I'm a mental mess.

[Squirmish]

First of all, I'm not trying to throw a pity party. I just need to vent and perhaps receive some advice from people who have experienced similar situations.

I've always been an anxious person, even when I was a kid. The problem is that my anxiety has never been taken care of and now it's getting really bad in medical school. I've made an appointment with a school psychologist but it's not until a few weeks from now, unfortunately.

My anxiety is really getting in the way of school and life. My grades on my first exams this semester were mediocre but I have not been keeping up with my classes these past few months at all and I'm concerned about my next set of tests. I am so behind... I'm an MS2 so I'm also concerned about Step 1. But I have no desire to study or even go to class. All I do is cry, have panic attacks, and feel anxious. I think I've had 5 crying fits today. Additionally, I'm a hypochondriac and I'm losing sleep over my health. I am positive that I have this chronic debilitating disease. I made an appointment with my school's clinic but it's not until late next week. I'm going crazy! It's also affecting my personal relationships with my friends, family, and significant other.

I'm worried that I'm going to end up dropping out of medical school with a huge debt because my grades suck or that I will be diagnosed with this chronic disease and it will force me to end medical school.

I don't know what to do. I wanted to post here because I won't be seeing any psychologists or physicians for a while and I needed to get this all of my chest. With exams in a couple of weeks, this is the worst time to be dealing with all this.

Thanks in advance!

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[sprinkibrio]

I'm so sorry you're going though this! See if you can get an earlier psychologist appointment. The receptionist can usually pull something if you let them know how acute your problem is. If they can't try to see if you can get the psychologist on the phone for a few minutes. You could also try to meet with your deans in the meantime. Good luck, I wish I could tell you something more useful.

 

[Chuck's Right Foot]

I second that advice. If there is anyway to get into treatment earlier, please do. There are effective treatments for anxiety (both cog. and pharm. based). The hypochondria symptoms are probably related and may abate with treatment for GAD. I hope you get the support you need.

I think it is great that you are seeking help as well. Too many people try to handle things on their own and don't make it out because they don't think they can be helped.

 

[Squirmish]

I'm so sorry you're going though this! See if you can get an earlier psychologist appointment. The receptionist can usually pull something if you let them know how acute your problem is. If they can't try to see if you can get the psychologist on the phone for a few minutes. You could also try to meet with your deans in the meantime. Good luck, I wish I could tell you something more useful.

Ugh, I tried getting an earlier appointment but it didn't work. I attend a large school and I guess a lot of people are having problems that warrant a psychologist.

I tried talking to a few of my friends that are classmates and it didn't help much, although I know they had good intentions. They said that we all suffer from some degree of hypochondria during second year and not to worry about it much. But mine is much worse. I am practically addicted to reading about my symptoms online and matching them with diseases. I've been reading tons of support forums for that chronic disease that I'm scared that I have. Not an hour goes by that I don't worry about. I know that it sounds pathetic but I'm practically obsessed with my symptoms.

Meh.

 

[WellWornLad]

I am practically addicted to reading about my symptoms online and matching them with diseases. I've been reading tons of support forums for that chronic disease that I'm scared that I have. Not an hour goes by that I don't worry about. I know that it sounds pathetic but I'm practically obsessed with my symptoms.

Symptoms can be psychosomatic. Listen, you sound like you've got a firm grasp on reality: you've made steps towards getting help, and you acknowledge that you're suffering from hypochondria. So take a deep breath and relax a little, because you're miles ahead of all the overanxious hypochondriacs that I know.

Maybe if you told us all your symptoms and what chronic condition you think you have, we could convince you that you probably don't have it.

 

[Squirmish]

Symptoms can be psychosomatic. Listen, you sound like you've got a firm grasp on reality: you've made steps towards getting help, and you acknowledge that you're suffering from hypochondria. So take a deep breath and relax a little, because you're miles ahead of all the overanxious hypochondriacs that I know.

Maybe if you told us all your symptoms and what chronic condition you think you have, we could convince you that you probably don't have it.

Okay. I am convinced that I have multiple sclerosis. I've been having fasciculations practically every day for 5 years straight! I've seen a couple of doctors for that and they say that it's benign because I don't have any other symptoms. The twitches seem to increase in numbers when I'm stressed, anxious, pissed off, etc.

However, for the past week, my left foot has been buzzing/vibrating. It's not the typical pins and needles sensation. It feels like there's a vibrating cell phone in my foot. I looked it up online and saw that many people with MS experience this.

Also, a few weeks ago, I enrolled myself in this autism study as a control patient. They wanted to compare brain MRIs of normal people with autistic people. I saw a scan of my MRI and I swear to God that I saw lesions. I wasn't allowed to ask about them.

Ugh so that's why I'm worried. I don't want to be taking tons of medications when I'm only in my 20s. I don't want to be disabled at a young age.

It also doesn't help that we're learning about neuro diseases in path. I'm literally too scared to read about them in my syllabus, which is part of the reason as to why I'm falling behind. I know, it sounds pathetic and even hilarious, but it's the truth.

 

[MrBurns10]

OP, check your PM box.

 

[psipsina]

Have you talked to student affairs and let them know that you are having problems? If you can't get yourself to study and you can't get in to see a doctor soon going on medical leave might be a better option than failing. Maybe they could help influence the speed of you getting into a doctors office??

 

[bioteach]

As long as you have health insurance, you can likely go elsewhere besides your school psychologist. Look up the psychiatrists or pyschologists that are covered by your insurance. You will likely get much more time with one of them than the school one. I know our school psychiatrist recommends that she be used primarily for meds and if we need greater help or want someone to talk to regularly to seek outside physicians/psychologists. At this point, I'm sure it is more than worth the co-pay to get in to see someone more quickly. Also with a private doc you'll likely be able to see them on a regular basis or on short notice versus having to always rely on the school psychologist's crammed schedule.

 

[meister]

Screw the school's psychologist/psychiatrist, call a private one and go see him/her. ASAP. I'd even consider paying out-of-pocket just to get seen sooner, probably around $100-$150.

 

[yaah]

Sometimes med school induces excessive anxiety because of the flood of change in your life. Ultimately, the cure for anxiety for many people is to simply become comfortable with it. That may require time, or it may require thinking differently about yourself and challenging yourself more. Everybody has different trigger points - some people are anxious about doing procedures on people. Some are anxious about being evaluated by physicians. Some are anxious about doing well on the tests. But sometimes it helps to realize that everyone in med school (and even beyond) is anxious about certain things. Some do a good job of portraying a level of confidence that belies their actual inner mind. Therapy may help, or it may not. The thing is, med school is a long time. If you have been accepted you can handle the work. If you really want to be a doctor the motivation will be there. The differences between reality vs perception are often hard to handle for people though. You don't have to learn everything today. You don't have to get 100% on your tests. You don't have to fulfill anyone's expectations except your own. Ultimately, some people decide that medicine is not for them, but this is not a decision that should be made rashly and hastily, given that it has likely been your goal for many years.

 

[MrBurns10]

Sometimes med school induces excessive anxiety because of the flood of change in your life. Ultimately, the cure for anxiety for many people is to simply become comfortable with it. That may require time, or it may require thinking differently about yourself and challenging yourself more. Everybody has different trigger points - some people are anxious about doing procedures on people. Some are anxious about being evaluated by physicians. Some are anxious about doing well on the tests. But sometimes it helps to realize that everyone in med school (and even beyond) is anxious about certain things. Some do a good job of portraying a level of confidence that belies their actual inner mind. Therapy may help, or it may not. The thing is, med school is a long time. If you have been accepted you can handle the work. If you really want to be a doctor the motivation will be there. The differences between reality vs perception are often hard to handle for people though. You don't have to learn everything today. You don't have to get 100% on your tests. You don't have to fulfill anyone's expectations except your own. Ultimately, some people decide that medicine is not for them, but this is not a decision that should be made rashly and hastily, given that it has likely been your goal for many years.

Yes, but what the OP describes is far beyond the scope of "normal."

 

[yaah]

Yes, but what the OP describes is far beyond the scope of "normal."

Although the anxieties and stress could be normal, that's what he/she needs to realize. Sometimes realizing that you are "normal" is half the battle.

 

[brianmartin]

They wanted to compare brain MRIs of normal people with autistic people. I saw a scan of my MRI and I swear to God that I saw lesions. I wasn't allowed to ask about them.

Alright, this is strange. You mean you literally saw lesions on your scan? Maybe you need to speak with a radiologist, not a psychologist. Is it possible you are so paranoid, you are imagining these findings?

 

[MrBurns10]

Although the anxieties and stress could be normal, that's what he/she needs to realize. Sometimes realizing that you are "normal" is half the battle.

But what I'm saying is that what the OP describes is most definitely pathological. Some anxiety and stress is normal for sure, but that doesn't encompass what's going on with the OP. And I personally think it's harder to recognize that something is actually wrong rather than realize that one is "normal."

 

[gman33]

If you are worried about your physical health, go see another doctor. It's better safe than sorry.

For the mental issues, it sounds like you need professional help. This is worth paying for, if your school can't provide some support.
I'd also recommend the book, "Feeling Good", by Dr. David Burns. It outlines some of the ideas behind cognitive therapy. I've found the ideas very useful in controlling anxiety/depression.

Negative thinking patterns can be adjusted in many cases, but it takes time and effort. Get some help and get on a plan to start improving. The sooner you can do that, the better.

 

[sprinkibrio]

I went to a very interesting talk today given by a psychiatrist that specializes in panic disorder and generalized anxiety disorder. He does cognitive behavioral therapy and mentioned it can be helpful for patients to evaluate the evidence for and against their anxiety. For example, if your afraid of dieing in an elevator look at the evidence in either direction and really weight it. A friend might help you be unbiased by emotions. The other thing he said was not to feed your anxiety (for you, not going on webmd, etc). He does <11 visits and no drugs. What's going on with you can definitely be helped.

Doctor heal thyself, huh? At least meanwhile.

 

[Trail Boss]

Franky says Relax.

 

[bipolardoc]

I've been through some of the same stress/anxiety over irrational fear stuff. My advice is hold on, seek help and don't stop trying. It doesn't go away quickly or easily. The further down you spiral the longer the climb is back out. Make sure you tell some people, make sure you don't tell the wrong people. Friends, mentors, appropriate faculty can help you, telling the wrong people can just be one more spiral downward if it causes you to worry about it. These are problems that I think alot of people deal with, many of our colleagues are just duck on a pond, they look like they are just floating along, under the surface the are kicking like hell. Becoming an effective physician requires that well all learn not only how to look like this sometimes, just don't get so good at it that you find yourself totaly decompensating before anyone else knows that you need help. People are more receptive to requests for help that you may at first think. Get your self straightened away or you WILL pay for it, on evals in deans letters, you will pay for it with your future if you do not take steps to solve the problems that you can and hide the ones that you cannot and make sure that at least one person knows the difference in case the s*** ever really hits the fan. This is not a situation where it is easier to ask forgiveness than permission. Good luck, deep breaths and know that it can get worse if you don't fix it now. Been there, done that.

I was wondering what happened to the OP, what he did for treatment. I been suffering from GAD myself for years without anything working. By the way, I dont know if I am bipolar (if you see my username), I am just like the OP, I even overanalyze my own mental illness and get into this warp of indecessiveness, over thinking, panic attacks, etc... If anyone had anything that worked for them please pm me. Thanks!

 

[WellWornLad]

Alright, this is strange. You mean you literally saw lesions on your scan? Maybe you need to speak with a radiologist, not a psychologist. Is it possible you are so paranoid, you are imagining these findings?

I would not take a quick glance at an MRI as proof of anything. What you saw could have been microinfarcts (tiny white matter "hits" that everyone has, although they're more prominent as one ages - I have a couple nasty ones). It could also be imaging artifact - hyperintensities around CSF/brain junctions in t2-weighted or localizer images, air/CSF junction distortions near sinuses especially in (EPI/fMRI), Beekley spot bleed (if they used one), etc. etc. etc.

Also, any research outfit worth their salt will take any suspicious scans they see to a radiologist. Many places require such a policy for IRB approval. When researchers seen hundreds of normal brains, anything abnormal really makes you sit up and go "wow," even if they don't know what it is. If there were lesions there (prominent enough for you to discern at a quick glance), they should know about it and/or be doing something about it. This assumes, however, that said research outfit is checking the scans for artifact and abnormalities - some people are just lazy and don't look at the scans.

Do this: call up the people who scanned you and ask what their policy is on follow-ups on abnormal scans. If they don't have such a policy, or if their policy doesn't include review by a bona fide radiologist, or if you just want to take matters into your own hands, demand an electronic copy of your scans, especially any structural protocols that were taken. I've made many a copy for subjects I've scanned, some just for kicks and some because they thought there might be something wrong with them. If they refuse, threaten to call their IRB and file a complaint. It's your brain, you have a right to see it, and all it costs them is about the price of a blank CD.

EDIT: DO take your scans to a doctor, however. Like I said, there can be many scary things in brain scan, 95% of which is normal.

 

[Squirmish]

I was wondering what happened to the OP, what he did for treatment.

Nothing has really changed. I tried calling around for an appt with a local psychiatrist but they're all booked or my insurance doesn't accept them. Once this holiday week has passed, I'm going to call my school counseling center every day to see if there's a cancellation. I've been doing that the past couple of days but it seems like no one cancels.

In the meantime, I'm trying to attempt a little bit of schoolwork each day to ease myself back into a routine. Because of the holidays, I'll be away from a computer for a few days so I hope that helps cut back on my anxiety.

Yes, I definitely believe that you need to make sure you tell the right people in situations like these. I've made the mistake of telling the wrong people and it just makes things worse.

To all the pre-meds out there, make sure you get your affairs straight before you start medical school. I wish someone had told me that before I started. Like I said, I've been suffering from anxiety since I was in elementary school but I've managed to deal with it until now. Med school really exacerbates situations.

 

[cbrons]

Ugh, I tried getting an earlier appointment but it didn't work. I attend a large school and I guess a lot of people are having problems that warrant a psychologist.

I tried talking to a few of my friends that are classmates and it didn't help much, although I know they had good intentions. They said that we all suffer from some degree of hypochondria during second year and not to worry about it much. But mine is much worse. I am practically addicted to reading about my symptoms online and matching them with diseases. I've been reading tons of support forums for that chronic disease that I'm scared that I have. Not an hour goes by that I don't worry about. I know that it sounds pathetic but I'm practically obsessed with my symptoms.

Meh.

http://en.wikipedia.org/wiki/Confirmation_bias

I used to be a severe hypochondriac, and it all happened my second semester of my frosh year of college (I was under a lot of stress before I started to get the health anxiety). It is definitely treatable... and I felt the exact same way you do now about the negative effect it has on friends, family, colleagues, etc. Mindfulness is a great thing to learn and therapy definitely does help (I was never one to be excited about seeing therapists, it took a lot for me to actually go to one). I thought I had every disease in the book, and spent a lot of time on WebMD trying to figure out what was wrong. There was even a time when I thought I had ALS (at age 18)... and even though I knew that it was ridiculous, and even though I saw the most highly regarded neurologist in my area who assured me (after thousands of dollars in tests) that I had nothing wrong with me other than my obvious psychological issues, I still didn't fully believe it. You will be okay, believe me. You are brave enough to seek therapy, that is the biggest challenge and one that not everyone is willing to do. I have no doubt that you will get through this, as I'm sure you are under a lot of stress at school... Its probably a very vicious cycle... you are stressed, then can't focus on school work because of your anxiety, then get stressed about not being able to focus, then get stressed about being stressed in general. Its rough .... BUT "this too shall pass"

 

[cbrons]

And as a side note, I remember one of the ER doctors in my town who was a recent med school grad. I told him I thought I had something seriously wrong because I was having muscle twitches etc. He told me I had "medical students syndrome"... the nurse agreed with him ... they then proceeded to tell me how they used to have the same hypochondriacal (sp?) worries when they were in school. Both of them...

 

[cbrons]

I was wondering what happened to the OP, what he did for treatment. I been suffering from GAD myself for years without anything working. By the way, I dont know if I am bipolar (if you see my username), I am just like the OP, I even overanalyze my own mental illness and get into this warp of indecessiveness, over thinking, panic attacks, etc... If anyone had anything that worked for them please pm me. Thanks!

2 quick things
1. Here is a good technique called mindfulness http://mentalhealth.about.com/cs/mindandbody/a/harvardmind.htm Basically it is just being aware of the effect your thoughts are having on you at any given time.
As an extension...
2. Just being aware of how your thoughts/conceptions lead to more worrisome thoughts and to subsequent actions helps A LOT. Whenever I would get anxious about something, I would take a deep breath and think about the situation in a completely logical manner... removing all emotion from my analysis. When I thought I had ALS, I stepped back everytime I would experience a fasiculation or some other twitch (or trip over myself, or get a sore throat), I wouldn't simply tell myself I was being crazy. I would consider that I might actually have a serious medical problem as a possibility because, after all, it is POSSIBLE. But after that, I would say, Okay, is there a more likely explanation for why I'm worried about this certain thing or this symptom... maybe I just tripped because, well, I just tripped? Everyone trips here and there, people get sore throats, etc. (you get the point). It is all about gaining an understanding about how your cognitive processes are subsequent cognitive processes. Its just a mapped out and planned way of talking to yourself. And a therapist (a well trained one, look out, there are certainly a lot of KOOKs and Quacks out there in therapy world) can help. I personally would see a licensed clinical psychologist whose specialty is anxiety and preferably only if I get a recommendation from a trusted source.

 

[anon-y-mouse]

Lexapro 10mg i PO qday.

Maybe you need some adjunct pharmacological assistance. Klonopin wafers to tide you through when the SSRI starts to work. Get this under control! You don't have MS!!

 

[themudphud]

First of all, get professional help asap.
Second, a few years ago I actually tutored someone who was in exactly your situation. It turns out that all this person needed was new system of studying for second year. I used to use hand-made flashcards that I made as I went through my second year notes. So I got this person to make flashcards and went over them with this person every time we met (only about 2 hrs/wk). This person also switched to the flashcard method on their own. And, I watched this student's grades get to "H/HP" level within 2 or 3 sets of exams. With increasingly better grades, this person's anxiety and mood greatly improved.
My point is, I think if you find a system that makes you feel better about how much you are learning and maybe improve your grades, your anxiety will also decrease.
If you need any suggestions, feel free to contact me: [email protected]

 

[GreyFox2002]

Ok, so I am a pharmacy student that likes to lurk into the MD forums every once in awhile. I can relate to the OP with this so here goes. I'm a second year, and while Pharmacy isn't nearly comparable to medicine in terms of rigor, it is still a very stressful educational program, and I was having similar issues related to GAD last winter around this time.

I had two options, pharmacological treatment or exercise. I chose exercise. I guarantee a lack of exercise is playing a huge role into your stress, and I guarantee 3-4 hours in the gym a week will do you a massive amount of physical AND mental good. You can't make the excuse that you don't have the time to exercise because you are spending COUNTLESS hours agonizing over minute symptoms like "fasciculations," scoring the internet for them to investigate them (which only fuels your anxiety), and than attributing them to a horrible, yet very rare, chronic illness. More so, these twitches your having could be an outgrowth of your anxiety!

You would do yourself a world of good, I think, to head to the gym right now, fire your iPod on with some music that amps you up, and start racking the weights or crank out some miles on the treadmill. I don't care if your out of shape, you need to try it. Do it 3 x a week for 2 weeks, and I would be shocked if your anxiety levels don't subside, at least somewhat. Of course, still discuss your issues with a psychologist.

I'm living proof that exercise is a great antidep./antianx. treatment method. After 2 weeks of a consistent workout routine and keeping with it, I was able to keep my emotions and issues in check, and under control. Aside from that, my focus, motivation levels, and therefore grades actually improved. I was able to learn more with less time invested. Without all the side-effects a drug gives you.

Also, if your issues have been heightening over the past few weeks, you may also suffer from SAD, resulting from a lack of sunlight. Exercise can also really improve this condition.

Good luck and you'll pull through it