How can I go on?

I would like to share a letter I received.  It cut me to the core when I read it.  There has been some editing for privacy, but I'd like you to visualize how this person feels as you read it.

"I guess I just have a lot on my mind that I need to get out....  There are so many things going through my mind I feel like I am almost going insane.  Literally going insane.  I cannot make my mind just think straight, I want too; I really do, but it just won't.  I wake up every morning and I ask myself, "Is life worth living?  Do I ask for help?"