Should I take a medical leave?

[kb09026]

So here's the situation: I've struggled with depression and anxiety since middle school. It's always made life difficult, but it never affected my academics (mostly because I've been relatively blessed with a strong intellect, so school just wasn't a challenge for me) until college. I just finished my first year at a top-10 university and I literally completely failed my second semester. My first semester I passed everything, but barely (mostly C's and 1 B+). Even though this will likely give away which school I go to, I will say that because of how my school works, my first semester lists everything as simply a "pass" (this is an institutional policy), and because I failed everything second semester I actually have no GPA, it just looks as though I didn't take any classes that semester (though any adcom familiar with my school's policy will know that I simply failed everything). On top of all that, the humanities class I took second semester I failed due to plagiarism. I won't even make up a story about that one - it was a serious, stupid mistake that I'll own up to. Though I definitely don't believe in making excuses for myself, I do believe that my depression and anxiety had a lot to do with my horrible academic performance. I've been in therapy since October and I'm on meds, but unfortunately my depression has so far been mostly unresponsive to medication (and I've been trying different variations of SSRI's since grade 8). For various (personal) reasons, we didn't even really begin dealing with the depression until a few months ago, when it became apparent that I was doing worse than I was letting on.

This summer I'm in therapy up to 3x/wk with my therapist, and it's going very well. I'm hopeful that in the fall I'll be ready to show what I can really do, and to kick butt in my classes (two of which will be a repeat of the classes I failed last semester). However, the possibility of taking an academic leave and doing an intensive outpatient program has been raised by my therapist, most likely because about 7 weeks ago I was nearly hospitalized for suicidal ideations (though it probably doesn't matter, I was only suicidal because I'd just gotten the news about the plagiarism thing, and that on top of failing everything else was really hard to deal with...). I know it sounds bad, but I'm really much more stable now that I'm seeing my therapist more often and I feel like I'll be in a much stronger space in the fall, but a part of me is uncomfortable with taking such a risk. FWIW, my therapist thinks I'll be in a better position to handle classes in the fall and doesn't believe I'll need to take a medical leave, but is willing to recommend me to a good program if that's what I feel is best. If I fail classes in the fall, it WILL ruin my GPA, unlike last year, so there's no "safety net" there.

I guess the question I'm getting at is: should I take a medical leave for fall semester and work on getting 100% better? And if so, how would I explain this to adcoms? Or should I take my therapist's advice and continue in the fall? I know I've probably left out a lot of vital information so feel free to ask if you need anymore info to give advice -- I've just included the bare minimum in the interest of not having to write a novel.

PS: I'm obviously (from my post count) new to the forums (not as new as I seem, though - I've been creepily lurking for a while), but I swear I'm not a troll if my post seems trollish for whatever reason. I just felt the need to say that since I've noticed a lot of people get called trolls on here when their post counts are low.

PPS: please no comments about how medical school or being a physician "isn't for me" because of my illness. I'm 100% committed to making this work whichever way I need to. I'm fully aware that my depression is most likely lifelong and will always only be "managed" and never cured, but that is part of my motivation for going into medicine (though I don't plan on sharing that in my PS). I fully believe that in spite of (or perhaps even because of) everything, I would still make a great physician, and though surviving medical school and residency will likely require consistent work and mental-health "check-ups", I am more than willing to do that to accomplish my goal.

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[BBender716]

I know this may not be the most useful response, but regardless of what may be some harsher posts in the future, you seem genuine and I truly am keeping you in my prayers. I hope everything gets better. Keep on keeping on!

 

[kb09026]

Though that was obviously not the response I was expecting (especially on SDN, of all places!) I truly appreciate your comment. Thanks.

 

[pmc2025]

Dude/Dudette - I'll also keep you in my thoughts and prayers. Depression is an evil evil thing, and one which I've also had to deal with. Hearing your story up until this point doesn't make me wonder if you have what it takes to be a doctor, it makes me wonder what I would do in your situation. While it may seem a bit overkill now, I'd strongly suggest the medical leave.

College is designed to challenge us beyond our breaking point and re-build us from scratch. Right now dude, I feel like you're in a fragile place. If something were to happen, would you have SI again? What effect would that have on your GPA? The program you mentioned (or even a non-hospital residential program) might do you a world of good, and can help you get to a place where you can take on everything that college (and later medical school) will throw at you.

Just my 2c.

PS - please keep us updated, and remember NEVER NEVER NEVER NEVER NEVER give up! There will always be people in this world who want the best for you, and who believe in you.

 

[MexicanDr]

Hey bro/sis-

I ll be praying for you and hope things turn out for the best.

I, as well have suffered from this terrible disease and finally seem to be doing well, after trying many things!

Talk to your doctor, get a second opinion. Ask about SNRIs or tricyclics if SSRIs are not working for you. How about ECT? I wish you the best, dont give up!

 

[GrantN]

Are psychiatrists not considered real doctors because mental illnesses aren't real?

 

[BBender716]

Are psychiatrists not considered real doctors because mental illnesses aren't real?

Somebody report this post for being trollish. I would but I'm on tapatalk and can't. Not funny.

 

[PetitAllegro]

As someone else asked - if you do for some reason hit a snag of sorts should you dive straight into fall semester, is a return to serious SI something you can seriously foresee happening? While I can understand your reluctance to delay your education further, your own safety and well-being should be paramount at this point. If you think the inpatient program would really benefit you, go for it. Tell the adcoms that you needed to take a medical leave for personal reasons; I don't believe you're obliged to provide them with any more detailed information (someone please correct me if this is wrong).

Best of luck to you

 

[venacontracta]

I would say if you are on the fence about taking a medical leave of absence, do it.
Reasoning behind this:

- No matter what you do, you'll have some explaining to do to adcoms.

- If you don't take a leave of absence and perform badly, which seems likely to happen (past data support this outcome, namely your past grades) it is very easy for what you offer as the explanation for that poor performance to be perceived as merely being whining or excuses.

- You can spin taking a leave of absence as a positive, e.g. you recognized that you were in a situation where it would be beneficial to take some time and make recovering your sole focus, you did what you needed to do, and now you're moving forward, not looking back, and not making excuses - hell, if you think hard enough you could use this whole thing to very effectively demonstrate your maturity and ability to deal with an adverse situation in the best way possible

- You had poor grades before. I'm assuming if you did not have these issues to deal with, you would do much better. The leave of absence will provide a clean break. You can say that before the leave of absence, you had these issues to deal with, and that's why you performed the way you did. You did what you needed to do, came back, and demonstrated what you were truly capable of. In this manner, the period of leave will help to mitigate the effect of the poor grades you've already earned.

- I don't think there's really all that much of a stigma or negative association with taking a leave of absence for medical reasons.

- With regard to the stigma and negative association that really does come with psychiatric issues, the best way to mitigate it is to demonstrate that you have been proactive, taking the steps needed to seek treatment and get better.

- You need to figure out a way to get better if medicine is what you want to do. You're embarking on a path which will provide huge amounts of stress and emotional tests. It is challenging enough for people without psychiatric issues. If you want to go down this path, you need to get better and find the treatment which is most effective for you. Even if you were to decide medicine wasn't what you wanted to do, the quality of your entire life will depend on how effectively you treat these problems. By taking time off to solely focus on doing that, you maximize the chances of success.

- With confidentiality being what it is, chances are the amount of information you reveal about this situation would be largely up to you. I think it'd be hard to completely hide what happened effectively, and as I said above, I think you could demonstrate a lot of positive character attributes in a very convincing way if you handle the situation well. Those might be reasons to reveal more than what you absolutely have to. But, I think you'll still have the choice to simply say "I had a medical issue, I took a leave of absence as you can see by the fact it is recorded on my institution's records, I dealt with it, and that was that." In other words, if you take a leave of absence, you'll have a more viable option of hiding most facts about the issue from adcoms. If your performance after the leave were stellar, I think you might be able to pull off not really telling anyone much of anything. If you don't take a leave of absence and as a result do badly, you have less options - you either don't say anything and suffer because they think your grades reflect your abilities, or if you don't want to do that, to effectively explain why your performance was bad you'd have to go into some details about the situation.

 

[kb09026]

Thanks everyone for your thoughts, prayers, and well-wishes. I can't even say how much it means to me. After thinking about it, I've decided to talk it over with my therapist with your comments and suggestions in mind and see what we can agree upon. As for the questions as to whether I see another SI coming in the future if I don't do as well as I forsee doing, I don't think that will happen. Though I can't promise that a leave is coming (I may just quit my job for the summer and see about an intensive outpatient for the next 2 months, and reevaluate how I'm doing at the end of summer), I do appreciate the concern and will be sure to keep you all updated.

More comments and/or opinions as to what I should do are always welcome. Thanks guys.

PS: I'm a dudette, FYI

 

[willen101383]

Hey! As others have posted keep your head held high. You WILL get through this and make it out the other side and on to medical school if that is what you want to do.

Last year I had similar stuff happen to me...insane panic attacks,exhaustion, depression, etc. I had to withdraw my acceptance from med school last year to figure out what the deal was. Turns out I had lyme disease that had disseminated into my CNS...causing insane debilitating symptoms. I got antibiotic treatment and have totally recovered. If I hadnt taken that time off to see the appropriate doctors who knows if I would even be alive right now.

While no therapy helped my symptoms because they were caused by an infection, I did go through a bit of CBT before we realized my symptoms werent psych related. It seemed incredibly useful and something I will def. recommend for my future patients. Does your therapist use CBT? If not I would def look into that...lightyears more useful than any psych drug out there.

So in closing...take some time off to fix your health issues. It will be a hell of a lot easier to explain to adcoms why you took time off vs having to explain away 4 years worth of unsatisfactory grades (and then repeat all those classes or post bacc or what not.)

 

[kb09026]

While no therapy helped my symptoms because they were caused by an infection, I did go through a bit of CBT before we realized my symptoms werent psych related. It seemed incredibly useful and something I will def. recommend for my future patients. Does your therapist use CBT? If not I would def look into that...lightyears more useful than any psych drug out there.

Initially she was definitely more CBT, but since the SI we're now doing more of a DBT thing (I'm not borderline, and she agrees...it's just the skills DBT teaches are more in tune with what I need right now). If I take time off I'd be doing an intensive outpatient DBT program. And thanks for the vote of confidence - I needed that

As always, more input (even if you just agree with everyone else) is always welcome.

 

[willen101383]

Initially she was definitely more CBT, but since the SI we're now doing more of a DBT thing (I'm not borderline, and she agrees...it's just the skills DBT teaches are more in tune with what I need right now). If I take time off I'd be doing an intensive outpatient DBT program. And thanks for the vote of confidence - I needed that

As always, more input (even if you just agree with everyone else) is always welcome.

Hey whatever works! Ive read about DBT as well. I think they should make some sort of CBT/DBT course mandatory in college to help people deal with certain things that arise in life. Esp for med school matriculants considering a healthy portion will go through "med student syndrome" with respect to health anxiety at some point. Would be a hell of a lot more useful than the "writing 101" course I was forced to take freshmen year!

 

[Evergrey]

OP, I think you will be surprised how many people have been in the same situation as you. I had a similar problem in high school, and I just... stopped showing up to class. My parents were furious. I didn't go to school for 2 months though (unexcused absences). Thankfully my school and teachers were really understanding and let me make up all the work over spring break. I won't compare myself to you though, because what is happening to you sounds really difficult and different in its own way.

I won't lie, changing your mind's bad habits is incredibly difficult, but also a very worthwhile effort. You sound like a really capable and mature person and I'm sure that if you take the proper steps, you can get yourself to where you need to be. I personally think that a leave of absence is perfectly appropriate in this case, and that if you can get some time off to figure things out, it could make all the difference.

I don't know if you have breached this with your therapist much, but what is your plan if you take the fall off? I know you mentioned the intensive outpatient program, that sounds like a great start. Take this as the advice of a layperson, but I would really encourage you to talk with your therapist about what you can do during a LOA to keep yourself busy/preventing yourself from being lonely (if this is a problem for you). I mean, if I were in your shoes, I would be very worried about just falling into a trap where I stay home all the time and don't work on getting myself better (since that's what happened to me).

Best of luck!

 

[kb09026]

Hey evergrey.

If I take the fall off I'd have to figure out how to stay in the area my college is in, because that's where I'd do the intensive outpatient and that's also where my therapist is. That would be about 2 months. Afterwards (assuming I'd still be in the same area and not at home) I'd continue to see my therapist (most likely twice a week) and most likely get involved in volunteer work just to keep myself busy and also get some clinical experience. If I could make the living arrangements work out, it would very possibly be a great experience where I could focus on getting better as well as work on improving my med school application, but if I couldn't get living arrangements worked out I'd most likely be home, which wouldn't really be helpful at all (loneliness during the day, overprotective parents, etc.).

 

[bonsaipalmtree]

Hey OP. I went through a similar situation (PTSD early in undergrad after a traumatic experience, which led to some bad anxiety). I stayed in school and it killed my GPA and I spent the rest of undergrad making up for it. In all my applications, I ended up having to explain two bad semesters to adcoms. My advice- take the academic leave. Get better, so that you can be the best sudent you can be All my best wishes to you.

 

[Procyon]

Sorry you're having such a hard time, OP. I know what clinical depression's like, and it isn't fun.

I agree with a lot of the stuff david06 wrote. It seems like some time off from school might be beneficial if it will give you the extra time you need to tackle this thing. There's nothing wrong with taking time off for medical reasons if you need it. Just imagine after you've taken the time off; I'm sure the idea of returning to school feeling strong and confident is an appealing one.

And for what it's worth, I have faith that you'll be able to pursue this career path just fine. Give anyone who tells you to run off and choose another field a good kick in the shins.

I hope you continue to improve and are feeling much better soon.

 

[wholeheartedly]

Hey OP, sorry you're going through this. I've dealt with some pretty brutal medical issues also and I learned the hard way that it's best to take care of yourself first. If you're able to get yourself squared away things start to flow so much better. I'd defintely advocate a leave. Staying could hurt you, and while taking a leave might delay things it'll only increase your odds of success in the long run. I wish I hadn't waited so long to take mine. Best wishes. I'll be rooting for you.

 

[Evergrey]

Hey evergrey.

If I take the fall off I'd have to figure out how to stay in the area my college is in, because that's where I'd do the intensive outpatient and that's also where my therapist is. That would be about 2 months. Afterwards (assuming I'd still be in the same area and not at home) I'd continue to see my therapist (most likely twice a week) and most likely get involved in volunteer work just to keep myself busy and also get some clinical experience. If I could make the living arrangements work out, it would very possibly be a great experience where I could focus on getting better as well as work on improving my med school application, but if I couldn't get living arrangements worked out I'd most likely be home, which wouldn't really be helpful at all (loneliness during the day, overprotective parents, etc.).

That sounds like a good plan. I agree with you, going home might hurt you rather than help you. I don't see any reason why you wouldn't be able to get living arrangements worked out, ultimately -- aren't there a lot of opportunities for summer subletting? There was at my college at least.. lots of people living at their parent's house during summer while still keeping a year-long lease on a house.

What is the deadline for taking a formal LOA for fall semester? Could you stay enrolled in classes and then reassess the situation at the end of the summer? That might be nice because you can see if you need to take extra time working to get better, and still save spots in the classes you want to take.

Additionally, after the outpatient program, you could get a job and work instead of going to fall semester. Maybe keep the hours low, ya know? And just live life. Do the things that school prevented you from doing, like going on all-day hikes in beautiful weather (lol that sounds awesome to me anyway). I dunno what I am saying Anyway I think people are generally very understanding about LOAs as long as you don't sit around at home.

 

[pmc2025]

Hey Dudette
I've been thinking a lot about your post since last night. I've read the recent developments in this thread, and I wanted to add a couple more cents to my 2 already stated. I think that staying in the same area as your college (unless its your hometown) might be a poor choice. You'd still be in proximity to your friends, but it brings up the possibility of a constant reminder of what happened, and what you're dealing with. It's probably expensive, and I don't know what your insurance will pay for, but I'm including a link to a facility with an excelent reputation and a great (almost spa-like) program! Again best of luck, and keep us all informed!!!


Sierra Tucson - beautiful facility, best-of-the-best clinicians.
http://www.sierratucson.com/RecoveryPrograms/tour.php


Also:
Mental Health Service Database - NIH
http://mentalhealth.samhsa.gov/databases/


Meditainment - Guided Meditations (some great ones for overcoming depressive episodes)
www.mediheaven.com

 

[kb09026]

That sounds like a good plan. I agree with you, going home might hurt you rather than help you. I don't see any reason why you wouldn't be able to get living arrangements worked out, ultimately -- aren't there a lot of opportunities for summer subletting? There was at my college at least.. lots of people living at their parent's house during summer while still keeping a year-long lease on a house.

What is the deadline for taking a formal LOA for fall semester? Could you stay enrolled in classes and then reassess the situation at the end of the summer? That might be nice because you can see if you need to take extra time working to get better, and still save spots in the classes you want to take.

Additionally, after the outpatient program, you could get a job and work instead of going to fall semester. Maybe keep the hours low, ya know? And just live life. Do the things that school prevented you from doing, like going on all-day hikes in beautiful weather (lol that sounds awesome to me anyway). I dunno what I am saying Anyway I think people are generally very understanding about LOAs as long as you don't sit around at home.

The only problem with housing is that I'm on heavy financial aid at school that's basically paying for my housing. If I took a leave I'd get no FA for that semester and no way to pay for housing. My parents can't really afford to pay for my housing (and I'd hate to have to ask them), and I don't know if I could make enough on my own to pay for it. The only way it might work is if I found a well-paying job and worked enough to cover half, and ask my parents to cover the other half. But I'd have to work kind of a lot, because housing here is ridiculously expensive.

As for the deadline for LOA, I really don't know. I've been trying to look it up to no avail.

Hey Dudette
I've been thinking a lot about your post since last night. I've read the recent developments in this thread, and I wanted to add a couple more cents to my 2 already stated. I think that staying in the same area as your college (unless its your hometown) might be a poor choice. You'd still be in proximity to your friends, but it brings up the possibility of a constant reminder of what happened, and what you're dealing with. It's probably expensive, and I don't know what your insurance will pay for, but I'm including a link to a facility with an excelent reputation and a great (almost spa-like) program! Again best of luck, and keep us all informed!!!

Thanks for the links - I'll definitely check them out. As I alluded to before, any treatment I do will have to be fully covered by insurance, because my parents really can't afford to pay for anything. But I'll still check them out and see what they say.

As for staying in the same area - I definitely understand your concerns. I guess the dilemma is this: inpatient programs are mostly either really expensive even if they take insurance, or meant for short-term (a few weeks at most) crisis situations. That means I can either stay at home or where I go to school. Home...is complicated. But I know that I probably wouldn't get much accomplished in terms of making progress on my mental health there. It's just not a good environment for that. Where I go to school, yes there are past demons (though that definitely exists at home as well), but my therapist is also here and seeing her has seriously done me a world of good. I'm unsure whether I'd even be alive without her help. I guess that's to say, I can't imagine getting better without having her in the picture. So I hope that clarifies my reasoning as to why I'd rather take my semester off close to where she is.

Finally, I just wanted to reiterate how thankful I am to everyone for their help, encouragement, prayers, and advice. It means more to me than you know.

As always, if you have anything to add, I welcome your input.

 

[Evergrey]

Would it be possible to find a friend's place to crash at over summer?

 

[kb09026]

Over summer - it's possible. My closer friends are all away on internships for the summer, but I "know" a few people I might be able to stay with. Thanks for the suggestion.

 

[bonsaipalmtree]

Hey OP, I had the same thing happen. I suffered from PTSD early in my college career and it killed two semesters of grades. I spent the rest of undergrad making up for it, and had to explain the situation over and over again to adcoms of medical schools. Thankfully, they somehow understood the situation...

If I could do it again, I would have taken the leave of absence, hands down, if only for the sake of grades. Willen101383 said it, and I'll echo the sentiment... take time off to get better. A leave of absence is easier to explain than 4 years of poor grades.

Also, grades aside, college is a one-in-a-lifetime experience that you never get to live again, and I wish I hadn't spent a year of it struggling to simply wake up in the morning.

My advice to anyone in a similar position would be to get better before going back to the rigors of college.

All my best wishes to you. I have been there!

 

[kb09026]

Hey bonsai

Thanks for responding. I'm really sorry to hear about your PTSD...my therapist actually thinks that the reason I may not be responding to medication is because I actually have PTSD, and not depression/anxiety like everyone has assumed in the past. But anyway. I was wondering how you explained your situation to adcoms? Even if I take a leave, come back and do a 180 turnaround in terms of my grades, I still have to explain first year to them. Being someone who's been there, do you have any suggestions for me? What did you do or tell them, personally?

 

[Wolfman89]

Hey whatever works! Ive read about DBT as well. I think they should make some sort of CBT/DBT course mandatory in college to help people deal with certain things that arise in life. Esp for med school matriculants considering a healthy portion will go through "med student syndrome" with respect to health anxiety at some point. Would be a hell of a lot more useful than the "writing 101" course I was forced to take freshmen year!

I agree Willen.


@OP,

Duddette, I feel you. I was recently diagnosed with clinical depression. As a psych major I was in denial of my depression for some time (which correlated with my drop in GPA) but now that I am on a SSRI that I am responsive too my motivation and whatnot has increased.

I just want to say that I will keep you in my thoughts and prayers.


Feel free to pm me if you want to talk at all.

 

[bonsaipalmtree]

Hey bonsai

Thanks for responding. I'm really sorry to hear about your PTSD...my therapist actually thinks that the reason I may not be responding to medication is because I actually have PTSD, and not depression/anxiety like everyone has assumed in the past. But anyway. I was wondering how you explained your situation to adcoms? Even if I take a leave, come back and do a 180 turnaround in terms of my grades, I still have to explain first year to them. Being someone who's been there, do you have any suggestions for me? What did you do or tell them, personally?

I danced around it in my personal statement. I made it very clear that I was "injured in a criminal manner" (i.e., I had to take my assailant to court, etc etc) but I did not give absolutely no details or specifics. They never asked me for them in the interview either. I talked about how the experience made me a stronger person in the long run, and how it's taught me to empathize with those in need- the experience helped cultivate my desire to be a physician. My grades went way up after that bad year, and I made sure to point that out- I tried to shed some positive light on the whole situation.

That said, I wish I would have just left school for a semester.

 

[MDhasbeen]

although taking time off now should be to help your quality of life asap and your grades a little down the line, you'll also need treatment now to ready you for the whole med school experience. the stress of med school let alone residency really brings out the worst in people. it's brutal. i don't want to discourage anyone with any sort of psychological issues from going into medicine because any psychiatrist knows how bad of a stigma the field sadly still has; and at least those who've been through the illnesses can at least sympathize with the patients. but i had a classmate friend drop out in ms1 because of her uncontrolled anxiety. to this day i wonder if it might've been different for her had she been in treatment sooner. so please don't let any of this drag on partially treated if there's any chance of it being helped now. the earlier you and anyone else out there in your situation get it under control, the less you'll suffer many, many years into the future. good luck!

 

[ReineAshe]

I guess the question I'm getting at is: should I take a medical leave for fall semester and work on getting 100% better?

NO. Medical leaves of absence usually have too many additional strings attached and put too much power in administrators' hands.

My best friend went to ..........., got raped, did this -- then discovered they wouldn't let her back in because the school simply thought it was too much of a risk. She subsequently met people who had the same thing happen to them, even at places like ........ In one case, the guy couldn't meet with the admin because he was too poor to afford weekly therapy.

Take a regular leave of absence this fall. At most schools, this will give you the power to determine if and when to return. Just don't tell them anything about why you are leaving in the first place.

And for future reference: don't go anywhere near the Uni's mental health services, if you can help it. Admins are increasingly just subtly forcing students with mental illnesses out and admitting transfers to (a) limit lawsuits liability and (b) increase revenues. (After all, they don't need to be offered favorable financial aid packages in order to enroll.)