instruction: hi doctor I struggle to focus and I cannot concentrate on my studies I just think about other things not always bad things but sometimes I think about throwing myself out the window when I am asked a question or if there are some people around I used to get panic and struggle to answer my voice will be too low and can hear my heart racing I have been self harming myself for over a year now I have got cuts and scars on my arm I do not get along with my family and I barely do anything anymore either I sleep or think simply lying in bed I sometimes hear voices of people who are not present I feel like tight chest and my breathing is difficult I want to do well at college but I am not happy my mood changes within a few seconds I am too shy to visit a doctor please help
output: hi personality issues psychotherapy dbt dialectical behavior therapy for further information consult a psychiatrist online