gotta find my purpose; gotta find me.
August 23, 2008 6:40 AM   Subscribe

I'm not quite hikikomori, but I'm scarily close, given I am neither Japanese, nor male. I have no friends; I don't talk to anyone I'm not related to, and I haven't left my house since May. I feel like I have no purpose in life, and that, at almost 22, I'm far too old to not have done anything yet, but I can't leave my room long enough to do a damn thing. Help. Please.

Backstory: I'm 21 years old. I've suffered from depression/anxiety for around 5 years. I stopped going to high school in my second last year (I showed up for exams), and dropped out entirely in my senior year, because I just couldn't take it any more. I went to a university I loved, at the age of 17, and I had a few friends there, but my depression got really bad, and after not attending a single class, passing any exams, doing any work, or basically leaving my room at all for two years, my school kicked me out.

I went back home, and spent a year technically attending the local college (not a university - I took Highers (A-levels, basically)), in the hopes that I could get into a university again, in the Science Faculty this time, instead of Arts. That did not happen. I stayed in my room, attended maybe 20% of my classes max, didn't do any work, didn't complete the year and did not get accepted into the school I wanted. Instead, I went to a school that I don't really like much (although it's in a town I love). I barely scraped through my first year here. The same pattern repeated itself - I stayed in my room, didn't talk to anyone, didn't do any work. By some miracle, I got into my second year (I showed up for resit exams last month, that are worth 100% of my grade, and scraped a pass).

That's where I am now. About to enter second year at university, and I have no idea what the fuck to do with my life. Probably, I'm going to continue at university, just to buy me some more time, if nothing else.

I have never held a job. I don't think I'm capable of it. And nobody would want to hire me anyway - even it is just a part-time job as a cleaner, or a waitress, or something. I turn 22 in two months. Already I have some grey dotted in my hair, and I feel like my life is over before I've ever even done anything. I feel old, and worthless, and like I might as well die because what else is there for me?

I feel very strongly that there's SOMETHING I should be doing, but I have no idea what that is, or how to find it. I keep trying to think what that something is, but I really don't know. The only dream I've had, for as long as I can remember, is to be somebody else.

I do that a lot. Imagine I'm other people, or in some other universe or something. I have these whole other lives built up inside my head - and I just dive in to them, because if nothing else, it distracts me from the bleak and hopeless nature of my life. The main dream, is that I have magical powers, and I can make myself thin, beautiful, talented, happy, with just a wave of my hand. It's stupid, and heavily influenced by the massive amounts of Sabrina The Teenage Witch I watched as a kid. And I dream I'm other people - right now, in my head, I pretend to be Ayumi Hamasaki, and have whole episodes plotted out in my head of what my life would be like if I were her. It's really, really fucked up, but that's all I want to do. For god's sake, I even started teaching myself Japanese, just so my fantasy life would be more accurate. I know it's incredibly unhealthy, and twisted, and sick, but when I fantasize about being someone else, it's the only time where I don't feel like a ball of nothingness and despair.

I just live inside my head, because it's so much better to pretend than to be the real me.

When I think about the future, I'm just filled with utter despair. I feel like there's nothing for me - I have no skills, no purpose. Everything just seems black. I feel so old, like it's way too late for me to still not know what I'm doing with my life, and like I should have graduated university by now, and have a job, and a husband (even though I'm gay), and a house, and plans for kids or something (this warped perception is not helped by my sister, who had a husband, a mortgage, and a puppy by the age of 19).

Treatment for depression is probably the key. I've been in and out of treatment for years now. But I'm in the UK, and the mental health treatment I've had is in the realm of farce. The first time I saw a GP, he prescribed me 20mg citalopram. After my first suicide attempt, he changed me to Prozac. When that didn't work, he upped my dosage. Eventually, I stopped going. My treatment has been spotty since then - every six months or so, I'll go to the doctor (it's been a different one each time), get rediagnosed, and walk out with a prescription for Prozac (it's always fucking Prozac). Therapy would probably be helpful, but is likely not an option. I can't afford private, and I won't get it on the NHS (I was on the waiting list, but by the time I got to the top of the list, I wasn't leaving my room, answering the phone, or opening mail, and so I lost my place, because I was too crazy to actually leave my room long enough to get help).

So. My question(s), at long last: How can I stop feeling this way, and how can I force myself to live in the real world, instead of the made-up one in my head? How can I find what it is I'm supposed to do with my life, or is it too late for me to make something of myself? If professional help is key, how do I find a treatment that works, and how do I stick with it? Super-extra bonus points if you can suggest things I can do with my life - it's helpful to know I have options, but I can't think of any.

Throwaway email:
posted by anonymous to Health & Fitness (35 answers total) 11 users marked this as a favorite
Your university should have some counselling services, where you can receive actual therapy instead of just prescriptions for drugs. You seriously, seriously need to speak with someone. I'm at university too, and I take weekly advantage of the free counselling (depression, drugs never helped, also have a tendency to stay home.)

Check your school's website, and if there is a student services or student union, they should be able to hook you up with an email or a phone number. My school also has group sessions for students with social anxiety and depression...possibly your school will too. At this point, it's probably more important than anything that you start doing therapy than even going to class (I know that's going to be a controversial statement, but so be it. I messed up a lot of years at school by having mental health problems that should have been dealt with first.)

It's going to be hard for you to tap into a passion that could lead to an actual "life" for you before the depression is handled, but you are right: you do have options, and the problem is that you just can't imagine what they are right now. Likely, even if an option were to be presented to you by someone else, you would somehow discount it.

That said, if you're interested in Japanese culture, that's at least a hobby you can start with. Learning Japanese would be cool. A lot of people also go to Japanese to teach English for a year. (But of course, that would require you to leave your room.)

I think it's important to point out to you that your life is not a tragedy -- yet. You're having a problem, a serious and really difficult problem. But your life is not even anywhere near over. Humans are remarkably resilient, and people who have gone through some of the most fucked-up shit imaginable can end up having really productive, happy, worthwhile lives. You can, and you will, if you get some help for this.
posted by peggynature at 7:05 AM on August 23, 2008

Your school(s) may have free or low-cost counseling resources, and if not therapy maybe career counseling could help. As a clinical social worker who works with adolescents I always try to get them to a psychiatrist, not a GP, but if that's what the NHS allows or all you can do, it's better than no medical attention. I'm not talking smack about GP's, but often they do not have a psych specialty and they are rushed though psychiatric interviewing, which can take up to an hour, in a 15 minute appointment. Good luck.
posted by ShadePlant at 7:06 AM on August 23, 2008

I should add - if it's really difficult to even get out to a therapy appointment, they might be willing to do a first session or two over the phone. Never hurts to ask.
posted by peggynature at 7:10 AM on August 23, 2008

Go back to your therapist. Tell them what you've told us (if you haven't already). Maybe ask if they think you should try Paxil (worked wonders for me). And spend some time on the "couch" talking to them. If you can't get one that will listen and seems to care, then try another one. I spent months curled up on the couch not talking to anybody, too. I dropped out of college too. I know exactly how you feel, and it's awful. I contemplated suicide several times, but couldn't figure out a reliable method that wouldn't leave my partner with a mess. I'd always thought psychological therapy was a joke, and the medications would turn you into someone else, or maybe some kind of smiling, mindless droid. Finally, I made myself call and make an appointment with a therapist. I was fortunate to pick one who was about my age, open-minded, had a good sense of humor about life, and honestly wanted to help. I spent a number of hours talking with him over two to three months, and he prescribed me Paxil, 20mg/day. It's a small dosage, and I had to take it for a couple of weeks before it started doing anything, but gradually life started to have meaning and pleasure again, and I didn't just want to curl up on the couch any longer. I'm still kind of a loner, but I engage with the world, have friends, do things, and am happy with the way my life is going. I also lost about 50lbs and started working out at a gym twice a week, mostly walking on a cross-country skiing machine for 30 minutes a visit. You can beat this, but you have to want it, and you have to force yourself to stay on your medications and keep seeing your therapist for as long as it takes.

As far as what to do with your life... You seem to have a very good command of the English language, and apparently have a vivid imagination. Sounds like a writer to me. Fantasy is big these days, and I think science-fiction is making a comeback. Japanese things are trendy now too; if you have artistic talent (or know someone who does) maybe you should try your hand at producing a manga. Or write some fantasy stories and offer them to some publishers (but be prepared for lots of "thanks-but-no-thanks" letters, from what I hear). Don't worry about what other people think you should do, or what you're "supposed" to be doing. Get your depression under control and then start doing something you enjoy, and things will work out.

Hang in there. Depression is a terrible, painful thing to deal with, especially since people who haven't dealt with it personally always offer helpful advice like, "Cheer up - it can't be that bad," or "we all have bad days," or "don't be such a wuss - get off the couch and go do something." They don't understand that it feels like you're suffocating under a heavy, black shroud, and that the life you live in your head or in your dreams seems so much more real to you than the one they see. You can get better, but it will take time, and it might not be easy. But you can do it. *hug
posted by Death by Ugabooga at 7:12 AM on August 23, 2008 [1 favorite]

After you go counseling, maybe you should consider a lifestyle change. Living an agrarian life has helped me a lot. In the old days they used to send sick people to the country because they knew the fresh air and sun and hard work was so healthy. It still is! When I started working on a farm, it was the first time in aggggges where I wanted to wake up and go outside. It was wonderful. It might not help everyone, but it's worth a try.

Two years ago today I was probably skipping class and sitting in my room making Livejournal icons about BBC dramas. Now I'm studying agriculture in an awesome country where I want to go out and do something nearly every day and I don't have to force myself. This morning I walked outside to harvest red currants and there were beautiful birds and dragonflies all around. My goal these days is never to go back to my old life. Yeah, sometimes it sucks, like yesterday when I was harvesting potatoes and there was a sudden downpour, but it's nothing like the torpor at university.

Most people's lives wonder they want to stay in their rooms. Looking back, I'm not sure that my psych was right when she said the problem was with me (genetic depression)...I think the problem was my boring unchallenging life.
posted by melissam at 7:35 AM on August 23, 2008 [13 favorites]

Hey, it's pretty obvious, but since no one's said it yet, I will: I hadn't done a damned thing with my life when I was 22 either. I was right around graduating from college time, but I was putting it off because I was only going to university to put off going into the real world. I had nothing I wanted to do with my life or anything. I wasn't particularly depressed about it; I just didn't care one way or the other really. 90% of the people around me were the same. So don't worry about that. It's normal.

As for what you should do with your life, here's my suggestion: Come be an English teacher in Japan. It's pretty easy to get a job; basically the only qualification is a native-level command of the English language, and I've met a lot of people who were even blurring that line. Teaching kids really makes you (me) feel like life is worth something, because you can live vicariously through all the kids and feel like you are influencing them in a positive way and contributing to their bright futures. And their overall positivity tends to seep into you in a way. At the same time you can do stuff like go to Ayu's concerts at the Budokan, although they probably won't let you on stage instead of her. On top of that, Japan has a really great health care system, medication really cheap, and there's more therapists who understand hikkikomori tendencies than anywhere else. One thing to note: it's a lot easier to get that job if you have a college degree, even if it's in something completely unrelated to anything, for example me and my illustration degree. So that might motivate you to go ahead and finish off university. Why not give it a shot? 頑張れ!
posted by donkeymon at 7:41 AM on August 23, 2008 [3 favorites]

You are so young and there is so much time to fix your problems and do everything you would ever want to do in the world. You have to keep trying. Understand that if you try something and you fail, you have to learn to get over it and try again.

I suggest going for a walk every day. In general, eating healthy and exercising will make you feel better. Make that a hobby, being as physically healthy as you can be. Then concentrate on hobbies related to your intellectual interests. Then parlay those hobbies into a career.
posted by whiskeyspider at 8:02 AM on August 23, 2008 [1 favorite]

Therapy is completely necessary at this point. I don't know how the NHS bureaucracy works, but you need to get yourself to the top of the list somehow. A few options: Go to the emergency room. You are in a state of emergency. Explain to them what you explained to us, or if you can't talk well about it, print out what you've written and take your write-up with you.

In the US, we have Social Security disability for this kind of thing, and I have to say you would be one hundred percent qualified for it. What sort of disability system is there in the UK? Whatever it is, apply.

You need to see a psychiatrist, not a GP, on a regular (monthly) basis when you're taking anti-depressants. Prozac may or may not work for you; you also may need something else to help with the anxiety.

A therapist who does behavioral work is the second thing you need: Someone who will give you assignments like "Leave the house by 11 a.m. and walk to the corner and back." Just to get you going. I've been there. I've been there a lot, and without my therapist I wouldn't be here.

In fact, from your write-up, it sounds like you could benefit from some time in the hospital. It wouldn't be fun, but it might help re-start your engine.

Whatever you do, frame this as an emergency. If you have parents or siblings or friends anyone who can help you, enlist them. You need a support system of people saying, "Anonymous is too ill to do anything right now, and we need help right away."

Until you can get the help you need, do try to go out of the house for a few hours each day. It doesn't matter what you do. Go to a museum, go to the park, go to the corner deli. Go to a cafe or a grocery store. Does that sound impossible to you? Because there have been times when it's been impossible for me, and that's when your support network comes in. If your sister or brother or mom or dad or whoever has to drag you out of the house in your pajamas, so be it.

And if you feel up to doing something, just a little bit of something, offer to volunteer for a few hours a few days a week somewhere. Explain to the folks you'll be volunteering for that you have a medical condition and can't necessarily *always* make it, but that you care and you'll try your best.

Time out of the house combined with exercise will do you a world of good.

But again, it sounds like this is much more of an emergency than that. You need to see a doctor -- not a GP but an emergency doc or a psychiatrist -- right now.

If you want to talk with someone else who's been down the road you're on -- almost eerily so -- feel free to MeMail me. And good luck: remember when you see a doctor that you are worthy of his or her greatest efforts to help you.
posted by brina at 8:29 AM on August 23, 2008 [1 favorite]

Read up on agoraphobia. Get the Anxiety and Phobia Workbook. Even if you can't get a therapist, this book is invaluable. YMMV, but a combination of Lamictal and Klonopin has worked wonders for me. I'm finally motivated to get out of the house and do stuff. Also, I stopped comparing myself to others. I accomplish what I accomplish, I am who I am, and if someone is more "successful" than me, it doesn't mean they're better than me. It means they're different.
posted by desjardins at 8:37 AM on August 23, 2008

Get a dog. Seriously. It's good to have another individual to care for and you sound like you could benefit from a) some unconditional love, b) daily walks, c) the easy interactions with other people that happen when you're out and about with a dog. If you're not up to dog ownership, consider volunteering at a shelter.
posted by carmicha at 8:41 AM on August 23, 2008

University counselling service and/or change your GP. Once you get into the dedicated NHS mental health system, you won't have to deal with the GP lottery. (At the start of my time at university, the college GP handed out temazepam like sweets; it was a very good thing when he retired.)

Yes, access to therapy is limited -- here the university's resources will be useful -- and medication is generally the first port of call, but this is where a wee bit of American-style doctor-doesn't-know-best can help. Even if you're ambivalent towards pharmaceutical treatment -- I'm not going to get into that debate here -- it can provide the jump-start that gets you out of the house and talking to people who know their stuff on a more regular basis. Even at your local surgery, you are allowed to say 'Prozac hasn't done a thing for me'. It's no skin off most GPs noses if they prescribe Seroxat (aka Paxil, not recommended by me) or Lustral (Zoloft) or Ef(f)exor, so ask for something else.

A few options: Go to the emergency room. You are in a state of emergency.

That's not quite the way it works. Go to your GP and ask to be referred directly to the local community mental health unit -- or, if you're at your wits' end, the local crisis team. If the GP won't do it, summon up your strength to register with another GP. If all else fails: get people who care about you to have you sectioned. No, really. You're not sticking with treatment, and that's not your fault, so a change of scenario and a bit of involuntary care might provide that jump-start. Stephen Fry paid them a visit for his recent documentary.
posted by holgate at 9:09 AM on August 23, 2008

If you can get into some kind of cognitive-behavioral therapy, I'd start looking at the way you're using the idea of how things "should" be something other than what they are. In my view, it's these "should" statements that make you depressed, moreso than the actual facts of your circumstances. It's possible to do almost nothing and still be happy about it; on the other hand, you could be very busy and conventionally successful and still be miserable because you're telling yourself there's something else you "should" be doing that you can't for some reason.

It sounds like it would be more beneficial to work with an actual therapist, but I will at least link to the book Feeling Good, an intro to CBT that is usually mentioned in this type of thread.

To give another example, I don't think there's really any problem with having an inner fantasy life; where you're getting hung up is telling yourself it's so horrible and wrong.

Practice accepting yourself and the world exactly as they are, as much as you can; and when you find that you can't, accept that as well. Note this doesn't mean that you don't try to change things; but change works better when you're not trying to resist everything that's actually happening because you've judged it to be wrong in some way.
posted by dixie flatline at 9:18 AM on August 23, 2008

Get a dog.


Do not get another living thing as a prop to make you do things. That is not fair to the dog, and it is not going to help you, either.

I would ask about doing therapy over the phone for a while, and definitely ask about medication.
posted by winna at 9:29 AM on August 23, 2008 [3 favorites]

I don't have any immediate advice that hasn't already been posted, but I do have an observation based on personal experience.

For me, the way out of the holes I've found myself in over the years (self-imposed and otherwise), has always had something to do with giving; finding a way to get outside myself and share my skills, experience or just time with some individual (or organization) that is in need. And don't let your darkness delude you, you do have something significant to share; even if it's just your ability to put sentences together and make a sense. You do this very well.
posted by philip-random at 10:03 AM on August 23, 2008

You are an excellent writer. You have a vivid imagination. You create worlds within your head. You’re teaching yourself Japanese. I can’t do that. I wish I could! Some parts of your life do not resemble society’s expectations (husband, mortgage, kid), but that’s ok. Society can go eat a banana. Give yourself credit for your skills and talents.

As for a purpose...I’m older than you and I still haven't found my life's calling. Sometimes I think I need to get back on that search and become Something... and I get dissatisfied. I’m happier when I remember that simple accomplishments count too. Something blissfully basic like making a really good cup of coffee. If I give myself credit for accomplishing the easy tasks, then I feel better equipped to deal with the hard stuff. I can handle the crappy parts of life because I made the world’s best coffee on Saturday. Yay me.

Do you think you’re a bit paralyzed by the size of what you want to do? It must be hard to imagine a career when you’ve never had a job. Finding a purpose is pretty big. Tackling an entire health care system for useful therapy is giant. Graduating from college is another major project. Have you tried sitting down and writing out what you’d like to accomplish in Daily To Do List form? Maybe just a week or two or tasks?

Be concrete and break things into steps. Try to winnow down the big tasks into small, doable tasks. “Graduate with a degree” is imposing. You could narrow this to “Monday: attend class – get up at 8, leave house at 9, go to class”. Your goal is the simple thing of waking up at 8 on Monday. Then your next goal is getting ready so you can leave the house at 9. Etc.

Once you get the hang of consistently doing the small things, then you can tackle the harder challenges. The key is to trick yourself into the consistency. You go to class everyday just because class is on your list. Class is part of your brushing your teeth. Anything on the list must be done. Once you’ve done it, congrat yourself.

Perhaps you could try this same approach with the task of getting therapy?

Apologies if this is too simplistic. A To Do list won’t fix depression/anxiety, but when I get paralyzed by big things starting small helps. (Coffee is nice too.)
posted by fiore at 10:09 AM on August 23, 2008 [3 favorites]

I can't speak to most of your question, but I hope this is some reassurance: I just turned 24 and I still don't know What I'm Doing. I'm doing a bunch of things, but none of them are really important to the universe outside of my little world. My father retired this summer, and he to this day has no idea What He's Been Doing, aside from whatever was necessary to make ends meet. He confessed that sometimes he wishes he'd had one, but is satisfied with his life overall. The lack of a grand plan in your twenties (or ever) is not a bad thing, at all.

You say in your post that no one would ever want to hire you. Why? Is it because you're a shut in? If so, if you can learn to be more outgoing, you will be more hirable. If, on the other hand, you're thinking you shouldn't even try because of something intrinsic to you, please stop thinking that way. You sound intelligent and well-spoken here, and if you can get yourself out dealing with people, I think you'll have more success with this whole "life" thing than you seem to think. I think if I knew you, we'd probably get along.

Yeah, I know it's easy for me to say that. But, seriously, try to work on getting out of the house. Get therapy, talk to friends, etc. Other people in the thread above me have some great advice. It ain't as scary as it looks out here. =]
posted by Alterscape at 10:24 AM on August 23, 2008

Listen to holgate. You need a referral to the community mental health team. You need to tell the GP "I am at imminent risk for suicide" and get a referral. Imminent risk for suicide is the magic phrase for jumping the NHS queue.

When you are at your GP, refuse any prescription for Prozac and ask for something else.

Do not worry about where you are at 22. My life at 36 looks nothing like my life at 22, and frankly nothing I was doing at 22 - going to university and working at a non-profit - has anything to do with what I'm doing now or was remotely useful in getting me where I'm standing now. Your only job for the next six weeks is to get yourself in to see a psychiatrist on the NHS. That is it.

Everything will get much, much better if you do that one thing.
posted by DarlingBri at 10:43 AM on August 23, 2008

For the social side of your life - I am going to guess that you are probably involved in some fandoms, maybe Japanese culture-related. There are probably others in your area that might hold meetups. That would be an excuse to go out of the house, and meet people in a no-pressure situation - fangirls/boys tend to be pretty tolerant of social foibles, and some of them are probably dealing with the same issues you are. Try to reach out to them.
posted by Mr Bunnsy at 10:44 AM on August 23, 2008

In terms of whether you should have done something monumental with your life, or whether you know what you're doing? I'm 38 and I STILL don't know that. But life is long, and there is time. There are so many famous people that didn't even START doing Their Lifes' Work until they were much older. (My favorite examples are Frank McCourt -- who didn't write his first book until he was 66 -- and Helen Hooven Santemeyer, who didn't really "make it" until her book "And Ladies Of The Club" was published when she was 88!)

Everyone is saying that you need to take care of the immediate, short-term matter of being depressed right now, and I agree. You can't find a purpose if you are suffering like this mentally. Take some time to heal yourself first.

But then I'm sure you're wondering "but after I do that, then what?" How do you find your purpose? ...Try taking a different approach. Let your purpose find you. Just try different things for the hell of it, and see what happens. If you try something and hate it, well, then, just don't do it again. If you try something and like it but aren't a pro, then you can keep trying to learn and get better at it. If you like something to do just for fun but it doesn't grab you enough to make a living at it, well, then, that's how you get a hobby -- go for it. But if you like something and it turns out you really are good at it, maybe then that's your purpose.

And "your life's work" can change. We all live long lives, and we all change our careers a lot. And lots of famous people did the same thing. Einstein was a patent clerk. Gaugin had been a bank teller before he quit to take up painting when he was 40. Frank McCourt was a teacher before he took up writing because teaching was the only job he could get. Clint Eastwood started as an actor and now has moved into directing. We all do a lot, and it's okay to change a life path if the one you've been on for a while doesn't make you happy any more.

But the only way to find what it is to do is just to try stuff purely to see what happens. If you try to figure out beforehand whether This Is The Purpose, it'll just put pressure on you -- so just try things just for the sake of trying them instead. See what happens. Play around. One of those things will take to you and you will like doing it too, and you'll run with it.
posted by EmpressCallipygos at 11:03 AM on August 23, 2008 [2 favorites]

I have had very similar problems. Almost spookily similar, in fact. Based on my experience, I would recommend you keep trying doctors until you find one that gets you and your problems. If you tell them about your suicidal thoughts, too, that should ring alarm bells. holgate hits the nail on the head about the NHS: once you're in the dedicated mental health system things work more smoothly. I was referred to social services and they got me both talking therapy and a decent psychiatrist quite quickly. They made sure I was doing OK, taking my medication, etc. By the end of it I was like a different person. Remember, you have a serious and tangible illness and you are entitled to treatment just like a person with a broken leg. You wouldn't expect to be chucked out the door with an aspirin then, and that shouldn't happen to you now.

Also, the university, when they realised the extent of the problem, actually had a decent support mechanism in place, their own counsellors, etc. It just takes a lot to get the mechanism moving. Which of course is precisely what you're unable to do as the depression is destroying your concentration and motivation. Just please, don't give up. People want to help. Part of the illness is stopping you from looking into the future but trust me, it's there. You sound bright, articulate, and although you don't think you've accomplished much so far, just getting through the illness is a massive achievement. I know that first hand. My life didn't get back on track until I was about 26 so you're one up on me already. I think you'll be surprised at how much you can accomplish in a short time when the illness isn't holding you back.

I always fancied the sound of the JET programme,, but I ended up doing something else entirely. I did spend a few years learning Japanese though, enough to watch films and be able to scoff at the subtitles! Perhaps you could find a language partner on campus or try some of the free Japanese podcasts, if you haven't already. I don't know how much any of this helps, but if you want to talk, or are having one of those long dark tea-times of the soul, feel free to contact me through the email on my profile.
posted by danteGideon at 11:10 AM on August 23, 2008

Yes to therapy, possibly inpatient, as that would prevent you from skipping appointments.

The other thing that struck me is how you're overwhelming yourself with all of these things you think you must do, NOW. I bet you wouldn't expect someone else to change their entire life like flipping a switch, don't expect that from yourself. Start with small steps. If you haven't left your place in a week, take a walk around 1 block. Expand from there, with small challenges. Success at small things builds the confidence to try bigger things.
posted by kattyann at 11:25 AM on August 23, 2008

I agree with everything EmpressCallipygos said times 10! Just because you decide something doesn't mean you can't change your mind.

I just realized the other day that I turn 30 in two months and I haven't done most of the things I thought I would have done by now. Problem is, those ideas are formed when you're what? 13, 14? That was a whole half-lifetime ago! 30 seems like a million years away, and 14 year old me had no clue what the fuck she was thinking about. I understand feeling like you should have done X, Y, and Z by now....but if there's one thing that I've learned in my twenties, it's that no one is keeping track, and it really doesn't matter anyway.

When I was 21, I was a college dropout who was working in the field that she had dropped out from! And I was known for asking my friends, "so...what do you think I'm good at?" It took me a bit of time to figure shit out for myself, and I'm still figuring it out. (I know this may not help, but I'm just saying - even though you feel like it, you're not alone AT ALL :)

I agree with other people that you should actively seek out help (other peeps have told you how to do it, scroll up!), and that you shouldn't get a dog. Yet. Pets rule, but they're also high maintenance, so maybe get one later. Right now you should just worry about yourself. I know dealing with it sucks, but it's really a good thing that you've realized that this is no way to live :)

Also, as others have said, you're a fantastic, descriptive writer. I usually don't bother to read really long posts (I get bored easily, sorry guys!), but yours drew me in.
posted by AlisonM at 11:26 AM on August 23, 2008

You might consider the traditional remedy of sex, drugs and rock 'n roll. You don't seem to be having much fun or getting laid. Visit the local gay women's pub or bar and have a few drinks. Tip the bartender. Go home with the anyone who asks. Go to a rock concert - the harder core, the better - dance like crazy, wail and wave your arms. Hey you only live once. And the husband fantasy is puzzling, so have a guy or two while you're at it, maybe that will make things clearer. Nothing good's going to happen between the telly and the fridge - just do it!
posted by richg at 1:23 PM on August 23, 2008

You might consider the traditional remedy of sex, drugs and rock 'n roll.

For someone who was simply *bored,* this may get them out of a rut. For someone who is obviously going through a Major Depressive Episode, this is a VERY BAD IDEA.

Empty sex is just going to make you feel emptier. Drugs are going to distract you, and then when you come down, the crash into reality is going to be ten thousand times worse. Your suicidal thoughts may lead you to overdose.

The rock n' roll... now, that's a good suggestion. But please, leave the sex and drugs out of it.

I'm 27 and I was diagnosed with Major Depressive Disorder at the precocious age of 18. I've had four or five Major Depressive Episodes in my life, and to me, your situation sounds *exactly* like a MDE. With this, you absolutely need treatment. No amount of routine change is even going to be possible, let alone effective. No hobby you take up will make your feel fulfilled. Your normal activities are hard enough, you absolutely will not be able to try anything new. The only thing that is going to change this is getting help.

I'm in the US, so I don't know how your health care system works, but try to get in to see a psychiatrist. Try to at least get your GP to do some basic screening for depression - in the US, there's a quick diagnostic survey that provides doctors with at least some idea of the severity of your problem. If you make an appointment with your GP and you can't bring yourself to go to it, you need to find a way to get inpatient treatment since you don't have the resources to get yourself help outpatient. If your GP prescribes Prozac, point out that you've tried it in the past and it didn't work. Try something new.

Do whatever it takes to find a therapist, even if it means going inpatient.

Once you get treatment, I can promise you, it will end. Life will be meaningful again. But you absolutely 100% MUST get treatment. There is NO other way.
posted by grapefruitmoon at 2:31 PM on August 23, 2008

I think, for some of us, the world of choices we have can be paralysing. 200 years ago, there probably would have been little choice. Follow in your parents footsteps career wise (farmer, maid etc), get married, have kids and so on. Now, we're told we can do anything, be anyone, etc, but make the choice now, now, now before it's too late. We're not told that it's okay to be nobody. I'm telling you now, it's okay to be nobody. You don't have to have or find a life's purpose, in fact, that seems to be such a problem for you that I'd postpone it if I were you. At 30, I would say, I shall seek my life's purpose, I'll be weller then.

The next thing I would do is start to realise what I need to do to survive now, and what surviving means. Does it mean a job at Macdonalds? Or are you perhaps not ready for that? Does it mean being able to walk down the street without being scared?

It might be possible to do this alone, but I think it would be very very difficult, so take the advice of posters above to get help. Otherwise, try the self-help books at your local library. Some of them are shit. Honestly, they really are. Some are gold (often recommended at metafilter like DAvid Burns' book).

Right now, your only obligation is to get on an even keel. You don't have to "catch up" to your peers. You don't have to finish uni. You don't have to be or do anything, but you will be happier if you can get this sorted out.
posted by b33j at 2:39 PM on August 23, 2008

I haven't read all the other replies, but I'm sure there are fantastic answers already. Not sure about the UK, but here there is a service called Lifeline (and the younger equivalent Youthline). It's an over-the-phone counselling service that you can call up and just have someone to talk to about issues you have in your life. If any UK mefites know of something like that - it won't solve all your problems, but it will get you on the way.
posted by minus zero at 4:38 PM on August 23, 2008

I think it is down to UK citizens to advise you on somehow negotiating the health care system. You probably need both talk therapy and continued work to find meds that actually work for you. This is your fundamental need. There is not maybe or probably about it. There is nothing more important to be doing with your attention right now. None of the other business you are talking about is going to happen until you can get out of your house and interact with people. The only pragmatic advice I could offer on this front is to ask, are there any functional adults who are acting as your advocates? Your parents? Siblings? Guidance counselors or whatever at school? You need help and it sounds like you're going to need help getting help. You missed one opportunity to take a shot at therapy. You can't afford to miss another one.

The only data point I wanted to add is that I've been plagued by this feeling of lacking a "fundamental purpose," or whatever the hell you want to call it, my whole life. At this point I really don't know if I'll ever really find "it" or if such a thing exists, or at least exist for me. I got treatment for depression anyway. I negotiate a life and a living anyway. I have a wife and a kid and a house and I am serious as a heart attack about living my life, in the here and now, for everything it is worth. I still fight to stay out of fantasy worlds - bad ones and sweet ones. I still get too distracted by alternate realities like ye olde metafiltre here sometimes. I look around and see that as far as I can tell most people don't have some dramatic defining identity or purpose. I'll be damned if I'm going to wait around to die seeing if that bus comes. I haven't abandoned finding a calling or vocation or whatever, but to the extent that it knocks me out of living in the moment it is just another fantasy world. The one other thing I can tell you about it is that Ask Metafilter is utter shit at providing any guidance on the topic, probably because it is simultaneously a damn difficult question and an utterly personal and individual one. It's not even worth asking.
posted by nanojath at 5:12 PM on August 23, 2008 [1 favorite]

I hope you take some of the suggestions here relating to clinical depression, I can't really speak to that part since I've never dealt with it myself. But to take a look at some of your other statements:

How can I force myself to live in the real world, instead of the made-up one in my head?
For an imaginative, depressed introvert, I think sometimes it can be difficult to find reasons to come out. Beating yourself up for it will force you inside further -- the trick is to find things about your real life that are better, real reasons to spend time there.

I thought this line was very telling: The main dream, is that I have magical powers, and I can make myself thin, beautiful, talented, happy, with just a wave of my hand. The implication, of course, is that you don't think you're any of these things, and if you were, you wouldn't have the problems that you do now. It winds up as a Catch-22 -- "If I'm thin and beautiful I would be better off, but it would take MAGIC to make someone like me thin and beautiful, so I'm stuck as my hopeless, miserable self forever." (On the basis of this post I'd argue that the talent is there, since certainly your writing is polished, and it's not everyone who's driven enough to teach themselves a language.) The depression intensifies and warps these feelings, but they're familiar even for people who aren't depressed. You talk about Ayumi -- I would think she too likely has causes for sorrow, self-criticism and doubt, and I am sure that there are times where, despite her beauty and fame, she feels like a failure. Being thin and beautiful guarantees nothing. I think the most important step I ever took for my own mental health was to realize that my life wasn't going to start when I was thin and beautiful, what Kate Harding calls "the fantasy of being thin." I would really recommend you read that article, because I may be off base, but I get the sense from that, that besides the clinical depression, your self-image is the other big thing keeping you back. Certainly I agree with the whole "get out and walk and eat fruit" thing, too, but it seems like your fantasy life is based around "if I was a whole different person, things would be great." You don't have to be anyone but who you are to have a life that makes you happy.

For god's sake, I even started teaching myself Japanese, just so my fantasy life would be more accurate.
You say this like it's really a shameful thing, and it's not. 80% of my motivation for learning Japanese in college was to try to read classical Japanese literature, and that seems fairly respectable and non-otakuish, but I'd be lying if I didn't admit the other 20% was to play Final Fantasy IV in Japanese. If you went to a Japanese class, I'd guess that half the class would have reasons for studying that were closer to your motivation than to "I want to work at a Japanese company and make big bucks."

How can I find what it is I'm supposed to do with my life, or is it too late for me to make something of myself?
It's OK not to know what you "want to do." My dad tells me he's 55 and he still doesn't know, and my mom just finished her Master's degree. Don't think about what you're "supposed" to do -- I believe this can bind you in and of itself, waiting for the fated opportunity or sign to come along. Get treatment for your depression, do what you have to do to survive, then think about what makes you happy. I use 43 things as a way to get out of my own head, think about my true goals and what actually makes me happy -- perhaps try listing a few goals, once you're at a stronger point.
posted by shirobara at 5:43 PM on August 23, 2008

'Imminent risk for suicide' is the magic phrase for jumping the NHS queue.

I just want re-emphasise this. The tendency, not just with depression but with British discussion of mental health in general, is to try and stiff-upper-lip it in a misguided attempt to avoid what you mistakenly think is self-pity. The conversation generally goes something like "have you thought about harming yourself?", "How seriously?" and if you answer is "seriously", then you will be referred. You have the right to appropriate help, and there are people who can provide it.

Your life hasn't even begun yet. What you need is a space to breathe. Get the help you need to step back from those days that bleed into months. Lewis Wolpert, in his book on depression, called it a cancer of the soul.

In the very short term: what you think is fantasy is what other people call 'ambition'. That may sound like bullshit, but there's a part of role-play in any attempt to get beyond your own limitations. (In some ways, CBT is therapy by acting.) If you can afford it, take a deep breath and spend a train-ride day trip or a EasyRyanBaby weekend flight and be someone with a fantastic life when you reach your destination. If you can't, be that someone on a trip to the shops on Monday.
posted by holgate at 6:42 PM on August 23, 2008

A few people have mentioned inpatient treatment so I'll follow up and ask - what can inpatient treatment do (better than outpatient treatment) to help someone who is not suicidal but is very, very depressed? I am in an almost identical situation as the OP except that I'm being treated by both a psychiatrist and psychologist, and so far it hasn't been effective. If I thought that going to an inpatient center would be more effective than what I'm doing now, I'd go - but I've always figured that the only difference would be that I'd be on "suicide watch", and it would probably be even more depressing because I'd be in a hospital setting 24/7. Can anyone speak to this?

To the OP - I wish I could offer some advice besides hang in there, things will get better. I'm struggling with the same things as you, but I've known people who have recovered from situations like ours, and near as I can tell, the common thread is a real DESIRE to get better. The fact that you are reaching out here suggests that you really want to get better, now get the resources that will help you get on that road.
posted by btkuhn at 10:18 PM on August 23, 2008

Yeah, Prozac does not sound like what you need. If you seriously are shut in as often as you say, you probably have an extreme case of social anxiety disorder. I'm guessing that's the main problem, not depression. If I never saw other human beings, I'd be depressed too. Your fear of going outside and interacting with others is what is holding you back.
posted by Deathalicious at 8:22 AM on August 24, 2008

A few people have mentioned inpatient treatment so I'll follow up and ask - what can inpatient treatment do (better than outpatient treatment) to help someone who is not suicidal but is very, very depressed?

It can do a few things, but chief among them is that it overcomes the issues the OP outlined with actually being able to go to appointments, which entails opening the mail and leaving the house - acts that in and of themselves can be completely overwhelming in a major depressive episode.

Second of all, residential settings can be very helpful places for adjusting medication. A course of medication action that may take 12 or 14 weekly visits to achieve might be accomplished in just two weeks inpatient.

And last but not least, it can be an enormous relief. You're some place safe, there are many people who's job it is to take care of you, nobody is criticising you or banging on your door telling you to go to class or get a job, and there's always another insomniac in the TV room at 3 am. Bonus!
posted by DarlingBri at 8:24 AM on August 24, 2008

obviously, your first and most important priority should be intensive therapy.

but once you've made progress, you might want to look into online classes. i'm surprised that no one mentioned this, especially since you say that you have such difficulty with getting to lectures. you can do them at the pace that's comfortable for you and at whatever time of the day that you're most productive.

you probably don't want to get a degree from an online school (not that i'm knocking them) but it might help you ease your way back into school without the pressure of getting to class every day on time. after successfully completing a few semesters worth of online classes you'll have a solid track record to support your bid to return to uni full time. you might even be able to transfer the credits back to your university (you will probably have to get the courses approved by a dean ahead of time and they will most likely want you to take the type of online courses that at least require you to sit for an in-person, proctored final).

however, there is the danger that by going to school online that you will use it as an excuse to withdraw even more. so make it a priority to leave your home every day-- join a local recreational sports league, volunteer at a homeless shelter, get a part-time job at a library, or even just schedule a walk everyday. it doesn't need to be big or impressive, just something.
posted by buka at 9:27 AM on August 25, 2008

buka: anonymous is in the UK. Universities work differently.
posted by holgate at 9:35 AM on August 25, 2008

My own experience is very similar. I am now 44, still not sure of who I am and what I want to do with my life. I still don't know what my purpose is or what I'm destined to be. I have had many tries at a life; I studied music, psychology, law, business administration, information science... only one degree have I completed, and I now work in an office as a low level administrator.

What I would like to share with you is my experience of how we all feel like we should have a purpose in life, some sort of cosmic destiny that will grip us and shape us, something that we will leap out of bed every morning to do with joy and excitement.... well, that is a myth. I am speaking from my own personal experience here, and I'm sure many people of my age will agree with me, that the idea that there is a single unique purpose in life for each of us is a myth. It is Hollywood, TV, romance novel crap. There is no "purpose" for each of us. There is no right thing to do. Please separate fact from fantasy. There is no calling that makes us do something that we are destined to do without effort.

We are what we are at any given moment. And that is the truth.

There is nothing that will one day make us jump up and say, wow, this is what I want to do, this is me, etc,etc . Trust me, please. I have lived a half life for 20 years thinking that one day something would make me want to go out and be someone, but it never happened. It doesn't. It is sooooooo terribly corny but once you realise you will be able to move on and make something of yourself, the truth is that LIFE IS WHAT YOU MAKE IT. If you want something, you have to go and make it happen. This could be anything; if you want a job - you have to go out and get one. If you want money - you have to go out and get it. If you want friends - you have to go out and meet people. If you want a nice car - you have to go out and buy one. Etc, Etc. Etc,. Please trust me; I have waited for years for the inspiration, the energy, the desire, the motivation, to be someone. It doesn't happen that way.

First step: decide what and who you want to be. Ask yourself lots of questions. For example: What do you want to do every day for a job? Where do you want to live? Is money important to you? What would you do on an everyday basis in order to get that money? Does study interest you? Would you rather be a plumber/clerk/surfer/journalist/police officer/father/artist/restaurateur/lawyer/etc? What do you find fascinating? Who do you admire and wish to be like? What things excite you?

Next step: accept that you have to work hard to achieve you desired outcome. Make a start: talk to people who do what you want to do. find out what the next step is.

Seek counselling: if you are feeling depressed or have a lot of trouble motivating yourself to do everyday things, see a counsellor, psychologist or psychiatrist. If depression is a problem, get help immediately. I have taken medication for years and it has helped me to live a life, earn an income, relate to others and be a person that can cope with whatever life throws at me. Be clear whether you are clinically depressed, or struggling with life issues. It is not helpful to attribute every life problem as "depression". Life is often horrible and hard, but there is a real difference between facing your issues by learning how to cope with life, and realising that you are clinically depressed and need psychiatric help. Medication can be a life-saver, but only if you are ill. Medicating away life issues that happen to all of us is a waste of time and money. Be sure of what you need from a mental health professional - make sure they are clear with you as to what you need from them and what you can do to help yourself.

Accept responsibility for your own life: once you decide what you want to do with your life and have dealt with any life issues or depression issues, you have to accept that you and only you can change your way of life. If you ware unhappy with they way your life is, the only person that can change it is you. This is the hardest part of it all. There is no way around it; if there is something you want, you will have to do it yourself. Work and effort, yes, it will take those for a long time. And nothing less.

After all of the above you still do not know what you want to do.... well, you can do two things: either relax and play around for a year or two and then make a decision, or just make a decision and go for it. You are very young. Very young. You have the gift of time and there is plenty of time for you to travel or work in a day job for a couple of years before you have to get serious and make up your mind to commit to something. Or you may never commit to anything. My point is that we have to shit or get off the pot. Be happy with what you do today. Sure, you may change your mind tomorrow and try something else. You may surf for the rest of your life and be happy with no money and lots of freedom. You might decide to work for a couple of years as a waiter and then go to university. You can be anything. And so can I. We just have to DECIDE and APPLY ourselves to achieve what we've decided upon. It's a simple as that.

One last thing: please do not go through this alone. Get help (friends, family, counsellor, doctor, psychiatrist, healer, witchdoctor, whatever) and get outside. Meet people. Spend time with people that you feel comfortable and happy with. Do things. Play sport. Go to the pub. Keep in contact with old friends. Make contact with others. Life is not a solitary pursuit. It is only our involvement with life that makes us experience real things. After years of clinical depression I can tell you that being solitary and insular will only serve to magnify anything that is unpleasant in life. Communication, sharing, involvement, belonging.... these things make us whole and contribute to a full experience of what it is to be us. If you want to know who you are and what you should be, spend time with friends, share things with them. The outside world teaches us and reality shapes us. That is real experience. If you spend all your time alone inside your room/house wondering who you are, you will never know. I wish I was learned enough to quote adages and analogies so that you will see what I mean, but I can't think of any. It all boils down to one thing: get out there and do something. You can analyse and ponder for years, but it is only by going out and doing things that real growth that occur. Reality is your friend. It never lets you down. It shows you the way.. get out there and do something. Make mistakes, make bad decisions, learn from them, make friends, be imperfect, make enemies, be amazing, be a fool, just get out there and do something.
posted by outside_makes_inside at 8:12 AM on October 6, 2008 [1 favorite]

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