‘Fear and anxiety became my normal’ – Addressing mental health in med school
Medical school and medical practice challenges our mental health at the best of times, let alone when we’re still processing past trauma. An Australian medical student explains how they worked to address their mental health early on to be better equipped for their medical career.
Trigger warning: Discussion of PTSD
I’m sitting at the kitchen bench in my share house, going over my tutorial notes when I hear the door open. Startled, my heart rate jumps, warning me that something is wrong, someone is here, and I’m not safe. I start to determine the threat. Are they angry? Are they annoyed about something? I turn my music off —maybe they don’t like it, I don’t want to be a nuisance.
But it’s just my housemate wanting to make a coffee. After having a friendly chat, I feel a sense of relief. I take a deep breath and return my focus to my notes, I remind myself that I am okay and I am safe.
While this reaction doesn’t fit this banal everyday scenario, the reality is that living in a safe place, not worried about my personal safety is a new experience for me. It’s the easiest my life has ever been – it’s a luxury. Yet, my mind hasn’t quite caught up on this reality which creates challenges in almost every area of my life, including medicine.
When I was diagnosed with PTSD, I became one of the 5-10% of Australians who will experience the disorder in their lifetime. When I got the diagnosis, I was shocked, yes, I had a dysfunctional family, but PTSD? Really?
‘PTSD, or posttraumatic stress disorder, is a set of reactions that can occur after someone has been through a traumatic event’ or in my case multiple events (complex PTSD).
For me, a lot of my trauma was throughout my childhood and much of it I have suppressed or forgotten. However, there are other traumas that I am yet to face, but inevitably will, especially in regards to medicine.
When I overcame my fear and pride by asking for help I allowed myself to access the support I needed from my GP and psychologist.
As medical students, regardless of our past lives and backgrounds, we will see, hear, and experience the extremes of humanity. In an article for British Medical Journal, Professor Ablert WU from John Hopkins University wrote, “it’s not a matter of if clinicians are going to experience trauma while providing care, but when and how often.”
Whether knowingly or not we have all experienced some level of trauma. When a person is exposed to a trauma, they have a fight/flight response, so in that moment you are prepared and ready. I like to compare this to when you are driving a car and suddenly the driver in the lane next to you tries to merge but you are in their blind spot! Your response is quick and immediate. Either: you hit the brakes in an attempt to dodge the car (flight); or you honk the horn LOUDLY and speed up (Fight!). There is an option three here too, you freeze and brace yourself for impact because you are paralysed by fear or feel the situation is unavoidable entirely.
The above scenario could be considered a traumatic event, whether the crash occurred or not as the event involved “exposure to actual or threatened death or serious injury”
The problem in PTSD is the reactions experienced in the moment of the event start to appear out of context and all of a sudden when someone walks into the kitchen or you enter the ward you feel as if you’re in a car that’s about to crash.
The day-to-day can become a trigger. When a person is triggered it “can make them feel like they're experiencing the trauma all over again,” the physical and emotional reactions can both happen, sometimes even together.
Reliving the trauma is exhausting and is why often sufferers from PTSD use avoidance to cope. When I had one or two triggers this was easy but as more triggers arose it became much harder to control my reactions, harder to avoid triggers and harder to focus on daily tasks.
Intrusive memories, fear, and anxiety became my normal. I didn’t know where to start. I felt confused and as if I was going crazy. I had no idea why this was happening or how to stop it.
My turnaround moment was when I confided in a friend who encouraged me to talk to my GP, get a mental health care plan and see a psychologist. I had never seen a psychologist before and I was concerned seeing one would reflect negatively upon my character and even affect my progression in the course should my faculty become aware. I did not want to admit there was a problem.
When I overcame my fear and pride by asking for help I allowed myself to access the support I needed from my GP and psychologist. I can now say that I am on the road to recovery (with plenty of bumps and potholes) but far less and more infrequent car crash moments.
Instead of waiting to see what happens when trauma crosses my path, I have a plan. I have people to connect with, a medical team to support me and a pre-made decision to speak up and reach out.
Reaching out was the hardest, bravest, and most important step in my journey with PTSD. I would urge others to do the same, speak up early, reach out and address your mental health early, so you will be better prepared for when you experience trauma in your medical career.
DRS4DRS promotes the health and wellbeing of doctors and medical students across Australia. For more information go to www.drs4drs.com.au
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