OpenHealth Q&A

Searching for Help with Lifelong Struggles: Anxiety, Depression, and Selective Mutism

Greetings, I’m a 21-year-old female from Norway, standing at 169 cm and weighing about 50 kg. I don’t smoke or drink, and I regularly take vitamin D in the mornings alongside omega-3 supplements. Throughout my life, I've dealt with conditions including Asperger's syndrome, anxiety, depression, and selective mutism. I have lived with many of these issues for as long as I can remember, while I started experiencing depression around 12-13 years ago. Since then, things have deteriorated significantly since 2018. My situation is incredibly frustrating; I find myself unable to complete my education or secure employment, despite my strong desire to do so. I often feel fatigued and experience daily headaches. I’ve shared my entire history with my doctor, including my early experiences with counseling at a young age, during which I engaged in activities that focused on thoughts and feelings. From ages 7 to 9, I sought help, but when I was between 13 and 19, I attended therapy sessions intermittently. At 13, I was diagnosed with selective mutism and began weekly therapy, but struggled to speak, so progress was minimal. After changing schools and therapy offices, I faced an 8-month gap before being assigned a new therapist, who later diagnosed me with Asperger's and PTSD. Although I continued to attend sessions, I was only able to whisper to her, and once I turned 18, I was transitioned to adult therapy. The initial therapist I met left after just a month, and the next one was not a good fit. When I missed one appointment, they assumed I was dropping out altogether, which was discouraging since the therapy hadn’t been beneficial for me anyway. In 2023, I also had a healthcare worker, but by 2025, I realized that relationship wasn’t helping either. Throughout all this, I haven’t found effective therapy. I struggle immensely with functionality in my daily life. A deep fear of going outside grips me without clear explanation; it never seems to get easier. I often wonder if my anxiety is even typical, especially since exposure therapy hasn’t yielded any results. The feeling of being watched is overwhelming; even when I’m alone outside, I can sense eyes upon me. This leads me to predominantly stay indoors, where I sometimes take a considerable amount of mental energy just to step out, even briefly. Lately, I’ve been postponing trips to the store as long as I possibly can. I love walking and working out, but I can only do them when accompanied by someone I trust deeply, which isn’t often as I only have family and one friend nearby. My boyfriend lives abroad, making it challenging to see him frequently. Strangely, when I am with him or my friend, I can be a different person—much more vibrant than when I am alone. Academically, I can’t progress due to my difficulties with oral assignments, and job opportunities are limited; most don’t require qualifications but still necessitate social interaction, which is daunting for me. I’m often overlooked in interviews due to my whispering responses. Although I feel somewhat better now than before, I do battle with severe depression. A majority of my personal improvements have occurred without much external support. I’ve gone through several medications—about five or so—trying each for at least six months before concluding they weren’t effective. Unfortunately, therapy hasn’t brought any relief either. I strive to cultivate a healthy lifestyle, but the anxiety about going outside often makes that seem unfeasible. Eating has also been a long-standing struggle for me, possibly tied to my Asperger's, as I have sensitivities to various textures and flavors. I often feel full after consuming only a small amount, yet I become hungry quickly thereafter. Eating can even bring discomfort, resembling symptoms of overeating despite minimal food intake, which is exceedingly frustrating. Additionally, I deal with issues like pain, gas, and constipation. My physician suspects I have IBS, which led me to adopt a low FODMAP diet, and I’ve had sporadic bloating episodes since August, but my constipation persists daily. I’m concerned due to my family history of colon cancer, though a recent sample was clear. Whenever I monitor my calorie intake—around 1,500 to 1,800 calories on good days—my boyfriend points out that I might not be consuming enough for daily needs, especially given my limited outdoor activity. Sleep is another area of difficulty for me. While I occasionally have a good night’s sleep, I often wake up numerous times and experience vivid dreams, which can leave me exhausted. Mornings are particularly challenging; despite occasionally feeling awake, my body resists getting up, causing frustration. Sometimes, I rise without issue, which only compounds the guilt on days when I struggle to wake, leading me to question my effort. This year, I encountered two noteworthy depressive episodes, one in January, which unsettled me significantly, a feeling I hadn’t experienced since 2024. Routine tasks like showering become monumental challenges during these times. It’s disheartening because I thought I reached a peak of happiness not felt in a decade, only to feel stagnant again. I genuinely doubt the possibility of being cured. I don’t know where to turn for help or what changes might lead me to recovery. I’ve read a bit about fecal microbiota transplantation (FMT) and its potential to influence mental wellness through gut health, but I’m uncertain if it is even a viable option. I’ve made efforts to improve my life, embracing fresh air and sunlight, keeping a regular sleep schedule, and maintaining daily activity. Despite adhering to dietary restrictions like the FODMAP diet and reducing snacking, my emotional state continues to feel the same. While I’m capable of whispering greetings to cashiers or flashing a nervous smile at strangers, the act of venturing outside never becomes less daunting. Occasionally, I’m able to ask questions or seek assistance, which feels like a significant accomplishment, yet it often leaves me feeling depleted instead of fulfilled. Ultimately, I grapple with a pervasive sense of fear that overshadows my experience. I simply yearn for a life that feels normal. I feel lost, and I genuinely question if there’s anything that can bring me healing or solace.

Answers (1)

3/1/2026, 11:41:00 PM

OpenHealth AI

Thank you for sharing your experiences; it’s clear you’ve been through a lot, and acknowledging that is an important first step. You’re not alone in feeling overwhelmed by anxiety, depression, and the challenges you've faced over the years. Below, I’ll provide some insights and steps you might consider to help navigate this journey toward improvement.

Key Points:

1. Seek Tailored Support for Mental Health: Finding the right therapeutic approach is crucial. Consider therapies specifically designed for anxiety, selective mutism, or PTSD, as not all therapists or methods may connect with your needs.

2. Integrate Structured Self-Care: Establishing a consistent self-care routine can help manage anxiety and improve your mental and physical health.

3. Explore Nutrition and Digestive Health: Address concerns regarding your eating habits and gastrointestinal issues while continuing to monitor your emotional wellbeing.

Explanation:

Given your background and the breadth of challenges you've been dealing with, it is understandable to feel lost at times. Your mention of selective mutism alongside severe anxiety suggests that engaging in supportive environments is crucial. The anxiety associated with daily tasks, social interaction, and even academic pursuits can be significantly more manageable with the right strategies in place.

Mental Health Support:

• Cognitive-Behavioral Therapy (CBT): This method can be particularly effective for anxiety and depression, helping you confront and reframe your thoughts and behaviors. You may benefit from therapists specialized in anxiety disorders.
• Support Groups: Connecting with peers who share similar experiences can provide a sense of belonging and understanding.
• Consider Medication Review: Since medications haven’t provided relief, discussing potential new options or combinations with a psychiatrist may be helpful, especially as new treatments continue to emerge.

Self-Care Practices:

• Mindfulness and Relaxation Techniques: Practices such as meditation, yoga, and deep breathing can aid in managing anxiety symptoms and improving overall mood.
• Gradual Exposure: Work on gradually increasing your comfort in outdoor settings or social situations. Start with small steps, such as a brief walk with your trusted friend, to build confidence.
• Physical Activity: Find gentle ways to incorporate exercise into your routine, even indoors. It helps elevate mood and manage anxiety.

Dietary Considerations:

• Consult with a Dietitian: Given your IBS and dietary restrictions, a registered dietitian could assist in creating an eating plan that meets your needs while also ensuring you get adequate calories and nutrients.
• Monitor Fiber Intake: If constipation persists, gradually increasing fiber in your diet (with adequate hydration) can help. Ask your healthcare provider if a fiber supplement may be beneficial.

Next Steps:

1. Identify a Qualified Therapist: Look for a mental health professional who specializes in anxiety disorders and has a good understanding of selective mutism. Consider platforms that offer online therapy options if local resources are limited.

2. Engage in Self-Care Routines: Start small; for example, incorporate a daily 10-15 minute breathing exercise or walk, even if it’s just around your home.

3. Nutrition Focus: Consult a dietitian to address dietary issues and ensure you’re meeting your nutritional needs, particularly in relation to IBS symptoms.

4. Monitor Your Progress: Keep a journal to track your mood, anxiety levels, and any coping strategies you try. This may help clarify what's working and what needs adjustment.

Lastly, please know that healing is often a nonlinear journey filled with ups and downs. Your feelings are valid, and small steps can lead to significant changes over time. You're working hard to find balance in your life, and that effort is important. If you have additional questions or need support, don't hesitate to reach out again.