For the last six months I have had trouble getting going. I sleep around 12 hours a day and have no confidence to do anything. This all changes periodically, when I think I can conquer the world and I do everything I've needed to do for months and I sleep two or three hours a day. I find myself wondering what is wrong with me and how I can maintain a normal life. This is seriously interfering with my attendance in college. I am a 20-year-old woman in fair health, and I have a vast family history of depression and a history of mental and physical abuse from my father. Should I seek help? If so, should I go to my family doctor or to therapy?

Jess

I think it's a good idea for you to seek professional help as soon as possible, since your ability to function in college is being affected.

If you or your therapist think medication may help you, then you can consult with your family doctor. Or you may want to see a psychiatrist -- the mental health specialists of medicine -- to take advantage of psychiatrists' expertise in psychopharmacology.

Be sure to tell the psychologist or therapist of your family history of depression, the mental and physical abuse from your father, and most important, the trouble you've been having over the past few months. It's also important, of course, to be honest with a therapist -- and yourself -- about any drug or alcohol use. Drug or alcohol abuse can result in a pattern like you describe, especially when narcotic, sedative or central-nervous-system-depressing substances (such as tranquilizers or alcohol) are alternated with stimulants (like speed or cocaine).

I can't say for sure what's going on with you, of course, without more information. You may be experiencing depression, or some other consequence of childhood emotional and physical abuse, or the cyclical pattern of bipolar disorder, or fallout from drug or alcohol use, or some combination of the above. A mental health specialist such as a psychologist is in a better position than your family doctor to accurately diagnose any psychological and emotional conditions you may be experiencing. Accurate diagnosis is your best bet for getting the help you need to get your life back on track. Good luck!