Dr. Mahir Shah, MD

Thank you for sharing what you’re going through—it takes courage to speak up, especially when you’re struggling. From what you described—feeling tired yet restless, trouble sleeping and eating, drug use, mood swings, anger outbursts, and regret afterward—there may be several things going on that are affecting your mental and emotional health.

At your age, these symptoms could be linked to a combination of factors: possible effects of substance use, unresolved stress or trauma, underlying mood issues like depression or bipolar disorder, or difficulty managing impulses and emotions. The fact that you’re aware something’s wrong and want to talk to a psychologist is a very important first step—and it’s the right one.

Here’s what I strongly recommend:

Immediate safety: Because you’ve mentioned getting violent, yelling, and concerns about the police being called, it's important to make sure you're in a safe environment. If you ever feel out of control or like you might hurt yourself or someone else, you should go to an emergency room or tell a trusted adult immediately.
Stop using drugs: Illicit drug use can make emotional symptoms worse and interfere with sleep, mood, and behavior. A psychologist or psychiatrist can help you with addiction treatment, including therapy and support programs for teens.
Get a full evaluation: You would benefit from a comprehensive mental health assessment to look into things like possible mood disorders, impulse control issues, trauma, or anxiety.
Start therapy: A psychologist can help you learn to manage your anger, improve your coping skills, and work through any emotional pain that may be fueling your behavior.
Talk to your parents or guardians: If you haven’t already, it’s important to involve an adult you trust so they can help you get the professional support you need.
You’re not alone, and there are professionals who specialize in helping teens navigate exactly these kinds of challenges. You deserve support, and the sooner you get it, the sooner you can start feeling better and more in control.

Thank you for reaching out and being so open about how you're feeling. It takes a lot of courage to speak up, especially when you're dealing with something as heavy as low energy, lack of sleep, not eating, and thoughts of suicide. I'm really sorry you're going through this—you shouldn’t have to feel this alone or overwhelmed.

You mentioned wondering if you might have bipolar depression or borderline personality disorder (BPD). The symptoms you're describing—feeling low, not sleeping, eating less, and struggling with suicidal thoughts—are very serious, but they can be caused by a number of different things. That’s why it’s important not to jump to conclusions or try to label yourself without getting a full picture from a mental health professional.

What I can tell you is this: what you’re describing sounds like depression, and it’s gone on for too long to ignore. Whether or not there’s something like bipolar disorder or BPD going on, you deserve real support—and there is help out there that works. Therapy can make a huge difference, and sometimes medication can help too, especially when sleep and appetite are affected this much.

Please talk to a parent, school counselor, or trusted adult as soon as possible and ask for help getting in to see a therapist or psychiatrist. If you're ever in danger of hurting yourself again, call a crisis line or ask a trusted adult to help you go to the ER right away. You’re not alone in this, and it can get better with the right care.

You don't need to have a diagnosis to ask for help—you just need to know that how you're feeling is serious, and that you matter.

Hi Rose,

First, thank you for being so brave and honest in talking about what you’re going through. It’s not easy to share things like this—especially when it feels like no one really understands. I want you to know that what you're dealing with is real, and you deserve help and support.

You mentioned that you have anxiety, depression, and trouble sleeping—and that you pick at your feet a lot, especially when you’re bored, stressed, or anxious. That behavior is something we call a body-focused repetitive behavior (BFRB), and it can be the brain’s way of trying to deal with strong emotions like stress or anxiety. It’s common in kids and adults who struggle with anxiety or depression, and it’s not your fault.

Here are a few things you can try that might help:

Keep your hands busy – Try using a fidget toy, squishy ball, clay, or textured object when you feel like picking. Some people even keep a special “calm box” with things that help distract them.
Notice when you pick – Is it when you’re feeling sad, nervous, or just sitting still? The more you understand your patterns, the more control you’ll have.
Try a soothing activity – Listening to music, drawing, deep breathing, or even a warm bath at night can calm your mind and help reduce the urge to pick.
Talk to a therapist – Since you’re already taking fluoxetine, it means a doctor is helping you with your depression. A Psychiatrist would be most appropriate. But therapy, especially CBT (Cognitive Behavioral Therapy), can teach you new ways to handle stress, anxiety, and picking behaviors. It really helps a lot of kids with the same kinds of challenges.
I’m really glad you’re reaching out. Please show this message to your parents and ask them to help you find a therapist who works with kids. You are not alone, and with the right support, you can feel better.

You’re already doing the hardest part—asking for help. That’s a big deal, Rose. Keep going.

Thank you for reaching out. What you’re describing—repetitive hand washing, intense fear of contamination (such as from saliva), social withdrawal, and disrupted eating—can be consistent with symptoms of Obsessive-Compulsive Disorder (OCD). You're not alone in this, and the fact that you’re recognizing these patterns is a strong first step toward healing.

OCD is a treatable condition, and many people experience significant relief with the right support. Treatment may include cognitive-behavioral therapy (CBT)—especially a technique called Exposure and Response Prevention (ERP)—and in some cases, medication can be very helpful.

Please don’t hesitate to reach out to a mental health professional who can provide a full evaluation and guide you through the treatment process. You can feel better, and there is hope.

Wishing you strength and healing ahead.

— Dr. Mahir Shah, MD
Integrity Behavioral Health, SC