Beating depression and anxiety in medicine school?

[isamvp]

Everyone guys! I hope you all are doing alright First of all, I want to apologize, as my mother language isn't English.

I'm a Spanish girl currently studying my second year and today I had my first appointment with a psychiatrist who told me that my depression and anxiety symptoms (which have been bothering me for more than half a year now) are caused by my tendency to be way too self-exigent as well as my auto-destructive behaviors, which only got worse when I started my second year. She's given me some basic advice, like "don't stress that much" or "you need to accept you've got a life besides your studies", which yeah, I know and I've been trying to do that the whole time and you see, no much progress here. Of course, I told her that, but you know how some doctors are; she just told me to try harder, some pills to sleep and gave me another appointment in 2 months to check how I am going. Maybe it's true and I'm not trying enough?

Anyways! How do you guys do to enjoy your normal life, aside from your studies? Like, I can't spend free time without feeling like "I'm wasting my time" or "I should be studying". Also, my closest friends aren't medical students and they don't understand how hard it's being for me and they keep saying "You're gonna be left alone if you keep enclosing yourself in home like that" which only gives me even more stress (I've tried talking to them about that and after several unsuccessful attempts I've simply given up). I don't enjoy going out anymore and besides, it's not like I've got much to share or say anyway since all I do is school-related (including the time I spent stressing over all the things I've got to do instead of actually doing something productive). Forcing myself to spend time on my hobbies doesn't work as I don't enjoy them anymore as I used to. I already exercise on a daily basis and I'm super careful with my eating habits as I've recently been diagnosed with irritable bowel syndrome. I just don't know what else I can do...

That's why I'd appreciate any advice/personal experiences! I guess I need some concrete examples so I can get an idea of how I should properly face the situation and make the correct steps.

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[anbuitachi]

Everyone guys! I hope you all are doing alright First of all, I want to apologize, as my mother language isn't English.

I'm a Spanish girl currently studying my second year and today I had my first appointment with a psychiatrist who told me that my depression and anxiety symptoms (which have been bothering me for more than half a year now) are caused by my tendency to be way too self-exigent as well as my auto-destructive behaviors, which only got worse when I started my second year. She's given me some basic advice, like "don't stress that much" or "you need to accept you've got a life besides your studies", which yeah, I know and I've been trying to do that the whole time and you see, no much progress here. Of course, I told her that, but you know how some doctors are; she just told me to try harder, some pills to sleep and gave me another appointment in 2 months to check how I am going. Maybe it's true and I'm not trying enough?

Anyways! How do you guys do to enjoy your normal life, aside from your studies? Like, I can't spend free time without feeling like "I'm wasting my time" or "I should be studying". Also, my closest friends aren't medical students and they don't understand how hard it's being for me and they keep saying "You're gonna be left alone if you keep enclosing yourself in home like that" which only gives me even more stress (I've tried talking to them about that and after several unsuccessful attempts I've simply given up). I don't enjoy going out anymore and besides, it's not like I've got much to share or say anyway since all I do is school-related (including the time I spent stressing over all the things I've got to do instead of actually doing something productive). Forcing myself to spend time on my hobbies doesn't work as I don't enjoy them anymore as I used to. I already exercise on a daily basis and I'm super careful with my eating habits as I've recently been diagnosed with irritable bowel syndrome. I just don't know what else I can do...

That's why I'd appreciate any advice/personal experiences! I guess I need some concrete examples so I can get an idea of how I should properly face the situation and make the correct steps.

It's very difficult, that's why it's so hard to beat.

Maybe hang out with some med school people who understand what you go thru. I and many others have found that non medical people do not understand what it is like despite many attempts at explaining it.

 

[Goro]

Everyone guys! I hope you all are doing alright First of all, I want to apologize, as my mother language isn't English.

I'm a Spanish girl currently studying my second year and today I had my first appointment with a psychiatrist who told me that my depression and anxiety symptoms (which have been bothering me for more than half a year now) are caused by my tendency to be way too self-exigent as well as my auto-destructive behaviors, which only got worse when I started my second year. She's given me some basic advice, like "don't stress that much" or "you need to accept you've got a life besides your studies", which yeah, I know and I've been trying to do that the whole time and you see, no much progress here. Of course, I told her that, but you know how some doctors are; she just told me to try harder, some pills to sleep and gave me another appointment in 2 months to check how I am going. Maybe it's true and I'm not trying enough?

Anyways! How do you guys do to enjoy your normal life, aside from your studies? Like, I can't spend free time without feeling like "I'm wasting my time" or "I should be studying". Also, my closest friends aren't medical students and they don't understand how hard it's being for me and they keep saying "You're gonna be left alone if you keep enclosing yourself in home like that" which only gives me even more stress (I've tried talking to them about that and after several unsuccessful attempts I've simply given up). I don't enjoy going out anymore and besides, it's not like I've got much to share or say anyway since all I do is school-related (including the time I spent stressing over all the things I've got to do instead of actually doing something productive). Forcing myself to spend time on my hobbies doesn't work as I don't enjoy them anymore as I used to. I already exercise on a daily basis and I'm super careful with my eating habits as I've recently been diagnosed with irritable bowel syndrome. I just don't know what else I can do...

That's why I'd appreciate any advice/personal experiences! I guess I need some concrete examples so I can get an idea of how I should properly face the situation and make the correct steps.

If you can, take a leave of absence and go and heal.

 

[anbuitachi]

i would try the above only if continued treatment does not work. since 1 you will delay your graduation, and 2 you dont know how long it will take to heal.. if it's too long your school may not even take you back, and the uncertainty of it all probably doesn't help either with anxiety. you still have a long way to go in terms of treatment. psych sessions are slow to work, and there's SSRIs too that you haven't started yet from what i can tell and those takes weeks/months to work (if they do)

 

[Fidelio17]

Of course, I told her that, but you know how some doctors are; she just told me to try harder, some pills to sleep and gave me another appointment in 2 months to check how I am going. Maybe it's true and I'm not trying enough?

Anyways! How do you guys do to enjoy your normal life, aside from your studies? Like, I can't spend free time without feeling like "I'm wasting my time" or "I should be studying".

I suspect one of the issues here is that the psychiatrist you saw is likely not a good fit for you. If the response to, "I need help because I feel anxious & depressed & socially isolated & stressed," is, "here are some sleep aids & you should try harder, see you in 2 months!"... then she's not listening & will likely be of little help.

You say that you're still exercising every day & eating well. I suspect you're still relatively high functioning (likely why the psychiatrist seemed generally unconcerned), but... rather stressed & unhappy. I get that. Sometimes it's hard to get someone to understand that you need help when you seem like you're still holding things together.

I suspect that you need a little more self forgiveness & compassion. Not "trying harder". You're already trying hard & it's not working. I'm not a mental health professional, but, for me, journaling, yoga & hiking are helpful in cultivating a sense of peace & mindfulness. I think you might find it helpful to explore (either on your own/journaling or with a therapist) why you're "self-exigent" & have difficulty "accepting that you have a life outside of your studies". There is a paradox in any endeavor, which is that there is a point of diminishing returns. It seems like you spent most of your time focused on your studies... even if that time isn't productive (ie. worrying about studying). I think compartmentalizing your schedule might be useful. Block out reasonable times to study with frequent breaks. (aka: study for 50 minutes, take 10 minute break, repeat. Stop after 3 hours & go do something else).

Also, don't think of your free time as "free". That implies that it is available for whatever, & whatever can include stressing about studying/school. Try to mentally reframe it as "me time". Plan things that you want to do during those times. I find it particularly helpful if I plan social activities with people I find refreshing to be around. (Side note: if your friends are threatening to abandon you because you have to study, then they don't seem like very understanding/nice people.) Of course, your me time can also include taking a nap or going for a walk or just sitting quietly or reading or drawing or... whatever. I like doing things that use creative energy as an outlet for expression. You say that you're not enjoying your hobbies anymore, so don't try to force yourself to like/do them because you "should". "Should" is a terrible reason to do things. It breeds more guilt & is generally unhelpful.

Also, I'd look into sleep hygiene if you haven't already. It requires more effort than taking a pill, but it's not a bad thing to be aware of.

 

[VA Hopeful Dr]

Exercise (which you're doing, kudos).

Eat well (which you're doing, again well done).

Make sure you're getting enough sleep - whether with pharmaceutical assistance or not, but completely agree with the previous poster who said to look into sleep hygiene - Sleep Hygiene

Start medication or some sort. I like SSRIs for everyone but there are other options.

Psychotherapy is also a good idea.

 

[humble_nous]

Everyone guys! I hope you all are doing alright First of all, I want to apologize, as my mother language isn't English.

I'm a Spanish girl currently studying my second year and today I had my first appointment with a psychiatrist who told me that my depression and anxiety symptoms (which have been bothering me for more than half a year now) are caused by my tendency to be way too self-exigent as well as my auto-destructive behaviors, which only got worse when I started my second year. She's given me some basic advice, like "don't stress that much" or "you need to accept you've got a life besides your studies", which yeah, I know and I've been trying to do that the whole time and you see, no much progress here. Of course, I told her that, but you know how some doctors are; she just told me to try harder, some pills to sleep and gave me another appointment in 2 months to check how I am going. Maybe it's true and I'm not trying enough?

Anyways! How do you guys do to enjoy your normal life, aside from your studies? Like, I can't spend free time without feeling like "I'm wasting my time" or "I should be studying". Also, my closest friends aren't medical students and they don't understand how hard it's being for me and they keep saying "You're gonna be left alone if you keep enclosing yourself in home like that" which only gives me even more stress (I've tried talking to them about that and after several unsuccessful attempts I've simply given up). I don't enjoy going out anymore and besides, it's not like I've got much to share or say anyway since all I do is school-related (including the time I spent stressing over all the things I've got to do instead of actually doing something productive). Forcing myself to spend time on my hobbies doesn't work as I don't enjoy them anymore as I used to. I already exercise on a daily basis and I'm super careful with my eating habits as I've recently been diagnosed with irritable bowel syndrome. I just don't know what else I can do...

That's why I'd appreciate any advice/personal experiences! I guess I need some concrete examples so I can get an idea of how I should properly face the situation and make the correct steps.

Sorry you're having a rough time in your life right now.

Lacking certain details, my advice is:

1. Get psychotherapy immediately (CBT) to work on taking better care of yourself. If your tendency to be way too self-exigent is unhealthy, then find out why you do this to yourself! Don't underestimate the ability of your subconscious beliefs to lead to unrealistic expectations which lead to only false shame.

2. I don't know what you mean by self-destructive behaviors. Also, that you were given a script for a sleep med rather than starting an SSRI/etc first (as VA Hopefule Dr suggested) suggests you're having significant sleeping issues but you don't mention this? Are you sleeping?

3. IBS sucks. I've lived with it for a decade now. Are your symptoms well managed? Is this contributing? How does it affect your diet/energy levels/mood? A GI once told me a happy bowel movement makes for a happy day.

 

[elphie236]

I don’t think your current psychiatrist is the right fit for you. Try a psychiatrist that works with students. Those usually know how to help students better. Maybe even a counselor at your school.

 

[knope321]

Congrats to you for opening up and seeing someone about your problems! I just want to add that a lot of us feel this way. Like we cannot relax. I think there is also this pressure to feel like you're having fun and having such a great life when really you are just tired, which is totally 100% fine. You are already doing better than me in terms of eating healthy and exercising!

 

[cali482]

I am a psychiatrist and treated a lot of med students and doctors over the years. I wrote a book in the last year available on Amazon to help med students and residents with depression. The stress of med school is brutal. Learning different coping strategies can make it more bearable. This mini manual is called Your Med School Surefire Survival Kit: How to Combat Med School Blues. I hope this helps you!

 

[FutureOncologist]

If you can take a LOA, take it. But some medical schools need a real emergency to consider you taking a LOA.

So if you can't, I'd finish up this semester if you haven't already. Try to stay focused on JUST passing finals and hang in there. Keep eating well, stay active if you can, and remember that it's only another week or so. Do you start clinicals soon? Or do you have a small break period between 2nd and 3rd year?

As someone posted above, start CBT with a psychologist or a licensed professional. Someone you can see at least once a week. Because you're anhedonic, focusing on outside interests/people won't help. You need to get to the root-cause of why you've become very self-loathing. Was it a string of average to below-average performances in classes or tests/quizzes? Were you placing high expectations on yourself that you couldn't live up to? These mind sets can spiral down from "damn, I didn't study for 10 hours in cardio;" to "I didn't get that one question right on my renal quiz. I'm going to be a horrible doctor." All because of constant negative self-talk that can put you in a place that can be hard to escape. I believe the anhedonia is an effect of these thought patterns and, until you can reverse them, the anhedonia will be hard to overcome.

In the mean time, take time to really get involved in a medical school interest group that takes your focus away from studies and gets you to be involved with others that know what you're going through. I can promise you you're not the only one.

 

[doc slinky]

First off, kudos to you for already doing everything you're doing and for seeing someone in the first place! I'm an MS3 and struggled with severe depression and anxiety during my first and second years, and getting up the courage to go see someone was one of the hardest things for me to do. I was fairly high-functioning like you seem to be, and I was lucky enough to find a truly awesome therapist. I'm sorry that the first psychiatrist you saw essentially told you to just try harder, because you're already a hard worker at baseline (otherwise you wouldn't have gotten this far!) and that advice sounds thoroughly unhelpful. My therapist helped me learn to balance the rigors of school with self-care and checking in on myself regularly. I haven't ended up needing medications yet, but I'm so much better now at figuring out when I'm going to benefit from studying harder versus when a night off is literally a mental health requirement. I had unrealistic expectations for myself that were overwhelmingly unhealthy, and it took a lot of work to overcome them. Essentially, we don't need to feel guilty about taking some free time to ourselves instead of studying. Take some time out of your busy schedule to do something you enjoy, or to just relax, and don't apologize for it! Truly though, I can't stress enough how important it is to find a therapist that's a good fit for you. That's first and foremost the critical next step for you. You're awesome and you got this!