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<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] Let me start by saying there are never too many concerns that you can bring into counselling. In fact, most people who come to see me for counselling have more than one issue they would like to work on in psychotherapy and most times these are all interconnected. In counselling, we work together, collaboratively, to figure out which issues you would like to address first and then together we develop an individualized plan of care. Basically, it’s like a road map of where you want to go, how are you going to get there, looking at stopovers, some scenic routes others possibly not so scenic, however, necessary. Of course, these plans can also change due to internal (what we have control over like our thoughts, feelings and behaviours) or external reasons (those things that are outside our control). I would encourage you to take the next step and reach out to a professional you can trust and build rapport with by co-journeying through whatever concerns you have by examining what has been working so far as you have learned to cope with some of your issues like insomnia, depression and anxiety, as well as being a breast cancer survivor. Then to help you by developing new coping strategies. Psychotherapy can be such a powerful tool to help you get to where it is you want to be. I know you can do it and you will see first-hand how psychotherapy will help you to move past these points in your life where you are feeling stuck. I like to quote Nike where their motto is, “just do it.” You can do it. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] It is never too late to get help and begin making significant changes and improvements in your life.  The right time is when you feel ready and open to change.  Sometimes when we have a history of trauma, like sexual abuse, the impact of that trauma can affect many areas of our lives as adults.  Working with a therapist who specializes in trauma is a great way to begin developing skills to manage present day life, learn to regulate your emotions and nervous system when you become triggered, and then in a safe environment have the opportunity to process past traumas so you can live your present life with more ease and joy.  People can and do recover from the impacts of trauma at any stage in their life.  It is never too late and you can feel better </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] You have been through so much and it sounds like you have a lot of things that have complied over the years. Regardless of the struggles you have been through, you do not have too many issues for counseling. Many times when someone starts out their counseling and healing journey, there are multiple things they would like to address and work on. If you decide to start counseling, you and your therapist can decide collaboratively what you would like to process and work on first. Be sure to express to your counselor if any of the above experiences you've been through is causing a lot of distress , as many times the first things addressed are the ones that are presently affecting your life or you emotionally. Often times when we experience negative situations in our life , but do not address them, they bottle up inside us and can manifest in other ways, such as depression or even physical symptoms like IBS or neck pain.  Counseling can give these bottled up emotions and situations a release. Given the situation you shared, not only do I not think that you have too many issues for counseling, but believe that you will be a great candidate and can get a lot from it. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] This is a great question! I personally don't believe that any client could ever have too many issues for counseling. In fact, that type of thinking may be stopping you from seeking counseling, so it may be hindering you from getting the help you need. In fact, all of what you described points to the importance of you seeking help in order to cope with the many challenges in your life. If you seek counseling, it will be important for you to understand that you may need to remain in counseling for a sustained period of time in order to work through each of these issues. All of these issues won't be able to be solved right away or in a brief period of time. Counseling will take commitment and hard work, but it is possible for you to recover and heal from all of the issues you described.Many clients come into counseling with numerous issues rather than just one particular thing. Most of the time, the issues relate to and exacerbate each other. We call these "comorbid" conditions, which means that two or more mental health problems exist at one time. A lot of the times, when you start to work on one issue, the other issues get better as a result.I encourage you to find a professional therapist that can help you learn how to cope with all of the mental health difficulties that you described. You deserve the help just as much as anyone else. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] Most clients have many issues that need working out. It is normal to have many events in our lives that trouble us and remain with us without counseling help. The right type of counsellor will help you focus on the main and most troubling issue you have first and work your way through all that you are managing step by step, goal by goal. Sometimes, working on  one issue helps to bring other issues to light in the context of your main problem. This can help you resolve some other issues that are connected. Look for someone with experience and specialty in your most pressing issue...even though you have had breast cancer, you may find that grief from your past is more troubling. Then you would look for a bereavement or grief specialist. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] It could be said that you might be the perfect candidate for counseling! No one is beyond hope, and someone brave enough to be honest regarding their struggles, with the intention of reaching out for help is certainly a person a qualified counselor would be happy to assist. You may want to do some research on therapists in your local area who specialize in mind-body connection, or one of the struggles you have acknowledged in your post, in order to find a therapist that is best suited to meet your needs. Good luck on your search, and remember that the world is a better place with you in it. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] Firstly, I would like to say how amazing that you have been able to live through breast cancer, sexual abuse as well as your depression and anxiety. You are stronger than you may believe at this moment for being able to continue to grow and live through these experiences. Take a moment to acknowledge your strength and know that this strength will be an asset during the therapeutic process that you will be able to tap into to find increased self esteem and more strength to address the concerns you are having. There are never too many concerns to address in therapy sessions. I hope you can find a great therapist who you can trust to listen and work with you to identify and address the most concerning issues first. Once you begin to do this you may find an alleviation of symptoms and feelings which could allow you to grow your capacity to manage difficult feelings and situations and address additional concerns. Before you even realize it the issues you are having will begin to feel more manageable. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] The most direct answer is no. I would venture to guess that several of the things you are feeling (symptoms) are connected. I would recommend a trauma counselor. You have several strengths (resources) that you are able to pull from and I would encourage you to focus on them as you deal with the issues you have placed on the back burner for so long. Sometimes people are afraid to address things because they feel or believe that they won’t be able to handle it. Compare it to a tornado. The storm has passed, but you are still in hiding for fear of the aftermath (the mess left behind). A good therapist is like a personal organizer to help you. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] It's not really a question of whether you have too many issues for counseling but more what would you like to work on in counseling? You control the direction of sessions and depending on how you're feeling in a particular day can predict what direction that session takes. If you want to work on all the issues you've listed it will just take some dedication on your part to see through the counseling long enough to find a resolution to each of the issues that is satisfactory to you. You work at your own pace in counseling and it does seem like you may be overwhelmed with the ever-growing list. But you may just be in search of self improvement and making yourself better, which is a great thing. It seems as though you may need some form of resolution to what has happened in the past and to work through the trauma you have experienced. That may be the base of your counseling needs in which self esteem and depression/anxiety may fall underneath it as well. If you want to start counseling don't let what you need to work on overwhelm you. Find the counselor that best fits with you and together you both can tackle any issue. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] A person never has "too many" issues to address in counseling. Participating in counseling with a licensed professional offers a safe place and therapeutic relationship where healing can occur. A trained therapist can help a person unpack and process past and/or current wounds (or events) which may  negatively impact day to day living. They can also help make sense of thoughts and emotions that sometimes feel overwhelming and confusing.  If you want to experience more emotional freedom and gain some tools to help understand and cope with depression and anxiety, I'd encourage you to schedule an appointment with a therapist in your area. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] You absolutely do not have too many issues for counselling. The fact that you are wanting to seek help is commendable and you should feel proud of yourself for reaching out for support. I know from my experience working with clients that some may say they have only one issue but when we explore it turns out they have many things that they want to discuss that are of equal importance. I believe that you deserve to feel happy, at ease and also get restful sleep amongst other things. Please do not feel hesitant because the fact that you know what you want to discuss and work on is amazing. You know the directions you want to go and the therapist just needs to help you get there. I suggest sitting down and making a list of what you want to discuss as well as what you feel is more important to address first. Perhaps the therapist can help you with that as well. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] Thank you for sharing your question.  I imagine it feels overwhelming and discouraging at times if you feel like there are too many issues to address in a counseling session.  I would encourage you to share these concerns with a counselor because a counselor can help you organize the concerns into a list of specific goals.  For example, a list of goals may look similar to this:1.  "I will learn about the effects of medication on the symptoms of depression and anxiety."2.  "I will learn about the factors that affect insomnia."3.  "I will learn about resources and support groups in my local area to help me cope with my traumatic experiences."4.  "I will practice self-care exercises each day and write about my thoughts and feelings in a journal so I can measure whether or not I"m making progress."This is an example of some of the possible goals a counselor can help you work toward each week.  Working toward a specific goal can lead to a feeling of accomplishment once you've completed it, and this may have a positive impact on your self-esteem.  I hope this information helps, and I wish you all the best! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] There are never "too many issues" to be addressed in therapy.  Most people come in with multiple issues they want to address.  The wonderful thing about therapy, is that often, as one or more significant issues begin to change and improve-   the lead naturally without much effort to improvements in the other areas.  (For example, as you begin to address trauma and betrayal from you past, you may find that the insomnia improves). Your therapist, with you input and direction, can help you to prioritize which problem areas to target first. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] The short answer is: absolutely not! The longer answer is that it might take some time to process all of the issues, and it may feel quite "muddy" in the issues for a lot longer than is tolerable (which is why counseling may have been postponed to begin with for you.) It's important to be realistic when entering counseling of any sort, and that the therapist be realistic with you about what you might be able to expect working with that person (I use the words "might be able to expect" because therapy experiences can vary.) But that not having counseling about trauma that you have experienced much earlier in your life can play a significant role in the process and how long that process could take to unpack all that may have been buried over time.It might also be helpful in counseling to work with the therapist on figuring out where to begin, but to also manage the feelings of being overwhelmed that may make it hard to continue to show up and do the work required, week in and week out. It isn't easy work trying to process past pain that you experienced, and so consistent practice of self-care, including leaning on support systems outside of therapy, is key. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] It is very common for people to have multiple issues that they want to (and need to) address in counseling.  I have had clients ask that same question and through more exploration, there is often an underlying fear that they  "can't be helped" or that they will "be too much for their therapist." I don't know if any of this rings true for you. But, most people have more than one problem in their lives and more often than not,  people have numerous significant stressors in their lives.  Let's face it, life can be complicated! Therapists are completely ready and equipped to handle all of the issues small or large that a client presents in session. Most therapists over the first couple of sessions will help you prioritize the issues you are facing so that you start addressing the issues that are causing you the most distress.  You can never have too many issues to address in counseling.  All of the issues you mention above can be successfully worked through in counseling. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] Absolutely not! When we have the courage to accept the challenge to address whatever is causing us pain, the solutions often generalize to many, if not all of our symptoms. I would suggest that unresolved trauma from sexual abuse is likely a primary contributing factor. However, it is important that you first build a trusting relationship with a therapist experienced in trauma treatment as this is an area of specialty that not all therapists are skilled in treating. Choosing one issue to work on, such as anxiety or depressive symptoms, and starting there will allow you the opportunity to get to know your therapist, learn coping skills for managing distressing symptoms, and establish emotional safety before jumping into trauma work. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] You do not have too many issues to address in counseling.  And your perseverance will serve you well if you choose to engage in therapy.  The trauma and medical event you experienced topped off with chronic sleepless nights would lead to feelings of depression for many.  The emotional reaction you've had to these experiences sounds normal albeit troublesome and I would imagine intensely painful at times as well.  Therapy can help prioritize what is the most impactful issue you are grappling with.  I find in therapy that when the central issue is revealed, understood, processed, and understood again in its current context, many other areas of the person's internal experience improve.  It sounds as though something has prevented you from seeking help from a counselor in the past, and it sounds as though you are more seriously considering it now.  Therapy helps and it can help you when you're ready. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] Not at all! Whatever issues you might have you can bring to the therapy room. Remember therapy is about YOU, not your therapist. You bring whatever you need to bring to the table. Keep in mind these issues are likely related. Remember you are a holistic being, more than just the sum of the parts. Just like any system, when you move something in one area, things start changing in other areas as well. Talk to your therapist to decide goals for counseling and establish priorities, and ENJOY THE RIDE! Growing, flourishing, and finally letting go of what hurts can be a beautiful and exciting process. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] I don't think you have too many issues for counseling.  If a client came to me for help with the same issues that you have listed here I would first want them to meet with their doctor to get a physical to rule out any biological causes to your depression, anxiety, and insomnia.  I would work with you on deciding which of these issues to tackle first.  I usually suggest starting with the issue that is easiest.  Reading through your symptoms I might choose anxiety to start with since you are in the early stages of it.  I like to give my client skills they can use right away, so I would focus on teaching you breathing exercises to manage the anxiety as well as cognitive restructuring so that when an anxious thought pops up you can talk yourself through it.  Once you felt that you had some control over the anxiety I'd start to work on some of your other concerns, but I would seek your input on what you felt like might be good to work on next.  My gut is that some of these issues would be resolved as you worked on others.  For example as you worked on your anxiety and began to process your trauma and as you began to work on self care and getting more sleep - your self esteem would probably improve.  I encourage you to meet with a therapist and ask them how they might be able to help you.  These are just some thoughts that came up for me on how I might help someone with the same or similar symptoms. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] I think this is a very common question that people who have never been to counseling before have.  There is a lot of anxiety in going to counseling for the first time.  This is normal.  In answer to your  question, the answer is an absolute NO!  An important thing to remember about getting counseling is that it is a courageous first step towards hope and healing.  Getting help is like training to run a marathon, it is not a sprint.  You have shared a lot of issues that you are dealing with from your past, that are now negatively impacting your present, but I believe that in getting the right kind of help and support, none of them are impossible to overcome.  Part of the therapeutic process is defining and prioritizing therapy goals.  In collaboration with you, as a client, a therapist is there to help you with this process in determining what you would like to work on first.  Not getting counseling, based on the history you have shared, has the potential to put you more at risk for mental and physical health issues.  You are already seeing this happen as you begin to experience new symptoms, namely your anxiety.  In therapy, you will gain understanding and insight, as well as learn skills and strategies to manage the symptoms you are experiencing.In conclusion, I would encourage you to reach out to a licensed counselor who has experience in treating trauma, grief/loss and will address shame.  These are three areas that I have found that gets to  the core issues that are contributing to your depression and anxiety.   I believe you can get the help you need to find hope and healing.  Best of luck to you! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] Hello, I'm so glad you decided to take the first step in opening a conversation first. Deciding to go to therapy can sometimes be difficult for some, but with the right therapist, healing is possible and obtainable, even with what you've described. To answer your question, no you do not have too many issues to go to counseling.  You've been through a lot and have been strong and at times it's helpful to have someone else to help you through it. What I would say is to be sure and find a therapist who is experienced in sexual abuse and trauma overall. But you absolutely do not have too many issues for counseling. Please feel free to ask any other questions you may have regarding your situation and I hope you find the therapist you're looking for, there are many great ones out there. Many of the issues you're experiencing may be tied together from the trauma. Best Wishes. Laura Cassity, LMSW, LMAC </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] Not at all my dear. Human beings are complex creatures, and in my opinion, our issues interconnect in a very nuanced web between our levels of being (for example, mind, body, and spirit). Everything you bring up affects all three. The truly beautiful thing about the human body is that when you begin to work on one, the others improve as well!I would encourage you to seek out a counselor who's style and approach speaks to you and start with whichever issue feels most pressing to you. A skilled therapist will flow with you at your own pace and make recommendations to other professionals (e.g., physicians, holistic practitioners, EMDR specialists for trauma etc) as needed to complement the psychotherapy work you're doing with him or her to help you find the total healing you seek. I wish you well on your journey! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? }} [/INST] Everyone has topics to discuss when they start therapy.   There is no correct number of topics.youSometimes people go to therapy for one specific area of their life.   Not everyone has the time or interest to utilize therapy just when a significant topic arises in their life.Since you are one person, no matter how many or few topics you would like to address in therapy, all the topics relate to you.Possibly the result of your therapy will be more transformational than if you talked only on one topic.  Lucky you, to be on the cusp of clearing and resolving many vulnerabilities at once.   You will feel brand new by the time you finish your therapy work! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have been feeling more and more down for over a month. I have started having trouble sleeping due to panic attacks, but they are almost never triggered by something that I know of. }} [/INST] It could be really helpful to see a counselor/therapist about your increasing depression/panic symptoms. Finding out the cause of depression/anxiety isn't always as straightforward as it seems, since both issues tend to become patterns we engage in rather than solely related to a specific trigger/reason. For example, if I am feeling down about a particular circumstance in my life, then I start seeing life through this lens of feeling down, and typically I'll start to see a lot more that I get down about, and it can really build very quickly on itself. Same with anxiety. Obviously, this is a very simplified example and it can be very difficult to see how the pattern is maintained, but that's where working with a counselor/therapist comes in. I would be curious about whether you can start to notice the initial sensations of panic, and if you can (through the panic attack) continue to maintain awareness of the actual physical sensations. Even better if you can talk yourself through the sensations you're feeling - such as saying to yourself "Okay, I'm breathing really rapidly, and my heart is racing, now my palms are sweaty and my chest is feeling really tight..." Reminding yourself that it's just your body's reaction to stress, and while it might be overreacting right now, you're okay and eventually it will go away. I highly recommend the SAM for Anxiety Management app for the anxiety piece, and I wouldn't be surprised if addressing the anxiety helped to address some of the depression too. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ How can I get to a place where I can be content from day to day? }} [/INST] One thing that comes to mind is making a list of some things that happen each day. It could be that there are things that are affecting how upset you are, but because so many other things are going on, you may not notice.Another idea to try is to keep a list for a month of one good thing that happened each day. This way, when you're having a rough day, you have a list to think of and take a look at.Are you eating and sleeping in ways that are typical for you (typically at least two meals per day and roughly 8 hours of sleep that night (may be different depending on your age)? These two ideas are closely related to changes in your mood.From where do you have support? Friends or family?Can you take 5 or 10 minutes per day to do something that you enjoy?If you think back to the last time that you felt "content," what was contributing to that?Another possibility is to try to be mindful of things that you do every day. For example, rather than eating a turkey sandwich as fast as possible on your lunch break, consider actually tasting it and enjoying it. Also consider giving yourself praise for doing something well. For example, when you finish your paperwork, take a moment to notice that and maybe reward yourself by checking your e-mail, reading five pages of a book, or something else that can be done quickly before you get back to your next task. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ A few years ago I was making love to my wife when for no known reason I lost my erection, Now I'm In my early 30s and my problem has become more and more frequent. This is causing major problems for my ego and it's diminishing my self esteem. This has resulted in ongoing depression and tearing apart my marriage. I am devastated and cannot find a cause for these issues. I am very attracted to my wife and want to express it in the bedroom like I used to. What could be causing this, and what can I do about it? }} [/INST] First step always is to do a medical rule out so that you're sure the problem is psychological and emotion based, not a medical condition which requires care and attention.If you are medically clear in the reasons for losing your erection, then reflect on what may be creating a loss in confidence in either who you are and what you're doing with your life, or whether your wife has these sort of problems within herself.Often a problem transfers ownership of who shows it.If you are a sensitive person its possible your erection problem reflects your wife's insecurities and self-doubt.  If she is someone who is reluctant to talk about feeling unsure then in a certain way by you showing a problem, she can avoid looking at herself.There may not be a direct cause such as usually exists in a medical problem.Medicine looks for symptoms to treat.Our emotional lives are much more indirect.If you feel stress at work or are unhappy in the place you live, for example, then your frustration may show up in your sex life.Basically, do a broad inward search of your life and what it holds and maybe ask your wife to do the same.You may clear the air within yourselves and between each other so the problem goes away. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ A few years ago I was making love to my wife when for no known reason I lost my erection, Now I'm In my early 30s and my problem has become more and more frequent. This is causing major problems for my ego and it's diminishing my self esteem. This has resulted in ongoing depression and tearing apart my marriage. I am devastated and cannot find a cause for these issues. I am very attracted to my wife and want to express it in the bedroom like I used to. What could be causing this, and what can I do about it? }} [/INST] For starters, know that this is a normal experience for many men at some point in their lives. While this can certainly cause some embarrassment, a diminished sexual esteem or relationship problems, it is important to know you are not alone. I am going to move forward assuming that you have already checked with a medical professional to rule out any medical problems that may be related to this. Assuming that is the case, for most this happens for two primary reasons. It is either a short term biological shortage of blood flow to the penis. This can be caused my diet, lack of exercise, even stress. Another primary reason for loss of erections are anxiety. Have their been recent relationship issues? Are you feeling as though you aren't satisfied in the bedroom? These are just a few aspects that can cause subconscious anxiety and loss of erection. My suggestion to you would be to seek out a counselor that specializes in sexuality that can assist you in moving forward with this.  Best of Luck! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I self-harm, and I stop for awhile. Then when I see something sad or depressing, I automatically want to self-harm. }} [/INST] In a way, self-harm can present somewhat like an addiction.  According to new research within the field of neuroscience there is a valid explanation for this.  When a person cuts or uses other forms of self harm, the body produces endorphins to help make a person feel better.  If a person was dealing with depression or high anxiety, that might be misinterpreted by the brain as a way to help oneself feel better and a new neural network or map might form (addiction) that would utilize this new behavior.  Another way to look at it would be thru a behavioral lens, a positive reward for a behavior, even though the behavior has other long term negative consequences.  Consider working with someone who can both have you work on and address those items that trigger your behavior and the root causes, in this case sadness or depression, and second find someone who can help give you alternatives that take into account the neurological requirement by replacing the behavior with another behavior (such as snapping a rubber band on the wrist) and working to extinguish the unwanted behavior.   Someone who is trained in Dialectic Behavior Therapy and/or Interpersonal Neurobiology would most likely have the skills and means available to address this with you. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I self-harm, and I stop for awhile. Then when I see something sad or depressing, I automatically want to self-harm. }} [/INST] Self-harm has a way of becoming a go-to method of coping. When we get stuck using self-harm as a way to deal and manage emotions, when something serious happens it totally makes sense that that will be one the first things to go through the mind. It is its own kind of addiction. There is a therapy, DBT or, Dialectical Behavior Therapy, which focusing on giving you new tools to get through hard times, understand and manage your emotions, to stay present and to deal with relationships. This one of the most effective interventions there is for self-harm. If you are interested in DBT, reach a local therapist in your area and ask if they do DBT or can recommend you to a DBT program. This can help immensely. Self-harm recovery is totally possible, but it is definitely hard work! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ It's not entirely true to say I enjoy being sad, but I always find a way to feel that way. I listen to sad music, read tragic stories, and, in a twisted way, like how bad it makes me feel. I focus on negative aspects of my life even if they aren't legitimate or I just make it seem negative. }} [/INST] It sounds like you are noticing that you are drawn towards sad and negative content and it's hard to understand why. This may sound counter-intuitive, but sometimes we do things that on the surface may look problematic (or even cause us some real problems) because it serves us in some unseen way. A simple example would be somebody who is addicted to a substance; their addiction may be causing serious problems in their life, and they may even know it, but the addiction serves them by helping them to avoid painful feelings that they anticipate having if they quit using. Now I am not saying that what you describe is an addiction, it is just a really illustrative example of the unseen benefit.One thing I would be wondering about is what is the unseen benefit of seeking out sad and negative content? I'd also be wondering what your relationship is to other feelings. These are things you may benefit from exploring with a competent therapist. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Every winter I find myself getting sad because of the weather. How can I fight this? }} [/INST] Seasonal Affective Disorder (S.A.D.) is a term that reflects how many people are affected by the changing seasons, especially fall to winter.  Everyone suffers with some form of this (lessened activity levels, increased isolation, etc.) while some find that this time of year can put them into a deeper depression. If you have noticed that this happens frequently, there are some ways you can definitely help yourself going forward:1. Attend therapy to learn strategies and tools to help you to manage your mood.  It's important to stay within the therapy until you feel you have mastered these tools. 2. Push yourself to interact more with your social groups and other positive activities. It's easy to go out and spend the day outside in the summer months, when the temperature is warm and the sun shines for long periods of the day, but it seems harder to find fun ways to spend your time when the temperature drops and darkness comes on so quickly.  Perhaps winter time could become the time of year where you and your friends have weekly board game nights, complete with hot chocolate and a fire?3. You may want to consider the purchase of a S.A.D. Light.  These are lights that expose you to additional ultra violet light to increase the vitamin D in our bodies, as well as the release of growth hormone (which releases when we wake up). There are mixed reviews of these products, however, and they can be expensive. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Every winter I find myself getting sad because of the weather. How can I fight this? }} [/INST] Thank you for sharing. It seems like since the "winter blues" happens to you every year it may also be impacting your quality of life and possibly relationships. What you report sounds like you may be experiencing Seasonal Affective Disorder (SAD) and is quite common to many from about fall thru winter seasons; but, also can impact folks during the Spring and summer months.The best care and treatment for SAD includes discussing it with your PCP (primary care physician), integrating light therapy (full-spectrum lighting) throughout home and workplace (where possible), psychotherapy, and possibly medications (e.g. Wellbutrin XL, Aplenzin).Be sure to exercise good self-care and checkout the Mayo Clinic's website for SAD here: http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/basics/definition/con-20021047. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Every winter I find myself getting sad because of the weather. How can I fight this? }} [/INST] One theory is that instead of "fighting" your feelings, accept your sad feelings and work with them.   Feeling sad may open many doors to reflect and make peace with the source of your sadness.Also, I believe fighting against the natural cycle of rest and hibernation may not even be possible to succeed.   Winter for most creatures is a time of withdrawal and slowdown.  Our bodies and moods are part of nature as well.  Fighting what is part of nature seems like a tiring fight which the person will lose.Last point, there are the winter holidays to break up the dark and cold of winter.   Maybe you can invent some of your own winter celebrations so you'll have a few gatherings to look forward to hosting. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Every winter I find myself getting sad because of the weather. How can I fight this? }} [/INST] Sometimes its quite literally the lack of sunshine that can affect our mood - in these cases it can be worth experimenting with a sun lamp, to boost your dose of vitamin D, when the sun isn't naturally out. Also consider, what is it that the change in weather, changes in your life? If for example, when its sunny you are an outdoorsy, active person and when the weather changes, you're whole activity level changes along with it, you could explore how to get some of that activity replicated indoors in the winter months. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Every winter I find myself getting sad because of the weather. How can I fight this? }} [/INST] There can be lots of different factors contributing to this. Here are some possible tips:Consider if you know anything about what specifically is making you feel sad? If you're looking for activities because you cannot participate in what you like to do in the warmer months, consider finding some indoor winter activitiesConnect with others. One idea is to join a group (such as a book club) that meets regularly. This could give you something to look forward to regardless of the colder weather.Enjoy the sunshine from indoors. You may notice that sometimes looks are deceiving women is bright and sunny outside, but is also quite cold when you open the door. If you are staying inside for the day, consider allowing yourself to enjoy the sunlight without specifically considering that it is also cold.Consider using a light box. Certain types of light boxes are designed to help with the "winter blues." You can find more information here: http://www.mayoclinic.org/tests-procedures/light-therapy/home/ovc-20197416Recently, one of the nurse practitioners that I work with has been checking a lot of vitamin D and vitamin B12 levels and she says the lower levels of these vitamins can contribute to feelings of less motivation or energy than is desired.Each of us has days when we are not thrilled about the weather and may be feeling sort of "bummed" or "down." If you find yourself having these days frequently or for several consecutive days in the above strategies are not helping, consider talking with a therapist about more specific strategies that may be of help to you. Also, because  if everything you would see is likely to live in your area, they would be familiar with the weather patterns where you are and may have some tips that they use for themselves or With other clients. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I am going through a divorce. He is extremely angry. He refuses to physically assist me with our teenager daughter. I have no extended family support. Often times, I feel overwhelmed, tired, and joyless. I feel out of control, sad and depressed on a daily basis. I am just going through the motions of life every day. I am in my mid-50s. I have almost 29 years on my job. How can I handle this? }} [/INST] Going through a divorce is often a very low point for the people involved.Are you surprised that your soon to be ex doesn't help with your teenage daughter?Usually patterns and dynamics in parenting are not  sudden developments.Is it possible that what you're feeling now is more intensity to the stress of parenting by yourself, not that this is a sudden problem?This is relevant because you may be more familiar and more capable than you're giving yourself credit.  The lack of emotional support is definitely stressful.Your parenting skills may still be at the level at which they were prior to the divorce.Take your emotional weariness seriously and reflect on the various ways of stress relief which are available and interest you.Give yourself extra time to rest, nurture yourself and be flexible in finding what feels right for stabilizing yourself.Since you talk about your daughter and help in physical ways, if it is a matter of strength that you need, talk with your attorney so that the child custody agreement includes whatever is physically necessary in the way of strength, in taking care of your daughter.The Courts are very good at making effort that the custody agreement offers proper care to the kids. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I just don't know what I want in life anymore. I'm can't figure out what it is that is keeping me distracted and unfocused. I can't put things into perspective at all. I'm just stuck, and I'm disappointed with my lack of accomplishments. }} [/INST] If you are a people-pleaser type or a natural caretaker, you can slowly "lose yourself" over time if you are always tending to the needs of others and neglecting yourself.  If this sounds like a familiar pattern for you, this may have happened without you even realizing it if you were raised in a family where you had to pick up the slack alot.  Maybe your parents were addicts or they might have even just worked all the time and you learned to "take care of everything" because that is what you had to do to help the family run smoothly. Over time, a person who grows up in this type of environment learns that you put the needs of others before your own.  You might also be stuck in these types of patterns in intimate relationships as well; if you completely give yourself over to your significant other and you don't create a life for yourself with your own interests and supportive friends, you are at risk of losing what is unique and amazing about you.  If you grew up in a family where you learned this role out of survival or because it was needed to take care of your family, it's easy to re-create this in adult relationships.In both scenarios, if there is no awareness that this "self sacrifice at the expense of others" is going on, your identity is shaped around being a caretaker/enabler/people-pleaser and down the road it can lead to depression, low self esteem, and a confused sense of self.  Basically, you spend so much time helping other people that you don't make time for yourself or create a life of fulfillment.  Before you realize it, you have been living a life for others instead of yourself and you have no idea who YOU are.  Supporting loved ones and friends is important and certainly admirable, but if you are always that person that rescues, those that rely on you begin to take advantage of you and they will suck you dry if you let them.  In conclusion, learning to set boundaries with those in your life that are too needy becomes a really important part of the process when you begin to recognize that you are unhappy and unfulfilled in life.  It sounds like you may be at that crossroads right now.  Take one small step at at a time.  Identify the worst offenders in your life that suck time and energy, and limit your contact and/or set some strong boundaries with those people so you can refocus and do some soul-searching.  Meanwhile, engage in pleasurable activities with people you enjoy being with, get yourself outside in the fresh air, get some good sleep, and eat some nourishing food! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I just don't know what I want in life anymore. I'm can't figure out what it is that is keeping me distracted and unfocused. I can't put things into perspective at all. I'm just stuck, and I'm disappointed with my lack of accomplishments. }} [/INST] Thank you for sharing! It can be very disorienting not to know what you want and where you are headed. Sometimes we are so focused on something we haven't achieved yet or on comparing ourselves to others that we lose touch with what we actually want and need. At times like this, it's important to go back to basics. Try out this simple exercise, take a few minutes to write down all your present responsibilities. For example: make meals, complete homework...etc.  Then in the column next to it, write down the things that you do for yourself to recharge yourself and to enjoy your time. Is your list of responsibilities way longer than your list of stuff you do for yourself? It is easy to get lost in the sea of responsibilities and disconnect from what you want and need. To fix that, write another list of things that you enjoyed doing in the past for yourself and start incorporating them into your schedule on a regular basis. This will help you re-connect with yourself, and bring focus and clarity to your life. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I just don't know what I want in life anymore. I'm can't figure out what it is that is keeping me distracted and unfocused. I can't put things into perspective at all. I'm just stuck, and I'm disappointed with my lack of accomplishments. }} [/INST] It sounds as if you would benefit from talking with a local mental health professionals so you can discuss some details.Having said that, I wonder if you could consider how you would define yourself to someone who doesn't know you. For example, honest, adaptable, fun-loving, dependable, compassionate, open-minded, dedicated, etc. If you're looking for a list of adjectives, try these: https://www.englishclub.com/vocabulary/adjectives-personality-positive.htm . There is a list of negative ones here too. If you're going to use those, try to use three positive ones for each of the negative ones. You could also try asking yourself what you love about yourself and/or what others love about you. Sometimes it's easier to consider what others see as our positive points and if this is difficult for you, try asking someone who you trust to help you with the list.The idea here is to look at your relationship with yourself. I don't mean this in a way that you would be talking to yourself and receiving answers, but rather looking at yourself in a way that you deserve the same kind of loving and compassion that you give to others or want others to have.I'm also curious as to whether you are eating and sleeping okay, as these things can really affect your focus and many other changes, such as differences in your emotions. Also, you saying that you are struggling to put things into perspective leads me to believe that you are going through some things right now that are not typical for you, if so, consider from whom you have support and the ability to talk about what you are going through.Consider Metta meditation here to help give yourself loving kindness: http://www.mettainstitute.org/mettameditation.html </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ My girlfriend just quit drinking and she became really depressed. She told me that she wants to move. What can I do to help her? I want her to stay. }} [/INST] You're probably not going to like my answer.Your question says a lot about what YOU want rather than what she wants or what may be best for her. Sometimes, what's best for a person is the hardest thing to do, and may be completely opposite of what YOU want.Addictions don't happen in a vacuum. If you've had any experience with addicts at all, then I'm sure you've heard the term "enabler". A lot of the times, when people think they're "helping", they're actually enabling the addict to continue their self-destructive behavior. Tough love and clear boundaries are needed in a lot of situations, but especially with addictions. Family and friends are often the biggest contributing factor to someone choosing to use/drink, continuing to do so, or relapsing back into it.You said she recently quit. You said she is depressed. She wants to move. When a person receives counseling for addictions, they are encouraged to make changes like this. They need to break the habit, and this means removing people from their lives at times. It means moving to new locations. Anything that may trigger a relapse needs to be identified and removed. Not only that, but the addict needs to do a lot of personal reflection to figure out WHY they use/drink in the first place, and not only break the physical addiction to it, but deal with whatever is the root cause that led them to use in the first place. She may need some time alone to figure out who she is as a person, time to make some decisions for herself and do what she needs to do to be healthy.Don't pressure her to stay. Let her have the freedom to do what she needs to do. If she stays, the decision needs to be hers and hers alone. It doesn't need to be made under pressure. That will only lead to resentment. Support her, but don't try to change her or make her do anything, especially for selfish reasons. Let her go. It sounds like she needs some time to focus on herself right now. It wouldn't be a bad idea for you to do the same. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ My girlfriend just quit drinking and she became really depressed. She told me that she wants to move. What can I do to help her? I want her to stay. }} [/INST] People often have very different values and opinions when they are drinking excessively and when they stop drinking so much.Did the two of you share drinking as an activity?  If yes, then did you stop drinking too?Often when partners meet each other as drinking buddies when one gets sober, the relationship ends.  Once the terms of any relationship changes, one possibility is that it dissolves.The best way to go is to start the conversation of what you genuinely want.  This is the only way she'll really know your thoughts.Ask her to give serious consideration and discussion over at least a few weeks or months, to moving away from you.  This is a fair request since you are in a relationship.If she's changed so much by giving up drinking, which is possible, that she no longer wants to be in relationship to you, then you are better off being without a drinking gf, even if the truth she delivers is a hurtful one. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ My girlfriend just quit drinking and she became really depressed. She told me that she wants to move. What can I do to help her? I want her to stay. }} [/INST] You should start by speaking with her about what has her so down. Have their been some significant events in her life that have affected her? Have their been significant events in your relationship that can be affecting  you both? If she just stopped drinking, she may be struggling to finding an alternative and healthier behavior. This is something the two of you can explore together. Also, if need be perhaps she can speak to a therapist to discuss her feelings about quitting alcohol. It sounds like you really care and right now she could use all the support she can get despite her pushing you away. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm a teenager. My dad has been jail for the last five years. It's tough, but my mom really tries to give a normal life to my two sisters, my brother, and I. I feel like I took upon a parent role when I'm the second youngest, and I'm not stable. My mother and sisters say I'm overdramatic. I’m just so hurt, and I keep breaking down. }} [/INST] It sounds like you have a lot of weight on your shoulders.I'm not sure what you mean when you say you're not stable and you are breaking down. If you are crying because you're sad, that is okay. If you are crying a lot or having trouble eating or sleeping, that's different than just crying sometimes because you are sad. It may be helpful to talk with a local mental health professional in your area. They can help you to figure out what you could do differently to have the role in your family that you would like while also supporting yourself and what you want. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm in my mid 20s with a husband and children. I love my family, but I feel like I've lost my identity, and I don't know who I am other than a mom and wife. At times, all I can think is what I gave up and how I feel unhappy and trapped, but I know I'd feel like worse without them. I loathe myself at times. I have an amazing life, so why can't I just enjoy it? }} [/INST] It is not easy being a wife and mother. You have shifted roles in your life. You went from having a career to focusing on your family. Transitioning can be hard, especially when we feel we gave something up that we really wanted. I want to acknowledge you for wanting to be the best wife and mother you can. I think it is great that you are self-aware and want to work on this.Feeling "unhappy and trapped" may also mean that you are  believing these negative thoughts are absolutely true. We have lots and lots of thoughts throughout the day. Sometimes we pay a lot of attention to some and some we ignore. Right now these thoughts are getting a lot of your attention and perhaps you are thinking because you are thinking them they are true.  Is it really true that you trapped? You also said that you have an amazing life. It doesn't sound like you are only having negative thoughts. You have some positive ones, too. However, you are giving a lot of weight to the negative thoughts, more weight than the positive ones.I also wonder if you are struggling with the fact that you are even having this thought. One thing that can be helpful is to recognize that you are having a thought, that it is a negative thought, that thinking it does not make it true, and to let it go. This is the basis for mindfulness work that can be really helpful. It is a great place for you to start so you can balance out your thoughts and emotions.Best of luck to you! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm in my mid 20s with a husband and children. I love my family, but I feel like I've lost my identity, and I don't know who I am other than a mom and wife. At times, all I can think is what I gave up and how I feel unhappy and trapped, but I know I'd feel like worse without them. I loathe myself at times. I have an amazing life, so why can't I just enjoy it? }} [/INST] It sound like there are some parts of your life that you really enjoy it and also some things that you wish were different.You say you feel like nothing more than a wife and mom, so I wonder if you could make a list of what else you are (friend, daughter, etc.). I also wonder if you could list your positive attributes or skills.I don't know what you gave up, but I wonder if there is some way that you could spend an hour or so a week working on things that you like and/or spending some time with what you did before you had children. For example, if you're missing a certain part of your career, maybe you could work with your husband to come up with a plan where you could do whenever that is for one day a week. There are often a lot of small changes that can lead you in that direction.Of course, that is assuming that you want to continue being involved with what you were doing before.  If not, what else do you want to do? What is it that makes you feel happy? What do you look forward to? Remember that looking forward to having an hour or two where you can do something for yourself does not mean that you are not a good mother or wife. These ideas can coexist.Can you talk with your husband about how you are feeling? Do you have trust for one another with feelings such as these? </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have been dealing with depression and anxiety for a number of years. I have been on medication, but lately my depression has felt worse. Can counseling help? }} [/INST] Thank you for asking this important question. I find that there are three steps to getting ready for treatment. Step one is expressing interest in wanting to receiving treatment for the outcome of positive behavioral change. Congratulations you did the first step! You are showing your readiness to start counseling by asking this question. Now the second step is to find a counselor who specializes in treating clients with Anxiety and Depression. The therapeutic orientations I have found to be helpful in treating clients with  Anxiety and Depression are a combination of Cognitive Behavioral Therapy with Mindfulness, and Solution Focused Brief Therapy. Receiving meditation for your symptoms if part of the treatment, and the other part is receiving counseling to increase your resilience for future events. Research has found that medication and psychotherapy treatments together shows the most effective outcome for Depression.  The third step is to increase your positive self-talk to motivate yourself to attend treatment. As counselors, we are aware of the anxieties and fears that are associated with talking to a new professional for the first time. However, remind yourself that you are doing this to improve your well being. I hope this was helpful, and good luck with your treatment journey. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have been dealing with depression and anxiety for a number of years. I have been on medication, but lately my depression has felt worse. Can counseling help? }} [/INST] Certainly counselling can help. however, there is a caveat, namely, you will need the right counsellor with the right approach. This leads to two questions: 1) What are the identifiers for the right counsellor, and 2) What is the right approach?1) What are the identifiers for the right counsellor? The right counsellor will almost certainly have a lot of experience. He or she will have done a lot personal work and have an ongoing practice of inner work both on their own and with the support of an experienced therapist. This person will be viewing you as a human being with challenges, not as a diagnostic category. He or she will be willing to work with you over an extended period of time and have experience doing such work. Further they will be well versed in approaches that are responsive to you in the moment and overall. The in-depth work will be collaborativel designed in an ongoing way that is responsive to you, the moment, your overall life experience, and their in-the-moment experience. It goes without saying that you will subjectively evaluate the felt sense of connection with this person and the feeling that they are invested in their work with you, value you as a human being, and value the connection. As well, it is crucial that you feel this connection and that your therapist 'gets you.' 2) What is the right approach?  As Carl Jung stated, "When the doctor sits down with the patient he (or she) must drop all theories and learn the theory of this person." The approach must include a bond between you and your therapist that is in a continuous process of development, attention to pre-verbal imprinting, development of awareness ability, ongoing development of the ability to attend to and stay with inner experience, development of a process orientation, attention to egoic structures that were seeded from the earliest days in the service of perceptions of threats to needs being met, identification of current egoic states and work with these inner selves and their relationship with each other to facilitate movement from developmental points of arrest, increased ability to access and contain non-ordinary states of consciousness, attending to what is, and working with this in the service of moving towards optimal human development.depression is generally experienced as the system shutting down. anxiety is a signal that something is wrong. anxiety is not the problem. it is a sign that there is a problem. the core of these issues is a lack of inner security that is the outcome of insufficient bonding. the work of psychotherapy is to establish an environment and relationship that will facilitate work with the bonding ruptures and re-initiation of the developmental process that stopped at an early stage. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have been dealing with depression and anxiety for a number of years. I have been on medication, but lately my depression has felt worse. Can counseling help? }} [/INST] From whom do you get anti-depressants?This person should be talking with you to know whether the pills are helping or not.Trust your own instinct that the pills aren't helping you.Pills work differently for everyone and not all people feel better from them.It is also possible the particular pills have lost their effectiveness because after around six to eight months, this usually happens.Try to understand what is depressing you.  This is slow work since you may have many theories.Just by addressing your own emotional needs and life structure in a caring and respectful way, may improve your mood so that you'll feel less depressed. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ There are many people willing to lovingly provide me with a home. I have food, clothes, and a university education, but I never feel like I belong. Even when I have a good time with people who are supposed to be close, I feel like I'm just out with friends and I never go home. }} [/INST] For some people, having a sense of belonging takes some time.You mentioned that you have an education and some basic daily needs. I wonder if you may be able to look at your relationship with yourself and what makes you feel happy, safe, and having a sense of accomplishment. If you have those feelings, I wonder how you define trust and who you trust.You say you have a good time with people who are "supposed to be close," so I wonder what keeps them from feeling close. I have also wondering if you have been emotionally hurt in the past, and if so, you may have some protective defenses that you use (maybe on purpose, maybe not) to protect yourself from being hurt again. Remember that this idea comes in degrees where you can be more perfect in certain situations and a little less in others. Being emotionally protected is on a spectrum or continuum, where you can make an infinite amount of adjustments or changes with different people and situations.I also wonder what it is that you want in your "home," and how you define it. Consider giving yourself permission to think about how you would define your perfect home in a world where there were no realistic restrictions (such as money or location). After you have that, consider what parts of that you can have. Perhaps there is a small part that you could make a reality within a week or so.Thank you for reaching out. If this continues to be difficult for you, consider seeing a local mental health professional so you can discuss some more specific details. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I am really worried about one of my friends because I think he has major depression. He disagrees with me on that. He is shut off when it comes to talking to people and telling them how he really feels. He told me he feels empty inside and the only emotions he feels are anger and sadness. I suggested to him to get help and talk to his mom about it but he refuses. }} [/INST] First of all, I can tell that you really care about your friend and I think it's great that you are reaching out with your concern. It's hard to determine whether your friend would meet the criteria for an official diagnosis of depression without working with him, however, whether he does or not, therapy may be beneficial for him in working through these difficult feelings and relational challenges. Unfortunately, you can't make your friend get help. He will ultimately need to make that decision for himself, however, you can talk to him about your concerns and your hopes that he will reach out for help. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've become so jaded that I can't control my thoughts. I cannot focus on anything and been having anxiety attacks. }} [/INST] I imagine that it's pretty disconcerting to feel as though you lost yourself.When you said that you are jaded, I'm not sure whether you mean that you are jaded toward someone, something, life in general, or some combination thereof.One of the difficult things about anxiety is that anxiety can lead to more anxiety because of being concerned about having another panic attack. Consider remembering that panic attacks usually only last a few minutes and the reason they don't go away right away is because of the way your brain releases chemicals because some part of your brain is reacting as if you are in danger in some way.As far as finding yourself, you may consider looking at what parts of each day you can control as a way to stay centered. You could also focus on something that makes you feel happy and/or comfortable.You may also consider the list of values here to give yourself an idea of what is most important to you, what it is that you are living by now, and what values you would prefer to live by. http://www.therapistaid.com/therapy-worksheet/values-clarificationIf this proves to be difficult, consider seeing a local therapist. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm currently struggling with diagnosed depression, anxiety, and Misophonia. Also, I am 99% sure I have Borderline Personality Disorder and Avoidant Personality Disorder. I read the DSM-IV, taken college psychology, etc. I know it in my heart I have them. Is self-diagnosing okay with the right research? }} [/INST] Any diagnosis is limited in its usefulness.Knowing the name of some typical ways you may feel, think and behave, doesn't help you or anyone to understand why the person is the way they are and how to change any of these characteristics.Both self-diagnosing and being diagnosed are equally unhelpful to know why you are the way you are and what to do about it.Consider yourself a person who wants to find a better way to be who you are, and this will get you further with better results than to read a list of descriptions which all are very indicting and negative sounding. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm currently struggling with diagnosed depression, anxiety, and Misophonia. Also, I am 99% sure I have Borderline Personality Disorder and Avoidant Personality Disorder. I read the DSM-IV, taken college psychology, etc. I know it in my heart I have them. Is self-diagnosing okay with the right research? }} [/INST] Hello, and thank you for your question. Self-diagnosing is something that we all do about one health issue or another. Taking a guess about what may or may not be happening to us is completely normal, however the actual clinical diagnoses of a mental health disorder requires a licensed mental health professional. Here are a few reasons for this: 1. Making a clinical diagnosis often requires other things besides matching up the symptoms of a disorder. To come to a diagnoses for any of the things you mentioned, a counselor would consult the DSM, but they may also use some type of screening tool, assessment or scale. Many disorders have similarities and it requires someone with training to tease out the differences in the symptoms. 2. Our judgement is sometimes off when it comes to assessing ourselves. We really can't be objective. Something as serious as determining a diagnosis really needs to be done by someone who has that objectivity. In addition, once you know your diagnosis, treating it usually requires help from a professional. 3. Sometimes the symptoms of a mental health disorder makes self-diagnoses impossible, in and of itself. For example, someone could be having hallucinations or delusions and not realize it. That would clearly make it impossible for them to diagnose themselves. There a many examples where something like this could happen with different mental health disorders. There are other reasons, but these are three important ones. Now, does this mean that you are wrong about your diagnosis? Maybe not. You may be correct. But, it is important to get this confirmed by a professional mental health clinician. If a disorder is then found, you can begin to talk about treatment. Hope this was helpful. Be well.Robin J. Landwehr, DBH, LPCC, NCC </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm depressed often, and my mind goes a million miles a minute. Every once in a while, things are okay for a few days. After a bit, I start noticing that I am picking at my skin profusely. After roughly a week, the anxiety is back and still picking. Sometimes I find myself causing fights to have change. }} [/INST] Hello, and thank you for your question. I am very sorry that you are struggling. I have a few thoughts and perhaps some of my colleagues will add something else. Depression and anxiety can both be chronic conditions, as you have experienced. This means that they may always require treatment in order to have some kind of relief from them. Treatment could mean medication or some kind of counseling. Some people may take medication for the rest of their lives. Some people may go to counseling at times when the depression and anxiety worsens. As you mentioned, sometimes the symptoms improve for a little while, but they can also come back. When they do, it is important to talk to your medical provider if you are getting medication, and/or to go back to your counselor and talk to them about the symptoms that have returned. Skin picking and some other behaviors are not uncommon for people who are experiencing something like anxiety. Many people report that they do this when they feel anxious, and some say it calms them down. It is not really a surprise that you are constantly trying to change things and even starting fights to do so. These are ways to try to avoid, escape and distract yourself from the feelings of anxiety and depression. That is a very normal thing to do. Nobody likes these feelings, and so distraction is something we naturally try in order to get rid of them. The problem is that things like distraction and escape do not work as a long-term solution. In fact, they usually make things worse for many different reasons. Depression and anxiety can  be treated, but it is likely something you will need some help with. I would recommend finding a counselor who has experience with anxiety and depression. Medication can be helpful, but I still recommend counseling. The reason for this is that the medication can help with symptoms, while the counseling can address the symptoms and provide you with very helpful skills. Be well,Robin J. Landwehr, DBH, LPCC, NCC </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm very depressed. How do I find someone to talk to? }} [/INST] Hang in there! Feeling depressed sucks but talking with someone can really help - so its awesome that you're already trying to figure out how to find that person. Tons of good suggestions already but to add my two cents - you can find therapists in your area and read a little bit about them to find someone you like the sound of via this website, and also via www.psychologytoday.com; if you have health insurance your insurer might be able to make recommendations as to therapists covered by your plan, or if you happen to be in school, the school itself should be able to connect you with either their own counselor or a center that they recommend nearby. Finding someone can take a few calls or a bit of research so if you need some immediate support, or find yourself having thoughts of hurting yourself, you can also call the great folks who run the Suicide crisis line https://suicidepreventionlifeline.org - they are great in moments of crisis. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm very depressed. How do I find someone to talk to? }} [/INST] Great that you realize talking with a professional counselor about how you feel, would be helpful!If you'd like a very fast response by phone, then google "depression hotline" for where you live.  And, if you have a specific topic which upsets you then google around with this topic to see if there are services specific to your interest.If you've got time to invest in looking for the best fit therapist for yourself, then google "therapy' or "therapist".There will be many, many names which come up.I know I sound like I work for google only it is the easiest way to find lots of information.I send you good luck! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm in my late teens and live with my dad. The only time I go out is for my college classes. Sometimes when I see my friends I want to talk with them, but sometimes I won't want to talk to them for days or even weeks. Sometimes I feel i'm not worth knowing or i'm never going to do anything right. Are they right, am I depressed? }} [/INST] If we were in my office together, I would offer that most likely you are feeling somewhat depressed. It's most important for me to impress that you "don't have to live like this..."  Other helpful information: Have you experienced similar symptoms before?  Anyone in  your family been depressed before?  Based on other physiological signs, like quality of sleep, appetite, energy/motivation, I would present you with some treatment options, one of which would be to consult with a medication management provider to assess your symptoms and provide additional information for you to consider. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm in my late teens and live with my dad. The only time I go out is for my college classes. Sometimes when I see my friends I want to talk with them, but sometimes I won't want to talk to them for days or even weeks. Sometimes I feel i'm not worth knowing or i'm never going to do anything right. Are they right, am I depressed? }} [/INST] Although some people managing depression feel sad or "down",  it is a possible to have depression without an obvious sad mood.  Many people indicate that they feel numb or flat.  People managing depression often have low motivation. They may stay in bed for long periods of time and only get up for absolutely necessary activities.  People with depression may also feel inappropriate guilt or shame.   If you have been experiencing the symptoms you described for more than two weeks, I recommend that you see a counselor to get a more in-depth evaluation.   The symptoms you are experiencing are typical of depression, and with a bit of support, you could regain energy and improved self-esteem.  The stigma surrounding mental health can make a diagnosis or a label of depression seem scary.  The important thing to remember is that mental health disorders are as important as and as treatable physical health disorders.    Hang in there.  Healing is possible! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm in my late teens and live with my dad. The only time I go out is for my college classes. Sometimes when I see my friends I want to talk with them, but sometimes I won't want to talk to them for days or even weeks. Sometimes I feel i'm not worth knowing or i'm never going to do anything right. Are they right, am I depressed? }} [/INST] Hello. Being a teenager in our society today can cause depression quite easily. We look at the world in which we live, and the doubts we have about being able to make a contribution, or to have value and worth with the people around us, and we begin to internalize those messages of self-worth. If that alone were not enough, you are trying to figure out where you want to go in life, and who you are supposed to be in the world. Teens are faced with pressures of being judged by your peers for how you present yourself; following current fashions; possessing the trendy things; and hanging out with the "in crowd." Here's a "secret" that might help with most of those issues: Not much of those problems I've just described will really matter as they might seem to right now, in the real world. If you are feeling depression because you feel you lack some of those things that are seen as important by others (like your peers), I can assure you that being someone who is kind; compassionate; understanding of another person's suffering; and the effort you make to be the best person you can become in the world, will far outweigh anything you experienced in your teen years.When we are young, we judge everything based on what our peers have, what they say, the way they dress, who's popular, who's not popular, and for the most of it, all of that is external. So the question becomes, are you trying to fix the feelings on the inside (the internal stuff), with the trappings of all the stuff on the outside (the internal)? That is to say, do you feel that if you had what your friends have, you would be happy and less depressed? Depression is usually a symptom of something much bigger, it is not typically a problem by itself (just as a person who experiences a high temperature may likely have a cold). So fixing the symptom requires looking at the possible causes. In your post, you mentioned that you live with your dad. Are your parents divorced or separated, or has your mom passed away? Either of these circumstances could certainly cause depression. Finding out when you started feeling depressed, might be able to pinpoint the trigger that caused it, which requires looking at when you last felt really happy. It is also important to keep in mind, that as a teenager, your emotions are often being experienced very randomly, and sometimes without cause. It is part of your emotional development, but as you grow older can learn how to manage those emotions better and practice doing things that help you feel better (without causing harm to yourself).Have you tried talking to your dad about your feelings, or maybe another relative if you feel safer doing so? Do you have a friend who is your best friend...someone who is there for you no matter what? If not, there is a service you can use that is a national number for teens to talk with teen peer counselors. They are teens like yourself, but they have some insights that might be helpful. Its called Teen Line (https://teenlineonline.org/). It helped me when I was in my teens, and has helped lots of other teens as well. You might find a place to get some referrals to other local services in your area. If you want are in Washington state and would like to connect with me directly, you call link to me via my profile page. Or perhaps finding a counselor in your local area might be useful. Most towns and cities have some form of low cost counseling. You might also check with your school for assistance.Don't be afraid of not always knowing how you are supposed to feel. Adults don't always have a handle on it either. Being a teenager carries a lot stress, fear, and uncertainty. But you are not alone, and there is help if you reach out for it. I wish for you the very best, and bright future. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm in my late teens and live with my dad. The only time I go out is for my college classes. Sometimes when I see my friends I want to talk with them, but sometimes I won't want to talk to them for days or even weeks. Sometimes I feel i'm not worth knowing or i'm never going to do anything right. Are they right, am I depressed? }} [/INST] The answer to the question of whether or not you're depressed, is less meaningful than what you are doing to feel strong and secure in your life.Otherwise, people shortcut themselves to go deeper in understanding who they are and what they'd like to do with their lives, and accept "depression" as though it is their new name.What you write sounds like classic depression.What to do about this feeling is to get closer to yourself in an accepting way.  Assume that what you do in daily living is somehow necessary.  Unless you are doing immoral or illegal actions to other people, to accept your own wishes as truth will open you to appreciate why you do what you do.Make believe you're interesting and find out more about who you are, if you have trouble to start with thinking of yourself as worth understanding.The more you appreciate who you are and your unique strengths, vulnerabilities and fears, the more these will dissolve by what seems on their own.In fact they will disappear bc you are believing in yourself and your ways.Good luck! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm in my late teens and live with my dad. The only time I go out is for my college classes. Sometimes when I see my friends I want to talk with them, but sometimes I won't want to talk to them for days or even weeks. Sometimes I feel i'm not worth knowing or i'm never going to do anything right. Are they right, am I depressed? }} [/INST] I'm alway wary of assigning a term to a feeling, as often that term becomes more important than the feeling itself. From the very little that you have written, it is clear that you are going through something that has made you extremely low, affected your self-esteem and motivation, limits your enjoyment of formerly pleasurable activities and affects your feelings of self-worth. All of these are aspects of being depressed, though you can be depressed and still not have "depression". Counseling is definitely a place where you can go and sort out why you have had such a sudden a drastic change to your mood. Sometimes our mood can be effected by changes in our routine, losses or significant disappointments. Talking with someone will not only help you to better understand why you are feeling this way, but they will also help you to ground yourself and learn strategies and tools to help you to manage your mood and strategize for the future. I do hope that you will reach out. Feeling alone can be harmful over long periods of time, as it can stop us from seeking out the support we need. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ She has trouble falling and staying asleep and she's always either extremely hungry or not hungry at all. She also gets angry and feels like crying really easily for no reason. She says she is always "kind of down." Is this depression? What can I do to help her? }} [/INST] Sounds like signs of someone who is depressed.Since the person in question is your friend, offer your friendship to listen to any situations or feelings she has about herself and the way her life is going.Depressed people are often lonely people and feel as though no one around them cares or notices them.  Your willingness to be available to her may lift her spirits.  Feeling loved goes a long way to dissolving depressed feelings.Also, if in the beginning when you offer to talk, there is a high chance she'll be defensive and turn down your offer.Try again on another day and then another day.When people feel depressed they usually shut down.  So you may need a few or several tries before your friend accepts your offer to show her you care about how she is doing.Also, watch for signs within yourself that your friends' depression is not sinking your emotions.  Depressed people are draining to be around because they often see and talk about only the negatives and drawbacks of situations. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I had a very troubled up bringing and I'm currently dealing with alot right now. I know some people may not think so, but to me its a lot. I feel overwhelmed. Could this be depression? I use to be in therapy as a child. Alll throughout elementry, middle, and high school I had counseling 2-3 times a week. I haven't be in counseling lately though. }} [/INST] What matters most is how you feel and what you're doing, with whom you're interacting, whether you feel you've got enough interaction to be happy.Whether or not a clinician would decide to identify you as "depressed" matters much less than how you actually are feeling, if you have some ideas as to what might improve your sense of being, and how to go about reaching your goals.If therapy during your childhood made you feel better and you feel you may be depressed, then trying therapy at this point in your life, makes sense.The worst that can happen is you find you feel better than you first understood.The best that can happen is you find a caring therapist who helps you find faith in yourself again. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ My mother is combative with me when I say I don't want to talk with her about my depression. She hasn't been supportive of me in the past and she isn't someone that I feel comfortable opening up to. She constantly tries to instigate conversations where she asks me questions that I don't want to or can't answer. I tell her I don't want to talk and she starts arguments with me. How can I get her to understand? }} [/INST] Your situation sounds extremely frustrating.You're doing the right move to state you don't want to discuss your depression with her.I guess you could ask if she would like to know your reason to not speak w her about your depression.  If you feel she can handle a reasonable conversation, and you would like to tell her your true reason, then schedule this or bring up the topic at a neutral time, not in the middle of an argument.Having an unsupportive mom is difficult enough to accept.  You may feel greater success and peach of mind to meditate on accepting her lack of understanding than to engage in arguing when she starts this. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I just feel sad all the time and I don't like anyone in my family. I feel like they're trying to control me and won't let me grow. }} [/INST] Hello,While one can be sad from time to time, feeling sad "all the time" could be a sign of depression. If you feel sad on most days, it is worthwhile speaking to a psychologist to determine whether you suffer clinical depression. Feeling sadness is a normal response to loss, whether you lose a family, friend, job, or something you deem important in your life. However, feeling sadness all the time is a signal that you are not happy about something in your life. If it is related to your family and often relationship with family members could affect our self-esteem and self-worth, then perhaps it is worthwhile exploring what you find unhappy about your relationship with your family. Is it that you do not feel heard, supported or loved? Is it that you feel disrespected, disregarded or feel unimportant? These are just a few examples of common issues that people report that contribute to their depression. To help you to uncover your reasons for your sadness or depression and to cope with them in a healthier and more constructive way, it may be helpful to contact a therapist who could support you with this process. You do not have to deal with it alone. Dr. Virginia Chow, Montreal Psychologist. For more information about depression, please consult my website at www.PsychologyResource.ca </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I just feel sad all the time and I don't like anyone in my family. I feel like they're trying to control me and won't let me grow. }} [/INST] Understandably the idea of someone who tries to control you, is good reason to feel sad.Your feelings sound like they are very strong and meaningful in your life.Keep in mind that your feelings about others has more to do with one's own self-view than with what the other person is actually doing.Unless the people in your family are actually interrupting and impeding your life in practical ways or by intimidation or other verbal ways to inhibit you, then there is a great chance your feelings of being controlled by other family members has more to do with your fears to be who you are than with any family members' actions. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I can't seem to feel any emotion except anxiety, not even for myself. }} [/INST] Thank you for posting.  I'm interested to hear some more information; such as, if you live by yourself or family, if you go to school/employed/unemployed, and what kind of things do you like to do with friends or by yourself.  Often times, when we are experiencing a strong emotion that we interpret as negative, we put most of our focus on that negative emotion and struggle to see that we do not always feel that specific emotion.  There are typically points in the day (even if it is for only in 1 minute intervals) when we do not feel that negative emotion.  When we overgeneralize, we use words like "always" or "never" and when we use those words and it may not be totally true, we feel the negative emotion based on an inaccuracy which is not fair to you.  Ask yourself some of these questions: Am I being realistic when I'm overgeneralizing things? Have I ever noticed a short period of time that I wasn't feeling anxious?  What do I notice when I am feeling anxious? What am I thinking about?  When was the last time I felt empathy?  What was different when I was able to feel empathy?  Hopefully this helps get you started. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I can't seem to feel any emotion except anxiety, not even for myself. }} [/INST] Empathy usually falls on a spectrum, meaning that some people show more than others. Empathy is the ability to look at the world through someone else's eyes or "walk a mile in their shoes." There could be some people in your life for whom empathy is easier to feel and those for whom you have no idea what they are experiencing.Empathy is not usually categorized as an emotion, but as something related to emotions. For example, you could have empathy about someone's anxiety.I'm not sure whether you are also referring to the idea that you don't have sympathy for yourself or others. That's a different concept, but also involves different degrees.When you say you don't have emotion except anxiety, I wonder if you are saying that you have anxiety all the time and it may be covering up other emotions? If you are experiencing a lot of anxiety, try to look at what it connects to and find something that changes your focus for a few minutes. This could be any number of activities, such as watching TV, cooking, reading a book, or many other options.If you are feeling as if you are just going through the motions and not having a lot of emotions about anything, if it's just been a few days, it may just be related to a current stress that will lessen in a few days. If it has been quite a while, consider tracking your mood and looking at when you do notice changes in your emotions. There may be some variations that you are not aware of.If you continue to feel anxious and as if you don't have as many emotions as you would like, consider talking with your primary care physician or a local therapist. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I can't seem to feel any emotion except anxiety, not even for myself. }} [/INST] Empathy is the ability to tap into our own experience to help us connect with others in order to be aware of how they are experiencing life.  It is a skill that we learn with practice and refine as we become mature. If you are feeling anxious, maybe you are able to understand better others who are going trough anxiety.  But I wonder if instead of feeling empathy, you may just want to find ways to reduce your anxiety.  A good idea is to be very aware of your anxiety triggers, and once you identify them explore other ways you could react. ¿Sera normal que no sienta empatía?Parece que no puedo experimentar ninguna otra emoción que no sea ansiedad, ni si quiera por mí misma. Empatía es la habilidad de usar tus propias experiencias para conectarte con otros y estar consciente de la manera que ellos experimentan la vida.  Es una destreza interpersonal que aprendemos y refinamos con la práctica y según maduramos como personas.  Si te estás sintiendo ansioso, tal vez puedas comprender mejor como otra persona experimenta momentos de ansiedad.  Pero me pregunto si en lugar de estar buscando sentir empatía, realmente quisieras reducir tus niveles de ansiedad.  Una buena manera es estar consciente que activa la ansiedad, y ya que lo identifiques, explora que otras reacciones pudieras tener. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I know I need to deal with my depression. But I don't know how and I don't want to tell anyone. How can I deal with depression without telling anyone? }} [/INST] Love yourself more and treat yourself kindly, with empathy and compassion.Usually when people feel depressed they also feel lonely and isolated.  Since at this time you wouldn't want to tell anyone about the way you feel, which includes the possibility that a few of the ones whom you tell would offer you emotional support, give this to yourself.Also consider to make a goal of eventually telling someone whom you are reasonably sure would understand and empathize, about your depression.This will help alleviate the sense of shame, unworthiness and pervasive guilt which often comes along with depression.Sending you good luck! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I know I need to deal with my depression. But I don't know how and I don't want to tell anyone. How can I deal with depression without telling anyone? }} [/INST] It can be really tough to tell someone - anyone - that you're feeling depressed. But finding that supportive person that you can share with is a big part of the battle with depression. Depression thrives on being secret, it seems to grow the more we isolate ourselves and hide it away so I'm with Laura Cassidy, when she suggests finding that professional support person so you can start fighting back against your depression. If that feels like too big a step right now, maybe check out a book or two... I'm a big fan of a book called 'Feeling Good' by Dr. David Burns if you want some practical thoughts on tackling depression and on 'Radical Acceptance' by Tara Brach if you prefer something a little more spiritual. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I know I need to deal with my depression. But I don't know how and I don't want to tell anyone. How can I deal with depression without telling anyone? }} [/INST] Hello,It is completely understandable that you would not want people to know about your depression. I would first like commend you for realizing that you need to help with your depression by reaching out here. That is a great start, and you've taken the very first courageous step. Depression can feel debilitating and overwhelming. Depression is also a very personal thing and no one has know but you and the therapist. The best way to begin learningand dealing is to pick up the phone and call a therapist or email a therapist and schedule a session. The great news is that with professional help you can feel better and you will learn how deal with and manage the depression. There are many ways to help with depression that a therapist can teach you and help guide. You do not have do this alone. Asking for help and going to therapy is a strength! This can be done in a private and confidential setting.Depression should be treated by a therapist, in a safe, confidential office setting. The therapist can then discuss your depression with you in more detail to figure out the underlying cause, how long you've been feeling this way and identify what brings on these feelings. There is hope and depression can be treated with great success, you CAN feel good again. Depression can be managed appropriately by seeing a licensed therapist. Often times therapy will offer relief because you would have someone there simply to listen to you, validate your feelings and listen to your story. The therapist will be able to offer professional insight and perspective on the situation and help you think outside the box. The therapist can do many things with you, provide insight and offer many ideas to help you learn new coping skills and ideas of things you enjoy, encouraging you to re engage in hobbies you once enjoyed or even discover new things you may enjoy. There are creative ways to learn to cope too!Your therapist will also be there to support you, without judgement, at your pace, through the entire process. But the first step is finding a therapist and beginning to identify the cause your depression. Healing is possible and getting your happiness back is also possible.Feel free contact me for additional help or informationLaura Cassity, LMSW, LMAC </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm dealing with an illness that will never go away and I feel like my life will never change for the better. I feel alone and that i have no one. How can I overcome this pain and learn to be happy alone? }} [/INST] Is it possible that even though your illness is chronic, that it goes through phases in which you are more comfortable and that it requires less focus from you than at other times?I think the idea of having a lifelong illness is frustrating and can be depressing to think about.  Thoughts are not necessarily the truth of what will actually happen though.Illness makes negative situations look worse so be sure you are concentrating on specific areas of your life and not just assuming they will work out badly because you are ill.One way to be happy alone is to love and appreciate, nurture and be kind to yourself.This frame of mind may generate new answers to find ways of being among other people too. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ How do I make myself happy without the people who made me happy? Now that they’re gone, I feel sad. It’s been two months now but I seem to be unable to stay okay and independent. }} [/INST] Hello. So, someone made you happy but is no longer around? I am sure that feels devastating. As a counselor I usually have to ponder this kind of thought because it lends itself to suggesting that happiness comes from the external, rather than the internal side of a person's life. Happiness is formed within ourselves. All the external trappings of happiness are usually quite fleeting, and temporary. Even relationships fo not last forever. If we get to a place where we are reliant and dependent on those around us to create happiness in our lives, then we lose the opportunities for us to do it ourselves. We are entirely capable of finding ways to be happy. Sometimes this entails working out issues that are holding us back from reaching a place of peace, or resolution to a specific problem.What I would offer to you, is to find ways in which you can develop happiness for yourself. What do you like about your life as it is right now? What can you do to create change in your life to increase your happiness? These kinds of questions can be valuable to you as you seek out ways to make happiness an internal rather than an external event. Mourning the loss of a social connection (in whatever way that occurred), is part of the grieving process, but it is not permanent. It is a path to healing and moving forward. From this, you can seek out new sources of happiness. I encourage you to remember that happiness is independent of the external experience you have in the world. Happiness is an expression of the internal feelings, so that will be the source or the font of positive emotion from which you really draw. If you are lacking in happiness, then it becomes important to examine why that is, and what you can do about it to promote self-care. Seeking out a professional counselor can also be a good option as you move through the grief/loss process and examine the reasons happiness is not in greater supply.I wish you happiness for every day of your life.Best wishes. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I feel like I am internally screaming all the time. Externally, I am calm, but I have this intense, unidentifiable emotion constantly. I don't feel sad. I don't cry a lot. I feel rather emotionally distant other than the internal screaming. It kind of feels like I'm a caged animal. }} [/INST] As far as the formal diagnosis of depression goes, it would be hard to determine without more information. It sounds like you are noticing that there is a significant difference between how you are feeling on the inside and how you express yourself outwardly. Part of you is quite distressed and yet it remains invisible to the outside world, almost as if it is trapped inside of your body. Many people who are depressed experience such things as intrusive thoughts, emotional numbness, difficulty expressing themselves, and bodily tension (caged animal?). In working with a competent therapist, you may be able to get more insight into what you are going through, the nature of the disconnect between you inner feelings and outer expression, and eventually gain relief from the distress as well as a greater sense of connection with yourself and personal freedom. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I feel like I am internally screaming all the time. Externally, I am calm, but I have this intense, unidentifiable emotion constantly. I don't feel sad. I don't cry a lot. I feel rather emotionally distant other than the internal screaming. It kind of feels like I'm a caged animal. }} [/INST] It sounds like you are trying to find a label to help you to understand why you are feeling the way you are feeling.  Sometimes there are no labels for how we feel.  Sometimes there is no name for the emotions that we are experiencing. Regardless, you do not have to continue to feel this way, no matter what you call it.  If you are seeking to experience an internal calmness such as your external calmness, you may want to try some mindfulness practices or meditation.  However, being able to get at the root cause of what you are feeling may be what you need to help you release this feeling for the long term.  I recommend seeking support for this to allow this internal screaming to get some air and begin to breathe. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've never been able to talk with my parents. My parents are in their sixties while I am a teenager. I love both of them but not their personalities. I feel that they do not take me seriously whenever I talk about a serious event in my life. If my dad doesn’t believe me, then my mom goes along with my dad and acts like she doesn’t believe me either. I’m a pansexual, but I can’t trust my own parents. I've fought depression and won; however, stress and anxiety are killing me. I feel that my friends don't listen to me. I know they have their own problems, which I do my best to help with. But they don't always try to help me with mine, when I really need them. I feel as if my childhood has been taken from me. I feel as if I have no one whom I can trust. }} [/INST] First of all, I am sorry that you have been missing out on your childhood. It may help you to know that many of us feel that we have missed out on our childhoods, as well, and that despite such deprivations, for many of us, our adult lives have been extraordinarily fulfilling due to our opening up to trusted adults. I recommend that you find a trustworthy adult to talk to. This may be a teacher, a coach, a school counselor, a minister, a family member, or a friend's family member. If none of these are available, try out a professional counselor, social worker, psychiatric nurse practitioner, psychologist, or a psychiatrist. It is best to get a referral for such a professional from a peer who has had a positive and safe experience with a particular provider. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've never been able to talk with my parents. My parents are in their sixties while I am a teenager. I love both of them but not their personalities. I feel that they do not take me seriously whenever I talk about a serious event in my life. If my dad doesn’t believe me, then my mom goes along with my dad and acts like she doesn’t believe me either. I’m a pansexual, but I can’t trust my own parents. I've fought depression and won; however, stress and anxiety are killing me. I feel that my friends don't listen to me. I know they have their own problems, which I do my best to help with. But they don't always try to help me with mine, when I really need them. I feel as if my childhood has been taken from me. I feel as if I have no one whom I can trust. }} [/INST] Life sounds extremely frustrating for you right now.As long as you've reached your conclusion that your parents do not take you seriously when you would like to speak with them on a serious topic, and that you feel unable to trust either of them, then work with your own information.Many people don't know how to listen and aren't trustworthy.  As painful and aggravating as having parents who fit this description, you're better off to honor what you realize than to continue fighting what is not in your hands to change.Since you write about having a similar problem with friends, then maybe this comes about because you pick friends who are similarly unsatisfying to be with as are your parents.The first step out of this dilemma would be to accept how crummy you feel about the way your parents are toward you.If you're able to live with the sadness and resentment of having parents who don't want to know how to understand you, then you'll start to develop a new and more satisfying definition of what you expect from the behaviors of your friends.Trust yourself that what you feel and see is accurate, then it becomes easier to trust and welcome new people who are formatted differently than either your parents or your friends who sound very similar to your parents' ways. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've never been able to talk with my parents. My parents are in their sixties while I am a teenager. I love both of them but not their personalities. I feel that they do not take me seriously whenever I talk about a serious event in my life. If my dad doesn’t believe me, then my mom goes along with my dad and acts like she doesn’t believe me either. I’m a pansexual, but I can’t trust my own parents. I've fought depression and won; however, stress and anxiety are killing me. I feel that my friends don't listen to me. I know they have their own problems, which I do my best to help with. But they don't always try to help me with mine, when I really need them. I feel as if my childhood has been taken from me. I feel as if I have no one whom I can trust. }} [/INST] I'm sorry you feel so alone and isolated, those feelings in and of themselves can lead to depression, stress and anxiety.  So job one is finding someone you can talk to.  A good friend or an open parent can be as helpful as a professional counselor, but if you don't have those, then by all means call your local Mental Health Association, suicide prevention, or go see your school counseling department. There are many of us now who do on-line, FaceTime, phone counseling so that is an option to consider in your situation.  On the other hand,  If you want to script a conversation with your parents (I'm a great believer in scripting) not that you're going to read it to them, but if you write down exactly what you want to say, read it over a few times before you're ready to have the conversation.  Why?  You'll be much more likely to do it if you're prepared, and you'll  have a better chance of saying everything you want to say in a calm but forceful way.  The same with your friends--you are probably a great listener and therefore attract people who want to talk--so you need to let these friends know you need something in return.  If you practice asking for equal talk time, then perhaps these friends will respond and surprise you, or if you make those demands you'll start attracting people who are looking for equality in friendships.  Now back to that script--first decide do you want to talk to both parents at once, or one at a time.  Then begin to write down the points you want to make such as:   I love you, and I know you love me but I don't feel as though I can trust your love to be unconditional enough to tell you who I really am, and how I really feel.  Find your own words to describe your own feelings.  If I can help, get in touch. You are right to reach out starting here, there are no prizes for suffering in silence and, as you already know, little joy in going it alone. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've never been able to talk with my parents. My parents are in their sixties while I am a teenager. I love both of them but not their personalities. I feel that they do not take me seriously whenever I talk about a serious event in my life. If my dad doesn’t believe me, then my mom goes along with my dad and acts like she doesn’t believe me either. I’m a pansexual, but I can’t trust my own parents. I've fought depression and won; however, stress and anxiety are killing me. I feel that my friends don't listen to me. I know they have their own problems, which I do my best to help with. But they don't always try to help me with mine, when I really need them. I feel as if my childhood has been taken from me. I feel as if I have no one whom I can trust. }} [/INST] One of the most difficult challenges we face is not being heard! It is incredibly frustrating and hurtful when others, especially parents, do not listen. While your parents surely love you and want to understand you, it may be difficult for them to fully understand your feelings and experiences. They are quite a bit older and have likely not dealt with some of the struggles that you face. I would suggest communicating your feelings to them about not being heard. Talk to them during a non-emotional moment when the discussion is not already heated. In other words, do not wait until an argument ensues to have an open discussion with them about how you are feeling. Prepare them by asking them what time is good for them to talk. Let them know you have something important to get off your chest. Try and avoid using exaggerated or extreme language such as "you NEVER listen," "you ALWAYS say..." and stray away from placing blame. Instead of beginning your statements with "you" try using "I" by letting them know how their behavior effects you. Finally, let them know that they are important to you and that having their trust and support would mean a lot to you. Perhaps giving them suggestions as to what you wish for and would like to see change would help them to better understand.I would also suggest that you seek guidance from a therapist, teacher, or school counselor if possible. Most schools have counseling resources on sight in which a trained professional is available to talk with students looking for help.Best of luck to you. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've never been able to talk with my parents. My parents are in their sixties while I am a teenager. I love both of them but not their personalities. I feel that they do not take me seriously whenever I talk about a serious event in my life. If my dad doesn’t believe me, then my mom goes along with my dad and acts like she doesn’t believe me either. I’m a pansexual, but I can’t trust my own parents. I've fought depression and won; however, stress and anxiety are killing me. I feel that my friends don't listen to me. I know they have their own problems, which I do my best to help with. But they don't always try to help me with mine, when I really need them. I feel as if my childhood has been taken from me. I feel as if I have no one whom I can trust. }} [/INST] First, thank you for sharing such deep personal information. It can be difficult to share such intimate information. To begin, it sounds likes your primary concern your desire to speak to someone who takes your mental health seriously. You've tried talking to your parents and your friends and neither have made that connection in the area you need. I'm sorry to hear that. it's unfortunate. However, I think a couple things can be done to try to address this. If you want support1) Parents- Sit down with one of them and tell them with all seriousness that you need to talk about something that is affecting you deeply. Perhaps speaking to both can be too much for one room. If you try to speak to mom or dad by themselves, it may create that intimate atmosphere needed to understand where you are coming from. 2) Friends: Like parents it can be difficult to speak to your friends about challenges with your mental health. When you're feeling down and anxious, friends can be great help or not their at all. With friends, it may be one of those things where you also need to create an intimate environment with one friend to speak to about your sadness and anxiety. If anything, speak to the fact you're hurt and help them understand that if they can't understand the depressionIf you don't want support Coping Strategies: Identify coping skills and strategy that help you when you're feeling down. Ideas:A.) JournalingB) PaintingC) ExerciseD) MusicE) Reading AffirmationF) Listening To Motivation Videos </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've never been able to talk with my parents. My parents are in their sixties while I am a teenager. I love both of them but not their personalities. I feel that they do not take me seriously whenever I talk about a serious event in my life. If my dad doesn’t believe me, then my mom goes along with my dad and acts like she doesn’t believe me either. I’m a pansexual, but I can’t trust my own parents. I've fought depression and won; however, stress and anxiety are killing me. I feel that my friends don't listen to me. I know they have their own problems, which I do my best to help with. But they don't always try to help me with mine, when I really need them. I feel as if my childhood has been taken from me. I feel as if I have no one whom I can trust. }} [/INST] Teenage years are rough for anyone, and this is a time for self-discovery and experimentation. Having older parents can certainly pose challenges. Most kids feel like their parents don't understand them, but yours are older than the average parents of teenagers. They're from a completely different generation than you are. It sounds like they love you, but may not understand you. The problem here is the generation/age gap, and there's not a whole lot you can do about that. What you can do is accept the situation and perhaps look at it a little differently. It seems like you're looking for affirmation from them, looking for their approval and understanding. It's never a good idea to look to others to define who you are or to get a self-esteem boost. Who you are and how you feel about yourself needs to come from inside, not from outside. One way you can have a better relationship with your parents is to stop looking at all the things you aren't getting from them that you want, and rather look at all the things you are getting from them. Yes, this is a glass half full or half empty point of view, but it works. The negative will overshadow the positive if you let it. Start looking for the good things in your relationship with your parents and your feelings towards them will become more positive.I'm not sure how your friends/peers made you feel like your childhood has been taken from you. That's a curious statement, and requires a deeper conversation to understand where that came from. However, I do understand feeling different and out of place, especially in high school. Find the strength within yourself rather than looking to others in your life to make you feel better or feel like a complete person. It helps to have friends and loved ones, but you can never rely on them to fulfill all of your needs. Set some goals for your future, work towards them. Focus on being the best YOU that you can be, and the right people will enter your life at the right time. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've never been able to talk with my parents. My parents are in their sixties while I am a teenager. I love both of them but not their personalities. I feel that they do not take me seriously whenever I talk about a serious event in my life. If my dad doesn’t believe me, then my mom goes along with my dad and acts like she doesn’t believe me either. I’m a pansexual, but I can’t trust my own parents. I've fought depression and won; however, stress and anxiety are killing me. I feel that my friends don't listen to me. I know they have their own problems, which I do my best to help with. But they don't always try to help me with mine, when I really need them. I feel as if my childhood has been taken from me. I feel as if I have no one whom I can trust. }} [/INST] Hi there. Being 15 years old can be a very difficult time in your teenage life. I remember when I was 15 and how I often felt my parents weren’t listening to me. It’s even more difficult when you feel that you do not have a friend that you can confide in. Having depression in the past and being able to get through it shows me that you can get through anything! Depression alone is a very difficult problem to work through. In addition to the communication problem with your parents, it appears that you are also struggling with stress and anxiety. We all have stress and anxiety in our lives. If we didn’t, none of us would be living. Anxiety & stress keep us on our toes! Often, I have to remind myself of this as well. However, it is how we manage stress and anxiety, so it will not overcome our lives. Are you familiar with relaxation techniques, such as: deep breathing exercises, meditation or yoga? Relaxation Techniques can help you tremendously in reducing your stress and anxiety. Deep breathing exercises are helpful when you are on the go, such as school, shopping, out with friends or whatever extracurricular activities you engage in. Most people do not take full advantage of their lung capacity. I know, that sounds silly. But, it’s true. You would be surprised how much air you lungs can hold. Imagine being in the Doctor’s office and taking deep breaths. This is what you want to do when you are feeling overwhelmed and/or stressed. Take a moment to take in at least 10 deep breaths and let them out slowly. You will be surprised how well you feel afterwards. Meditation and Yoga are also healthy forms to working through stress and anxiety. You will need a quiet place for your meditation. You want to be “in the moment” and take in the peace and serenity. All it takes is a quiet place, closing your eyes and thinking of your “happy place.” Some people use meditation music as well. If you have access to this type of music and or the internet for more ways to practice meditation, please go for it! Yoga on the other hand will take a little more work and practice. I would not suggest you learning this on your own, if you have never attempted yoga before. Find an experienced Yoga instructor to teach you the ropes and/or ask your school counselor about the possibility of getting someone to come to the school to teach the students. Lastly, in regards to your parents it is very important to be able to have a relationship where you feel comfortable communicating. I would recommend writing a letter to them, if you are unable to express how you feel in person. A letter is more intimate and requires a little more effort on their end. If they are open on working on this relationship, maybe suggest family counseling to fully work on this issue. I hope this was helpful for you and I wish you the best! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I don't know how else to explain it. All I can say is that I feel empty, I feel nothing. How do I stop feeling this way? }} [/INST] Your question is very broad because feeling empty can develop for many different reasons.You're certainly not alone in feeling this way!Try to follow the logic of your feelings by asking yourself questions about the empty feeling.   Doing this may open up a discovery about the reason for the emptiness feeling.When do you feel empty, are there certain situations it happens more often than another, what helps the feeling go away, what or who is helpful in relieving the empty feeling.Sometimes people need a little help to get started in understanding how to recognize their feelings.Consider a therapist, any disciplined practice which encourages self-knowledge, such as some yoga practices, and a creative discipline like photography or music. As long as you concentrate on increasing your self-understanding, eventually you'll find the answer to your question! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ People who are parental figures in my life have, in the past, hurt me, and some continue to do so. It makes me feel like I'm not good enough for my husband or the life he provides me. I have had jobs, but I am going through a lot of my past garbage and trying to figure out when it all went wrong. Any time I bring these things up, I am expected to be over the issue. These are people that you can't just cut out, but I have never received apologies for so much of my pain. I don't know what to do any more. I don't know who I am anymore. }} [/INST] Hello. Adults who come from abusive home histories (physical, emotional, or even psychological), may take a long time to heal from that abuse. We carry our past with us everywhere we go, and it is up to us to find resolutions to past hurts. This is often easier said than done, but it is possible. From the perspective of those with whom you have shared your concerns, it might be assumed that based on where you are in life and who you are now, that you have already worked through any issues from your younger years. Some of our deepest scars in life are indeed invisible and suppressed. We have to get to the place where we can take care of the inner child that is still hurting, by recognizing that those who hurt us - however they did, might have had their own challenges which prevented them from functioning and behaving in ways we might have deeply needed. Those who have directly hurt you, may not be capable of acknowledging and understanding how you were affected by their actions - even in the worst of cases. They themselves may be doing what they can, either out of shame or heartbreak for their own actions, to work on forgetting how they behaved toward you all those years before. How are they behaving toward you now? Can you find it in your heart to forgive those who have hurt you? Forgiveness is the gift we give ourselves, and isn't dependent on an apology from an offender. By forgiving (even in the absence of any apology), we are releasing the weight of the burden we are carrying that reflects the offense we feel was committed against us. Sometimes therapy can be helpful in this process. Talking with someone who can be non-judgmental and reflects an empathetic position toward you might be what you need right now. Seeking out a therapist to help you work through these negatives feelings and thoughts is much easier, than trying to go it alone. I would encourage you to reach out and find someone who resonates with you on that journey, so that you can begin a path toward healing.Warm regards,Shawn Berthel, M.S., LMHC </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I am going through a very hard time and I'm so depressed. My parents are getting a divorce and a lot of bad things are happening. I want to lull myself. }} [/INST] It sounds like a tough time and it's normal to feel down when your family is going through a divorce or other hardship. There's a difference between feelings like sadness, discouragement, grief, loneliness and depression, though. Sadness is sadness and sometimes we have to go through a grieving or other process, that is a normal reaction to events in our lives. Depression, on the other hand, is more about being stuck. Lulling yourself with self-care sounds like a healthy response and a way to give yourself support. So as to the uncomfortable but healthy part of your feelings, do the best you can to put names to it and share with a trusted other person. You will find comfort. The part of your situation that's depression -- feeling stuck, not able to get out of bad, concentrate, changes in sleeping and eating, loss of enjoyment in living, poor hygiene, feelings of hopelessness, that's different. First step, identify your own symptoms of depression. If you have any thoughts of hurting yourself, tell someone. If you're not sure, you can try 800-lifenet or other support line to get feedback. First aid for depression includes: daily care and feeding, good sleeping and eating, lots of exercise--even when you don't feel like it-- healthy socializing, and focusing on talking to yourself in a positive way. If you aren't able to move yourself out of your depression,  work with a professional to make short-term goals and get some support. You may also talk to your doctor or psychiatrist about trying an anti-depressant to give you a little lift while you go through a rough patch.Best wishes,Karen </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I am going through a very hard time and I'm so depressed. My parents are getting a divorce and a lot of bad things are happening. I want to lull myself. }} [/INST] Consider yourself quite normal for feeling overwhelmed and depressed about your parents divorce.   This is the most natural way to feel at this time.Depending on how old you are, and whether you live under their roof,  are dependent on their support, and are either part of the decision or not, of with whom and where you will live, start considering these points.How did you find out about the upcoming divorce?Are either of your parents reluctant to answer your questions or is it clear that neither of them want to talk about anything with you?Whatever your fears and questions about your own future, these are all real.  It is necessary for you to know about your basic future.If you are living on your own and the main problem is your inner adjustment that your family structure is completely changing, then probably a good therapist would be a great help to you now, to clarify these tensions.Sending lots of good wishes for an easy resolution to your new path! </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ My depression has been reoccurring for a long time. It all started when I was being bullied in high school. In ninth grade, my principal told me I needed to stay home for a couple days to protect myself while she spoke to my classmates. I needed professional help for my stress because I was having crying spells from the stress of going to school and confronting my classmates. After that, I was fine for a couple of years. I entered my first year of college in a really tough program with high demands of expected work. I believe my depression re-booted from there with the stress. I began to cut myself because a friend of mine at the time told me how she used to do the same and it used to feel good for her. Obviously, that wasn't the right choice. I regret ever doing that, seeing as even though I'm not self-harming anymore, I always look back at that time whenever I feel very stressed. I have a big problem with handling problems in life. Whenever a problem arises, I get stressed and I feel hopeless, as if it's not going to get better. I get way too stressed from my problems, which leads to overreacting a lot (especially when talking to others), which then leads to depression. I have a hard time coping with stress because I know that if I could handle it easily then I wouldn't be sad all the time, and I would say and do the right thing instead of overreacting to my loved ones. }} [/INST] I couldn't help but notice that you did not specify your age, so I am unable to set the total chronological order and length that you have suffered in this way, but I want to start by commending you on seeking out additional coping techniques on your own.  Unfortunately, it sounds like you were offered some that were more dangerous than helpful, but be proud that you were able to curb those before they caused too much harm. From what you have written, stress has always been a difficult thing for you to manage.  Often, when I am working with those who offer the same concern, there is a degree of people pleasing that comes with that stress.  When we are trying to make others happy, especially when we are unable to distinguish the proper "rules for success", it can make even the simplest of tasks overwhelming. Stress management is just that, management; of our own anxieties about the needs of others, about our skills and the ability to complete a task and having multiple requests at any given time. Each of these aspects requires a separate sets of "tools" to manage them accordingly. For example, assertiveness communication training could aid in communicating with your colleagues to manage their expectations of your deadlines and abilities, but it will not assist you with managing your own anxieties. Try to separate the different areas of the problem, in order to help yourself to find a solution and work on them in their own time. Perhaps keeping a journal will help you to better understand why you are so easily overwhelmed by stress and help you track some of your less-helpful responses to stress. For example, does a certain person's style of communication always make you feel undervalued and therefore push you to finish their requests first? Is there a certain time of the day where you start to fall off in productivity?  Is that the time fo the day where you also tend to pile up your requirements?Try to ask yourself some of these harder questions and see where they lead you. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've been depressed for quite a while. I've been trying to work through it, and my boyfriend has been my rock. He is honestly the only person I trust enough to talk to about anything, but he decided to break up with me because of my depression. I cannot afford to see a therapist or anything, so he saw no hope in staying with me. My insurance has a $5000 deductible, so I’m screwed. I've had everything from suicidal thoughts to trying to quit my job. I have no one. My family doesn't care about me; they kicked me out when I turned 18 a few years ago. I had friends, but they have all moved on with their lives and have no time for me. My ex-boyfriend is trying to help but is making things worse because every time I see or hear him, I break down into tears. I found out that I will never be promoted now because of my depression. }} [/INST] It sounds like you have been struggling with this for quite some time, using many of the same coping techniques that feel tried and true to no avail. Often, we fall back on coping techniques that would be helpful in other problems (stress, social anxieties, etc.) for our depression, but the truth is that depression requires it's own little tool kit. Depression is all-encompassing, and, based on what you've written, the symptoms are already affecting work and your personal life in myriad ways.  The best route forward would be to seek out counselling, admittedly, but if your insurance deductible is too high, that can be very expensive. I would recommend contacting your Employee Assistance Program (EAP) if offered by your employer. If not, you can look into community centres for counselling options, check if your doctor will give you a referral or your local religious organization. If, however, you are motivated to get your depression under control, there are some great workbooks out there that you can use on your own or with your therapist (as long as your therapist is trained in Cognitive Behavioural Therapy, or CBT), such as "Mind Over Mood". </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again. }} [/INST] Hello, and thank you for your question. This is a very serious time. I don't mean to frighten you, but you are right to be concerned. The time right after people leave the hospital after receiving psychiatric services is a time of high risk for suicide. It is very important, after hospitalization, to get follow-up care with a professional as soon as possible. If your husband has an established therapist, this is the time to call. It is also a good time to alert your support system of friends, family, clergy or others to let them know he is still struggling. This is good support for him AND you.It is important to think about means and opportunity to make another attempt. Means really do matter.  So, if you have a firearm in the home, it is really important to remove it. You can't remove all things that a person may hurt themselves with, but some things are more lethal than others. Firearms are very lethal. I am not sure what means he used last time, but try to reduce the opportunity for him to access it again. This is where your support system can help out. People can take turns hanging out with him until you are sure the crisis is over.If you believe that an attempt is going to occur, talk to your husband about going back to the hospital. If he refuses, you will want to find out what your options are to have him go even if he doesn't want to. I know the thought of that really hurts, but it can save his life. Calling 9-1-1 is always a good option if you are not sure. Usually a suicide crisis, meaning they want to harm themselves right now, lasts a few minutes, hours or days. Sometimes when you get them through the crisis stage, they no longer want to commit suicide. But, as you are indicating, that feeling of wanting to commit suicide can come back again. So, it is always good to have a plan. If you want more information, call the National Suicide Prevention Lifeline. They will always answer: 1-800-273-8255. They can help you create a specific safety plan. I do hope things work out alright. Be well. Robin J. Landwehr, DBH, LPCC, NCC </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again. }} [/INST] This is actually more common then we often realize, and actually understandable, as he has gone through a trauma, an unresolved existential crisis.  He was taken care of by others and now is again left alone with his own internal, and rather horrific inner struggle.In my work with CCT, or Contextual Conceptual Therapy, (see www.suicidetherapy.com) I have learned how trapped suicidal people are in their own isolation, also called a "mysterious isolation," a form of self protection which cuts the off from their Self, or spirit.  And unless they address this message from their soul, accompany a guide on a journey to discover their own missing information, that is to recognize how their own uncomforted emotional pain has resulted in a coping stategy which has effectively cut themselves off from their own beauty, their Self, and their ability to receive love from themselves and others. Their attempt to kill themselves is a cry from their soul or spirit that they cannot live the life they are living any longer.  They take this literally and try to end their life, when in fact what their soul or spirit is saying is they need to begin to live the life they came here to live. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again. }} [/INST] I'm thankful to read your husband found care and that his suicide attempt wasn't successful.   While he was hospitalized, and prior to his release, your husband would've been provided in writing a self-care action plan. This typically includes things like committing to a contract 'not to harm' and what to do if he felt overwhelmed by his anger, depression, and hopelessness (e.g. call 911, call therapist, go to nearest hospital emergency department). Additionally, his protocol would've provided instructions for his taking medication(s) as directed, having a follow-up appointment(s) with his psychiatrist/psychologist/clinical social worker, and participating in some form of small group support.  If your husband's struggling as you describe, and you are feeling overwhelmed or frightened for his (your) safety, I'd encourage you to seek immediate assistance. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again. }} [/INST] This must be so difficult for both of you.  Watching someone you love suffer so profoundly can bring up lots of difficult feelings.  Without knowing what you are already doing, I have a few thoughts to share with you. First and foremost, know that you cannot fix this for him, and get support for yourself.As much as you are able, make space in your relationship for him to talk about what he is experiencing.  He might not want to talk, and that is ok.If he wants to talk, try to listen without judgement and without trying to talk him out of his feelings.  Focus on validating his feelings and just sitting with him in his pain.Let him know how you feel...that you love him, that you care, that you are concerned, that this is scary for you too, that you are here.I hope that this is helpful.  On my website (www.sarahmcintyrelpc.com), I've written a series of blog posts about coping with distress.  The techniques I've written about there may be supportive for you and your husband.  Sending warm wishes your way.  -Sarah </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again. }} [/INST] I appreciate that you are concerned about your husband's emotions and want to support him as best you can right now. I imagine that you must be going through your own difficult time too. You've had a complicated shock and trauma in your life and in your marriage; it's normal for both of your emotions to move from hope to despair to fear, anger, gratitude... there is no wrong way to feel and there is no particular pattern your emotions or his will follow. Try not to assume what he is feeling but ask him instead. "How are you doing today?" is something that can be asked over and over again and your love and compassion for him will come through. If he has a hard time talking, you can share your observations. "I notice you're more withdrawn. This worries me." Certainly it will help you if you know what he's thinking and feeling because he hid his intentions to hurt himself. It's normal that you want to know. If there is depression and hopelessness, this likely was part of what led to his initial despair. There is help out there. Depression is treatable, and seeking that treatment is important right now at this vulnerable time. This is the kind of complex situation that can be assisted by a therapist who is qualified to help you both understand and manage your emotions. Whether your husband seeks help or not, I hope that you do. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again. }} [/INST] A failed suicide attempt is commonly thought of as a “cry for help,” however it can also be a serious attempt to find a permanent solution to depression, hopelessness or other feelings a person feels are unbearable. It’s wonderful that you want to support your husband, but If your husband is feeling depressed and hopeless, you can best help him by getting him to a mental health professional. Feelings of hopelessness and depression, and previous attempts at suicide are all risk factors for future suicide attempts. With a mental health professional, or in the emergency room of a hospital, your husband should be evaluated for suicidal thoughts, intent and plan, and if he is a danger to himself he should probably be hospitalized again until he is stable. Without knowing the particulars, your husband may suffer from Major Depressive Disorder or some other illness on the depressive spectrum. In that case medication could help him immensely, at which point you can offer your support and encouragement him to practice gentle self-care. And do not forget to practice it for yourself.  Remember: a suicide attempt not only affects the person, but it is an immense stressor for his or her loved ones as well. As they say, “put your oxygen mask on first.” Then you will be better able to provide your husband with calm and loving care and attention.Kayla Schwartz, LMSW[email protected] </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again. }} [/INST] The fact that you're reaching out for help here is really helpful.The first thing I would suggest is that you consider seeing a local mental health professional yourself to be able to talk about the details, how this is affecting you, and how you can hold onto you are while also being supportive to you husband.From the way that you describe this, I wonder what has changed since coming home from the hospital. Perhaps you can have a conversation with your husband this and mention that you are asking him questions to learn more about his experience and you can discuss how you notice that things were going much better when he came home from the hospital, and now things are not as good. Perhaps he can tell you about what is different so that you may know him would be most helpful to him.I also hope that you husband is still continuing with his own treatment.There may also be a local peer support telephone number for the county that you live in that they be able to help you determine whether your husband needs more immediate treatment if he is feeling hopeless again. There are national crisis telephone numbers listed below as well. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again. }} [/INST] Since as husband and wife your lives are closely joined, how your husband feels greatly influences the way you feel.Give yourself some time to concentrate on how you've been affected by your husband's suicide attempt.   Even if you decide against immediately telling him how you're feeling, knowing this about yourself will guide how and the topics you bring up with him.Is your husband talking easily with you?Do you have some ideas as to what is creating his feeling of hopelessness?The ideal approach would be if the two of you are able to discuss what bothers him and what bothers you.Depending on how far away you each are from such a position, you may benefit from speaking with a licensed professional therapist who can guide you and or you and your husband on opening up for discussion what feels stressful enough to merit taking one's own life. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again. }} [/INST] It seems like you are very receptive of your husband’s emotions and want to support him trough this time.  But it is also important of being aware of your emotions.  How are you feeling after the suicide attempt?  It is common to experience negative feelings while you try to make sense of the incident.  Feelings like anger, shame, guilt and fear are frequent; while, wanting to avoid, minimize and become distant from the person are parts of the defense mechanism to attempt a quick resolution.  Once you understand and overcome those feelings you may be in a better position to help your husband; who may be experiencing some negative feelings as well.First, it is important to have a safety plan in place, which includes removing harming objects from the home, knowing who to call if there’s a new attempt (either 9-1-1, or nearby treatment center), have a professional expert who monitors you and your husband’s progress, either a Counselor or mental health provider could help you manage negative feelings and identify ways to handle triggering situations.Once the safety plan is in place,  make him feel supported and not judged, saying open ended statements, like: “I am glad that you are here, please let me know what I can do to help you through this process”.  Making small changes toward a healthier living may help as well.  Exercising, eating healthier and practicing new leisure activities may be good ways to start.  Also, explore your spirituality and your husbands, looking for ways to encourage each other by joining a support group or finding people who share your spiritual beliefs.If you have more questions or concerns I offer teletherapy in the State of Texas, and traditional Counseling in Puerto Rico, call 787-466-5478. ¿Cómo puedo ayudar a mi esposo después de un intento de suicidio?Después de que el llego a casa del hospital estaba enojado, luego por un tiempo maravilloso.  Ahora está deprimido y sin ánimos.Parece que estas muy atenta a los sentimientos de tu esposo, y que lo deseas ayudar durante este momento de su vida.  Pero también es importante estar consciente de tus propias emociones.  ¿Cómo te has sentido luego de este intento de suicidio?   Es común que experimentes emociones negativas mientras los recientes sucesos hacen sentido.   Sentimientos como coraje, vergüenza, culpa y miedo son comunes, y el querer evitar, minimizar o distanciarte son mecanismos de defensa igualmente comunes.  Ya que comprendas y superes estos sentimientos,  estarás en una mejor posición para ofrecerle ayuda, recuerda que tu esposo también debe de estar experimentando sentimientos negativos. Es muy importante tener un plan de seguridad, esto incluye remover todos los objetos que pueden ser dañinos o facilitar un futuro atentado, saber a quién llamar en caso de una emergencia (9-1-1 o una clínica de emergencias cercana),  tener un experto que monitoree tu progreso y el de tu esposo, puede ser un Consejero u otro experto de salud mental que te ayude a manejar los sentimientos negativos y situaciones retantes.Ya que el plan de seguridad sea activado, crea un ambiente donde tu esposo se sienta apoyado y no juzgado.  Utiliza frases abiertas para comunicarte, dile que estas feliz de que este contigo, y quieres saber cómo puedes ayudarlo durante esta etapa.   También haz cambios pequeños para mejorar su calidad de vida como pareja.  Hacer ejercicios, comer más saludable y compartir actividades puede ser un buen comienzo. Explorar tu espiritualidad y la de tu esposo también puede ser de ayuda, y encontrar personas o grupos que compartan esos mismos intereses puede ser una manera de mantenerse motivados.Si tienes más preguntas o preocupaciones sobre el tema, ofrezco teleterapia en Texas y Consejería Tradicional en Puerto Rico, llama al 787-466-5478 para más información. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I always feel like I'm doing something wrong. Everything I do is crappy. I want to cry all the time. I can't eat or sleep. }} [/INST] You are describing some of the most common symptoms of depression: low self esteem, difficulty sleeping, changes in appetite, sad mood, feelings of hopeless and feelings of worthlessness. A full assessment/evaluation with a mental health professional is warranted to understand if indeed you meet criteria for a Major Depressive Disorder i.e.., are delressed. One thing I often tell patients is that "Do you think you are depressed?" People often answer yes or no, but many individuals respond with a question: How would I know? To that I often explain that if I stopped watching movies or better, stopped enjoying watching movies that would be a clear indication for me that I am delressed. It would be a sign that I have lost pleasure or interest in the activity that I typically enjoy most . I'll ask you to think of one activity which you really really enjoy.  It could be anything from reading, to being with friends, to skiing to watching tv.  I would like to now ask you if you have stopped enjoying that activity or can't find the motivation to engage in it? This is another symptom of depression: loss in pleasurable activities. The good news is that there are many effective, available treatment if you are indeed in a depression or simply, you want to modify/decrease your depressive symptoms i.e., you want to stop feeling so tired and so worthless. Treatment includes one or more of the following: psychotherapy, medication, exercise. Any one or combination of both of these can help to improve your mood. The even better news is that feeling that you are doing something wrong can diminish with appropriate treatment over time.  I hope you find this information helpful. The most important next step is to get evaluated by a mental health professional typically a psychologist or psychiatrist, and for both you and the professional to better understand your symptoms and your mood in the context of what is going on in your life. </s>
<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I no longer carry expressions on my face, and my emotions are decreasing the more I have fights with my fiancée. }} [/INST] Sometimes when we fight a lot with our partner, it becomes more uncomfortable to share emotions because it feels like it will lead to another flight or disagreement.You could try having a conversation when you're not fighting and starting it out by saying that you would like to discuss something important to you and see if your fiancée is open to that.Something else is that you could have an agreement that if one of you is having a really strong emotions in a difficult conversation and would like to break from the conversation, you could agree (ahead of time) that you'll say that you would like a "timeout" and will come back to discuss the issue in a certain amount of time (usually about an hour) and then try to resume the discussion. The reason this can work is it can give you a chance to calm down and then still go back to the discussion rather than not talking about it again. This only works if both of you agree to that before something starts, though. </s>
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