One Messed Up 22 Year Old

[gymnastforever]

I have so many problems I don’t even know where to start, or which board to post on.  

I have had eating disorders/disordered eating and depression since I was about 13.  Disordered eating started with an anorexic type phase/compulsive exercising, then it was replaced with Binge Eating Disorder (BED) during all four years of university.  I recently graduated and had a solid 3 month bulimic phase.  I have since stopped purging, for fear of my teeth/esophagus/digestive system, etc.  I have not been clinically diagnosed for any of these problems, but I have been studying them for years so I know very well what the problems are.  Last year, I went to a walk in clinic and received a prescription for 37.5 mg Effexor XR, which I only took for 5-6 months (no follow up with the doctor).  I also talked to a school counsellor about my BED, which helped slightly.  I stopped taking meds because I wanted to take the time to really work on improving myself and not rely on drugs to make me feel better.

Recently, I have been questioning if I am bipolar, which I never considered until now.  I definitely do experience phases of euphoria for periods of time, yet they are very short lived.  My depressive phases are longer lasting, far more intense and harder to “snap out of”, so I have always thought it was just depression.  I’m still quite certain it is depression rather than bipolar, as I have had intense suicidal thoughts for nearly two years now, and I usually have more signs of depression.

Next concern, I have been picking my scalp for I don’t know how long.  I was always embarrassed about it, and thus avoid other people touching my hair most of the time.  I mostly just pick at spots where there might be build-up or flaking skin.  It’s gross because it’s impossible to pick all the white flakes out of my hair afterwards, and I am certain my hair is thinning because of all the stress I’m putting on my scalp.  I fear that this might be a form of OCD (trichotillomania), as I also pick at my skin imperfections compulsively.  Which leads to my next problem...

ACNE!  I am so incredibly frustrated by my skin condition right now.  My skin has not been even semi clear in probably 8-10 months or so.  I have a lot of under the skin acne, as well as other little bumps, frequent cysts and some blackheads, dark circles under eyes, and sometimes dilated pores/uneven skin texture.  I have spent a fortune on countless skin regimens, and other topical products, as well as specially formulated vitamins for healthy skin.  I have even been to a dermatologist back home but three months in between follow ups just didn’t give us enough time before I moved.  I would love to go on acutance and fix this problem, but I am concerned about the side effects, as well as the cost.

On top of all these problems, I struggled with my sexuality for the past three years.  I am now comfortable with it, but all of these problems listed above have left me with zero self-esteem and no hope.  

I know this is a ton of rambling, but I am desperate for some advice as to where to start.  I am on the other side of the country, away from home, with my medical insurance ending at the end of 2009, so I am going to have to go to a walk-in clinic to begin with and start explaining how messed up I am.  I feel like all my problems are constantly making all the other problems worse and it just continues in a vicious cycle.  I need a starting point, but every day I change my mind as to what problem I should treat first.  If only there were a magical pill to treat depression, acne and OCD all in one go, I’d be set!  I’d appreciate any advice offered.  

[mammo]

Hi, at least you're doing better, and that's a big step.  I understand how depression can push one to suicidal thoughts, but it's never the answer and may just be worse.  When I lost my son, and then his son...my sweet grandson, believe me I thought about it, but fortunately it didn't last.  Don't beat yourself up for trying to beat this on your own, it just shows how strong you are.  But now you know that a chemical imbalance can only be helped with medication.  Do try a dandruff shampoo, they are very effective, and if it doesn't work then you have more than just dandruff.  If your scalp isn't healthy, your hair cannot be either.  It all goes hand in hand.  You may even find out that your scalp, hair and skin may be all related.  Dandruff shampoos are not expensive, and you can't know if it will work until you try it.  As for your skin, I agree it's rare for acne to begin at 19, so I think your idea of seeing a dermatologist is a giant step in the right direction.  They can
also advise you on the flaking and your hair.  I know it would do no good to tell you how unimportant looks are compared to what's inside.  I think as women, we worry about our looks and appearance all the time, it's human nature for us.  One thing I've learned is only time will teach you to be happy inside, but I still want to look nice on the outside.  Only now it's worrying about the wrinkles....lol  I think as women we can be too critical of ourselves, but I also know that even the prettiest of women are never happy with how they look.  It takes 3 months to get an appt. with a dermatologist where I live, I guess they're in high demand. But keep working on the inside, learn to like yourself, you have many reasons.  When all is said and done, everyone wants someone who is bright, kind, caring, and fun. These alone makes one beautiful.  You have so much going for you, you have a direction and a goal, not many women your age do.  You will get thru this, and come out well ahead of the game.  Stay with us, and keep us informed, we do care........

[gymnastforever]

Thank you soooo much for the fast reply; it means a lot to me!  Although I am not completely over my eating problems, I would have to say the past month or so has probably been the best I have been in about 4 years.  

I know suicide is not the answer, and I would never act on it.  I have tried to stop these thoughts, but they have become so frequent that it's hard for me to remember the time when I would be horrified by just the thought.  I used to say to myself (before two years ago) that I would never have those thoughts, and I would never allow myself to fall THAT deep into depression.  I guess that's part of the illness though; thinking these things so often and so intensely that we feel it is normal.  

As for chemical imbalance, I was convinced I had one, and that's why I resorted to meds last year.  I have a degree in nutrition (ironically) so when I took myself off of the prescription, I started taking omega 3's specially formulated for regulating mood.  (I do not eat fish, so I knew I was deficient in omega 3.)  However, they aren't doing me much good and I am realizing that I NEED to be taking meds AND therapy.  I guess it's part denial, part stubbornness, that I think I can do everything on my own and don't need any real help.

As for my hair - yes, it probably was derived from wanting white flakes out of my hair.  If I remember back far enough, I guess it might have started when I had a sunburn on my scalp and it started peeling.  It's embarrassing, though when roommates or other people see me doing it.  I just started using salon shampoo/conditioner so hopefully that helps.  I don't really want to use anti-dandruff shampoo because I have heard it doesn't work for a lot of people.  

Yes, the acne definitely does decrease my self esteem significantly.  Especially since I currently work in a restaurant... I am in the kitchen with mostly guys.  All the servers (most are girls) are way prettier than I will ever be, and they all have flawless skin.  So I can't help but feel inadequate when I am around them.  (I know physical appearance is not everything, but I feel ugly on the inside as well, so that doesn't help.)  I am well aware of the dangers of Acutane, and that's why I have waited so long, to the point where I can't stand it anymore.  I guess it ties into what you said about depression, that anything seems like it would be better.  I have heard horror stories about Acutane, but I have also had a few friends who had success with it, so I have no idea how I would react to it.  Plus I believe with Acutane you must be using two different forms of birth control, which would just be more medication that I would have to be prescribed!  I will think about antibiotics first I guess.  Topical treatments just aren't working anymore.  I didn't start to get bad skin until I was about 19, so I'm sure it ties in very much with my binge eating.  

I'm going to make it a priority to go to a walk in clinic tomorrow to get a referral to a psychiatrist (and dermatologist if the doctor is nice enough).  I just found out that the province I am currently living allows residents to see specialists (like psychiatrists and dermatologists, etc.) free of cost, so I would just have to pay for meds.  However it takes three months to get this medical services plan, but it will probably take at least that long to get an appointment anyway.  I guess it will be a relief to not have to pay for the appointments, only the meds!  Thanks again so much for taking the time to read and reply :)

[mammo]

You've have had a lot to deal with in your young life, congratulations on getting over the eating problems on your own!  I think the first step is for you is to see a psychiatrist to get evaluated as to exactly what your problem is, he can help you work thru your issues thru therapy and/or medication.  Please don't think suicide is the answer, it may just be the beginning of something worse.  Depression can take you to this point, and one feels anything must be better.  But you've accomplished a lot on your own which tells me you're a very strong, bright person.  Sometimes we can have a chemical imbalance which we cannot handle on our own, and only medications will help.  Sometimes we don't even know why we're depressed, just that we are, and this is where a psychiatrist plays an important role.
As for your hair, could it be a habit derived from wanting the white flakes out of your hair? If you use a dandruff shampoo this should all go away, and maybe if you have nothing to pick at, you'll no longer do this. It could be OCD but why not start with the simplest thing first and go from there.
With acne, any skin condition, we all tend to pick at these, but once having a son who endured severe acne, I know how this alone can affect one's self esteem.  It sounds like you need something of prescription strength to help with this and Accutane seems to work well.  But I sense you already know the serious side effects of accutane. It can cause suicidal thoughts, severe scarring, and depression, and anyone who has had an eating disorder should not take it.  But antibiotics can work well with acne, and this and all other treatments should be tried before Acutane. You're at an age where it should start improving on it's own.  There seems to be some good OTC medications for acne, have you tried asking your local pharmacist, they can head you in the right direction with this also, and it would be less expensive for you.  Your stress and depression may be adding to this problem also. Plus, you need to make sure the products you do use aren't in some way making it worse.  I truly think a psychiatrist is where you need to begin with all of this, just get to the root of your problems and work your way out.  As for your sexuality, this has got to be weighing on you heavily also.  Speaking with a psychiatrist and getting your depression under control is a good start with this also.  You've made some big steps on your own, and recognizing that you are depressed is another.  So, please get help so that you can start to feel better.  I know you feel messed up, but you're not, you're just dealing with some major issues that may be too much for you to handle on your own, we've all been there.  It can all be very over-whelming in not knowing where to start, this is why I feel a psychiatrist is best.  Once you can start feeling better emotionally, you can start tackling other issues, one at a time.  Don't be so hard on yourself, you're dealing with a lot, and be proud of what you have conquered on your own.  There are many people here who can offer other advice and support for you, so know you're not alone in this.  We're glad you're here and will help in any way we can.  Take care.....