Dealing with medically treated anxiety as a resident. My story and yours

[CautiousLearner]

I wanted to share my story here and see if any of you felt comfortable sharing yours. I joined residency this year, somehow, I always knew I had GAD but always put it aside. But when I joined residency the anxiety hit me like a truck.
I didn’t have a lot of folks to share this with. My mother would respond with what do you have to worry about and hard work is important and needed.
there are several days when all I’ve done is come home and cry in my pillow. Don’t get me wrong I love residency, but my anxiety is another beast.
I started taking med therapy and have found good control of my anxiety on most days.my anxiety is still there but doesn’t control me.
I wanted to share my story in hopes if you are struggling you know that you aren’t alone. Please if you feel comfortable do share your journey with mental health as you go through residency.

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[Crayola227]

Can we ask what sort of medical therapy are you on? SSRIs?

 

[Roxas]

I had the same thing happen starting intern year of psych this July. Very likely had diagnosable depression and anxiety throughout med school but ignored it, but then got bad enough that I saw a pcp for it this year. Started an ssri which helped a little, but the side effects were problematic enough that I stopped after about a month. After which time my ability to sleep better remained so I’ve just dealt with the rest since.

Still going strong.

 

[Candidate2017]

I would discourage the use of any medication unless absolutely needed. I encourage change in behavior and life styles. I remember taking sertraline in my intern year. I only took 3 days sertraline and stopped it because of unbearable drowsiness. When I sign for life and disability insurance nowadays, I still get questioned about the medication. Additionally, behavioral therapy probably is still preferred over medications for anxiety.
Just find some friends to talk to or do something different during non-clinical hours or your free time. Try something else, like massage, exercise

The strength of evidence and statistical analysis used by life/disability insurance companies is very strong. It should tell us something about how anxiety disorders and depression decrease life expectancy and functioning. But I'm going to guess your anxiety doesn't rise to the level of anxiety disorder, as many PCPs hand out psychotropics for symptoms rather than for symptoms that cause functional impairment.

However, if someone actually has an anxiety disorder and needs SSRIs, then they should be on SSRIs (and therapy). Saving a few dollars on insurance premiums doesn't warrant avoiding SSRIs any more than avoiding DM meds.

 

[Candidate2017]

I had the same thing happen starting intern year of psych this July. Very likely had diagnosable depression and anxiety throughout med school but ignored it, but then got bad enough that I saw a pcp for it this year. Started an ssri which helped a little, but the side effects were problematic enough that I stopped after about a month. After which time my ability to sleep better remained so I’ve just dealt with the rest since.

Still going strong.

Hopefully your experience helps you realize physicians need to better prepare patients for expected side effects and ask about side effects because patients won't disclose them. Many psychotropics have awful side effects, but are most are temporary. Patients are willing to tolerate temporary side effects if you prepare them well. Even for longer term side effects, and permanent side effects, I find a fair number are remarkably patient and willing to tolerate them if they feel they have a good relationship with you.

 

[CautiousLearner]

I am really glad we are having this discussion! I am on a low dose Buspar Therapy, if that helps. I have it for the last month and a half and it has helped me get past my anxiety. I do not have dizziness and do not "sleep" on the job. the level of pt care I have is not affected by it.
One of the challenges I always had was that shame, the one that comes with what is wrong with you that you can't handle this by yourself? Most of the folks give me between two extremes of solutions:
1. "Walk it off", what that implies is, I will often hear from those I confide this to, you just need to sleep, talk, relax or be more social. It is difficult to explain what that means. If anxiety was completely fixed with any of those things, I'd be cured a long time ago. My anxiety has gotten bad to the point that I barfed once during my orientation session, thankfully I did it in a separate bathroom.
2. The other extreme is, oh you need medication, you need a fit to serve evaluation [mainly med school friends]. Meet with psychiatric services, meet with therapist.

Either way, I feel that we or at least experience the burden of everyone's opinion. I had been thinking about this medication for sometime now, however, when I realized that I have to learn to be an advocate for my own health this is an option I considered.

All that being said though, please, please share your experiences. I want future residents and medical students to know that if they need help, it's not to shy away from it, that they are not alone in this chaotic journey!

Thoughts?

 

[ekmf27050]

I am really glad we are having this discussion! I am on a low dose Buspar Therapy, if that helps. I have it for the last month and a half and it has helped me get past my anxiety. I do not have dizziness and do not "sleep" on the job. the level of pt care I have is not affected by it.
One of the challenges I always had was that shame, the one that comes with what is wrong with you that you can't handle this by yourself? Most of the folks give me between two extremes of solutions:
1. "Walk it off", what that implies is, I will often hear from those I confide this to, you just need to sleep, talk, relax or be more social. It is difficult to explain what that means. If anxiety was completely fixed with any of those things, I'd be cured a long time ago. My anxiety has gotten bad to the point that I barfed once during my orientation session, thankfully I did it in a separate bathroom.
2. The other extreme is, oh you need medication, you need a fit to serve evaluation [mainly med school friends]. Meet with psychiatric services, meet with therapist.

Either way, I feel that we or at least experience the burden of everyone's opinion. I had been thinking about this medication for sometime now, however, when I realized that I have to learn to be an advocate for my own health this is an option I considered.

All that being said though, please, please share your experiences. I want future residents and medical students to know that if they need help, it's not to shy away from it, that they are not alone in this chaotic journey!

Thoughts?

Thank you for sharing. The shame is pervasive. I'm so glad you sought treatment, because you deserve to feel better.

"Oh you need medication to function?" Would that be asked of a diabetic patient, or a hypothyroidism patient, or an endometriosis patient? The medications for those conditions can cause side effects impacting work just the same as SSRIs- our body is hormones, receptors, and the black box of our genetic reaction to medications. But someone having a panic attack because their levothyroxine dose was increased too far, or crying at work because their new hormone treatment is impacting their moods, is not viewed through the same lens.

I can function without medication, but I don't want to. Stigma and medical anxiety kept me away from treatment for so long. But after the first semester of medical school, which was successful, I was tired of beating down the anxiety all the time. A couple med changes, a low dose SSRI that works, and my migraines are gone, my stomach is calmer, and my muscle tension is somewhere near normal. Now of course, the obstacle is convincing physicians that every physical illness or injury is not a manifestation of my well-controlled anxiety.