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How can I overcome low self-esteem and depression?

Q: I am a 30-year-old unmarried female. I had epilepsy and then suffered depression. Sometimes I cry, sometimes I laugh. I am considered as an extremist and have troubles dealing with people. I am overly emotional and have changed various jobs, which was not because I was career oriented, but I have a tendency. I want to do everything. I feel I am very intelligent and born to do various things in life. I have a fear for reading newspapers or books. I can't concentrate for long and now I don't even try. I have failed various interviews, because of low self-esteem, and lack of confidence. I want to get married to this guy I like and prove my intelligence. I have a habit of looking for problems in myself. Please advise.

A:In the brief query, you have mentioned several problems. First of all, there is this problem with mood, which you have mentioned as proneness for crying, laughing, over emotionality, and depression. A problem with mood can indeed manifest in different ways. Are there distinct periods wherein you feel happy, over intelligent, wanting to do everything, and thoughts of having been born to do various things in life. If these are present, during these periods you might also be feeling very enthusiastic, brimming with energy, indefatigable, talking a lot, making a lot of friends, spending a lot of money, generally bubbly and cheerful. This specific period can be alternating with periods wherein you are feeling low self-esteem, no confidence, and fear of reading newspapers and books and lack of concentration. These periods can be distinguished by pervasively feeling low, hopeless, helpless, decreased energy levels and inability to enjoy things. Thus, there may be two very distinct phases: of happiness alternating with feelings of sadness. Depending on the severity and the cycling they can be managed with medications by which the mood may remain stabilised and not fluctuate between the highs and lows, which may be dysfunctional. However, such mood disturbances can also occur due to thyroid disturbances, use of any sort of drugs, premenstrual mood disturbances besides certain personality traits amongst the other several associations. The management distinctly depends on what your disorder is conceptualised as. It would be prudent to get a Thyroid function test done and reviewed. A charting of mood on a daily basis would give you more information regarding the variation of the mood state and the type of cyclicity. It would also make you aware of the antecedents or precipitating factors. This may best be reviewed by a Psychiatrist for further appropriate management. However, if the mood swings are conceptualised as secondary to maladaptive personality traits and poor coping skills, you would be best helped by a psychologist if engaged in psychotherapy. May I also add, marriage in itself is not considered to be the cure of various problems (it is really a very big myth). It can have both positive and negative effects, and one should weigh and consider the pros and cons and decide based on that. It can both have a therapeutic containing effect based on the strength and support that you are able to derive from the relationship. However, on the other hand it can act as a stressor to exacerbate the problems with respect to adjustments to a new person, fulfilling the expectations etc and if it doesn't work it can have a negative effect based on the friction, which might develop. Also, there needs to be information provided to the would be partner regarding the existing problems and issues since if information is not provided earlier, the spouse may feel having been taken for a ride if he is not able to cope with the problems, which he would eventually come to know. This concept of providing accurate information at the beginning may best be visualised in the movie - "Lage raho Munnabhai".

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