It creeps up on you.
One moment you’re overcoming your fears, forging new paths in life that weren’t available to you before. Then come the everyday little stressors. You shrug them off, such is life.
Each one increases the tightness in your chest imperceptibly, the lump in your throat, the panic.
I had been there before – the fear of asking questions, of looking stupid, of being a hassle. These had become manageable within a classroom/lecture environment with some counselling and relaxation techniques, but this wasn’t enough to allow me to cope, let alone thrive, within the hospital.
Imagine trying to learn to interview and examine patients when you’re so scared the patient will say no you cannot even bring yourself to enter the room. You walk aimlessly around the wards – heart pounding, hands shaking, on the verge of tears constantly.
You aren’t learning enough, you’ll never make a good doctor.
You are asked simple questions, but in the instances you don’t freeze you have so many things to say that you jumble your words. They think you’re stupid, doctors don’t say stupid things.
It doesn’t end there. Going home means facing life.
Your pet has to be put down because it wasn’t recovering from surgery. You’re a terrible carer.
Your long term partner is eying off yet another woman. Obviously you’re not attractive enough.
You hit a street sign. You’re a hopeless driver, you could have killed someone.
Every morning you wake up disappointed you’re alive. You look at the train arriving at the platform, or the car driving past, and you think “what if I just ended it?”
Then you panic because you realise that something is wrong, and maybe it has been wrong for a while now. Why weren’t you proactive? Doctors are proactive.
I thought I was burnt out. At the start of the year I had thrown myself into every extracurricular activity I could, in addition to clinical placements. I called the counselling service not so much for help but for validation of my experiences. It became apparent that I needed a lot more help and whilst my immediate concerns regarded participation at uni, underlying what I thought was burn out was actually my old friend social anxiety, insidiously isolating me and destroying my self worth.
I was referred to a clinical psychologist and for a couple of months had weekly CBT sessions. It was such relief to have proper, in-depth sessions examining what was underlying this anxiety.
Like most medical students (I imagine) I have a deep seated fear of failure, particularly failure in the eyes of others. It took a while to understand that, but now that I do I can apply that knowledge and work through the small stuff before it gets overwhelming.
Admitting something wasn’t right was not the biggest difficulty for me, I knew I wasn’t okay. What I struggled with was thinking that it wasn’t bad enough, as though until you reach some critical point you aren’t worthy of support and help. I know logically that is not the case at all, but stigma is rooted in all of us, and that fear of being perceived as weak is a difficult one to shake.
I still have days now where I’m anxious, it is something I have to manage day by day.
Last year’s relapse was a difficult period, but I am grateful it happened because it forced me into obtaining help.
To my friends and peers, I cannot stress enough that your feelings are valid. You do not have to be bad enough to benefit from support. For some that could be informal counselling sessions, for others CBT or pharmacotherapy. Whatever it is seek it out, and support each other in finding it.
Medicine is bloody hard, and life is going to continue rolling onwards alongside your medical studies and future career. There will be ups and downs, and it is imperative that you look after yourselves throughout it all.
The best doctors are the ones who care for themselves first.