Patient: So like. I’m 16 and doing my GSCE’s I’m rather behind in coursework and can be a little stressed out. For the last year or so I’ve been feeling as if I feel nothing. I used to self-harm. There is a rather intense backstory I hate explaining. I don’t know. When I’m happy, yeah I’m happy. When I’m depressed I isolate myself from everything and keep eating off the feeling. When I’m bored I get the urge to just kill someone in the most horrific way possible. I dis-like, if not hate most of my family. I’m pretty sure they resent me. My father’s told me die lots etc. I have really low self-confidence and self-esteem. (Idk if they’re the same thing) I would get help but I’m far too shy and I can’t identify anything to go for help about. My only girlfriend has cheated on me 5 times. She’s broken my heart many times over but I’m still with her. I just don’t know what the hell is wrong with me. I’m so confused about the way I feel. I feel like there’s nothing inside me. My self-worth is immensely low. And keeps being lowered by my father. I have spoken to childline about my home-issues and they suggested that I consider being re-located via Social Services. However I don’t want to re-start my whole life. As I have 3 friends who have accepted me for me. : I just don’t know. Is there anything wrong with me?
Doctor: From what symptoms you explain it sounds that you may be having some kind of depressive episodes or dysthymia ( ie overa ll low mood, lack of interest and initiative over 2 years) or just some adjustment and stress issues. It really is difficult to tell you about what you exactly have as for that I would need to talk to you further and understand your situation.However you also said that you have low self esteem and confidence along with the above mentioned symptoms. I would advice you the following- Try talking and confiding in a confidant or some one you can talk openly about these issues with. Sharing your thoughts and ideas will help releive some of the stress you are experiencing with regards to these matters. This person can be anyone: either one of your 3 friends or a counsellor at school.-Contact and book an appointment with your family physician for a more indepth analysis of your symptoms. There is medication as well as psychotherapy which can help treat this and is effective.- Contact childrens services again if you feel the situation at home is becoming worse and is causing you more distress.Moreover having said this it is important to note that many adolescents in this age group go through similar if not the same symptoms and it many a times attributes to the stresses of home , school, peers and relationships during this phase. In case you have any thoughts about hurting yourself or other I request you to seek help wither from your friends / counsellor/ family physician and talk about it.