I am feeling worthless. What causes it?

Question

Hello doctor,

I feel very sad and have negative thoughts about life. I am anxious and feel useless and worthless.

Could you please diagnose and guide?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Thank you for contacting us, and I am genuinely sorry you have to go through the extreme psychological pain. This is not your weakness, but a disorder that is making you feel like this and act like this.

This is most likely major depressive disorder, and you should immediately contact a psychiatrist. Experiencing suicidal thoughts, feeling worthless, and hopeless are symptoms of depression.

I am glad you reached out for help. Major depressive disorder is a treatable condition, and many people live a normal life if proper help is taken. In this disorder, a person starts to believe that nothing is going to be fixed, everything looks gloomy, and the person starts losing hope. You would have observed a loss of interest in activities and people. Everyone who is suffering from depression would feel exactly like this.

There are two strategies to manage this disorder: one is to take medicines such as SSRIs (selective serotonin reuptake inhibitors), and the other is psychotherapy, such as cognitive behavioral therapy. You will see improvement in four to six weeks. Since these medicines and psychotherapy take time, you need to tell yourself that in a few more weeks, you will feel normal.

Sometimes these thoughts and feelings become out of control, which is the exact reason I am advising you to visit a mental health facility and immediately meet a psychiatrist.

There are also some medical causes that need to be excluded first, such as hypothyroidism, anemia, low iron, vitamin B12, and vitamin D deficiency.

If you have experienced hypomanic or manic episodes in the past, such as grandiose feelings, irritable mood, spending money recklessly, decreased desire for food and sleep, more energy, and these last for a few weeks to months, then your diagnosis would be changed to bipolar disorder.

In bipolar disorder, extreme caution is mandatory while taking antidepressants, as they can trigger the manic episodes. If you have bipolar disorder in the family, then the risk is higher. Therefore, careful assessment is essential.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.