind on a daily basis. I end up snapping at everyone or not dealing with normal issues, because I feel so overwhelmed.

My son’s therapist suggested I see someone, but I don’t know if that’s the right thing I need. Help? I’m afraid of losing my son to his illness, my husband because of the difficulties with son, and my sanity in it all.

A: Thanks for reaching out for help. You’ve hung in there a long time with your son’s illness and it sounds like it’s wearing you down emotionally.

I’m glad to know that your son is in therapy, and from what you’re describing, it sounds like it is time for you to get some help. I suggest specifically being assessed for depression and anxiety. The irritability, overwhelming feelings, and fears you’re describing deserve attention and treatment. It’s common for parents of children with chronic mental health issues to feel discouraged, down, overwhelmed, and scared. It’s also common to feel isolated, alone, and helpless.

After seeking support for you, I recommend accessing additional help for you and your family. Since you already have a relationship with your son’s therapist, he or she may be an excellent referral source for additional support services. Have you discussed with your son’s therapist your need for specific skills to manage your son’s behavior, or requested to include the family in the treatment process? If your son’s therapist isn’t comfortable with family therapy, ask if there are any recommended colleagues who work with marriage and family issues. Also, ask your son’s therapists for book recommendations about your son’s specific struggles. If you haven’t already done so, it may be helpful to read about your son’s illnesses, and encourage your husband to do the same. Gaining more understanding about what your son is going through may help you frame his illness in a more manageable way, help you less overwhelmed, and help you feel more prepared to support him.

Check with your local school district about parenting classes and support groups for children and families with ADHD and other behavior problems. If you’re feeling overwhelmed by my suggestions, ask your husband to help you research additional services to help your family during this time of crisis.

Take good care of you and yours!
Julie Hanks, LCSW

This post was originally published on my PsychCentral Ask the Therapist column

Q: First off I would like to thank you for taking the time out to help me. But the problem is I’m depressed but nobody knows it.

Half the reason I am is because I have no really close friends to hang out with or etc. While everybody is usually going to the movies, the beach, or somewhere fun I’m at home. My mother has started to notice it, she always suggests I hangout with my friends but truth is I don’t have the heart to tell her I don’t really have any. It started at the age of 11 when I started to notice I didn’t have a lot of friends like all the other kids did.

I have tried on several attempts to makes friends, but all miserably failed. I try not to be clingy or to appear desperate. I think I have been cursed not to have any friends and it kills me every single day. I don’t wanna go talk to a counselor in person, it makes me feel even more abnormal. And I don’t wanna tell my parents because they’ll feel bad for me and I hate it when people feel sympathy for me.

I’m just tired of feeling so alone all the time, I mean it used to not bother me as bad but now that I’m getting older it really has taken a toll on me. I just wish I had somebody to talk to, or to share my feelings with. I’ve tried to make friends before but I’m probably what you could call a “outcast” I don’t really fit in and it really does bug me.

Another reason why I’m depressed is I get made fun of a lot. Every time I got to school I get called fat, ugly, pig, horse face, I know I shouldn’t let it bother me but it does. It gets so bad sometimes that I feel like just running to the bathroom and cry my eyes out. Getting made fun of has really taken a toll on my confidence as well. I used to be really confident now I can’t even stand looking at myself in the mirror.

Another thing is I always compare myself to my cousins. I mean I’m the youngest of the family. All of my cousins are gorgeous, have an abundance of friends. They always have someone took talk to. They don’t know it but their the only ones I hang out with. I haven’t been to an actual friends house in over a year. Which is pretty bad if your my age. I just wish I could be happy and perfect like they are.

Thank you for listening and really do hope you respond, because the truth is this is my only hope. And again thank you for taking the time out to read my “story”.

A: Thanks for reaching out for help so you can start to feel better. It is painful, especially during the teen years, to be excluded from peers and to feel on the outside of social events.

I feel bad that you’ve been so mistreated by your peers. No one deserves to be bullied, made fun of and tormented, including you. If this is happening at school, please reach out to a counselor or administrator so they can help put a stop to this cruel behavior and make sure that they keep your identity private so you don’t have to suffer retaliation from peers. Their behavior is unacceptable.

I’m curious about your comment, “I hate it when people have sympathy for me.” Sympathy and empathy are ways that people express love and concern for you, which is what we all ultimately want and need. I know it feels like a huge risk, but the only way to help the loneliness is to let someone in and share your painful feelings with — your parents, or a trusted teacher or school counselor. Please let someone know how down and alone you feel. Please talk to your parents about your depression and ask them for help in finding a counselor in your area who works with adolescents. Also, your parents or counselor can help you find an adolescent therapy group to help you practice relating to peers in positive ways, help you understand why relationships are so difficult for you, and develop the skills to build and maintain strong friendships.

It’s hard to believe, but your life can get better and you can have meaningful relationships, but the first step is to let someone in your life know about your pain and ask them for help.

Take good care of yourself.

Julie Hanks, LCSW

Originally published in PsychCentral.com’s Ask the Therapist

Hi. At last I have found one good place to open up myself. I’m going through the very common quarter life crisis… And I’m really confused.

A little of background about me. I’m from India and 26 old. As typical orthodox family in India my parents started seeing for marriage proposals. During the same time I started liking a friend in my office. It was around after 3 months I felt within very strong feeling towards him. I proposed to him but he was not ready for commitment. I decided to wait for him and be friends with him. But after that he happened to meet a gal and she fell in love with him and proposed him too. Things went worse in my life – seeing her being and mad about him. After 2 and half yrs. he decided to go ahead with other gal and coincidentally my parent were able to find a good marriage proposal at the same time. He got married to other gal and i went ahead with my parents. After this, the marriage proposal also didn’t go well, as I found the guy to be very rude and never understanding me. I decided to quit it and conveyed to my parents, and after a lot of discussions, my parents dropped it.

During all these tough time in life I had a very good friend who supported me and understood me and cared for me a lot who proposed me for marriage as well but I never had any feelings for him more than as a friend. I’m really confused what I should do. I always wanted my life partner to be as a good friend and lover and I’m not sure whether my feelings would change towards him. Any guidance?? Please help me. I’m really worried to go ahead with my parents marriage proposal again. I don’t like anyone in my life now.

A: What a difficult situation you’re in. While I am unfamiliar with the cultural norms of arranged marriages in India, I do know that it’s painful to have a man you love choose to marry someone else. If I’m understanding your question correctly, you’re wondering if you should marry your “good friend” with the hope that romantic feelings develop, or if you should go ahead with the arranged marriage with to a man who doesn’t treat you well. A man who treats you poorly during courtship is likely to continue to mistreat you after marriage. If your parents agreed to “drop” the arranged marriage after you shared your concerns with them, then I suggest you let go of that relationship for good and seek out other options for marriage.

There is a third option I’d like to suggest and that is to not move forward with either option. Please take some time and figure out what you value most in your life and what you want in your relationships. The decision to marry is one of the biggest and far-reaching decisions you’ll ever make. You may want to consider continuing to date your “very good friend” nonexclusively and see if any deeper feelings develop, while you continue to meet other people. While romantic feelings can develop over time, there’s no guarantee that they will. Since it seems that your parents responded to your concerns before, I encourage you to consult them again and ask for their help in finding other men to court.

Take good care of yourself!

Julie Hanks, LCSW

Originally posted in my PsychCentral.com column