I was sitting in on my first year of medical school’s orientation, zoned out on my phone refreshing Twitter. The school’s wellness coordinator was giving a spiel about mental health and how often many medical students fail to recognize the state of their own. It was around 3 o’clock, and already, I was tired from all the activities going on that day. Lecture after lecture, different people came to speak about the different aspects of the school we would face and the resources and people we should go to if we ever had any questions or concerns about any troubles encountered. My mind kept wandering, “What am I gonna wear tomorrow for my first day of school? Who am I gonna sit by at the cafe? Are college parties really all what they are hyped up to be?” I snapped back to reality as my classmate asked a question about our school’s health clinic. Shyly, he gazed around the packed room and stared back at each set of anxious students’ eyes. He took his time and moved his eyes back down to his feet as they dangled in front of him. Everyone could sense he was either going to say something really personal or something that might embarrass him. He cleared his throat, “How many medical students usually experience depression or anxiety?” A temporary silence fell over the room, as it took the coordinator a minute to digest the heaviness of his question. She stood tall, with curly hair on a podium pointing to a pie chart stating, “Around 30% of medical students experience symptoms of depres…..”, I zoned out again.
My first two years of medical school were great. I met some amazing friends and explored the new city. For the most part, med school was a breeze with a side of the occasional breakdowns mixed with a sprinkle of moments of incompetence; Other than that, I was good and did not have any complaints. During the times I went back home, I was excited to catch up with my family and friends and tell them about all the new things I was experiencing. Slowly, I had realized that medical school was more than just academics, partying and drama; medical school is a time of self discovery and fulfillment of one’s purpose.
But something changed. At that time, I could not quite figure out what it was. Was the world rotating slower? Was I going through seasonal mood swings? Was I slowly becoming jaded by all the pressure from school and studying, that I forgot who I was? I spent much of my time trying to put my finger on why I felt so out of place. It felt like an out of body experience not being able to articulate what I was going through and made me frustrated because not only could I not talk about it, but I could not also pinpoint what happened.
Fall came around, which meant another semester spent in the library with just me, my books and my thoughts. Every morning, I would spend about ten minutes looking in the mirror trying to navigate my feelings and why I felt so off. A couple months had passed, so I felt like I should have been able to figure it out. Still nothing. I went to class, talked to my friends to catch up and stressed about our upcoming exam; then, I went back to the library. Me. My books. My thoughts. This cycle went on for a while until I stopped showing up to class. My friends used to text me reminding me that that class was starting, but it became such a habit for me to ignore the text message. And so, the notifications gradually decreased in frequency.
Hours would turn into days, long nights would turn into weeks and the weeks dragged on into months. The ten minute gaze in the mirror quickly turned into mornings wiping away tears from the night before as I stayed up unable to sleep. Turning my car key in the ignition, my mind would immediately be flushed with all the things I had to do for the day, compiled with the things I had to do from yesterday because I could not get myself to complete the tasks. When I arrived at the school, I would take one look at the PowerPoint I needed to have already gone over and just be overwhelmed with having to go through it and not being able to catch up.
It was no longer just me, my books and my thoughts in the library. My crippling anxiety had decided to accompany us as well.
My mind abandoned my body. It became this dissociated captain, while my body was held captive as my anxiety would control every aspect of my world. Overthinking became my new drug, and just like any other medication, it came with a list of side effects. My mind filled with racing thoughts while my hands shook uncontrollably from fear of the unknown. My lungs would collapse, leaving me gasping for air as if I just ran for my life. Most nights I stayed awake, bracing for it to all restart the next day.
From the world’s perspective, nothing had changed. To everyone, I was still that girl who laughed a lot and wasted her time on Twitter while studying hard to get good grades. But on the inside, I was a girl who felt trapped in an alternate reality that she could not escape. I put an extreme amount of effort into making sure the two worlds did not collide. I preferred the outside world’s version of myself and not my internal truth. So, I did not tell anyone. And if I did speak about it, I would do it in a form of a joke so people would unknowingly mistake my cry for help as some sort of a playful banter, which fit the mold of the girl they thought they knew. However, I was okay with that. Plus, I always found it difficult to talk about my feelings with my family and friends. Not because they would not care, but because I had this paralyzing fear that they would not understand and worse, look at me differently.
Hours would turn into days. Long nights would turn into weeks. And the weeks dragged on into months. But this time around I knew the truth. I knew why I was feeling the way I was, and knew I needed help. I became so frustrated with myself and just kept asking the question why? Why did this have to happen to me? My life was good, my friends were great and I studied hard to get the grades I wanted. Why am I still feeling like this? I saw patients that dealt with much worse, and yet here I was on my hands and knees praying to God, tears in my eyes, begging him to just take this problem in my life away. But I guess I did not pray loud enough or realized how bad it had gotten.
I laid in my bed thinking about all the possible ways I could bring it up to my friends and family. Nothing I thought of felt good enough and I would rather just deal with it than address the issue. They say doctors make the worst patient.
I ran into one of my freshman year advisors at an event and we briefly chatted, catching up about how my life had been since the last time I spoke with her. It had been years since we spoke, but in my mind, it was way more than that. I felt like a totally different person. We talked and went our separate ways. About an hour later, I received an email from her. I opened it and was immediately overwhelmed with what she wrote. She, too, had noticed that something was off and asked if we could meet the following Monday. We did. That was the moment I knew that I could not continue the life I was living. Her accounts and memories of me from freshman year were starkly different from my current reality. My life used to be filled with laughter and happiness. And now, it was filled with self-doubt, constant worrying and a person she could not recognize anymore. After the meeting, I was left with one question: What would I want my future patients to do if they were feeling like this?
“Around 30% of medical students experience symptoms of depression or anxiety while in medical school,” my mind flooded back to the memory of me sitting playing on my phone at orientation. The doctor walked in. This time my phone was locked as it sat on the counter while my feet dangled from the chair. The lights were bright. The room was filled with posters about treating high blood pressure and diabetes. I was used to being the one walking in wearing the white coat. This time I was on the other side. This time zoning out was not an option. I was the patient.
Buspirone 7.5 mg. Twice a day with food. This is my new life. I get up in the morning and look in the mirror. I am free.