In episode 300, I received a question from a listener who’s feeling completely alone, unsure of what they are feeling, and therefore struggling to know how to ask for help. In this post, I break down the elements at play here and take a look at how you can take steps toward asking for help.
Hey Duff, Im an 18 year old male and I have no idea what’s going on with me. I always have this sinking feeling in my stomach. I can’t sleep and I always feel so alone even with people that I love. I want to ask for help but I have no idea what to say when they ask what’s wrong with me. Thank you for the podcast it really has helped me understand a lot.
Hey, man. Thank you for writing in. I am particularly proud of you as an 18-year-old man for writing in to the show and trying to pay attention to these issues. It’s an unfortunate reality that a lot of stigma continues to exist when it comes to mental health issues in men. The fact that you said you want to ask for help is awesome. If you’re open to getting help, that already puts you in a different category. There’s a good chance that you can make some serious progress and pull out of these gross feelings you have. Let’s talk about some possibilities about what is going on here.
Understanding what’s going on
At 18, you are in an interesting phase of your life. I’m not sure exactly what you are up to in life – whether you are a student, in the workforce, or some combination thereof. For many people, this is a period of life where you are starting to have more responsibilities and independence. Life starts to become more “real”. It could be the case that you are running into some emotional difficulties as the result of these transitional aspects of life such as trying to figure out what you want to do for work, applying to schools, considering a relationship, moving out on your own or taking steps toward doing that. Again, I’m not sure what you are doing with your life at the moment, but there are plenty of common reasons for feeling a lot of feelings when you are at that age.
Even if there aren’t identifiable stressors or contributors to your current situation, that doesn’t make them any less legitimate. Even in our diagnostic manuals, there is something that we call adjustment disorder, which basically recognizes that someone is having clinically significant mental health symptoms, but it’s not due to a chronic condition like recurrent major depression or bipolar. Instead, it’s due to the circumstances of someone’s life. This can happen during transitional periods like going off to college, switching careers, or even something like moving to another state or country.
I don’t want to overinterpret too much here based on what you mentioned. But the sinking feeling in your stomach is a common sensation that many people with anxiety report. That feeling of the bottom dropping out like when you get really bad news. That’s common. People with anxiety often talk about a feeling of impending doom. The sleep disruption, loneliness, and persistent feelings of sadness or emptiness sound a lot of like depression. Nothing you are describing here is completely off the wall. It’s also plenty for you to be concerned about. I think it’s important to remember that your own experience and subjective feelings matter.
A lot of people do not seek help because they don’t feel like they are “bad enough” or they don’t have the perfect narrative to describe how they are feeling or why they are feeling the way that they do. You don’t need to be suffering worse than anyone else to seek help. In fact, a lot of the times it’s actually better to seek help before you are in a really bad place. Nobody wants you to have to hit crisis or rock bottom point before starting to get better. You also don’t need to fully understand what is going on with you. That’s one of the points of getting professional help. They can help you sort through that. You know what you feel. You feel lousy enough to be concerned. You are uncomfortable enough to write into a podcast and to consider getting professional help.
How do I explain what I’m feeling and ask for help?
In terms of what you can say, you’ve already done a pretty good job in this question. You don’t need to know the conclusion. You need to tell them what you are experiencing. I would encourage you to start with your primary care doctor. As always, you will want to make sure that you rule out the simplest possibilities first. Those would be that there is something fully understandable and identifiable that you are responding to, or that there is something physiological going on that is making you feel the way that you are. For example, if you were living in an abusive household, anxiety would be totally called for to keep you safe. There are also some physical issues like low testosterone, thyroid issues, anemia, or autoimmune disorders that can make you feel symptoms that mimic those caused by psychiatric conditions.
So you make an appointment with your primary care doctor. When you call and they ask why you would like to make an appointment, you can simply say that you have been having trouble emotionally, that you are not sleeping well, and that you are having a general hard time and you want to try to get some help because you aren’t sure if it’s more of a physical or psychological issue. When you get in with the doctor, they will ask what is happening and you basically explain it the way that you did for me here. Tell them you having been having a hard time. That you aren’t sleeping well. That you feel down and sad and lonely even though you don’t think you “should” feel that way. That’s basically all you need to do to get started. They should be able to take over from there and ask you some questions. They will ask if there’s anything going on in your life that could be causing the issue. They might ask about family history or if you’ve ever had psychiatric issues before. If they don’t ask about any physical issues, you can always speak up about it. You can say that you’ve heard sometimes there are hormonal or vitamin issues that can cause emotional difficulties and ask if they think you should do some blood work to look into it.
I should also jump in here to say that substances are also something to consider. If you are drinking, smoking weed, or using any other substances, those can definitely impact your mood, energy levels etc. BE HONEST about these things with your doctor. They aren’t a cop or some judgmental parent. They need as much info as possible so that they can best help you out.
Aside from talking to your doctor about these things and getting the process started that way, you can always also reach out to a therapist to talk to. There are a number of options here. You could talk to someone in person, you could work with someone remotely over a program like zoom, or you can sign up for something like Betterhelp to start off with. Really any starting place would be good. You probably just need someone external to help you reflect on your situation and identify areas where you might be able to make adjustments or cope in a more effective way. It sounds like you are just now starting to think about ways to approach these issues and work on them. That’s actually great because you are very young and that also means that there are many stones that are still unturned. There are many potential avenues for getting some relief.
So, there’s a lot of hope for your situation. I’m proud of you for recognizing your needs. Hopefully this gives you an idea of where to begin. Good luck!
You can listen to this on Episode 300 of the podcast!
Thank you for the great question!
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