I am a 43-year-old woman with two children who bring me a lot of joy, and a partner who is a devoted father, whom I love very much. But I am very unhappy and my life is a mess. I am very lonely and have zero confidence.

I have suffered from increasingly severe facial hair since my early teens. Over the years I have tried various treatments, and 10 years ago laser hair removal, which had little effect. One GP suggested a contraceptive pill but my migraines ruled this out and he said the NHS offers no other options. Since having children the problem is worse and I have to shave every morning and wear thick makeup.

Although loving, my parents were not people we could confide in about personal issues. Looking back, I think my mother’s battle with depression had something to do with this. Already a shy teenager, my self-consciousness meant I spiralled into a secret world of early-morning hair removal and avoided social situations where I had to make small talk. This pattern of behaviour has continued all my life, through university and in my work as a teacher. I currently don’t work; my social awkwardness has steadily increased and I have no friends.

 My partner has many friends and before he met me he went out a lot. He enjoys social situations. I can’t imagine anything more stressful. I try too hard when I meet people and don’t know how to chat or feel relaxed.  Unfortunately, his friends and family find me so difficult that he now doesn’t get invited to gatherings as I am “part of the package” and he is becoming more insular.

I am worried that as they get older my children will suffer from not being invited to parties because I have noticed some parents at their preschool avoid me. I don’t know how to change how I interact with others so I that seem “normal”. 

How can I get the confidence to get into work again? I just want to enjoy my children growing up and have some measure of normality.

I know it doesn’t seem so to you (and that’s the perspective that matters), but you’ve achieved an awful lot despite how you feel. You’ve made something of your life, including having a job that lots of people would find highly stressful! Many people loathe social situations and your husband may or may not be invited to fewer occasions, but you tend to go out less when you have young children. So you may not be the reason for his curtailed social life.

I think your mother’s depression has contributed to your anxiety and counselling (see later) may help you unpack this. But let’s look at the “severe facial hair” that’s causing you angst. I must stress that I’m not suggesting you go down one route or another, but given that it is causing you such distress, I want to run you through some options.

I consulted Dr John Briffa, who is a practitioner in nutritional and integrated medicine, about your letter. He said the excess hair could be innate – in other words, it could be genetic and to do with your ethnicity or it could be because something is out of kilter in your body – it could be both.

You don’t mention if anyone else in your family has excess facial hair so that may be a pointer to it being a hormonal imbalance. “It’s possible,” says Dr Briffa, “that you have relatively high levels of androgens [male hormones, of which testosterone is one].” We wondered if you had other symptoms such as acne and thinning of your scalp hair.

High levels of androgens can be the result of the effect of insulin on the ovaries. Insulin is secreted in response to carbohydrate (sugar and starch) in the diet and Dr Briffa suggested you consider low-carb eating for a while to see if this helps.

Also, go back to your GP. There are other contraceptive pills you could try. There are also pharmaceutical drugs that block testosterone, which your GP can tell you about if excessive male hormones are the issue.

Hair removal systems have moved on a lot over the past 10 years and you can now get machines (laser, pulsed light) for domestic use. They do cost quite a bit though, so I see that might be a barrier. Perhaps a female GP might be more empathetic?

I would also speak to your GP and ask for face-to-face (rather than phone) counselling if that’s what you want.

Going private is also an option (bacp.co.uk/psychotherapy.org.uk) but it will cost. I get the feeling you have reached a place in your life where you don’t feel happy, but in a strange way, it’s familiar. And to reach out and try again for help seems scary, doesn’t it? But you seem to be someone who can, despite what you think of yourself, achieve much. Take little steps to help yourself into the next stage of your life.