Tired, worried and depressed. How to pull yourself together before Medical School?

[victorduraace]

Hello!
I am medical school applicant from one of European countries, I would like to hear from you on how to improve my chances of getting through first years of Medical School.
I am 20 years old healthy male, currently through gap year.
I am applying again this year, since I needed only a couple more points during entrance exams and I am well prepared now. So let's say I make it into the MS this fall. Pass my exams well. What should I do now?
My primary concern is that I suffer from sort of anxiety and depression and chronic fatigue. I don't find my sleep refreshing at all and feel tired all the time (say, every other day).
Then it is a wasted day and my performance suffers a lot. I would literally understand nothing from my chemistry book despite 7-8h sleep. I can't imagine doing a semester in Med School in such state.
It is apparently going to kill my chances of getting through rigors of learning there.
I have ruled out most typical reasons for my issues(diet, exercise, thyroid hormones ok, bloodwork clear).
I am looking for advice what could it be? I will get full treatment done by competent doctor but first I need to figure it out what it is and we got short of ideas. My thoughts are it could be:
-poor sleep quality (get somnography). Maybe sleep apnea?
-general exam anxiety and depression. During gap year I would spend some days so stressed out, panicked and unable to learn anything. I intend to see a psychiatrist and he/she will probably prescribe me treatment. My anxiety and depression have been a lot worse in college and during finals. Now it's not that bad, but it will strike back in MS and I need to be prepared for that. I will consult it with psychiatrist in summer and likely start low doses of SSRI and anty anxiety meds along with psychotherapy. NOTE: I am sensible guy and will not self medicate.
I know many people drop out of their medical course because of mixed anxiety, depression and tiredness. This makes me vulnerable. Many of us are on meds to keep them going.
It is right thing to do if there is health problem and treatment is done under doctor's supervision.
So I am not ashamed if I will have to be treated. depression, anxiety, whatever
What else can I do to improve my chances of performing well under these circumstances?
Regulating my sleep cycle (if that's the case) , learn how to study better?
I will take good care of myself in summer, and find out what's wrong medically.
I am very dedicated person and will do my best to become a doctor.
Thanks for advice
Victor

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[noleknight16]

Hey Victor! I am sorry to hear that you are going through some tough issues. As a fellow pre-med I can understand. If sleep isn't satisfying at all, consider what kind of bed you are using on top of a sleep study. I know that a poor quality bed does affect my sleep. I also find that I am so much more relaxed and calm with 7-8 hours sleep on a good bed. Try to get close to 8 as possible (even though we all know realistically this won't be possible in med school). Also make sure your room is as dark as possible and try to eliminate using bright screens before bed. Wind down with some light reading instead.

What kind of exercising are you doing? Are you really working out hard (preferably with a mix of aerobic and strength training) for 45-60 minutes? If not give that a try too; 4-5 days a week.

What kind of thyroid tests did you get done? Just a TSH or did you get your free T3/T4 levels checked along with antibodies for Hashimotos/Graves (TPO/TG + TSI)? If the former, then consider a more detailed thyroid evaluation if you suspect thyroid issues for any reason. Hard to tell based on the info you provided but may be worth doing.

I would try all these before going to anxiety/depression medication. There's no shame in being treated with SSRIs or Benzos. Just make sure you give all alternatives a go first.

Good luck!!!

 

[Elizabethx89]

I've been having similar issues. I'm just so damn tired all of the time. Last night, I slept from 2 a.m. to 10:30 a.m., and I was still struggling to stay awake in genetics class today. I, too, have had a lot of testing done, at least the cheaper tests. Sleep studies are way too expensive for me, but I do have reason to believe I have sleep issues.

I, unfortunately, can't offer too many suggestions because I've yet to figure out what's going on with me either, but I wish you luck. I know how frustrating it is when your issues are a giant mystery, and after a while, the doctors don't even want to deal with you anymore.

 

[Darth Doc]

Hello!
I am medical school applicant from one of European countries, I would like to hear from you on how to improve my chances of getting through first years of Medical School.

I am looking for advice what could it be? I will get full treatment done by competent doctor but first I need to figure it out what it is and we got short of ideas.

Go to that competent doctor and ask them. There are a lot of wonderful residents on this site, but giving out medical advice online (or receiving it) is not a great idea. In the US there are parasites, vitamin deficiencies, hormone deficiencies, sleep apnea, as well as emotional problems that can cause a non-specific symptom like fatigue. And once you work through all of those possibilities there are other diagnoses such as chronic fatigue syndrome that are diagnoses of exclusion.

We can't do any of the work up here. My advice is to go to your medical provider.

 

[victorduraace]

I have been there and we ran out of ideas... I will see psychiatrist, get sleep study...
I only did TSH level and been told it's enough to screen thyroid problems

 

[Elizabethx89]

Yeah, most doctors are pretty darn adamant about TSH being a sufficient test to detect thyroid issues. Whether or not this is always the case, I can't say. I'm just a pre-med.

That said, in the process of trying to figure out my own mystery health issues, I ordered advanced thyroid testing for myself through DirectLabs. I was at a desperate point where I didn't care how unlikely it was that the tests would detect something the TSH test didn't. I was trying everything I could think of (and that I could afford) on the off chance that a test might finally show some kind of indication of the problem.

Anyway, a few months later, I told my (former) gynecologist that I had comprehensive thyroid testing done already. He asked who ordered the tests, so I was honest and said I ordered them myself. He then, in an incredibly condescending voice said, "What, are you a doctor or something since you're ordering your own tests?" I told him no, I was desperate and had heard that TSH alone isn't always sufficient. He smugly replied, "*I* would have just done the TSH test too."

So yeah, finding someone willing to run the more advanced thyroid testing is really hard. It's one of those topics that doctors often roll their eyes at the moment you mention them...practically on the level of the topic of vaccines causing autism haha. (I don't believe they do, just using the example for comparison.)

 

[noleknight16]

I'm obviously just a pre-med and not a doctor but I do know that TSI mimics TSH. Theoretically a person with normal TSH could have TSI in their blood and causing issues.

Its likely TSH alone is a sufficient diagnostic tool for the vast majority of us. I'm not trying to freak you out or anything. Just wanted to let you know if you have reasonable suspicion that the tests can go deeper.

 

[ChE04]

I'm obviously just a pre-med and not a doctor but I do know that TSI mimics TSH. Theoretically a person with normal TSH could have TSI in their blood and causing issues.

Its likely TSH alone is a sufficient diagnostic tool for the vast majority of us. I'm not trying to freak you out or anything. Just wanted to let you know if you have reasonable suspicion that the tests can go deeper.

Just a premed and already dx'ing Graves disease over the internet... FYI, if you have something other than TSH stimulating the thyroid (like an autoantibody), TSH will be low, not normal.

 

[victorduraace]

My doc ordered all the hormones and seeing endocrinologist asap.

 

[noleknight16]

Nm

 

[QofQuimica]

OP, we do not allow our members to solicit medical advice on SDN. In addition, it is dangerous to solicit medical advice over the internet in any case; you should be evaluated by a licensed physician who can examine you and conduct any appropriate tests. Please call your physician for an appointment. Closing thread.