Editor’s note: The author’s identity has been withheld by the Editorial Board due to the sensitive nature of the article.
If you feel that you may have symptoms similar to those described, the in-Training staff encourages you to speak to someone at your medical school or an available hotline.
By the time this whole ordeal draws to a close, I guess I will be another statistic added to the list of those who couldn’t bear the plight of what others so often misunderstand.
Of course I am no angel. Not even close to it. There are things that I have done and said that would, in essence, extrapolate toward this unnerving regret that bothers me. I killed my parents — not literally — but through words. Telling everyone around me that they were no longer there. It was a combination of impulsivity, anger and delusion. At the onset it seemed like an unforgivable sin, but knowing what I know now, I went through most of that hurt and I went through it alone. I ended up hallucinating an entirely imaginary relationship with this ideal person who never existed — or so I found out later during the course of my plight. My psychosis had spiraled out of control and I, as a medical professional, did not realize who or what was transpiring before my very eyes.
My struggle began around nine months before my eventual diagnosis. This was on a background of an entire lifetime governed by this haunting feeling that something was different or not quite right. Being the overachiever that I was, no one noticed. I was always left to question whether my reactions were just a disproportionate reaction to certain life events. I was repeatedly told the same thing.
Fast forward to the time when I finally got to live my dream through working with kids and practicing medicine. Of course, even under normal circumstances, if everything works out well for you, there is always a tumultuous road that you have to overcome before being able to make a difference in any way possible. That is true for all aspiring young professionals, particularly in medicine. But what ensued next was perhaps a life-altering experience.
Two months into my residency I knew that there was something that was a tad bit different. Of course, at that point, I figured it was all that energy that was brimming within me that led me to try working more; aimlessly running around in the middle of the night even in bone-breaking cold, dishing out whatever money that I had aimlessly and not sleeping one bit. Yet I was working fine. I was functioning fine. As it turns out, nobody would notice anything wrong even though these subtle signs were concerning. These first few episodes were all about intense energy culminating into this rather numb feeling. Everything seemed to be moving at a slower pace to the point where I was frequently agitated and annoyed at the way other people were working. Of course they would’ve been working way better than I ever was. There was this false feeling of invincibility and that was super uncharacteristic for me.
As much as those moments are a blur at this point, the only thing I remember is this feeling of being out of control. There was this catharsis brimming within my head that I couldn’t explain. One would’ve thought that having gone through medical school and filling my head with multitudes of information I should have been more cognizant of what was going to happen. But I wasn’t. It is this very air of ignorance that is perhaps awfully disturbing. It revolves all around … even in the medical fraternity.
This was just the beginning.
Over the pursuing few months there was a dramatic evolution of these spells that I was having. There were days when I had so much energy that I could practically accomplish anything within the space of a few hours, followed by episodes where there was a lingering feeling of guilt and dread, during which it was difficult to keep on standing at work. These variations were sometimes scalloped all in the space of a single day. When I was ‘high,’ or so called ‘manic,’ I had these feelings ranging from invincibility to uncontrollable with destructive anger. How I controlled these urges at work is beyond me. But at home I was unbearably destructive. Most of my days were marked by this specific hallucination of another version of me that was cutting its wrists. Then there was this impulsiveness that would culminate in me blurting out stuff that I shouldn’t have, without being aware of the consequences that these would have in the future.
And then there were these ‘lows.’ These awful spells where I felt hollow. Feeling awful without a reason. All I wanted to do was lie down, curled up in my bed, without having to talk to anyone. Facing people every day was a challenge. Having crying spells was a given. There was this persistent battle within my head that I could not explain. At that point nothing that was happening to me seemed rational. It wasn’t something that I could physically see. It wasn’t something that would’ve popped up on a simple medical test. But there was only one thing that I knew: I was miserable and there was no one who could possibly help me. There was also this feeling that I would come forward as a weak individual, especially in a profession where strength and composure are important.
Over the course of the next few months, I ended up going persistently downhill with two suicide attempts and countless hours spent trying to conjure up the courage to end my misery. I’d hit rock bottom. Days were hard to pass by. Each day was a battle. Smiling in front of a bunch of people at work seemed like an awfully big accomplishment. I was bereft of all cause. No ambition whatsoever. I did not know what I was doing. I had this persistent feeling of hopelessness and doom.
It was by a random stroke of luck — and lies — brought up by my non-functioning left hand and the prospect of work clearance that I ended up at a psychiatrist’s office for the first time. “What do you want from us?” they asked. I just wanted my energy back, I told them. Of course, I never really opened up about my reckless behavior. I would lie about a lot of things and always had this insecurity about being taken off work and never recover from that trauma. Not sure why that was. Subsequently, I was prescribed fluoxetine, an antidepressant which I took reluctantly for a week. Maybe two at the most. But what followed was another period of a mild high. I was maybe mildly shuddered out of that persistent low, but my mood swings became more frequent. Then came the initial mention of possible bipolar. But I got away with quetiapine, an atypical antipsychotic. Being on these was not fun. It made me sleep excessively.
As it turns out, I would overdose on these pills and end up in the ER. They eventually observed me for a while and let me go even though I was suicidal at that very moment. Even while being on quetiapine, each day was a struggle. There were days when I was so dizzy that I could barely stand up at work. On other days I could barely walk around and felt like I was just dragging my feet. It was like my body just did not have the strength or the will to keep up. I wanted to grab hold of the person standing next to me and tell them that I needed help during some moments.
A month later brought me to a different continent that I called ‘home.’ I realized that going to a place that was culturally closer to my heart would benefit me in the moment. Additionally, I considered that it was necessary to go back and finally face the traumatic experiences of my childhood, which were marred by unfortunate stories. Bonding with them was never easy as they were at fault for a lot of my suffering and broken childhood. There is something peculiar but fascinating about family that cannot be ignored. I could not name what it was, or why, but I knew that I wanted someone to help me through this process. Seeking this social support was helpful, along with the realization of facing the demons of my past. My experience put into perspective the importance of family as a support and, equally, confronting your past as a framework for recovery. My journey also made me realize the importance of helping others going through the same condition, thus building an entire support network.
Eventually, I was able to see a psychiatrist who gave my struggle a name: Bipolar Disorder Type I. I finally realized that what was happening to me was in fact a biological process. It was something concrete and real — not an inappropriate reaction to anything. I was subsequently started on this huge cocktail of medications and made another diagnosis which, since then, I have grown to respect.
Although at this point my future is uncertain, knowing that I survived gives me solace. It gives me hope. I may not return to the same place or be able to pursue my dream; however, I just wanted to share my experiences with the medical community out there and with all those people who have been through difficult times of this proportion. Especially to the medical community: mental illness is real and it can affect anyone. Sometimes it’s not about stress or life situations. Other times stress consumes you, and that is a battle in itself. However, with use of all of the supports available, all of this is treatable. Medical professionals who struggle with any mental illness must be empowered to share their experiences and be open about their struggles. Just because you don’t see something doesn’t mean it’s not real.