I was in a very bad accident a year ago. I had to have plastic surgery to re-assemble my face, among other injuries. Since this accident, I have been very sensitive to everything sad or violent, crying about anything. About a month after this occurred, I broke up with my boyfriend because I thought he didn’t care about me. Now I find out that he gave me HPV, and that my pap smear was abnormal.
I am so sad all of the time, I cannot sleep or eat, and it is very difficult for me to work. I often think about suicide, and it seems that no one understands my feelings. Things seem to keep getting worse since my accident. I also feel that if I did talk about this with someone, then I would be guilty of bothering him/her or making him feel bad, and that makes me upset, too. It seems that I am depressed, but maybe it is just because of all of this. I do not know what to do. I feel scared all of the time. Please give me some advice on how I can make myself feel better.
You describe very serious symptoms of anxiety, depression and hopelessness, as well as symptoms of a stress response. An acute stress response (also known as an acute stress disorder) can happen whenever someone has undergone a severe and unexpected trauma with associated fear, helplessness, and/or horror. It happens within four weeks of the traumatic event and is characterized by numbing, detachment, a sense of being in a daze and of things being unreal, as well as recurring images, thoughts, and flashbacks of the trauma, avoidance of any reminders of the trauma, and marked symptoms of anxiety and increased arousal.
If these symptoms last more than a month, then a person has developed a post-traumatic stress disorder (PTSD). PTSD is a serious psychiatric illness that requires professional evaluation and treatment. It is a disorder with a strong neurobiological component — the trauma and the associated stress symptoms result in physiologic changes in a person’s brain and body. If left untreated, your anxiety and depression can worsen significantly, and develop into a chronic pattern. The sooner a person gets help after a severe trauma (especially if they are experiencing any of the symptoms you describe), the better their long-term outcome.
I would recommend that you see a psychiatrist, mainly because your symptoms are so severe and because you have thoughts of suicide. It is likely that medications will be very helpful to you, as well as talking therapy, and it is possible that you may need to consider a brief hospital stay if your symptoms continue to worsen. Your whole system — your physiology — has been affected by the accident and by the subsequent depression, stress, and anxiety you are experiencing. Finding some spiritual support (through pastoral counseling or other religious activity) will be helpful to you also. If there is any kind of “trauma survivors’ support group” in your community — for people who have experienced severe traumas or losses — you may find a special kind of understanding and help from others who have had similar difficulties (the Internet can be great for this also).
As for feeling worried about how a professional will react to your story — the very fact that you mention this tells me how anxious and depressed you are. Feelings of guilt and shame are common in depression and in stress reactions. Nothing you can possibly say will scare away or “depress” a professional. We are trained to work with people in distress and to offer them help and treatment. On the contrary, when you speak as clearly and honestly as you can about what you are going through, this allows your psychiatrist to figure out the best way to help you feel better so that you can begin your healing.