Tired of being sad and worrying bout what people think of me

Hello everyone,

My story’s quite a long one. I’m a 23 year old guy who’s been struggling with some things over the last couple of years.

During my fourth year at med school, which is now 2 years ago, I had a mental breakdown. I felt very exhausted and couldn’t find the motivation to study for my exams anymore, which was a big contrast to the years before. I consistently rank among the top of my class and before my breakdown, I was extremely committed to my studies, to the point of having major anxiety issues during my exams. I sincerely believed I was going to fail a subject, and then ended up having very good grades. Then all of a sudden, I felt like I couldn’t care anymore. There were several issues that lead up to this low point:
The most important issue was that I am gay, and was closeted at the time. I had literally confided to no-one about my sexuality, and had great difficulty with accepting it.
Despite succeeding in studying my subjects very thoroughly, I always had some major difficulties with keeping my focus. I am also the kind of person that can’t stop thinking about everything, which paradoxically didn’t help very much.
An unhealthy situation at home.

I took a break from school, went to a therapist who helped me come out to my family and friends (who were all very accepting), and was diagnosed with Attention Deficit Disorder and intellectual giftedness – which explained part of my difficult learning experiences. I travelled to recover and felt better again. I re-started university with concentration-enhancing medication, which helped me greatly. I still have a somewhat difficult relationship with my parents. I love them very much, and they love me to death and take very good care of me, but we are completely different characters. I have a great relationship with my sister though.
My parents constantly argue, with both sides being very irrational. This makes my home situation very exhausting. Outside our home, virtually no one is aware that their marriage is hanging by a thread – because my parents share the belief that to the outside world, it is important to only show one’s best side. And that is what I was taught to do as well. As a child, I was very polite and well behaved. People always congratulated my parents for raising such well-behaved children. I think our education has been way too strict – at times we were barely allowed to move or speak at public events. Sometimes it feels like we weren’t allowed to be children. On top of that, my dad was very intimidating, and could be verbally aggressive towards us, to the point that I was genuinely scared of him. Bottom line, pleasing our parents and the outside world was always considered very important. It lead to me becoming very self-conscious and even though I loved my parents, I didn’t feel like I could share everything with them. I’m pretty sure this is also a big reason why I had difficulties coming out: it didn’t fit in the perfect normal family situation, and I felt ashamed of myself and was scared my parents would be ashamed as well. Now deep down I knew they would accept me being gay, and this was confirmed when I came out to them. They try to do their best to not make it a big thing, even though I feel like they are not 100% comfortable with my sexuality. I don’t blame them for that.

Now, 2 years later, after a period of feeling more motivated, I feel like my mood is deteriorating again. I’m feeling emotional and sad, and it’s hard to think positive. I can’t really give a clear explanation. My grades are as good as always. The only recent bad thing that happened is that I broke up with my first-ever boyfriend. We were only together for about 4 months though, but I have to admit that at times it is hard to cope with. My sad feelings started way before our break-up though.
I can’t feel real passion for my studies anymore. I miss my old class mates from university who I studied with before my breakdown. Even though my new class mates accepted me pretty well, it’s just not the same. Seeing my old class mates graduate is very hard.
When I return home from uni during the weekend, I feel sad and flee to my room to avoid contact with my parents. I can’t deal with their relational $#%^ anymore to be honest, and I’m looking forward to living permanently on my own. On the other hand, I feel sad and lonely, am scared of what the future will bring and since recently, I feel irrationally physically ugly even though I don’t have any genuine reason to think that. I am embarrassed about my looks and am scared people will notice my embarrassment. I feel more self-conscious than ever. I sweat when meeting new people and at times I stumble over my own words. I’m very scared people will sense I’m feeling uncomfortable and reject me, and it hinders my social interactions. I just feel like a “weird ugly gay loser”. I wish I didn’t care what other people think of me, I am so sick of it. But I don’t know how to overcome my fears. It feels like I am always looking for something to feel bad about, and this way I will never be happy. How can I live a normal life constantly worrying about what people think of me and feeling ashamed? I just don’t know what to do anymore. I need a definite solution. Any advice?