Dear Charlie:

I am tired of trying. I have been in therapy for two years. I was sexually abused as a child by a sibling. I'm just so, so tired. I've done everything possible to disappoint my family, short of failing out of school. I frequently drink rum and coke to take the edge off and am borderline abusing prescription drugs. I sleep around with men I don't know whom I meet on the internet. I am risking being excommunicated from my church for my behavior. I have no husband, no boyfriend, no children. I feel that I have nothing to lose except school. I am barely hanging on to school. I'm only taking 5 hours and I am not even accomplishing the bare minimum for those credit hours. I frequently find myself skipping appointments for different activities during the day. When I do talk to people, I somehow manage to seem normal, even happy. I am addicted to internet pornography and sex and probably starting to fall into alcoholism. I feel that my life is no longer worth living. What's left? I've been under the care of a physician and more than one therapist, one of whom I've been with for about a year. I am already taking medication for anxiety and depression. There is nothing left to do. People keep telling me that I have options (especially when I call crisis lines, which I've done in order to keep promises made to my therapist), but I just don't see what these "options" are. To me, it's clear. I keep on living my pathetic, lonely life spiraling further and further into depression and addiction or I can end it all now before my family finds out that I've screwed everything up.

Signed: Hopeless

Dear Hopeless,

Charlie hears that you’re dealing with multiple issues. Though you sound like you are in a bad place, Charlie is encouraged that you wrote this letter and that you are reaching out for help.

First of all, Charlie is concerned about your safety. For example, you say you are depressed and mention the phrase “I can end it all now” as an option. It is not uncommon when feeling depressed to have some suicidal thoughts. However, Charlie is left wondering if you have intent to harm yourself and/or a plan to harm yourself. If yes, Charlie encourages you to seek help immediately. If you are in eminent danger, Charlie suggests you go directly to the Ball Hospital ER (747-3241). The staff there can check you in and keep you safe until you start feeling better. If you are not in eminent danger, Charlie encourages you to share how you are feeling with your therapist and physician. Together, the three of you can work out a plan to keep you safe. You note that you are already taking medication for anxiety and depression, which is good. If you share the intensity of your current suicidal thoughts with your physician, he or she may consider changing the dosage and/or trying a different medication.

Charlie is very sorry to hear that you were sexually abused as a child. You follow this disclosure by saying, “I’m just so, so tired”. Charlie wants you to know that healing from childhood sexual abuse is a process. Though survivors such as yourself make progress in therapy, the process is often felt in small increments and can seem to go on forever. From the sound of your letter, Charlie is guessing that this is how you are feeling right now. Though you sound discouraged, Charlie wants you to know that there is hope.
Survivors of sexual abuse can and do heal— it just takes time.

You also note concerns about addiction. In this context, you mention alcohol, other drugs, and sex. It is not uncommon for survivors of sexual abuse to want to numb themselves from the pain they feel and alcohol or other drugs or sex can provide immediate relief from these feelings. Though helpful in the short-term, these coping methods tend to cause problems of their own. For example, because alcohol is a depressant it will tend to fuel the depression you are feeling. Charlie is also guessing that it could be contributing to your “skipping appointments … during the day”. You also say, “When I talk to people I manage to seem normal, even happy.” This makes Charlie wonder how forthcoming you are with your caregivers about your alcohol and drug usage and sexual behaviors. If you’ve been less-than-honest with your therapist and physician about this, Charlie encourages you to be open and honest about your behaviors. This can be a starting point for making some collaborative decisions about where to go from here. Together with your therapist and/or physician, you can decide whether a more intense treatment program is indicated or if your needs can continue to be met on an outpatient basis. You also mention your church. Though churches vary in their views on mental health and addiction, Charlie wonders if this might be a helpful resource to you as well.

Lastly, you mention your schooling and your family. Because you note how very important schooling is to you, Charlie encourages you to hang in there. Do your best to attend to the fundamentals: attend class regularly, stay up on your assignments, and study well in advance of quizzes and tests. In order to accomplish this, it would be important to minimize your drinking during the week. You also make it clear that it is very important that you not disappoint your family. Charlie doesn’t know them but wonders if your family may more understanding than you think. If so, you might consider sharing with them what you are going through. Doing so may provide some relief and also provide you with another helpful resource. Re-establishing social connections may be especially important to you because you mention feeling lonely.

You say “there is nothing left to do” but there is much left to do. It takes courage to heal. You’ve shown great courage in reaching out for help in multiple ways. Though the journey can be long, there is hope. Charlie encourages you to stay the course.

To feeling hopeful again,
Charlie