Depressed

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enter_and_escape

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3rd year student on rotations. Was diagnosed with severe depression 6 months ago, but have been able to pass by rotations so far. I have been on Lexapro for about a month now but haven't really seen any significant improvement. Have been talking to best friend and therapist but nothing has helped significantly. Not much support from family because we are not well-to-do and don't have a lot of resources and parents have high expectations. Exercise helps transiently but by the end of the day, I feel sad again. I tick all the SIG E CAPS symptoms. Lately, also having anxiety episodes out of nowhere. The cumulation of all this is I failed a shelf exam last month and will have to remediate the shelf exam.

At this point, I feel really hopeless. I feel like I'm getting nowhere. I've tried everything. I am not significantly much better than how I was 6 months ago. I am considering taking LOA for a couple of months to recuperate and come back stronger. My concern is how will that LOA be looked upon when I apply for residencies. Planning to go into IM. Any advice will be appreciated. Thank you!
 
I've been seeing a doctor. PCP gave me Lexapro and referred me to a therapist. All the solutions have been great but last only transiently. I feel good in some parts of the day, and other times, I feel sad again.
 
Hey, I am so sorry that this is something you're having to deal with on top of all of your other responsibilities, and I really hope that you find something that works so you can feel better as soon as possible. That being said, your health is infinitely more important than being off schedule. In the end medicine will be here, but you need to make sure that you're healthy enough to take it on. I'm not a PD, but I would think that taking time off for your health would be more understandable than potentially failing a rotation or having a subpar performance on boards. I hope everything works out for you!
 
The last S in SIG E CAPS is suicidal ideation. Please see your doctor NOW.

LOA is better than anything else for you right now. See the appropriate people at your school.
 
Firstly, you are doing the right things. Continue therapy, that will be a long-term process that will serve you well with time. Trust the process! While recovery does take time, I do definitely think you should speak to your doctor about the lack of progress you feel you've been having, and whether to change the medication to try something that works better for you. Lexapro is the basic SSRI that doctors start with, and there are other ones that may be more effective. I do concur with your plan to take time for yourself. There is no shame in taking a few months off to get yourself in check, find what works for you, and to get back to your healthy self. It doesn't have to be such as hassle to get through this process. When you're healthy and stronger, it will be a lot easier. And as others have said, it's waiting for you as soon as your health is in shape. Worry about how to explain the leave of absence later (which can be done and is a very minor detail of your record that will presumably not hold you back). You're on the right track. Good luck!
 
enter_and_escape said:
3rd year student on rotations. Was diagnosed with severe depression 6 months ago, but have been able to pass by rotations so far. I have been on Lexapro for about a month now but haven't really seen any significant improvement. Have been talking to best friend and therapist but nothing has helped significantly. Not much support from family because we are not well-to-do and don't have a lot of resources and parents have high expectations. Exercise helps transiently but by the end of the day, I feel sad again. I tick all the SIG E CAPS symptoms. Lately, also having anxiety episodes out of nowhere. The cumulation of all this is I failed a shelf exam last month and will have to remediate the shelf exam.

At this point, I feel really hopeless. I feel like I'm getting nowhere. I've tried everything. I am not significantly much better than how I was 6 months ago. I am considering taking LOA for a couple of months to recuperate and come back stronger. My concern is how will that LOA be looked upon when I apply for residencies. Planning to go into IM. Any advice will be appreciated. Thank you!
Click to expand...

You just need a pulse to get into a community IM program. Don't get hang up on the sdn gunner mentality around here sometimes with min average Step 1 and Step 2 or bust stuff.

I would highly advise you to continue working with your psychiatrist, work with your school admin, and get some "me" time right now to get yourself right. You won't be helping you, your family, or your pts in your current state.

Your chances for community IM are fine with a failed shelf exam and a LOA.
 
Talking out my a** but I am with QueenJames. Regular exercise can be super beneficial. I know it was for me in the past when I was struggling with depression. But its obviously not the absolute solution and the other posters are right. Go see a psychiatrist.
 
madiso30 said:
Talking out my a** but I am with QueenJames. Regular exercise can be super beneficial. I know it was for me in the past when I was struggling with depression. But its obviously not the absolute solution and the other posters are right. Go see a psychiatrist.
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Why are you and other users repeatedly telling this student to see a psychiatrist when they already established they are on an SSRI and are currently working with both a psychiatrist as well as therapist, and have tried exercising.

It's easy to say "see a psychiatrist" but you guys should at least read the post in its entirety before responding. The main focus of this post is on whether a temporary break or LOA is viable to regain control over a depressive state, which it always is.
 
enter_and_escape said:
3rd year student on rotations. Was diagnosed with severe depression 6 months ago, but have been able to pass by rotations so far. I have been on Lexapro for about a month now but haven't really seen any significant improvement. Have been talking to best friend and therapist but nothing has helped significantly. Not much support from family because we are not well-to-do and don't have a lot of resources and parents have high expectations. Exercise helps transiently but by the end of the day, I feel sad again. I tick all the SIG E CAPS symptoms. Lately, also having anxiety episodes out of nowhere. The cumulation of all this is I failed a shelf exam last month and will have to remediate the shelf exam.

At this point, I feel really hopeless. I feel like I'm getting nowhere. I've tried everything. I am not significantly much better than how I was 6 months ago. I am considering taking LOA for a couple of months to recuperate and come back stronger. My concern is how will that LOA be looked upon when I apply for residencies. Planning to go into IM. Any advice will be appreciated. Thank you!
Click to expand...
Keep going son, watch a motivational video, listen to a hype song. DO you! If you feel weak do something to address it. Don't give up, the bigger the challenge the more you have to break things into small pieces. Find a way to make yourself improve everyday, even if its say only doing 5 uworld questions a day. You know you can do that, and as you keep doing it you will start to get that confidence back in yourself. Don't worry about remediating a shelf exam. That can come later, you will do that to, you have passed every major test so far, and a small one like the shelf will not stop you. Focus on what you can do today, right now, to make your situation better.

If you have no money download the anki decks for step 2 from the med school reddit (Wiwa, step II Zanki). Just make yourself do something, even if its small, get that small victory, go super short term. I want you to hit it tonight. Do 10 cards or 5 questions. Go do those things, make yourself believe again, cause you didn't get this far unless you are a winner. You have achieved and you can achieve. Go get it son, we are waiting and expecting your victory.

I have a PM for you, but you can't receive messages, PM me and I will help you.
 
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A leave of absence isn’t ideal (you already knew that) but it’s better than continuing to fail things because your health isn’t under control, be it mental health or otherwise.

Take care of yourself please (that means continuing to exercise, talk to friends and family, go to your counselor, and also talk to your psychiatrist and let them know your current regimen is not cutting it).
 
ScienceLover97 said:
Why are you and other users repeatedly telling this student to see a psychiatrist when they already established they are on an SSRI and are currently working with both a psychiatrist as well as therapist, and have tried exercising.

It's easy to say "see a psychiatrist" but you guys should at least read the post in its entirety before responding. The main focus of this post is on whether a temporary break or LOA is viable to regain control over a depressive state, which it always is.
Click to expand...

No, OP said they were working with a doctor and then clarified it was their PCP, which typically means their FM/IM doc, not a psychiatrist. Heed your own advice about reading the post in it's entirety...

With that being said, it seems like their PCP is managing this properly thus far and established care with a therapist. Additionally, Albinohawk is correct that SSRIs typically require 6-8 weeks to take effect and may need to be titrated up after that. However, if OP is truly "ticking all the SIG E CAPS symptoms" including that final S (SI), I think this is severe enough that they should be seeing a psychiatrist.

ortnakas said:
A leave of absence isn’t ideal (you already knew that) but it’s better than continuing to fail things because your health isn’t under control, be it mental health or otherwise.
Click to expand...

Couldn't agree with this more. Having to deal with an LOA on your residency application is better than failing out of med school and not having an application at all. OP needs to (continue to) seek help to manage this and get healthy as it seems like they are past the point of managing this with lifestyle changes.
 
ScienceLover97 said:
Why are you and other users repeatedly telling this student to see a psychiatrist when they already established they are on an SSRI and are currently working with both a psychiatrist as well as therapist, and have tried exercising.

It's easy to say "see a psychiatrist" but you guys should at least read the post in its entirety before responding. The main focus of this post is on whether a temporary break or LOA is viable to regain control over a depressive state, which it always is.
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because sometimes in psychiatry if a drug doesnt work, you can try another drug, another modality of treatment, change dosing. All of this can only occur if the person goes and seeks their psychiatrist.
 
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Although the underlying theme of this thread is about the potential repercussions of an LOA, there is also medical advice being given. SDN is not for medical advice. Stick to the topic at hand, please.

OP, you need to call your family doctor. If needed, don’t forget about the National Hotline, 1-800-273-TALK.
 
libertyyne said:
because sometimes in psychiatry if a drug doesnt work, you can try another drug, another modality of treatment, change dosing. All of this can only occur if the person goes and seeks their psychiatrist.
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Hmmm, I'm pretty sure most FM docs can manage a tier 1, maybe tier 2 case such as this one...
 
libertyyne said:
the point was to go see their healthcare provider. It doesnt matter who.
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A point that was established much earlier in the thread. Not sure why people are beating a dead horse here.
 
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