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I wake up in the morning and don’t want to get out of bed. I feel sad and anxious. I have no energy to study, work, or eat. My room is always messy and I don’t feel like cleaning up either. I have no motivation for anything. How do I help myself? 

Answered by Rishav Koirala, psychiatrist and researcher 

Lacking motivation to do anything, or even getting out of bed is common among many people. I went through the same thing around two weeks back. Although I was working, a part of me always felt sad and tired. I didn’t feel like doing anything either. Feelings like this are episodic. Sometimes it lasts a short while, sometimes longer. 

Keeping yourself active is important. Although you won’t feel like it, push yourself to get out of bed and indulge yourself in some physical exercise. It helps our body to release dopamine. You might not see the result immediately, but this will help. The worst thing to do at times like these is to stay put.

It’s important to keep yourself busy at times like these. It will be tough. But that’s where you shouldn’t give up. Sometimes, you need to push through this feeling and get the work done. The more you procrastinate, the worse this feeling will get. Also, avoid being on your own all the time. Go out, hang out with friends, and meet people. That will give you some positive reinforcement. And if you are under medication for any mental health issues, do not discontinue.

Don’t shy away from asking for help. This issue might not be severe, but feeling low all the time is something to be concerned about. Although it might not be depression or anxiety, there are a few diagnoses like dysthymia (persistent mild depression) and postpartum blues (low mood and mild depressive symptoms that begins shortly after childbirth) that have symptoms like these. If the feelings don’t go away even after you have made the needed changes in your lifestyle and have done everything I mentioned above, it’s always a good idea to seek help.

I’m a 35-year-old woman in a toxic marriage. My husband and I fell in love and got married a few years ago. But things soon went wrong. He even admitted that he has been cheating on me. Unfortunately, for some reason, I’m unable to let him go. We’ve come such a long way. I don’t know what I will do without him, or how I will be able to move forward alone. I want to make things right, and I’m willing to forgive him. But it seems like he doesn’t want that. I think he wants to leave me. The thought of separating is overwhelming me. I’m scared of not having him in my life. I don’t know what it is but it doesn’t feel natural. What should I do?—A troubled wife Answered by Kapil Sharma, counseling psychologist, Nepal Institute of Mental Health It’s not easy to compromise your feelings every step of the way and be there for the person you love even when he has treated you harshly. So, it’s commendable that you have been trying to mend the relationship despite having so many issues. From what you’ve told me, I can see that you’re in a dilemma about what to do next. The uncertainty of what’s going to happen has overwhelmed you and made you anxious. But going on like this, and letting yourself struggle mentally and emotionally is only going to make things worse. With relationship issues, the most important thing is communication. You’ve mentioned that you have tried talking to him and are willing to let things go if he’s willing to be with you. So maybe you need to have that one last conversation with him that will help you figure out what you need to do next. I know it’s easier said than done. The thought of separating is already difficult for you, and to think that that might be one of the two outcomes of this conversation terrifies you. But it’s the conversation you will have to have someday. So why wait and suffer? You deserve better than that. Sometimes hearing each other out can solve a lot of problems. Maybe he has a different perspective than you do. It doesn’t mean that his cheating on you wasn’t wrong, but if you’re willing to let that go then I think you should hear him out to get a clear answer about his feelings. You can also talk about what might happen if you two are together for the next five-ten years. The answer to that will also help you be certain about what to do next. If communicating on your own is difficult, couples counseling is always a good option. There, you will have someone to guide you through the process. Either you guys will be together or you’ll have to go separate ways. That’s something you’ll have to prepare yourself for since being in a toxic relationship isn’t good for either of you. Who’s going to take care of your well-being if not you? If he doesn’t want to communicate, then you know you have a clear answer on what to do next. That’s the time when you think of yourself. Being afraid of going separate ways is natural. But that’s something you might have to do. So, it’s good to surround yourself with people who will understand and support you. Going through this alone will be difficult. If you aren’t comfortable with sharing your situation with friends and family, you can always seek help from a professional. Dealing with emotions as heavy as this can be difficult. So having someone guide you will be nice. Initiating a conversation will be difficult. And the thought of going separate ways will be scary. But you have to take a step back and think about how this situation will hamper your mental peace and well-being. You will get better with time.

I’m a 20-year-old student, and I think I might be suffering from Post Traumatic Stress Disorder (PTSD). As a child, I was pretty outgoing. But that changed when I started getting bullied, and there was no one to help me out. My classmates enjoyed joking about my looks and passing hurtful comments, and teachers ignored it. I’m still traumatized. I have no self-esteem, and I think I’m showing early signs of depression. How do I deal with this? Please help!—SK Answered by Dristy Moktan, psychosocial counselor, Happy Minds First of all, I would like to acknowledge and appreciate your courage to be vocal about what you are going through. That’s the first step you need to take in order to heal. Secondly, you should understand that the environment you grew up in, as a child, has had an impact on your personality. So, recalling the events that occurred in the past will help you find the main reason for your PTSD. It could be, for instance, like you mentioned, your experience during the school days.  However, one thing I would like to suggest is never resort to self diagnosis. A lot of patients tend to google their symptoms and come to a certain conclusion that might be completely wrong. Some of the results are the worst case scenarios. Thinking you have something similar will only make you more anxious. Being bullied can be an extremely traumatizing experience, but that doesn’t always mean you have PTSD. So, in order to get the right diagnosis, it’s best to visit a professional. In case you are diagnosed with PTSD, it’s essential for you to be vocal about the instances that trigger you. So, to start your healing journey, releasing all your built in emotions there and then, whether to a professional, or someone you trust, is the first step. That also includes explaining your feelings to someone whose actions might have affected you, for them to understand your triggering factors and be mindful about it in the future. If you don’t, this issue might get worse. What usually happens is, our mind goes into a defense mechanism where we suppress disturbing emotions, which might result in chronic depression and severe PTSD, which we want to avoid.  About raising your self-esteem, it always starts with working on yourself. In many cases, it’s just our negative thoughts, habit of overthinking, and self-doubt that pushes us behind. And in most instances, we are aware of that. So, in moments like that, ask yourself: “Why am I thinking this way?”, and reflect on your answer. Knowing that answer might help you understand your mental health status even better, and work on finding a solution.  Secondly, it’s important to engage yourself with things that help you get your self-esteem back. The process of doing so might not be the same for everyone, but you have to start somewhere in order to come out of your comfort zone and boost your confidence. It can be a certain activity, getting back to your hobby, or even hanging out with your friends. But it’s on you to find a method that helps you best in order to raise your self-esteem. This is something called a hit-and-trial method. You have to keep on trying until you find a solution.  If you are having a hard time, cry and let it all out. Don’t suppress your emotions because everything you feel is valid. Hug yourself and practice self-affirmations. Ask your loved ones to hang out with you and have meaningful conversations with them. Do anything and everything that makes you feel good about yourself, and give yourself enough time to work on yourself.  Also, creating a schedule for your daily activity helps. Set aside a time for journaling. Jotting down how you feel can help you understand your mental health status. Finding some inner peace by meditating can be helpful too. You aren’t alone in this journey, so I urge you not to panic. Whatever you are going through right now can be treated. 

I’m a 22-year-old who was diagnosed with depression, anxiety, and Borderline Personality Disorder (BPD) when I was 17. Right now, everything in life is pretty good. My relationships are going well and even work is satisfying. But there is this void in me that makes me sad all the time. I know the reason too. It’s because I’m bad with self-love. I want to change that, and do what it takes to be happy again. Please help me!—AN Answered by Rishav Koirala, psychiatrist and researcher  It’s good that you know what the problem is. You are already halfway there to solving it. You might think this feeling will never go away, but trust me when I say everything will be okay. I too have felt like that at one point in life, and things got better with time.  What you are feeling is the result of your BPD, that you say you were diagnosed with five years ago. Having this personality disorder makes it difficult to accept yourself the way you are. There are other things like abandonment issues that fuel that feeling. But the thing about personality disorder is it can be managed unlike other illnesses. It doesn’t mean you need to change your personality entirely.  Instead control the feelings that make you uneasy. And the first step of doing so is to realize you need help—the step you just took.  Then, it’s time to analyze your emotions. You say everything is going great but you still feel empty. So ask yourself, what makes you feel that way? Is there something or someone that triggers this feeling? Is your surroundings good for your mental health? Figuring this out will help you know what to do next.  Sharing helps. Don’t hesitate to share how you feel with someone close to you. If it’s not easy for you to open up at once, do it gradually. See how they react when you share something small. If you like the way they respond, you will automatically be comfortable enough to call them up when you need to. But in case you don’t, find someone else who will understand your situation. But don’t let a few people demotivate you from being vocal about your emotions. Not everyone will say what you want to hear. But that doesn’t mean there won’t be anyone with whom you can share how you feel. It can be your partner, your friend, or a psychological professional.  In BPD, it’s natural to seek constant affirmation. Hearing people say things like “Good job!”, “You are doing great!”, and “We are proud of you!” can act as positive reinforcements for your feelings. It can also be things like “I will always be here for you”, “I will not leave you,” or simply “I love you”, to help you with your abandonment issues, since it fuels the feeling of self-loathing.  Don’t get me wrong, you will not depend on these affirmations all your life. What I’m trying to say is these positive words from your close and loved ones can help you see yourself in a different light. It will help you to love yourself the way you are. If you have people who bring you down constantly, it’s best to avoid them.  Also, another trait of those with BPD is to push people away. It’s a response to the abandonment issue. With fear of being abandoned, people with BPD tend to avoid getting close to anyone, or push them away if they see a chance that s/he might leave. It’s their way of shielding themselves from the pain of being left alone. You need to avoid doing this. It will only make you feel more lonely.  Finally, mindfulness meditation is the key to keeping yourself calm. You can find 30 minute-long videos for mindfulness meditation on YouTube. I recommend videos by Michael Sealey. I would also suggest you work with a psychologist who will guide you through mindfulness meditation and therapy.