Q. I am a 20-year-old African-American male. I find it very difficult to interact with family, coworkers, and peers. For some reason all my thoughts are negative about others and myself. I tried self-help methods, consulting pastors, family, and peers, but all were unsuccessful. I feel extreme stress day to day, hour to hour. Can you give some suggestions?

A. It's possible you may have some type of anxiety or depressive disorder, but only a professional mental health evaluation could determine that. So setting up an evaluation is my basic advice.

Many people with social phobic disorder or social anxiety disorder find it very hard to be around other people. They constantly fear the criticism or rejection of others; feel very self-conscious or inadequate, etc.

Negative thoughts about yourself could point more to a depressive disorder, particularly if you feel a sense of worthlessness, guilt, and low self-esteem. Either type of problem may respond well to talk therapy (psychotherapy), medication, or a combination of both. The first step is to get a thorough mental health evaluation; for example, with a clinical psychologist or psychiatrist.

In addition, you may find the following books useful: The "Anxiety and Phobia Workbook" by E.J. Bourne, PhD; as well as the book, "Feeling Good", by Dr. David Burns. I wish you well in overcoming these problems.

Other Resources:

• More Questions on Anxiety Disorders

November 2003

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