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Summary
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A reader describes self-injury, eating-related difficulties, compulsive patterns, and dangerous impulsive behavior despite often feeling happy. They want to know whether these experiences indicate a mental health problem.
The response takes the concerns seriously and reassures the reader that discussing them is neither a nuisance nor unimportant.
Rather than settling on a diagnosis, it identifies several areas needing assessment and urges prompt psychotherapy, suggesting a cognitive behavioral therapist with eating-disorder expertise because of the risk of harm.
Question
Reader · Identity withheldI don’t really know where to start but basically I think I have some sort of mental problem. Little things tip me over the edge like a girl who I don’t know made a rude weight related comment about me at a party and I should’ve forgotten it and moved on but instead I cut the word fat into my thigh over and over until my friend found my razors and took them away.
\nI’ve had a history of eating related problems that I won’t bore you with and at first I thought it was just silly teenage girl stuff that a lot of people go through but it’s started feeling odd to me like it could be caused by something bigger.
\nAlso I have all these weird things that I never really realised were odd until recently, like if I go somewhere I haven’t been before I start moving stuff to make it neater and some times I find it impossible to interact with people or like if some one touches me and I don’t expect it it some times really really gets to me like I feel really uncomfortable and angry and just want to hit them.
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Also I’ve started cutting again but it’s under circumstances that make sense but one of my friends who used to do that, she did that at all funny angles like no order or sense to where the cuts were. Like when I’ve done it there’s always been sense and a ritual to it. either the word that I’d go over and over each time I cut or neat lines in a row.
\nWhat I’d always used cutting for was to keep control of everything and just so I could feel something that wasn’t sadness or confusion or stress but how would that work if there isn’t any order to it like it just doesn’t make any sense to me.
\nThe most weird thing about it all is that I’m a really happy person. Like seriously really happy but when something goes wrong I just can’t take it and do silly things like standing still in the middle of the road watching a car coming towards me waiting for it to hit me or drinking until I can’t think straight or just anything that seems like a good idea at the time. Also I know I just sound like an attention seeker but I’m not.
\nHonestly the last thing I want is the attention. I can’t stand it. Everyone gets so worried and upset and angry and I hate doing that to people and even if they didn’t care I wouldn’t want them to now because I can’t stand the idea of people knowing I’m feeling rubbish, I suppose that’s really proud and stupid but I can’t help it.
\nAnyways, sorry for this long rant I think I kind of got carried away there but yeah it’d put my mind at ease to find out if there’s something wrong with me and if there isn’t that’d help too. Either way just an answer would be amazing. Sorry for being a nuisance. Regards Bambi xoxo.
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Answer
Allan Schwartz, Ph.D.Dear Bambi,
\nFirst, I want to assure you that your E. Mail is not a \"rant.\" In fact, what strikes me immediately is how you apologize for your self. For example, you refer to your self as a \"nuisance.\" Therefore, what I suspect is that you may suffer from low self esteem.
\nYes, you seem to be dealing with some serious problems, even more than low self esteem. For example, it is worrisome to me that you believe that cutting yourself makes sense some of the time. I assure you that self cutting does not make sense and is not a healthy way to handle problems.
\nYou mention a number of problems that appear to come under the heading of Eating Disorders. Self cutting is one of those problems. You mention the fact that you have a history of eating disorders and that is never something \"boring\" or unimportant to discuss. Eating disorders usually include lots of depression, the wish to be perfect, the attempt to control things in life and a good amount of anxiety.
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You also refer to the fact that when you travel you do some things that fall under the category of Obsessive Disorder. Obsessive-compulsive disorder (OCD) is driven by anxiety and is an attempt to reduce anxiety and take control.
\nYou also mention that, in addition to self cutting, you stand in traffic while a vehicle comes racing towards you.
\nAll of this appears to be very self destructive. All of this is in stark contradiction to your description of your self as a \"happy person.\"
\nI want to urge you to see a psycotherapist and find out what problems you are dealing with. I would suggest a Cognitive Behavioral Therapist (CBT) with an expertise in Eating Disorders.
\nThe types of things you describe appear to be serious and I urge you to enter therapy before the possibility that you cause harm to your self.
\nBest of Luck
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