Depression is like the person who shows up to a party without an invite or any notice. And when they’ve arrived, it feels almost impossible to kick them out. The start of the year was the happiest I’d felt in a long time. I was beginning my chapter of independence: new town, new home and new people. A few weeks later, I suddenly felt as if I had fallen into an abyss and any scrap of vitality, hope or purpose had been replaced with emptiness.
I don’t think I can describe how broken I felt at the time, partly because I had no idea why this was happening again and partly because pain dulls with time. There were no warning signs or emotional triggers like the previous episodes, and yet I suddenly felt like I was drowning and barely being kept alive.
The first month was like purgatory. Every single morning I opened my eyes, I had a few seconds of ignorance before I was drowning again. I did not have the energy or motivation to leave for placement. I woke up feeling paralysed by my lack of being, returned to sleep and waking up covered in guilt and self-deprecation. I started avoiding my roommates so I didn’t have to admit I’d skipped another day. Sometimes I even lied and collected the lies in my stomach like acid. I felt ashamed when I saw an email from my clinical supervisor questioning my attendance, and thus questioned my own ability to become a doctor. After five years of enduring this unwanted guest in my mind, I was finally desperate enough to commence my first anti-depressant.
The first week on fluoxetine was a journey of sedation, dizziness, nausea and diarrhea. The next week was nonexistent concentration and dwindling motivation. The last six weeks of therapy was the worst: violent, murderous, tumultuous nightmares, at least three every night, that left me feeling on the precipice of purgatory.
My frustration and helplessness was peaking. I wanted to drop out of medicine because I felt I could not look after myself, let alone future patients I had the responsibility to care for. After the midyear break, I scrounged up the resilience to try again. I spent two weeks weaning off fluoxetine, and every day felt like a step backwards. I began citalopram and initially felt the relief of being able to sleep without the presence fear. However, I doubled the dose, and then ensued insomnia and round two of nightmares centering on childhood abuse, sexual assault and death.
I have learnt two things from this year… Firstly, the most important protective factor for any mental illness is support. I would not have made it through this year without my parents and friends who have shown me more comfort, love and empathy than I ever thought I deserved. Secondly, seeking help earlier is always better. If you’re thinking things aren’t that serious yet, do not wait until you’re desperate to get the care you need.
Thirushi Ganeshanathan, Monash University, MBBS Year 4C (2017)