Anxiety in medical school

[PunkinHead4]

I'm an MS1 who's struggled with anxiety since middle school. I've kept it under control my whole life until my second semester of medical school. I don't know how else to describe it other than a "mental breakdown." I've had to take a medical leave of absence from medical school because of what has happened, but nothing has ever caused me so much inner pain and stress as medical school has. I have a B.S. in biology, and I've considered other options in the medical field, such as doing an accelerated program to get a BSN or becoming an APRN. I think my family wants me to try to tough it out and stick with medical school, but is it worth it? Has anyone else had similar experiences? I'd appreciate any thoughts/advice. Thanks.

---

Members don't see this ad.

 

[Oso]

Have you sought out professional help?

I definitely recommend professional counseling/psych services to manage your issues and optimize your performance as much as possible.

PM me and we can talk more if you'd like. I've had some things that I managed on my own through high school and college but **** started hitting the fan about halfway through M1 year and I finally asked for help towards the end of M1. It's been tough, but it's possible -- if you ask for help from qualified professional people.

 

[mk04447]

I'm an MS1 who's struggled with anxiety since middle school. I've kept it under control my whole life until my second semester of medical school. I don't know how else to describe it other than a "mental breakdown." I've had to take a medical leave of absence from medical school because of what has happened, but nothing has ever caused me so much inner pain and stress as medical school has. I have a B.S. in biology, and I've considered other options in the medical field, such as doing an accelerated program to get a BSN or becoming an APRN. I think my family wants me to try to tough it out and stick with medical school, but is it worth it? Has anyone else had similar experiences? I'd appreciate any thoughts/advice. Thanks.

Pretty easy for me to recommend sticking it out, but I do realize that may be difficult advice for you to follow. Here's how I would tackle your situation. I assume they intend to roll you back a year and they'll let you pick back up where you left off with the next class? If so, step 1 SSRI. Next, get all the slides you missed from a classmate. They either just started or are about to start summer vacation? Crash in your parents basement and study like you never left, teach yourself. This will do two things, reduce the flow of new information hitting you when you return and that will allow you to finish MS1. I think once you do that and you can see an end to the pre-clinical blocks in your rearview mirror, maybe you can begin to believe in your ability to do this. That's really the problem, your school already believed in your capacity to do this when they gave you the seat, you just have to convince yourself.

 

[Goro]

Anxiety is poorly managed on an anonymous internet discussion board.

Seek out a psychiatrist, STAT

It's easy for people who are ignorant about mental health issues to say "stick it out". Would they the same thing if you were peeing blood???

 

[fivelikes]

First of all, I'm so sorry for what you are going through. I have been there myself. I experienced some of the worst anxiety and depression of my life during my first semester of MS1. Fortunately, I was able to get help and am now finally back to feeling like myself. If I can do it, you can do it, too. Here's my advice to you:

1) GET HELP NOW. Find a psychiatrist and a therapist. There is absolutely no shame in seeking mental health care. In fact, I'd guess that at least almost half of your classmates are either in therapy or taking some sort of anti-depressant. It's no more shameful than taking insulin if you are a diabetic.

2) Don't make any decision about whether you want to leave or stay in medical school right now. You're on leave, so I assume you have at least a few months before you need to go back to school. Take this time to regularly see a counselor and psychiatrist, take some time for yourself, engage in some self-care, exercise, and enjoy life. Only when you are fully back to feeling like yourself should you make the decision on whether or not you want to stay. During my first semester of med school when I was in the darkest place I've ever been, I wanted to quit every single day. I thought that I had made the biggest mistake of my life by coming to med school. Now I realize that it was the anxiety/depression talking and I'm so glad that I didn't quit. I'm not saying this will necessarily be the case for you because I don't know your particular situation, but never make important life decisions when you are not in a healthy mental place. Take the time to get better, and then sit down and make the decision.

3) I know everyone says this and it sounds cliche, but yoga, meditation, and exercise help tremendously. Getting a gym membership was one of the best things I did for myself. Working out regularly, doing yoga, and meditating daily can do wonders for anxiety. I recommend the app Insight Timer for meditation. If you get a counselor, he/she can also help you with meditating and learning to disengage from your anxiety. Highly recommend.

4) Lastly, remember that this is not uncommon. In my med school alone, there are probably 10+ people who have taken a leave during MS1 due in some part to mental health reasons. This is quite common, but I truly believe that you can overcome this and come back to kick ass in med school and become a fantastic doctor (if that's what you truly want). I applaud you for recognizing that you needed to take a break and for seeking help. But seriously, GO SEE A PSYCHIATRIST NOW. It will do you no good to wait any longer.

Best of luck, and if you ever want to talk more, feel free to shoot me a message!

 

[mk04447]

Anxiety is poorly managed on an anonymous internet discussion board.

Seek out a psychiatrist, STAT

It's easy for people who are ignorant about mental health issues to say "stick it out". Would they the same thing if you were peeing blood???

Totally true. Problem is, these days, if it quacks like a duck, walks like a duck, it isn't always anxiety. I can't tell you how many 16-28 year old patients I've seen who simply lack the basic coping skills necessary to deal with life, but we treat it like anxiety. I've got to believe, as a basic rule, if you get this far the odds are more likely the expectations thrust on you in medical school are the nidus, not an underlying disorder. We've all heard, occasionally we find a zebra on the hill, but more often than not it's just another horse. Is this what's going on in this particular case, how should I know, but I'm willing to bet in the vast majority of these cases it is. That's probably why the empiric treatment is stick it out.

 

[NeurologyHopeful2018]

Totally true. Problem is, these days, if it quacks like a duck, walks like a duck, it isn't always anxiety. I can't tell you how many 16-28 year old patients I've seen who simply lack the basic coping skills necessary to deal with life, but we treat it like anxiety. I've got to believe, as a basic rule, if you get this far the odds are more likely the expectations thrust on you in medical school are the nidus, not an underlying disorder. We've all heard, occasionally we find a zebra on the hill, but more often than not it's just another horse. Is this what's going on in this particular case, how should I know, but I'm willing to bet in the vast majority of these cases it is. That's probably why the empiric treatment is stick it out.

This is the best post on SDN I have ever read. Give even the brightest student at Harvard only 10 days to study for Step 1 - all of them will present with anxiety and depression.

 

[Anicetus]

I'm an MS1 who's struggled with anxiety since middle school. I've kept it under control my whole life until my second semester of medical school. I don't know how else to describe it other than a "mental breakdown." I've had to take a medical leave of absence from medical school because of what has happened, but nothing has ever caused me so much inner pain and stress as medical school has. I have a B.S. in biology, and I've considered other options in the medical field, such as doing an accelerated program to get a BSN or becoming an APRN. I think my family wants me to try to tough it out and stick with medical school, but is it worth it? Has anyone else had similar experiences? I'd appreciate any thoughts/advice. Thanks.

The stupidest thing I’ve seen my classmates do is not seek professional help when letting anxiety and depression ruin their grades and ultimately their match this year. So much for “toughing it out” because now they have to “tough it out” in a s*** residency program in a s*** location. I seeked out help the moment I realized something was wrong because my pride can suck a fat one. My future is more important than my colleagues finding out about my illnesses.

 

[Goro]

The stupidest thing I’ve seen my classmates do is not seek professional help when letting anxiety and depression ruin their grades and ultimately their match this year. So much for “toughing it out” because now they have to “tough it out” in a s*** residency program in a s*** location. I seeked out help the moment I realized something was wrong because my pride can suck a fat one. My future is more important than my colleagues finding out about my illnesses.

Sadly, there are too many medical students who see getting help as a loss of face and a sign of weakness.

 

[Anicetus]

Sadly, there are too many medical students who see getting help as a loss of face and a sign of weakness.

Or crying as a sign of weakness?

I saw getting a 204 on step 1 from being stubborn as a BIGGER sign of weakness.

 

[operaman]

Echoing the above to seek help immediately.

Your story is not uncommon I’m afraid. People smart enough to get accepted to medical school can typically self-manage a lot of things BEFORE hitting the demands of medical school. As you’ve already learned, the pressures of med school are unique and hard to convey to someone who hasn’t been there. You are wise to take LOA and clearly you have some thinking to do.

AFTER you’ve gotten appropriate treatment and are a bit removed from the recent struggles, you will want to have some tough conversations with people who know you best and make a decision about how best to proceed with your career. I will say that MS1 tends to be a big transition time and punishes people with poor study habits and other vices, but in terms of overall stress and difficulty is arguably one of the easiest parts of medical school. Second year and step 1 tend to be much tougher and anxiety provoking. MS3 is no less demanding and now eats up 60-80 hours of your week with time on the wards making it even tougher to study and take care of personal things. M4 is stressful insofar as matching goes but itself is generally much more relaxed.

The real burden of training comes with residency. The rigors of training, the hours, the exhaustion, and the stress of knowing you can really hurt people is overwhelming. Add to this the constant scrutiny from your upper levels and attendings as well as annual written exams to prepare for. You will want to consider this part of training as well when thinking about future directions. Many people have anxiety and are able to do it but it takes deliberate effort and a lot of professional help. It also takes a lot of self awareness in picking a program when the time comes and selecting quality of life and more relaxed pace over things like perceived prestige (ie. Don’t wind up at some NYC meat grinder program).

 

[Dhooy7]

I'm struggling tremendously as well. Would appreciate any reocmmendations. I have been focusin on deep breathing, meditation and seeing learning specialists but my nervous system and nerves get to me during tests. It has been impacting my performance tremendously.

 

[teenyfish]

I'm struggling tremendously as well. Would appreciate any reocmmendations. I have been focusin on deep breathing, meditation and seeing learning specialists but my nervous system and nerves get to me during tests. It has been impacting my performance tremendously.

Speak to your school regarding test anxiety? Maybe they can offer you some assistance with test-taking strategies or extended time on exams.

 

[ciestar]

I'm struggling tremendously as well. Would appreciate any reocmmendations. I have been focusin on deep breathing, meditation and seeing learning specialists but my nervous system and nerves get to me during tests. It has been impacting my performance tremendously.

You’re at the point you need to be seeing a behavioral-health specialist.

 

[bballdragon5]

I'm struggling tremendously as well. Would appreciate any reocmmendations. I have been focusin on deep breathing, meditation and seeing learning specialists but my nervous system and nerves get to me during tests. It has been impacting my performance tremendously.

I had similar experiences, but different issues. I had to take an academic leave of absence from medical school and did not so well on my step 1 exam although I passed. One thing that has been emphasized a lot on this thread is seeking help with I am going to echo. If it is indeed something deeper, there are things whether it is counseling or medications that can be helpful. Another thing is that they can assess your need for texting accommodations, which may help with some of your test day issues. I would also look to see if you have a department in your school for academic success or student academic help (don't know what its called in other places), but my school has people available that work through study habits and stress coping that may be useful for you. Another is look for your sources of support. I had given up a lot of mine because I became so boxed into studying. You have to have a life outside of medical school. There is no way you can just be a medical student because it will consume you. Whether it is doing meditation, yoga, sports, trivia nights...whatever you enjoy doing, don't give it all up just to study. Finally, you have to, and this is probably the hardest, be okay with failing. This comes with finding balance in your life as your life is no longer just defined by your academic performance, but you have to be okay sometimes with getting a 70 instead of an 90 or an 80 instead of a 90. I think as soon as I stopped stressing out about the number, I was able to focus better on the test and calm my anxieties. Along the same lines, when you apply to residencies, they will ask about challenges and struggles, or if you take a leave, why you took a leave of absence. By highlighting how you've changed and overcome these experiences, you can demonstrate a type of resilience that not many others may have experienced. Therefore, don't stress out too much about your future if medicine is something you indeed want to continue to pursue.

 

[NickNaylor]

Anxiety is one of the most treatable conditions on mental health that there is. It is remarkably responsive to both medications and psychotherapy. If you still have student benefits through your school, it's very likely that there is a student mental health clinic at your institution - make an appointment for an assessment. If you don't have access to that, go see a psychiatrist for an assessment.