Please help... going into med school with depression & anxiety?

[thefirebuuurns]

Heya. Longtime lurker but first time posting on SDN. I've been fortunate enough to get accepted into medical school and will be matriculating in the fall.

But I'm scared sh**less.

I'm scared because I have a history of depression, generalized anxiety, and panic attacks. I was put on anti-anxiety medication for a short while but had very adverse side effects so I stopped it. I just started seeing a psychologist to learn coping skills before I matriculate, but my insurance doesn’t cover mental health, and because I’m financially disadvantaged, I don’t know long I can realistically afford continuing these sessions (my finances are a reason why I couldn't afford them in the first place, on top of working to support my family).

This will be my first time moving away from home (the school I've decided on is an exhausting few hours drive away from home, but the school is located in a barren place because it’s under construction, which makes the surrounding scenery depressing). I've lived with my family and close to extended family all my life because I attended an UG institution that was very close. I come from a very family oriented culture, am a first gen college student, and am ridiculously close to my parents and siblings. For this reason, my support system has always been my family.

I'm concerned because I know medicine is a rough road that, as @Goro always says, is a furnace that breaks even the healthiest of students. I thought long and hard about going into medicine and decided it is was a truly want to do. But I'm concerned I'm not going to be able to adjust properly because of my mental health conditions. And I'm scared that, since this is my first time away from family/friends and on my own completely, that not having my family nearby would make it unable for me to cope throughout medical school, especially during M3 (clinical) years. I know, I know -- I realize I have to “grow up," but please understand family life is an critical part of who I am and how I cope.

I've considered going to another med school where I've been accepted that’s only 20 miles away. But I’ve been hearing a lot of "meh" things about the school (not having enough research opportunities, administrative frustrations, not as academically strong). Both schools in comparison are new med schools. I’m not sure if I should go to the school that’s closest to home but "hate" my life because I may potentially be limited in research and academics that will affect my residency options, or stick with the program I've chosen and "hate" my life because I’ll be constantly bedridden with depression and anxiety that will be worsened by the fact that I miss my siblings and elderly parents.

Any advise would be nice. Thanks for reading everyone.

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[TheZaLord]

Unless there are things at the school you were leaning towards more heavily that trump a support system, I would strongly advise to go the the place closest to your support system.
There are many, many, many posts in which I have read that having a support system is crucial in medical school.
Doubly so if you have a history of mental illness.
This is coming from a person who also has a history of depression, by the way. It's in the past, but I always wonder, if it is entirely behind me...sometimes I feel I am just waiting for the other shoe to drop.
If that is a big part of who you are, and how you cope, I do not suggest you go into one of the most challenging experiences of your life without that back-up. Seriously.

 

[Catalystik]

I would strongly advise to go the the place closest to your support system.

Agreed. But thinking creatively, can you maybe talk a family member, or two, into coming along with you to the farther school?

 

[thefirebuuurns]

Unless there are things at the school you were leaning towards more heavily that trump a support system, I would strongly advise to go the the place closest to your support system.
There are many, many, many posts in which I have read that having a support system is crucial in medical school.
Doubly so if you have a history of mental illness.
This is coming from a person who also has a history of depression, by the way. It's in the past, but I always wonder, if it is entirely behind me...sometimes I feel I am just waiting for the other shoe to drop.
If that is a big part of who you are, and how you cope, I do not suggest you go into one of the most challenging experiences of your life without that back-up. Seriously.

Here's a run down:
School A (further from home) -- what I have currently chosen:

• New MD school, more academic oriented, ABCF grading
• Good amounts of resources for research to do within the school itself, more research funding (6x the amount than school B)
• state of the art anatomy lab, new facilities overall
• Clerkship years: No comment really on clinical rotations but it seems majority of grade is based on shelf exam, on A/B/C

School B (closest to home):

• New MD school, more clinical oriented, ABCF grading
• subpar research opportunities (all students go to neighboring institutions or have to hunt someone down to do research)
• very weak anatomy lab (not because it's prosections, but no fresh cadavers, have to study off of preserved specimens and computerized programs)
• Clerkship years: disorganized clinical rotations & annoying clerkship grading (unnecessary assignments + evals > shelf exam when it comes to cumulative clerkship score), also on H grading scale

I felt a good "vibe" at both schools in terms of nurturing faculty and supportive classroom environment, and students report that their faculty is indeed very supportive at both schools. COA is similar in both schools. Similar step scores.

I'm just worried that if I go to school B (closes to home) I'll be limiting my success in the future in terms of residencies and such vs. school A which has been doing very well overall and projected to do better over the next few years.

Agreed. But thinking creatively, can you maybe talk a family member, or two, into coming along with you to the farther school?

Not realistically possible unfortunately. Dad can't relocate work, mom has to take care of younger siblings, and my sisters can't relocate work. I'd feel terrible to ask them to come with me and sacrifice what they've established. We're also financially below the poverty line so moving isn't feasible unfortunately.



Thanks you two, I appreciate you reading through this and offering me guidance in a time of need.

 

[TheZaLord]

It's a tough call, man.

Without the depression and anxiety, I would say go for school A.

But I know what it is to be depressed, so my concern for you is the isolation that may trigger another episode. I do not envy the decision.

Also, with you seeking treatment, it may be good to discuss with your therapist. An objective view on your resiliency, and additional things to consider can't hurt.

As far as money for treatment goes, I've been considering that. The institution where I am doing my post-bacc has some support for students with mental health needs. A certain number of sessions with a psychologist (or psychiatrist, depending on the need) are free. Beyond that, I think it was something around $20 per session, unless you have insurance and the copay would be less. They also may work with you on a sliding scale based on income.

Additionally, if you are religious, some churches offer counseling services. Now, I do not mean "Christian counseling" from the pastors, but many sponsor a practice employing LCSWs, psychologists, etc...that will work with you on a sliding scale. Other religions may do this as well, if you are not Christian.
One of churches in this area sponsors one for the community at large, religious or not. I wouldn't let the association with a church or anything scare you away, either. When I first sought help I went to one, and there was no discussion of religion or anything unless I personally brought it up.

 

[crunchywhit]

Hello OP

First, if you can PM me your location, I can work on finding some sliding scale or free care. I work on mental health referrals in my area and would be happy to look into it for you.

Second, I am a person that is highly dependent on my family for support. There are many reasons for this, and I have had struggles commiserate with the ones that you had, but ultimately my family really is that close. I had to move away for my graduate degree and postdocs, and I achieved my goals, BUT I was much less productive than I could have been. I sometimes wonder if I even benefitted from the big names in my academic lineage because of this.

I talked to my mom about potentially moving in with us during med school and she was able to make it work... if I am fortunate enough to make it off of one of the alternate lists

I do think it's worth asking. We are below the poverty line as well so I'm not ignoring that. It doesn't hurt to have the discussion with family though.

I do believe that you should think seriously about staying close or bringing support.

I am glad you are thinking about these options. A smart person recognizes their limitations and adjusts their plans accordingly.

Best of luck to you

Heya. Longtime lurker but first time posting on SDN. I've been fortunate enough to get accepted into medical school and will be matriculating in the fall.

But I'm scared sh**less.

I'm scared because I have a history of depression, generalized anxiety, and panic attacks. I was put on anti-anxiety medication for a short while but had very adverse side effects so I stopped it. I just started seeing a psychologist to learn coping skills before I matriculate, but my insurance doesn’t cover mental health, and because I’m financially disadvantaged, I don’t know long I can realistically afford continuing these sessions (my finances are a reason why I couldn't afford them in the first place, on top of working to support my family).

This will be my first time moving away from home (the school I've decided on is an exhausting few hours drive away from home, but the school is located in a barren place because it’s under construction, which makes the surrounding scenery depressing). I've lived with my family and close to extended family all my life because I attended an UG institution that was very close. I come from a very family oriented culture, am a first gen college student, and am ridiculously close to my parents and siblings. For this reason, my support system has always been my family.

I'm concerned because I know medicine is a rough road that, as @Goro always says, is a furnace that breaks even the healthiest of students. I thought long and hard about going into medicine and decided it is was a truly want to do. But I'm concerned I'm not going to be able to adjust properly because of my mental health conditions. And I'm scared that, since this is my first time away from family/friends and on my own completely, that not having my family nearby would make it unable for me to cope throughout medical school, especially during M3 (clinical) years. I know, I know -- I realize I have to “grow up," but please understand family life is an critical part of who I am and how I cope.

I've considered going to another med school where I've been accepted that’s only 20 miles away. But I’ve been hearing a lot of "meh" things about the school (not having enough research opportunities, administrative frustrations, not as academically strong). Both schools in comparison are new med schools. I’m not sure if I should go to the school that’s closest to home but "hate" my life because I may potentially be limited in research and academics that will affect my residency options, or stick with the program I've chosen and "hate" my life because I’ll be constantly bedridden with depression and anxiety that will be worsened by the fact that I miss my siblings and elderly parents.

Any advise would be nice. Thanks for reading everyone.

 

[thefirebuuurns]

It's a tough call, man.

Without the depression and anxiety, I would say go for school A.

But I know what it is to be depressed, so my concern for you is the isolation that may trigger another episode. I do not envy the decision.

Also, with you seeking treatment, it may be good to discuss with your therapist. An objective view on your resiliency, and additional things to consider can't hurt.

As far as money for treatment goes, I've been considering that. The institution where I am doing my post-bacc has some support for students with mental health needs. A certain number of sessions with a psychologist (or psychiatrist, depending on the need) are free. Beyond that, I think it was something around $20 per session, unless you have insurance and the copay would be less. They also may work with you on a sliding scale based on income.

Additionally, if you are religious, some churches offer counseling services. Now, I do not mean "Christian counseling" from the pastors, but many sponsor a practice employing LCSWs, psychologists, etc...that will work with you on a sliding scale. Other religions may do this as well, if you are not Christian.
One of churches in this area sponsors one for the community at large, religious or not. I wouldn't let the association with a church or anything scare you away, either. When I first sought help I went to one, and there was no discussion of religion or anything unless I personally brought it up.

Thank you, your concern means a lot and I'm glad you're able to relate with my situation. I'm also glad you're doing better yourself in terms of your depression.

I wish School A wasn't so isolated. It's in the new developing area that's about 30 mins away from the main city. There's nothing but grass for miles and miles... there are a few convenience stores nearby but not until you've driven at lest 10 minutes. I feel like I'd be more comfortable moving out where School A is if it wasn't so empty. I feel like emptiness worsens my depression. I like having stores to run to where I can run errands to take my mind off whenever I'm having extreme anxiousness and or depressive moments. Don't get me wrong, School A does have some things, but they're far away and therefore would require a bit of driving or traveling. Not exactly possible to do when you're under stress due to the med school curriculum anyway.

At the same time I don't want to turn down opportunities. School B, while closer to home, sounds like it'll make med school unnecessarily and more complicated and difficult than it already is, and I feel like that extra pressure will also increase my anxiety --> increase my depression as well. I feel like there's no winning wherever I go.

I'll look more into the counseling services both schools provide, and also look into any religious institutions in the community that may sponsor the services that you mentioned. I didn't know churches and the like provided those kind of things. Thank you.

Hello OP

First, if you can PM me your location, I can work on finding some sliding scale or free care. I work on mental health referrals in my area and would be happy to look into it for you.

Second, I am a person that is highly dependent on my family for support. There are many reasons for this, and I have had struggles commiserate with the ones that you had, but ultimately my family really is that close. I had to move away for my graduate degree and postdocs, and I achieved my goals, BUT I was much less productive than I could have been. I sometimes wonder if I even benefitted from the big names in my academic lineage because of this.

I talked to my mom about potentially moving in with us during med school and she was able to make it work... if I am fortunate enough to make it off of one of the alternate lists

I do think it's worth asking. We are below the poverty line as well so I'm not ignoring that. It doesn't hurt to have the discussion with family though.

I do believe that you should think seriously about staying close or bringing support.

I am glad you are thinking about these options. A smart person recognizes their limitations and adjusts their plans accordingly.

Best of luck to you

I did have the moving conversation with my family actually, and we deduced that it really wasn't feasible, especially not for my mom & dad and my younger brother. As I just explained to the other individual I quoted above you, the better school (school A) is in a new area and doesn't have much established. My dad runs his own small convenience store that he's had for years so he can't leave the store, and my brother can't relocate schools. One of my older sisters considered moving for me but there wouldn't be anywhere for her to work, plus she's not done with her current degree program. It's a huge thing to ask for someone and I think I would feel worse if I knew my family was sacrificing their own needs just to support me through the next 4 years, especially in an area where I don't see myself continuing to live or practice in the future. I also worry, what about when it comes to residency? And job offers? I can't do this forever and expect people to move with me.

May I ask how you coped or what you did to mentally survive and get your through your graduate and postdoc degrees when you were away from your family?

I just don't want to sell myself short in terms of future success if School A offers better opportunities in terms of research, and therefore, matching. I wish I knew if my condition was manageable but it's too late to tell know since I only just started seeing a psychologist and the deadline to pick a school for multiple acceptances is next week. It's frustrating to know that it's myself in the end that brings myself down in moments like these.

Thank you for your encouraging words, and I really hope you're able to make it off the alternate list for your desired school.

 

[anbuitachi]

What caused your depression. You have to really think about whether there's a high chance med school will make you more depressed or not. Med school will be a lot of studying, not a lot of outside contact and not much time to go to psychiatrists.

 

[crunchywhit]

What caused your depression.

People can be depressed without an identifiable causation event.

 

[OldstockJr]

xanax if u ok with drugs, depression sucks, ive been there. copious amounts of beer works too, but thats if u ok with alcohol too.

so if ur ok with drugs and alcohol go that route. i kind of wanna say jk but thats how ppl cope. but a healthy alternative is to take up exercise and fit it in to ur morning routine

 

[Winged Scapula]

SDN is not for medical advice, especially bad advice. Please keep comments more about lifestyle and coping mechanisms/strategies

 

[GadRads]

Having a good support system is extremely important. Go where you will be happiest and most comfortable. Your performance in medical school is more important than the name of the university.

I don't recommend alcohol or drugs. Daily or frequent exercise is a better way to reduce stress.

 

[thefirebuuurns]

What caused your depression. You have to really think about whether there's a high chance med school will make you more depressed or not. Med school will be a lot of studying, not a lot of outside contact and not much time to go to psychiatrists.

As others have mentioned, it's unknown was causes depression. In my case I have no idea what sparked my depression, but it's been there for a while now and has gotten worse over the years since I didn't seek counseling for it. I don't think med school itself with all the studying will necessarily worsen my depression but I do think the environment will. This is why I am struggling between choosing schools A and B. I would much rather go A for their academic program, but it's further away from family + is in a barren city that is isolated from normal parts of civilization (this will change over time as they build more things, but definitely not during my lifetime as a student there). School B is not as strong academically and has a few flaws in the way the curriculum is structured (nothing terrible, but just little nuances that might be a pain in the butt to go through while in med school) but is much closer to my family and is in a major city with a lot of activity.

Having a good support system is extremely important. Go where you will be happiest and most comfortable. Your performance in medical school is more important than the name of the university.

I don't recommend alcohol or drugs. Daily or frequent exercise is a better way to reduce stress.

I feel like I will be happy in either schools but for different reasons. I will be happy in School A because I like the people and the program more, but I hate the environment. There's nothing but flat grass. Not even trees. Just mostly grass. Even the med students themselves at the school complain that while they like the program, the area is extremely difficult and inconvenient to live in, and there isn't anything around that can give momentary "escape" from med school unless you want to drive almost half an hour away to find something like a Barnes and Nobles or something.

School B will make me happier because I'll be near family and I'll thrive in the environment, but I don't like how their curriculum is set up.

It seems that you are a current med student. What is life like exactly as a medical student? How much time realistically do you have aside from studying to give yourself "a fresh of breath air" in between studying? I'm not talking about going out and partying. But just maybe taking a quick shopping trip. Or visiting the new restaurant that's in town. Etc... I'm sorry if this is a silly question. But thank you so much for responding.

 

[Sardinia]

@thefirebuuurns You've probably ran through these item sets. But honestly, if you haven't try to run through them because only you can pick the best school that will meet your needs.

• What in particular about M3 are you afraid about?
• What do you think are the strongest triggers behind your anxiety/depression attacks?
• After assessing those external stimuli which school do you think will: exacerbate your problems/offer amelioration towards those problems?
• What is the school's stance on taking a leave of absence/failing a class?
• Pass/fail or letter grading?
• How important is your support network going to be when you have to prep for Step 1 exam?
• Which school will allow you to excel despite you having this disability?
• If you assume there is a 1% chance of having a panic attack why leave yourself prone to not having a 100% guarantee of a support network around you on the off chance that it happens?

 

[DR MOM]

I vote support network. Doing research in medical school takes extra work on your part no matter what school you go to. The opportunities might be there but if you are too unhappy and overwhelmed you might have a hard time pulling it together and getting the work done. I have a good support system that came with me to med school and being able to come home and have dinner with my family or go for a walk with my wife makes the inevitable stresses of med school much more manageable. The only thing that would maybe trump that would be pass/fail grading in the first two years - but it looks like your schools are both similar in that regard.

One thing to consider is going to the school near home and then taking a year off to do research before or after third year - is that an option for you there?

 

[DokterMom]

I don't mean to be cruel here, but if you can't cope emotionally due to the lack of your support network, it won't matter how great School A is. It won't do you any good at all if you can't make it through. Similarly, all the wonderful research opportunities in the world won't save your residency application if other portions of your med school career are sub-par.

If having your family close by enables you to thrive and succeed at School B, your relative success there (and simple completion of the program) will outweigh the difference in prestige.

If you're worried about coping emotionally, go to the school where your chances of success are greatest.

 

[GadRads]

It seems that you are a current med student. What is life like exactly as a medical student? How much time realistically do you have aside from studying to give yourself "a fresh of breath air" in between studying? I'm not talking about going out and partying. But just maybe taking a quick shopping trip. Or visiting the new restaurant that's in town. Etc... I'm sorry if this is a silly question. But thank you so much for responding.

Med school is busy, but there is downtime, although not too much. There is also sufficient time (to a reasonable extent) to go out shopping, to check out lounges/bars/clubs, etc. I attend medical school in a big city with good friends (outside of med school) and some family relations. All these made the quality of life outside of medical school excellent. It was nice to be able to turn down invitations to outings and events (so I could study), as opposed to going to medical school in the middle of nowhere with little outside social support/networking. This does not mean going to medical school in boring locations is the end of the world, but I prefer city life with good friends and a better quality of life

If I were in your shoes, I would pick the school next to family in the better environment. I attended a lower-ranked med school in a better city over a higher-ranked school in a boring location, and it did not hurt me in the residency match.

 

[thefirebuuurns]

@thefirebuuurns You've probably ran through these item sets. But honestly, if you haven't try to run through them because only you can pick the best school that will meet your needs.

• What in particular about M3 are you afraid about?
• What do you think are the strongest triggers behind your anxiety/depression attacks?
• After assessing those external stimuli which school do you think will: exacerbate your problems/offer amelioration towards those problems?
• What is the school's stance on taking a leave of absence/failing a class?
• Pass/fail or letter grading?
• How important is your support network going to be when you have to prep for Step 1 exam?
• Which school will allow you to excel despite you having this disability?
• If you assume there is a 1% chance of having a panic attack why leave yourself prone to not having a 100% guarantee of a support network around you on the off chance that it happens?

I have thought about these item sets before, but I'll elaborate a little on them.

My issue with School B (which is closer to school) is that they take Step 1 after 3rd year. It sounds stressful to have to study for shelf exam, do assignments, and then have to take boards after 3rd year, which is the summer when you start applying to residencies. I don't particularly like this system and I feel like it would overwhelm me. Students have still done well on their boards in that school but they're also giving the newer classes less time to study now (a week less from my understanding). The students there have mentioned that by the time they have their designated study period, they've forgotten all the basic sciences and it's difficult to review because it's been a year since they've studied the material. With less time to study for incoming classes, I assume it'd be even worse.

I'm having a hard time trying to figure out my triggers. Since I have both generalized anxiety and generalized depression it's difficult to pinpoint. I'm just naturally anxious or spend half the week "normal" and the other half of the week having a hard time finding joy in everyday things. I wish I knew the roots to my problem though.

I think both schools have their pros and cons. School A will be further away from my support system so that will make me more anxious than usual, however, they do have psychologists and support services available for students attending the COM (aside from the fact that you have to drive 30 minutes to see a psychiatrist since they have none on campus). However I feel like I'll be just as anxious at School B even if I'm closer to my support system because their curriculum is so disorganized (such as the step 1 issue after M3 year that I mentioned) that I'll be stressed for academic reasons.

Neither are pass/fail, both are grading. School A seems more strict on remediation, as they tend to make students who get a C or two remediate the year.

When I'm studying for step, I'll make sure to study at home regardless of which school I go to, so I'll have that support nearby.

I guess I feel frustrated because although I will feel more prepared academically at School A and would prefer to matriculate there, School B is closer to a support system which is hard to pass up. In the end I guess it ends up being whether I want to be stressed because my family is so far, or whether I want to be stressed academically because the school I'm attending has a very cumbersome curriculum that students there seem to complain about.

If I were in your shoes, I would pick the school next to family in the better environment. I attended a lower-ranked med school in a better city over a higher-ranked school in a boring location, and it did not hurt me in the residency match.

Thank you, it's nice to hear that's there some down time in medical school, albeit not too much. For School A (which further away and is in a somewhat secluded city), it's still possible to go to outings and whatnot, but it's just a longer drive to do anything fun (20 minutes), which honestly no one has time to do. In a few years from now, when more stores open up in the immediate area, this won't be a problem anymore, but it won't happen when I'm there. I have the option of moving downtown to the main city during M3 and M4 years, but it's the first two years which are the most brutal for any med student -- and it's those two years that I'm worried about.

Both schools are similar in prestige, but it's just that School A offers more opportunities and resources for their students to excel as residency candidates than the school that is closer to my home. Both schools match well, but School A seems to have students going into more stronger residencies than School B, but from my understanding I should take match lists with a grain of salt.

One thing to consider is going to the school near home and then taking a year off to do research before or after third year - is that an option for you there?

It is an option from what I hear, but I'm not sure if I can fiscally afford doing a research year. With how things are at School B (closer to home), I would probably have to go to an OOS or away institution to do research anyway, and unless I find a very fruitful lab or generous PI, I'm not sure if banking on one research year for majority of my research will make me competitive enough for residencies.



Thank you everyone for your responses.

 

[ridethecliche]

I haven't read all the posts here yet, but I recommend that you call up the dean and ask if you can defer by a year to get your mental health in check. There might even be a chance that you could do research or work at the school for a year and establish care in the area since that's a good way to make sure you don't lapse when you start school.

I have a friend that was diagnosed with bi polar disorder and they applied but asked for a deferment to figure out drug dosages/therapy/etc. It has made medical school challenging, to say the least, but they're doing damn well all things considered.

This is an article that my friend wrote. Please read it.

This will not stop you from being a doctor, but you owe it to yourself to take the time needed to figure things out and get a handle on your health before taking this giant leap forward.
Good luck!

http://www.kevinmd.com/blog/2015/10/a-medical-students-psychiatric-hospitalization.html