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Query

Sometimes I get sudden anxious fits, and lately this has been getting worse. When I remember that I have work to do and have no time to waste, I panic and remain frozen for hours. What should I do? -P.R. 

Answered by Dr Rishav Koirala, Psychiatrist and Researcher

From what you have mentioned in your question, it sounds like you are having episodes of anxiety that escalate into panic attacks, which explains you not being able to move from one place for hours. But this alone does not give the entire picture of the problem. It is necessary to consider various factors that can contribute to these episodes. 

It is essential to ask, “What other symptoms do you have?”, “When do you get these episodes?”, “How often does this occur?”, “What are the triggering factors?”, “What is your coping mechanism?” etc. 

Figuring all of this out will require an evaluation of your mental state and of other factors that might have contributed to these issues. 

We can give you a proper diagnosis only after we figure out answers to these questions through a rigorous evaluation. It is always important to find out the root cause. 

Once we have the diagnosis, we can proceed towards possible solutions, be it in the form of medication or psychological therapy. In the end, I would like to assure you that there is a solution for whatever you are going through right now.

For the time being, I suggest that you avoid caffeine and alcohol, and maintain a strict sleep cycle as well as a healthy lifestyle. Taking these steps may help you to an extent.

Query

“Recently, I have been burnt out and I cannot accomplish anything without feeling immensely tired or irritated. Any suggestions on how I manage?” -A struggling student 

Answer by Dristy Moktan, Psychosocial counselor at Happy Minds

Burnout occurs when we run out of physical, mental, or emotional energy. We feel like doing nothing, lack motivation, get tired, and develop a negative attitude towards ourselves and others. In most cases, it is due to overwork—you didn’t get enough rest. It happens to most of us when we are so occupied with our daily tasks that we often overlook the signs our body is trying to convey. As a result, we keep pushing ourselves to achieve our goals rather than give ourselves much-needed rest. 

To combat burnout, it is most important to take breaks. You must pay attention to your body cues. You must recognize what is causing your stress, and be sensible enough to remove yourself from that situation. If you're not used to taking breaks, start small. For instance, getting up from your desk to get a cup of water could help. This may not sound like a big deal, but it is. You must also remember to check in with yourself from time to time. Self-reflection is useful in determining how one feels physically and mentally. It could be as simple as asking yourself, "How am I feeling right now?"

Another way is to practice mindfulness. The idea is to be as emotionally aware as possible. Deep breathing practices can help you manage burnout. Taking mindful breaths allows us to focus on the present moment. It takes little effort and can be done at any time—and it works wonders if practiced on a daily basis.

We often hesitate to say ‘no’ and therefore tend to accumulate things to do for ourselves. You must put things on a pause if you are experiencing burnout. If you're comfortable, communicate what you're dealing with. If you can’t, keep in mind that it all comes down to balance. You must balance your professional and personal demands while maintaining your health and well-being. 

Similarly, making adjustments to your routine, such as setting and keeping boundaries, doing things you enjoy, getting adequate sleep, eating nutritious meals, working out and focusing on priorities, might also help.

If you have been feeling this way for long you should consider getting professional help. It can be really good to have a safe space to talk to someone you don’t know, is neutral, and is trained to provide clinical feedback. 

Query

I'm a 20-year-old male who cannot complete any task on time. I always leave my work for the night before the submission date and when the time finally comes to do it, I get stressed and anxious. I then become hard on myself, regretting why I hadn’t started earlier. I tell myself that I won't repeat this mistake again. But then the same thing happens with other deadlines. I am stuck in a cycle of procrastination. What should I do? - P.S. 

Answer by Kapil Sharma, Counselor at HUDEC Nepal 

You being aware of your habit and acknowledging it is a good thing. So this is the perfect time to work on it. 

Procrastination is a form of short-term stress relief for you right now. You may not be a procrastinator by personality. Perhaps you just have a habit of starting your work late. 

First, we need to figure out the reason behind this habit of yours. Reflect on why you’re doing this. Do you procrastinate on particular tasks or in all tasks? 

Normally, the cycle starts with you getting a new task. You may then feel a sense of discomfort, perhaps due to a lack of self-esteem or motivation. Fear of mistakes or perfectionism could also be the reason. In some cases, people feel they need to do their best and they are not quite ready to tackle the assigned work just yet. So they leave it for another day, thus starting to procrastinate. And this cycle keeps repeating for other works as well. 

When a person becomes a habitual procrastinator, they develop an aversion to their work, which then leads to avoidance. Avoiding these tasks offers them temporary relief, but will eventually raise their stress levels when it dawns on them that there is so much to accomplish in so little time. 

When you realize why you’re procrastinating, you will be able to figure out how to get out of it too, what habits to learn, and what to change. 

One thing to remember is that big work needs big motivation, and small work needs small motivation. For a task as simple as doing the dishes, if you have a sink full of dirty dishes and no motivation to wash them, you can divide it into smaller tasks. Maybe just clean a plate and a bowl now and then do something else. Come back after some time to do the rest. In no time, you will have washed all the dishes without even realizing it. 

Looking at the end goal or thinking about what you will achieve after doing certain work can help you get that motivation, be it big or small. 

Query

I’m a 33-year-old newly married woman with a full-time job. Ever since I got married a few months ago, I have struggled to understand the culture of my husband’s family, and to adjust with my in-laws. Juggling my home and work has been frustrating. Sometimes I have to leave work early just to attend a function that my in-laws want me to be present at. It is difficult to fulfill all the responsibilities of a ‘housewife’ when I also have job priorities. My in-laws complain that I’m not social enough or present at home enough. They expect me to be a traditional housewife. I do care about them but I feel burned out with so much on my shoulders. What do I do? —A.K. 

Answered by Krishangi, Psychologist at Happy Minds 

This is a common problem for most Nepali working women. They are defying the old social norms, and there are bound to be some pushback and friction. You’re feeling obligated to please your in-laws by sacrificing your career and identity.  

There is a clear generational gap between you and your in-laws. For them, it is what they have been taught and seen their whole lives. You can’t tell them to suddenly flip a switch and change their mind—it’s not that simple. It is natural for them to have such expectations of you because their in-laws had the same expectations of them.  

You have to try to be patient and gentle with them. Make sure you let them know that while family is important to you, you also cherish your job and that you are not trying to sacrifice one for the other. Tell them that you are simply trying to balance your priorities.  

In a situation where they expect you to be present with them or at a social event when your work schedule doesn’t allow you to do so, tell them in a respectful manner that you can’t be there. You can stand up for yourself without sounding rude. Convey your message respectfully. There has to be a healthy discussion, where you and your in-laws can meet halfway when it comes to such problems.  

If you still have difficulty standing up for yourself, try to talk to your husband about it. Tell him how it is from your perspective. Maybe he can support you in having a fruitful conversation with your in-laws.