The dilemma I’m 22 years old and going into my fourth year in medical school. I have been using study to escape loneliness, insecurity and anxiety that arose from the stress of the course and my failure to establish friends.

Despite my struggles with being shy and lacking in confidence, I managed to remain part of a solid group of friends through primary and secondary school. Unfortunately, I was not so successful in university and the dark voices in my head got the better of me. I comforted myself that, although I would never be the life of the party, I could still shine through my academic achievements.

Travelling through Europe and working in America this summer were steps I’m proud of. I’ve also been to some counselling sessions and I eat well, exercise and go out with my few friends whenever the opportunity presents.

However, the scholar’s lifestyle has left a void I can no longer ignore. Solitary evenings with my head buried in books have left me hollow and when term finishes, I have few companions to turn to. I’ve never had a boyfriend, or even the prospect of one. I fear I’m becoming bitter. How can I nurture myself with human connection?

Mariella replies Don’t be so hard on yourself. It sounds like you’ve packed a lot in in these last few years, much of which would have been hard to achieve if you’d added a gaggle of pals into the mix. Your travels through Europe and work experience in America are not trifles. It takes courage and enterprise to embark on such adventures and those are the qualities you need to see you through this tough passage and on into the future.

I get so many letters from young students like yourself that I could fill a compendium with the “lonely student” theme. There’s a stream of correspondence from 20-somethings struggling with the pressures of their studies coupled with a sense of isolation and near existential angst. You might feel alone, but you’re already one of a large gang, even if it’s one in which none of its members particularly wants to be included. It’s hard to feel as if you’ve accomplished anything in today’s world, because we’re over-exposed to those who are apparently doing better via social media.

You’re one of a gang that no member wants to be included in

I’m starting to wonder if ignorance isn’t bliss. When I was your age I was only intimate with people in my vicinity and they all appeared to be living similar lives. We struggled to pay our rent, couldn’t wait to escape the office, or our classes on a Friday night, and worried if we’d ever meet anyone to share our lives with. Nowadays I’d probably be glued to Instagram, so paralysed by my perception of what my peers appeared to be achieving that leaving the flat would be a pretty intimidating step. There’s no more confidence-eroding occupation than comparing your own lifestyle to the supposed success of others and, worse, there’s a masochistically addictive compulsion to such damaging habits. You don’t mention social media particularly, but its impact on how we live and perceive ourselves has been seismic and if it hasn’t affected you then you’re pretty unique. Forcing yourself out into the world can seem a much bigger deal than watching it via your fingertips, but it’s the only way to get a true picture of what’s really happening out there.

Is it too far of a stretch to suggest that your sense of your life is the new normal? You’ve chosen a tough degree and a demanding profession, but also an incredibly worthwhile one. Some of us play away our youth and pay for it by having to seriously knuckle down in middle age. You have embarked on what is most likely the opposite trajectory, with your sacrifices in youth paving the way to a rewarding future. Recently, David Graeber, the LSE anthropologist and author, concluded that 37-40% of people feel their jobs are pointless; worse still, they are generally correct. The career you’ve chosen doesn’t fall into that category and, therefore, you have far more chance of feeling like a valued participant in society once you emerge from the strain of your finals.

With lifelines stretching to 80 and beyond, you have a long time in which to meet kindred spirits, expand your social horizons and find a peer group with whom you feel comfortable. Fuelling our natural sense of our own insignificance is easy – it’s no wonder it’s what religion thrives on – but our greatest achievement as individuals is to battle those debilitating instincts. Your fears are universal and every step you take to combat them, every small act of bravery, will be rewarded.

You’ve shown determination and resilience in your studies. If you employ those qualities in your search for like-minded souls, you won’t fail. Meanwhile, find an engaging hobby to help you unwind and brush up against your contemporaries – and embrace the possibility that each person’s path is different and you’re doing pretty well. Carry on at your own pace, in your own time and in your own way, but in the knowledge that you are not alone and just need to look a little closer at those around you to see it.

If you have a dilemma, send a brief email to mariella.frostrup@observer.co.uk. Follow her on Twitter @mariellaf1