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Avatar universal

One Messed Up 22 Year Old

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.  
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Avatar universal
Thank you so much for taking the time to read and reply; it means a lot to me.  

That is a very good point your therapist made.  I need to hear that because I am very stubborn and feel that I can do everything on my own, so it's good to be reminded that I actually do need the help of a professional.  And yes, I definitely know I need meds AND therapy, so I am making it a priority to go to the walk-in clinic tomorrow to get a referral for a psychiatrist (athough, I am sure the wait list is at least three months or more, so that's what has been discouraging for me to do this.)  I guess it's just easier for me to express my problems to people I do not have to face, but I'm going to have to be able to share everything with the professional in person.

I definitely know my issues are very much tied in with each other, that's why it's difficult to figure out which one to start with.  I consider my depression and eating issues to go hand in hand, because they both pretty much started when I was 13.  I always think of it like the "which came first, the chicken or the egg?" scenario.  I believe my acne is the direct result of binge eating, since it started within the year that I started binge eating.  Which totally makes sense because I am overloading my digestive system, so my body has to make comprimises so my skin is a visible reminder or all the stress I put my body through.  I'm hoping when I go to the doctor tomorrow they will give me two referrals; one for a psychiatrist and one for a dermatologist!    
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Avatar universal
I'm sorry to hear you're having such a hard time. You sound like you have done a lot of reading about the things you are experiencing which is good, but it's not enough. When I was your age I also could analyze and intellectualize all my issues and I had a therapist who told me "that's 50% of the solution....maybe.". Knowing what is wrong and doing something about it are two different things. I personally wouldn't worry so much about correctly diagnosing yourself but just go on into that clinic and tell someone what is going on just how you told us here. Let the therapist determine correct diagnosis and treatment. Then let them treat you! I'm not saying you shouldn't participate in that treatment, it's essential that you do so for it to work! But be open to suggestion and guidance. I understand you don't want to rely on medications, but often a combination of medication AND therapy is ideal at least for a period of time. Find a therapist you can work with and trust and then stick with it and they will help you to go step by step through the issues. You will find they are not entirely separate issues but are all related and what helps one will help the other. (The acne does need a separate clinician though it may be exacerbated by your stress as well). Good luck to you!
Zoe
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