Starting medical school was supposed to be the start of a promising career in doing what I was passionate about and had put in considerable effort to dedicating myself toward. Instead, the first year with my boots on the ground was a nightmare worthy of a Kubric-style flashback.
A couple of things a tutor mentioned to me this year:
1. Everybody lies
2. Nobody cares about the medicine.
I thought he was joking at first, trying to make a reference to a popular television programme. But then I lived them. Everybody lies, but not always with malicious intent. We all ignore facts and perceive reality based on our own preconceptions. And in my case, nobody considered the medical causes of that.
I experienced anxiety for the first time this year, at an organic and behavioural cause – triggered by the advent of a relationship and the onset of chronic pain. Psychotherapy, horrendously failed gun-fighter speed dispensing of psychoactive medications did nothing but worsen my circumstances and eventually work to cause more harm than good. Of course, we are encouraged to seek support from our peers. Well, at least the hospital stay that resulted in came with free meals. The simple fact was, nobody cared about the medicine. And by that I mean, nobody cared about what the problem actually was or even asked. Simply, they made a judgement on the few facts they had and attempted to fit this notion to a human being. I couldn’t figure that such intelligent people, clearly more intelligent than I am, couldn’t understand what I was trying to say. Logically, I thought I was unable to articulate myself.
That’s when I stopped talking and started paying more attention to the negative self-talk and developed the greatest self-hatred I’ve experienced; fuelled by the memories of decisions made while ill or under the influence of medication side effects, peers and non-peers fostering a sense of inefficacy, nay, a sense that I should not only be afraid of consequences, but afraid of myself.
And to turn up to classes, make jokes, treat everyone where possible as if nothing is wrong, was a challenge. In fact, one of my future colleagues advised: “Take a year off and find another year group because nobody wants you here.” And that’s when I really shut up. Being a House-level rational thinker, I pondered substance abuse. And feeling nothing was certainly a better option than feeling anything at this point, particularly how I was made to feel by keeping up an act for those who did nothing wrong so as not to perturb their world unnecessarily and by avoiding the pain of experiencing losing control of my actions which ultimately caused likely irreparable emotional pain for somebody I love.
So yes, if someone argues that existential anxiety/depression exists – it does. And if someone else argues that peer environments can breed substance abuse, absolutely. I am glad I did not go down that path. It would have moved likely irreparable emotional pain and a one in million chance at reconciliation to a very irreparable funeral service.
Backstory. After experiencing anxiety, of which significantly low (read: zero) self-worth and organic disease were the cause, I was convinced by my former therapist that I had dissociated into an alternate personality.
I wish I had. Because I didn’t dissociate. I was simply anxious and being defensive, without ever having had to deal with anxiety before, and everyone around me assuming I deal with it incredibly well because ‘I’m anxious about this and most people are, but you seem to be holding it together well so you must have anxiety but deal with it so well’ – nobody could believe what I was going through, and neither could I.
Still waters run deep. How I hate these idioms, but they are with some merit.
So where does this leave things?
I’ve learnt a few lessons:
1. It makes no difference who you are. Only what the world you interact with perceives you to be. And that is disappointing.
2. Good intentions and a desire to help mix poorly with incomplete information.
3. Being highly functioning and experiencing mental illness garners a ‘toughen up’ or a ‘let it go’ response, which has the potential to transform one from highly functioning, to not functioning.
4. Friends are good to encourage you to get help. But often the best-conceived efforts end up being harmful because friends are not often experts.
5. Being fortunate to have the financial resources to bail on support networks that are ineffective and seek help from an experienced psychotherapist, as well as open-minded GPs and physicians leads to significantly better outcomes than for those who are less fortunate – which we have a responsibility to change.
And where to from here? I’ve mostly stopped talking. I have a therapist for that. Which seems to go well with my peers, until I am at the point in my journey where I am able to talk about ‘what goes on in therapy’ as it were. I’ve had enough of being made to feel defective by myself and by others, and recognising that there will always be those who will do so and will be persuaded to do so helps move along the path.
Ultimately, finding an explanation for how I experienced anxiety and how to manage it effectively in the future – is worthwhile. And learning to recognise when those you will share that with will want to see it as an excuse rather than an explanation; is just as valuable.
And lastly, I’m not my anxiety. It is a part of me, which I can apologise for, and work on managing. As an incredible young woman once told me: You don’t need to be a one-person barrage or a superhero and save the world. Just share a thought that might lead to something positive and reflects who you are. And don’t apologise for it.