Feeling Lost

[cadere]

I'm not really sure what I'll gain by posting here, but I don't feel comfortable burdening any of my few friends; even if I did, I have been physically incapable of vocalizing my feelings in any meaningful way. Any time I even really think about it, it's as though something crawls up into my throat and blocks all the words, or I convince myself that I'm just looking for attention. Usually both. Even typing this is hard, but at least I can delete it later with no lasting consequences.

Bit of background: first year med, three year program, relatively non-trad.

PM101, I feel so lost. I am going through the motions of pre-clerkship, and retaining nothing.  I am surrounded by people who are consistently more prepared, have more knowledge, and who for the most part seem to have gotten their feet under them.  Everyone around me seems to have adjusted so well to med school, and all of the competing demands on our time. I just... haven't. And I don't know what I'm doing wrong, or what's wrong with me. 

On average, I usually wake up feeling at least ok, but I inevitably spiral downwards throughout the day. My sleep has been inconsistent over the last few months. Everything has the potential to become a silent internal crisis (or an external one if I'm alone), and I just feel so out of control of my emotions all the time. In my personal relationships outside of medicine I have become increasingly oversensitive and combative. I have never been a very positive or upbeat person, but if you've spoken to me in class, you probably wouldn't guess just how negative my internal monologue has become over the last few months. I am very good at being superficially put together. Objectively, I have things going for me. Nice place, cool research project (that I've been shirking). solid relationship, etc., and have no reason to be feeling these things. 

It wasn't like this at the start. I was stressed, sure, but a lot of that was adjusting. I can pinpoint the week in November when things started to go wrong, and I slowly started to spiral to where I am now. I have good days. A good week or two. But I can't remember what it feels like to not wake up hating myself and wishing I could make myself stop feeling this way.

I have tried speaking with our counselor, and while they are lovely, I definitely didn't feel like we clicked, and the coping methods they provided have been pretty ineffective for me.  While I recognize many of my thoughts as irrational, CBT and "positive self-talk" both require that I be able to, well... muster the ability to be positive? This is something I struggle intensely with, and it usually makes me feel worse when I fail. I haven't been back since that first session, and while my partner consistently expresses that I should be seeing someone, I have difficulty seeing how it will help, since I can't a) verbalize my feelings, and b) even typing them out like this has made me feel like a whiny attention seeker who is making it all up. And if I can't even motivate myself to work harder on school-related work, I'm sure you can imagine how easy it is to avoid making an appointment that I really don't want to make.

If you made it through that rambling, unedited mess, thank you. I appreciate it. Getting it out in some format is good, I think.

[goleafsgochris]

Youre gonna get a bunch of replies telling you to seek help, go to counselling, blah blah blah; I feel you probably know that if you feel depressed you should seek help, so I wont get into that.

I think a lot of people feel that way in med school.  At least in terms of being poorly prepared, not knowing as much information as you need to, etc.  I felt that a lot throughout.  I recommend trying some "self CBT": 

FIRST- has there been any actual consequences to you "not adjusting well"?  Like have you failed anything?  Or just feel you are behind?  If you haven't failed anything, that's great.  You are basically not in a worse position than anyone else.  Aside from feeling shitty, you are a perfectly adequate med student, and all you need to do is keep trying your best (trying harder on days you can), and try and keep your self confidence up.

Second, can you think of any other reasons why you feel shitty?  Aside from feeling like falling behind (which may be normal, see the previous paragraph), is there anything else negative in your life?  Are you satisfied with/do you like your relationship?  Is there anything you can change for the better?  Alternatively, are things pretty good?  If that's the case and you still feel shitty, it may be time to consider whether it is a chemical depression.

If you HAVE failed things in your program, then school work needs to trump everything else.  Not getting through med school will make everything worse.  This to me is what distinguished normal med student angst from a potentially much worse outcome.

 

[Persephone]

Finding a counselor you click with can really help make the counseling process a lot more effective for you. I'd suggest researching different approaches to counseling and seeing what resonates with you and then seeking out a counselor who is trained in that approach. I see a transpersonal counselor because that's an approach that works for me, but there are a dozens of others. Good luck and all the best!

[LostLamb]

I also would not settle for the counselor that you've seen if you didn't click. Most of the efficacy from counselling actually derives from the therapeutic relationship, and if that isn't there then you're wasting your time and possibly money, too.

I will echo the above poster regarding schooling--if you're failing or dangerously close to that, then you need to speak up to your student affairs office and come up with a plan to address that.

Consider reaching out to your province's physician support program (PFSP in Alberta) for help. They are a sometimes overlooked resource, which can provide advice and access to resources.

The other thing is, is there anything medical going on with you? Have you seen your family doctor and explored this? One example is sleep apnea, which can impact quality of sleep, concentration, mood, among other things. It is a relatively easy fix and can have a huge impact on quality of life.

Hope you find the support you need.

LL