Tell Me About It: Feeling worthless, but reluctant to seek counseling

Adapted from a recent online discussion.

Question: I am a 32-year-old, married-with-children, educated professional who on outward appearances should have no reason to be miserable. However, I am.

Some recent events have triggered deep self-esteem issues that were probably always with me but now I can't seem to get over. I feel I am unlikable, unlovable, and that no one really cares about me. I am possessed by irrational thoughts that I am worthless.

No one in my life really seems to be able to help me move forward. I think I need help but am scared and not sure if my issues are serious enough to warrant it.

I definitely think my self-esteem issues are starting to impact my marriage and family. In addition, I see this as a cycle that my mom also suffers from, and I don't want to inflict it upon my children. At what point is there a solid basis for counseling? I am afraid to call a counseling place and have them shun me for not having serious enough issues.

Answer: "No one in my life really seems to be able to help me move forward": rock-solid grounds for counseling.

No reputable "counseling place" will shun you, ever. Your fear of that, in fact, sounds like depression talking, as do a few other remarks (feeling unlikable and "possessed by irrational thoughts," nothing you try is working, mom had similar issues.)

Please know that whatever ails you, it's exactly what counseling is for - and a therapist knows that. Do your homework to find a quality provider with whom you feel comfortable, and then be patient with the process of getting well.

Q: OK, so, close friend has decided to give it another try with the loser boyfriend (drugs, limited employment, lack of emotional maturity) she broke up with five years ago when she fell in love with Loser Boyfriend No. 2 (drugs, limited employment, lack of emotional maturity . . . yes, there's a pattern).

She asked for my thoughts and I told her, honestly but not cruelly, ending with, "You're old enough to make your own decisions." She, of course, ignored my advice and is pursuing this relationship. Bad idea? Yes. My responsibility? Nope.

At some point, I will probably meet him. It is not my job to judge, so of course I will be civil. But I'm really not a good enough actress to fake a "Hey, it's so great to meet you!" that I really don't feel. And "Hey, aren't you the guy who totally (messed her up) five years ago?!?! How the heck have you been?!?!" doesn't seem quite appropriate. So, any suggestions?

A: (1) "Hello, I've heard so much about you."

(2) You do realize your close friend is the problem, right? Her pattern suggests emotional issues as serious as those of the men she dates, if not worse. When she asks again for your thoughts, try, "I hope you'll consider counseling, because these men are so obviously troubled that your seeking them out concerns me" - if you haven't already.

You may fear that'll be a friendship-ender, but looking out for the friendship is about you. To the extent you can, please look out for her.