A reader writes: "I am a 42-year-old woman. I am married with one child. Since I was a child, I have suffered with anxiety and low confidence. I was bullied on and off through my teenage years in school and on one occasion, I took a whole load of pills, prepared not to wake up the next morning*. To this day, my parents still don't know what I did that night.

After school, I went to work in a good job in administration. At this point, I was drinking a lot and arriving into work with a hangover a lot of the time. I still don't know how I was able to hang on to my job, although I was a hard worker and I put a lot of effort into my career.

Gradually, my drinking got worse and I was depressed, but I didn't know this at the time. I was surprised my husband stayed with me. I didn't realise how sad I was, as I was drinking to block it out. This kept the pain I was feeling at bay. I continued this way for years. I wasn't able and I'm still not able to talk to anyone about how I was feeling. I didn't understand the sad feelings. I was terrified of them and I would block them out.

After a very bad breakdown two years ago I was referred to a psychiatrist. I was terrified but I agreed to go for treatment for alcohol dependency. I discovered it was the smokescreen that I had used for years. I had to deal with all the emotions that I had blocked out for years and I felt so alone, even though I have my family there to support me. I was diagnosed with major depression.

Two years on, I am doing much better. I don't drink any more thank God, but there are days when I really struggle. Simple things like getting out of the bed are more than tricky at the best of times. I'm on medication for the last two years, which has been a help, but I have to take them on time, otherwise, I'm jittery and anxious.

I struggle with is my emotions: they are so strong at times and too much for me to cope with. The anxiety I have suffered with for years has come back. I don't want to go back to the way I was. I'm struggling and I don't know what else to do. I am so unhappy – I hope you can help me with my problem." 

Dr. Eddie replies: What strikes me about your letter is the level of distress you have and are experiencing. Like many people, you used alcohol to numb your strong emotions. Thankfully, you are not drinking now and when I read this, I think of your strength to stay sober and your ability to bounce back from adversity. In an client assessment, I would focus on the level of anxiety you have experienced from childhood and whether social anxiety was / is present. For example, did you use alcohol to cover up shyness? 

I would also be interested in your self-esteem. For many people, a sustained low mood over decades is not depression but chronically low self-esteem associated with negative core beliefs about yourself e.g. I am unlovable…I am bound to be rejected…I am defective so others will not love me. Beliefs are beliefs; they are not facts. New beliefs can created.  

For you Mary, in addition to medication, it’s important that you build tools to tackle your powerful emotions and flawed core beliefs: just because you believe them does not make them true. An effective way to tackle the dominant emotions in your life – fear (anxiety) and sadness (depression) may be a course of cognitive behavioural therapy (CBT).

Check out the Psychological Society of Ireland (psychologicalsociety.ie) to find a reputable practitioner, with experience dealing with cases like yours. This could help you answer the fundamental question: 'What keeps my difficulties going?’ 

Something that may help you recognise and cope with pervasive fear and negative thinking is a mindfulness-based stress reduction (MBSR) course – you will find reputable ones at mindfulness.ie

Mary, you have strengths, resilience and resources; I can tell this because you have taken steps to deal with your alcohol issues and have seen a psychiatrist. Now may be the time for therapy. 

*If you are affected by any of the issues raised in this article, you can contact; The Samaritans (phone 116123), or Pieta House (1800247247).