I feel overwhelmed, sad, I have low self esteem and when I feel alone then I'm having panic attacks.

Hi Julia,

It's good you're reaching out for help--it sounds like you're dealing with a number of challenges right now. While I don't know exactly what's going on in your life and so can't suggest anything specific aside from talking with a therapist about your experience, here are some general questions I would ask to help determine what could be causing you to feel this way:

1. I would want to know about any trauma history you may have. Having panic attacks when you're alone could be a result of many circumstances, such as a difficult breakup or a significant loss in your life, but it can also happen when someone has experienced trauma and feels unsafe. If you have experienced trauma, CBT and EMDR treatments are both great options to work on this.

2. I would also inquire about what your routine looks like. You mentioned feeling overwhelmed and it sounds like you also feel a sense of hopelessness--that could be coming from work, family life, issues with friends, health problems--any number of things, but regardless, it's important to have balance in your life. I'm guessing that you have limited self-care currently, and looking at how you can increase your balance and self-care opportunities would be important.

3. What coping mechanisms are you using? There are a number of excellent coping skills that can help immediately when faced with symptoms, such as panic attacks, as well as preventative strategies that can help you cope on a more regular basis. If you choose not to participate in therapy, I would suggest doing your own research on coping skills including mindfulness strategies and grounding techniques.

4. What does your support network look like? Developing a greater support network, which sometimes really just involves utilizing more effectively the support network you already have, can make going through a difficult time much either. Unfortunately, some people struggle to open up to others or reach out for help. 

5. Are you taking on too much? As with the last question, if you're someone who tends to be there more for others but not allow others to be there for you, whether that be at home or at the workplace or with friends and family outside of the home and workplace, that can absolutely impact your daily life.

6. How persistent/pervasive are these symptoms, and what have you tried so far? While I certainly encourage you to consider participating in therapy, if your mental health symptoms are particularly significant, you may want to also talk with a doctor to help you get through this difficult time. 

Anyway, these are just some ideas of what you could start taking a look at. I urge you to sign up for therapy, whether that be on this platform or elsewhere. Whatever you're going through, even though I know it doesn't feel like it right now, it can and will get better.

Take care,

Nicholas DeFazio, MRC, LPCC-S, LICDC