Dear Doctor Silen,

Here I am again, doing what I should not be doing. I’ve skipped class and I feel guilty about it, even though it’s the first time. Normally I wouldn’t feel so guilty, had it not been for my lack of effort during the last two to three weeks. During this time frame, I’ve dealt with severe depression coupled with an ever-increasing amount of lethargy. After a lot of consideration I’ve decided to disclose the circumstances that have brought me to this point. My primary goals are to communicate how this state of degradation impales me, how self-doubt continues to add to my personal failures, and present effective ways of dealing with these setbacks.

Last week was school vacation, but there was much work to do. I was behind by two chapters in the reading for my psychology class and I had to start writing a paper. I also had homework in my math class. I procrastinated all week because I felt overwhelmed and incapable of doing the work. I was not intellectually up for the challenge. Through out the entire week I was depressed and completely debilitated by lethargy. Mounting hopelessness painted the entire world gray. I avoided the work because I thought I’d have trouble with the concentration and the absorption of the material. I completely gave up, which only added to the depression.

The week before that I felt significantly better. I was capable of doing the everyday responsibilities that go along with running a household. I felt optimistic about the future. I was more energized. I studied sporadically for my psychology midterm; yet, I skipped it altogether, because I was convinced that I’d fail it. I gave up studying two days before the midterm, which only added to my lack of confidence. It wasn’t until the evening of the midterm, about an hour and a half before, that I decided to decamp. On the surface, I justified this decision by reminding myself of my professor’s policy to drop the lowest exam score and that I could just do well on the next two exams, but deep down, I knew there were significant, underlying issues that had caused me to run away from my responsibility.

One of these issues was a constant, self-doubting thought process, which had been whipping around in my mind for days. It impacted my behavior and the choices I made. This happens on a regular basis. For example, I give up on exercise because I lack the confidence in my ability to succeed. I’m scared to fail. I shy away from talking to people because I lack the confidence in my ability to initiate a conversation. Over the course of the past few weeks, there have been times that I fought to swim against the prevalent currents, which these self-doubting thoughts create, yet most of the time, I had given into its powerful force.

There is a conscious, but minuscule part of me that truly believes in my ability to be successful this semester. When I feel capable, I will gear up to hit the books, and after a successful study session, I even look forward to more reading. My confidence grows. Still, the majority of the time is spent believing that I lack the ability, the qualification and the strength to perform at all. During these times I neglect my coursework. In truth, at any moment, I’m closer to accepting a seemingly inevitable defeat. My intuition tells me to prepare for an absolute catastrophe.

During the last two to three weeks everything has exponentially spiraled out of control and all I can do is remain dormant. I want to reach out, but I’m unable to. It’s a phenomenon that affects all aspects of my life, such as the interaction with my family and the ability to execute everyday tasks. It also abates the already dwindling supply of self-efficacy, which is the principle force behind my successes and failures. My lack of ability to estimate or make personal judgments can be attributed to the break down of this force.

Personal failures have dreadful repercussions, such as disappointment, despair, and debilitation. Yet though I’ve acknowledged that these conditions are a direct result of the choices I make, it is still not insight for me to re-engage and plan alternate approaches .For example, I know that if I don’t do my reading then I’ll get behind. If I get behind then I’ll be stressed; which leads to anxiety; which causes me to feel overwhelmed and to give up completely; which causes me to feel depressed. It is a vicious cycle! And I recognize it for what it is, but cannot break free from it.

I continue to undergo therapy with you because it’s my way of telling myself that I’m proactive at getting better. However, there are many ways in which I’ve been resisting therapy. For one thing, I have not been an honest reporter. I haven’t told you about the numerous times that I’ve been crippled by lethargy and have laid on my couch nearly all day, for several days in a row. I haven’t told you about my on-going, obsessive thoughts that I’m not good enough; that I don’t have what it takes. I haven’t told you that, during my extreme lows; I have no desire to take care of myself. Over all I don’t report most of the depressive experiences I suffer from or to what degree these experiences debilitate me. I under estimate the severity of my depression and its potential to adversely impact my thoughts and feelings. This inability to function impacts my family, too. I haven’t told you that I feel a monstrous amount of guilt because I neglect my emotional needs and the emotional needs of my children. This is the appalling, hideous, repulsive side of me that I keep hidden from everyone (including my husband) because it makes me feel extremely ill at ease.

Instead, I’ve been a biased reporter. I’ve shared only the experiences, which inspire and motivate me. I’ve shared my plans to go back to school, and to get a job, or aspects about my desire to write, etc. I report the more positive things about my life and myself because I’m petrified that you’ll think I’m a terrible person and a lousy mother. And it is disdain and harsh judgments that I dread the most.

I’ve realized that I can get better and that only I can take complete control in this process. It is imperative that I learn how to turn my negative thoughts into positive ones. In order to do this, I need to learn to develop new personal constructs. Personal constructs are cognitive structures we use to interpret and predict events. It is my belief that the psychological problems I suffer from are caused mostly from defects in my construct systems. Cognitive approaches to therapy will teach me how to process information differently. I must come to see how distorted cognitions affect my emotions and behaviors and how to deal with future and recurring problems.

If I want to become emotionally and mentally well adjusted, then I have to accurately report my progress, and in doing so, it will require me to be attentive to my inner-voice, which evaluates my thoughts and feelings. This will be challenging because I’ve ignored my inner-voice for years, partly because I’ve been disinclined to connect to it. Also, I haven’t had the desire to execute constructive approaches to improve my mental health, even though I fully realize the potentially positive effects that could ensue as a result of my willingness to use them. Specifically, I want to develop a healthy self-image, to build an abundance of self-esteem, and to achieve a higher level of self-efficacy. I dream about what it would be like to be happy and energetic, and to approach each day with an “I can do it” attitude. I want to escape from this “freeze frame” atmosphere. I know that empowerment can become a driving force behind everything I accomplish. If I give myself a chance, I can stand tall!

This letter is my way of reaching out for help. It is a testament to the effort and dedication I’m willing to put forth so that I can make it to the top of this up-hill battle.