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I’m a 16-year-old boy, studying in grade 11. I prefer to stay alone and I don’t usually share things with anyone. Whenever I’m not doing anything, I’m consumed by thoughts, both good and bad. Sometimes, it’s difficult for me to fall asleep. I wake up thinking about things. I sometimes dream about the things I think about and I feel a little off. Is this normal? What can I do to stop overthinking?

Answered by Kapil Sharma, counseling psychologist, Nepal Institute of Mental Health

First, I’d like to thank you for reaching out. Though it might seem alarming, what you are experiencing is common during adolescence as this is the phase when you are discovering yourself and are curious about things as well. It’s completely normal to have a stream of thoughts. It could be either positive or negative. Having said that, if your thoughts become overwhelming or distressing, you might have to do something to manage them.

According to the development perspective of psychology, adolescence is considered to be the time period when there is a conflict between your need for isolation and social interaction. You said you prefer to stay alone and that’s natural. Everyone wants personal space and it becomes all the more crucial during the teenage years. But you must remember that connection is extremely important for emotional well-being and socio-emotional development.

So, engaging in healthy social interaction can be good for your emotional health. It can also help you gain different perspectives which can be a great learning experience and give you a sense of belongingness as well. I suggest you consider striking a balance between personal time and spending time with others. Make sure you have at least a few good friends who understand you. Also, you must have an outlet for your emotions, be it journaling or by cultivating some hobbies that take your mind off things.

As far as difficulty falling asleep due to racing thoughts is concerned, again I’d like to reassure you that it’s quite common, particularly during the teenage years. Establishing a calming bedtime routine can help. Practice relaxation techniques like listening to music, meditation, etc. Maintaining a sleep diary (like recording when you went to bed, when you woke up, how you felt before going to bed and upon waking up, etc.) can help you understand your sleep patterns and eventually help you sleep better.

Recurring dreams are sometimes connected to our subconscious mind, like how we process our thoughts and experiences. If this is causing significant distress, then you must figure out the underlying emotions. What are you dreaming about? What message do you perceive from them? In this regard too, maintaining a sleep journal can help. It will help you understand your emotions better and address them.

If you find yourself thinking too much and unable to sleep despite trying the above-mentioned solutions, then I suggest you seek professional help. He or she can guide you better and help you find a way out of the conundrum.

I’m 22 years old and work makes me anxious. Although I get it done on time, I’m always panicking. I feel like I shouldn’t take a break and start working as soon as I wake up, and need to continue until it’s time to sleep. I feel guilty if I don’t do so. What should I do to overcome this? 

Answered by Kapil Sharma, counseling psychologist, Nepal Institute of Mental Health

First of all, it’s important to understand what triggers your anxiety. There might be a certain reason or incident that pushes you to become anxious every time you think of work. It might be because of money worries, having some uncertainties, fear of failing, or maybe you think your work is quite urgent. It’s important to figure out the reason behind the anxiety.

You need to track down when it exactly started. Was it when you started working somewhere new, or is it because your supervisor changed, or any other reason that might make you uncomfortable in your work environment? Also, you say you panic whenever you have to work. So when does it start? Before, after, during, or throughout your work? That’s something you need to think about as well.  We can only sort this problem out once we’re fully aware of when it started and why it triggers you. 

Once you have figured it out, think about the first thing that comes to your mind when you start getting anxious. Sometimes we assume the outcome of our work based on our past experiences. Maybe something like that triggers your thoughts as well. It’s important to understand if you’re panicking based on facts, or your emotional judgment and assumptions. 

You have also said that you feel guilty of taking short breaks from work. But working all the time isn’t healthy either. Why do you think you can’t take a break? Is it because you are afraid of procrastinating, need to complete everything on your plate as soon as possible, are taking upon work that’s overbearing, or is the work urgent? You need to ask yourself these questions. Also, I suggest you try out a task management tool called ‘Eisenhower Matrix’ that helps you organize your work based on urgency and importance. 

As for your guilt, take a pen and a piece of paper and list down the reasons why you feel guilty. Most of the time, the reasons behind our guilt are just assumptions and nothing more. We can work through it but we need to know what’s behind that feeling. There are cognitive-based training and task management skills that you can get from a professional if you need support. Doing this alone can be difficult. So don’t shy away from seeking help.

In this generation, depression and anxiety have become major issues and it’s high time we take care of our mental health. We should be cautious about mental health as we might not be aware of the potential triggers. Since anyone might go through mental health issues, priority must be given to it. When I experienced it, I understood it. 

Life was going well. I was having a good time and hanging out with my friends and family. Although there were highs and lows, I was satisfied with myself. As I mentioned, everything was going smoothly but one morning I woke up with a heavy pounding heart and didn’t know what was going on. I woke up because I felt a kind of shiver go through my body. I had a strange feeling as I was shivering rather than sweating during summer. The fear was there.

I looked around my room and suddenly felt like I didn’t belong there. I felt detached from myself, the surroundings, and reality. It was a battle with myself. I realized I was having anxiety and what felt like a panic attack. From that day, I started having anxiety frequently which was not normal at all. I thought I could take care of myself but it got worse. In time, I felt completely detached from myself and the world.

Voices were louder than before. I started feeling lightheaded, experiencing brain fog as I felt heavy and numb. I was having trouble thinking. When I was anxious, there used to be pain in both of my hands, like hundreds of needles were being stabbed inside them and my body temperature and heart rate used to increase. It felt unreal. I didn’t know what was going on. I used to cry a lot. When I looked in the mirror, I once had the impression that I didn’t know who I was, that something wasn’t right. That was the time I decided to go see a psychiatrist.

I was already experiencing anxiety while waiting for my turn in a hospital because the voices around me seemed loud and seeing so many people made me feel uneasy. During my session with the psychiatrist, I broke down in tears as I explained to him that if I have to endure these feelings for longer than a month, I don’t want to live. He advised me to give it some time and to keep a positive outlook because everything would be okay. He also recommended medications.

After the visit with the psychiatrist, I was diagnosed with anxiety disorder and depression. Every day was a struggle. I still felt like time was moving extremely slowly, that there was no point in life, and I lacked the energy to face another day during that time. As time went by, I started taking the medications and also went for counseling, and that really helped. Although I haven’t totally recovered yet, I’m getting better. However, there are times when I feel terribly depressed. 

Every day, I suffer mentally in different ways. I occasionally think I’m doing okay, but after a while, I start to doubt my abilities and start feeling worthless. Knowing my symptoms, I used to divert myself if I felt anxious. Walking and reading books were helpful. I used to stand up and walk whenever I felt anxious, and it helped. From my suffering, I got to learn so many things about mental health and how vital it is that we look after our mental health. And it is so important to prioritize ourselves.

Furthermore, to all those suffering mentally, I would like to say that I know it’s super hard but this will pass for sure. At some point, you may feel like you can’t make it and there is no hope but always respond to negative thoughts with positive ones. I know it may feel like a war in your mind but at least try and push yourself. Despite how simple it may seem, this is exhausting. Accepting that you have a mental disease is the first step towards overcoming it. That is why don’t forget that you are doing this for you. There’s always room for hope.

Physical and mental issues exist. Everyone takes medication when they experience physical difficulties, so it’s crucial to consider doing the same if you are experiencing mental issues. Additionally, keep in mind that seeing a psychiatrist and/or a counselor is not a huge thing, and taking medication if necessary is acceptable. This is just a simple reminder that we will get through this and that you aren’t alone.

I wake up in the morning and don’t want to get out of bed. I feel sad and anxious. I have no energy to study, work, or eat. My room is always messy and I don’t feel like cleaning up either. I have no motivation for anything. How do I help myself? 

Answered by Rishav Koirala, psychiatrist and researcher 

Lacking motivation to do anything, or even getting out of bed is common among many people. I went through the same thing around two weeks back. Although I was working, a part of me always felt sad and tired. I didn’t feel like doing anything either. Feelings like this are episodic. Sometimes it lasts a short while, sometimes longer. 

Keeping yourself active is important. Although you won’t feel like it, push yourself to get out of bed and indulge yourself in some physical exercise. It helps our body to release dopamine. You might not see the result immediately, but this will help. The worst thing to do at times like these is to stay put.

It’s important to keep yourself busy at times like these. It will be tough. But that’s where you shouldn’t give up. Sometimes, you need to push through this feeling and get the work done. The more you procrastinate, the worse this feeling will get. Also, avoid being on your own all the time. Go out, hang out with friends, and meet people. That will give you some positive reinforcement. And if you are under medication for any mental health issues, do not discontinue.

Don’t shy away from asking for help. This issue might not be severe, but feeling low all the time is something to be concerned about. Although it might not be depression or anxiety, there are a few diagnoses like dysthymia (persistent mild depression) and postpartum blues (low mood and mild depressive symptoms that begins shortly after childbirth) that have symptoms like these. If the feelings don’t go away even after you have made the needed changes in your lifestyle and have done everything I mentioned above, it’s always a good idea to seek help.