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Self-Harm

Eh.

Took a hiatus. I’m sorry. But hopefully I’m back. Making no promises with my crappy schedule. But here I am. As I told one of my patients yesterday: let’s take it day by day, ok?

So. I did 2 months of psychiatry. I loved it, the hospital, the patients (mostly), the staff, everything. I felt stupid at first, then got the hang of it. Then on my last day I did an impromptu half hour teaching session about psychopharmacology with the medical students and I thought: well, I actually know more than I do. And that was awesome obviously.

But then I started medicine. A month of it. It’s been a week. Let’s just say I’ve found myself teary eyed in the bathroom or when I’m alone in the work room at random times. Yeah, it’s that bad.

And it’s not the team I’m working with. The team is great (except the attending, more on that below). It’s the fucking schedule. Minimum 12 hour shifts (that mostly turn to 13 or 14), 6 days a week. I bet you can guess which day of the week I have off, judging by the date on this post….and how frequent my potential posts will be.

The attending I started off with was good. He was chill and relaxed. The attending I have now is an overachiever. And I don’t bode well with that. I’m the chill type of person, by doctor standards, that is. No wonder I ended up in psychiatry, it’s the chill people specialty. I did enough overachieving during my teens. Ain’t nobody got time for that.

I feel stupid 24/7 and it’s taking a toll on me. Last time I did medicine was a year ago. “Rusty” is an understatement for my current status. It’s like I never went to med school and need a refresher course on everything. At least during my 2 months of psychiatry I felt marginally stupid but knew some things. Here it’s just straight up embarrassing every time I have to round on patients in front of the team, especially the attending.

My attending gave me feedback yesterday. He said nothing I didn’t know already, about my performance anxiety apparently having no reason to be as I seem more sure of myself, about how I should brush up on what my patients have to refresh my memory….but what really hit me was him saying “study on those topics even if it’s 2 minutes”.

Haha! Dude. SERIOUSLY?! I have no time to take my trash out in a whole week and my apartment stinks, let alone study. And let’s be honest, I don’t care about the topics. As terrible as that sounds. I just want to be done with these four weeks and marginally pass, setting the bar as low as possible so that the next psychiatry cointern that comes around doesn’t get treated like shit. I just want to know the basics so I’ll know when to recognize a medical problem in my psychiatry patients in the future.

Dude: just tell me what to do. And I’ll do it. Don’t expect me to be interested, though.

He did, however, reiterate something my program director has told me a few times before and something I’m proud of: that it shows I have good rapport with my patients. And really, as long as I know the basics and have good rapport with my patients, I’ll be set. No need for me to overachieve. It’s not like I have the time for it, either way. I’ll worry about studying for real when I get back to psychiatry and neurology rotations (and I’ll have the time for it).

So, medicine…it sucks and I would rather do 10 batches of laundry in a single day than do this for a prolonged amount of time (and trust me, I HATE doing laundry).

Yesterday I couldn’t take it anymore. A patient started masturbating as I was interviewing him. Yes, you read that right. Hello, trigger! Hello, feeling disgusted and used! And of course, nobody in the team gave a shit except the females. Then another patient’s family was driving me nuts with wanting special treatment for the patient.

And already my head had gone over to dark places because another patient was irritated with me when I went to talk to her. I found myself thinking about suicide, yes, solidly for the first time in a while.

I was able to manage the thoughts. But yesterday I couldn’t take it anymore. I got to my apartment at 9:30pm and just started bawling. How can anyone live through this? Why is this necessary? I just want to help people and lead a balanced life. Is that too hard to ask for?

I texted the Russian. And he got worried. He came over. Cuddled and held me while I cried like a baby and just let everything out of my chest. Everything including our current crappy relationship situation, or whatever it is, because both of us have shitty schedules and barely interact. Started crying even harder after I told him I didn’t want to get depressed again (he knows I’ve been depressed, although not in detail….I’ll get around to that when things are more stable between us).

And I guess I just needed a good cry and a day off, because today I feel better. I was able to finally clean my apartment.

I’m not depressed. Not yet. And I hope not ever again. But I know myself better than anyone else, and I know that if I don’t get enough sleep or enough balance in my life, I will fall down that slippery slope quick. And medicine is exactly the type of environment that depression festers in.

No wonder there’s so much physician suicide. But that’s nothing new to me, really. It’s just more tangible when you’re no longer a student and are actually in the front lines. I honestly think it’s unnecessary for one to work 14 hours straight, 6 days a week, and expect to be ON all those hours…sometimes having to skip breakfast or lunch. Nobody gets a sticker for toughing it out. What’s the point, then? My attending went so far as to make the medical students rotating with us come to hospital tomorrow, on a holiday. His reason? “Well, in my day, when I was a medical student…” Seriously dude? Times a-change. Get over it. I have to go because it’s my work, but the med students? Come on.

And…I’ve gotten more shit from my medicine patients in one week than I did from my psychiatry patients in 2 months. Oh the irony. Especially since people think psychiatry patients are “the difficult patients”. Pfffffft. Sure.

I try my best. I really do. And my intentions are good. But it’s difficult not to have your morale eroded quickly with so much crap going on.

And that, my friends, is my current “life”, for lack of a better word. Everyone keeps telling me it will be over soon, but soon isn’t soon enough. I want it to be over now.

And because I like to finish things on a lighter note: it seems things with the Russian are turning more solid/stable every day. His schedule is going to be better now, apparently. Can’t say the same for me, unfortunately. We’ll see what happens.

I’m fucking fat and disgusting. That’s what I am. I’m a disgrace. I can’t stop eating. Food every-fucking-where. I’ve purged five times during my vacations so far. I feel disgustingly, sickeningly, and horribly full right now.

Meanwhile, my friend barely eats, gets full with only a few bites, her cheeks are sunken, and you can see her bones. I’m a fat failure, piece of shit trash, who can’t snag a decent man in her life and never will. My face is looking absolutely horrible again and I’m fat. So fat I can feel it on me and in me, in my throat, in my stomach, in my body and everywhere.

My stomach isn’t flat anymore. I usually lose weight when away from home but this time around it’s been the exact opposite and I can feel it. I have this incredible urge to purge right now but I can’t because I can’t get a third ear infection, much less away from home.

What’s worse? I can’t restrict because my friend will start suspecting weird shit going on with me. Or maybe I could? She probably wouldn’t say much. I’ll give it a try. I just know I can’t continue eating.

I recently discovered that if I put in enough effort into keeping my eyes open while purging I don’t get petechiae on them. It’s disgusting though. Who likes to look at vomit? It’s like the eating disorder is telling me: Haha, you’re disgusting and fat, and the trade-off for not getting fatter is having to look at your own fucking vomit…a tangible demonstration of what a cesspool you are.

I’m a cesspool, yes.

When you’re hungry but you feel emotionally miserable so you decide to restrict/starve because you don’t want to keep feeding the monster (yourself).

That’s my current state.

It’s a mix of feeling great because I’m finally fucking restricting without my parents breathing down my neck, but at the same time feeling like shit because hunger sucks. But honestly, I prefer to starve myself than not doing it and then feeling sad AND fat.

It feels wonderful to starve while miserable. You know why? Because at least I’m getting skinny while miserable. (Yes, I’m fully aware of how horrible that sounds.) I don’t think my piece of shit body and the shit person that I am deserve the goodness of NOT feeling hunger.

To me, feeling hungry means emptiness. But a good emptiness. Empty of life, of soul, of anything that causes pain….I can focus solely on my hunger and how far I can take it, while ignoring the problems and fears in my life (solitude, changes, heartbreak, etc).

I’m always starving for something. Food, companionship, love….there’s always something. And right now I feel I deserve none of it.

Because this guy “dumped” me I now feel obviously very sad, but in addition I feel absolutely despicable, laughable, pathetic, and beyond disgusting. As a result, I don’t want anyone to pick and prod at me, not even myself. I want the disgust that is me to cease existing. And what better way to cease existing than becoming smaller as the seconds pass by and having your body slowly involuting while feeding off itself?

Somewhere in that argument there’s a big, gaping hole. I know it. But I can’t pinpoint it right now and I don’t really care either. I just want to be as cruel to myself as possible…because this guy “dumped” me, because I can’t hold down a romantic interest, because I’m fugly as shit…

I’m trying to explain something that doesn’t make any sense. Bummer. I’ll get back to it later.

In the meantime, I’ll just go to sleep….starving.

Ah, I think I’m depressed again. Though I don’t want to call it that. I’m feeling shitty. Yeah, that feels just about right.

It just so happens that I’ve been kind of crappy with my Prozac since I left home to visit the Russian in October. And I haven’t had therapy in who knows how  the fuck long. G and R? I don’t know who they are anymore. I also haven’t been writing as much and today and yesterday I tried to sketch but I couldn’t even doodle. Sigh.

And I know what triggered it all. In addition to the obvious (the Russian, interview season, thinking about my goddamn future on a daily basis…) I’ve been back home for a few days now. It was like turning on a switch.

I’m back in the noise and with my parents, but most of all back to this tired old place where I’m from and which I’m so sick and tired of. It doesn’t change. It literally does not change. If you visited this place 50 years from now you’d find the same people, the same conversations, the same problems. I’ve always been an outcast here, and having the joy of pretending I was a nomad across the different states for a month now made me forget just how much I don’t fit in here.

Also, not helping my depression is the fact that I need a fucking car to get anywhere interesting here. Sounds stupid, but it’s much easier for me to balance my emotions when I know I can just pick up my two legs and go somewhere within 5 minutes without having to turn on a car and think about gas, traffic, or road rage. So, I lock myself in my room because it’s just fucking easier and it’s my comfort zone…hence the isolation and falling into depression again.

And then there’s my parents. The same old tired crap that drags me down again and again. I love them to bits but my god, I cannot live with them anymore. Anything they do or say sends me spinning into bitch-mode.

I’ll be leaving for another interview in a few days. Then I’ll be a tourist somewhere else for a few more days. Then I have to come back and study for Step 2 CS. Oh the excitement…

And the Russian. Nothing there, obviously. Texted him today because he has a pair of earrings that I adore and left in his apartment. I refuse to leave them there. I suggested he ship them or we meet up quick when I’m back in the city that I adore in January for an interview. I was crossing my fingers he’d say meet-up, but was expecting having to text him my address. No answer. No nothing. Texted him again, nicely, asking him if he had any preference. Again, nothing.

I’m so fucking heartbroken you guys. I want to be angry at him and I know it’s what I should be, because he’s the one avoiding me and not showing face. But I can’t help but think that I was just wrong in sending him that angry text (which wasn’t even insulting, by the way, it was firm and angry but not indecent). I keep thinking about the small things we shared before it all went downhill…the conversations, the uncanny coincidences in things we liked and just the things we talked about, the movies we liked and joked about, the conversations about medicine and philosophical stuff, him saying “I love listening to you ramble”, the kisses, the intimacy, the jokes we shared, the places we went together, that cute smile of his, and that fucking geeky laugh he has that makes me weak in the knees because it makes his tough exterior melt away for just the teeniest second…..

I miss him you guys. And there’s no getting him back. There’s no fucking getting him back (ah, hello tears…they’re starting to well up). I fucking ruined it.

And of course that sends me on a tailspin of thinking: Oh I don’t want to be a doctor anymore, fuck I don’t want to be a psychiatrist, why am I even interviewing for residency?, I’m a good for nothing idiot, I’m fat and pathetic, can’t even hold onto a great guy who was interested, I just want to crawl in a fucking hole and wither away and die in my own fucking shit.

Last night I couldn’t sleep. I can’t sleep anymore. The noise in this house and this fucking neighborhood just don’t let me sleep. The noise in my head, thinking about interviews and the teeniest details about what I answered, what I did wrong here and there, how I would rank the programs, where I would be willing to compromise where I not to match in my #1 program (which is very possible)….it’s all keeping me awake at night.

And then come the thoughts of wanting to die, the suicidal thoughts that never come to fruition because fuck, if I’ve made it this far I’m not just going to kill myself on a whim (in my case, I know it’s “on a whim”…I know myself well enough to know that the thoughts will wither away after a while, doesn’t mean it’s “on a whim” for others though).

And then, by fucking g-d….I wake up in this fucking good-for-nothing place that offers me, you guessed it: NOTHING. This place offers me zero opportunities, zero life, zero happiness. The only things I find here are my parents and siblings, my friends, and my dogs. Nothing else.

So I wake up. Go back to sleep. Wake up. Go back to sleep. Dream about the Russian never coming back home from work. Wake up. Go back to sleep. Dream about the Russian avoiding me during an interview day where we coincided. Wake up. Can’t go back to sleep. Hate myself. Sit on the bed. Get up. Open the blinds….and fuck, I’m still in this shitty place they call my hometown. I’m here again. Stuck again.

I go through the day. I eat dinner. Hate myself for it. Purge a bit. Feel the high. Alone.

No Russian. No new interview invites. No new adventures. No place to grow. It all withers away the moment I start to get comfortable. Hurting so much.

(And yes, I’m crying.)

 

Gosssshhhhh interview season. My current stats: 9 interviews scheduled, 5 down, 4 to go, 1 program I won’t rank, 1 program I’m still debating whether I should rank. Would love to match at the top program in the city that I adore. I get excited just thinking about it and ideas about research/community/advocacy work I could do there crop up.

But the more time passes the more I feel I didn’t convince them of wanting to have me there. The Program Director and most of my interviewers there didn’t reply to my thank you emails. And I overthink everything that happened that day. Whatever. Honestly, I wouldn’t be surprised if I don’t match there, so I don’t want to get excited. I’m expecting to be let down on Match Day.

As for the Russian…

It seems the Russian is no more. He started ghosting. Then he didn’t return a call I made after he hung up apparently because he couldn’t hear me. Then I did the most stupid thing ever: sent him an angry text. He didn’t answer, obviously. Then I did something even more stupid: sent a text apologizing. Again, he didn’t answer.

So I guess it’s over. And I feel it was all my fault. I feel whatever sliver of hope there might have been I completely ruined. I’m sure he thinks I’m a “psycho-freak”, after all he knows about me and what happened. I’m so angry at myself, because here was this guy who liked me and there I go ruining it. I’m a fucking dumbass.

And of course I think of all the romantic and good stuff we shared. I’m such a fucking IDIOT. I really like/liked him…

Meanwhile, I put up with his ghosting and such because I’ve got such a low self-esteem. I know I should put myself first and argue if he were to come back ever (which isn’t going to happen), but I can’t trust myself to do that. My low self-esteem always getting in the way.

So here I am, alone again. Self-sabotaged all the way to finally pushing away a guy who was into me and willing to date me, which hadn’t happened that way to me ever before.

And because of the Russian being no more, I feel the need to self-destruct and neglect a bit….cause myself a bit of pain. I’m looking into getting an ear piercing, eventually a tattoo (although that’s something I’ve always thought about doing, it’s not new).

And because of that need to self-destruct, and because tomorrow is Thanksgiving, I’ll just eat whatever I’ll have in front so no one will suspect of my eating disordered ways. Then I’ll purge if I feel it necessary. Or I’ll restrict in sneaky ways. Who knows what I’ll do? Because I don’t care. Because I’m kind of hating myself right now for giving the Russian an excuse to disappear.

It’ll just be me and my mental screwed-up-ness. Forever alone, single, and crazy/psycho/freak. Happy Thanksgiving.

 

I purged a small portion of my dinner a little while ago. I feel like a failure for not getting rid of more, but I let it all fester in my stomach for too long after eating.

I have petechiae around my eyes now, as always happens. But, and this is new, while purging I could feel the acid burning my throat. Plus, the fact that dinner was particularly spicy didn’t help matters either.

It’s been about an hour since that happened and I can still feel a chunk of barely digested food/vomit hanging around the back of my throat. It refuses to go down no matter how much I swallow. Glamorous, right?

Triggers today: eating too much, my distended abdomen, the number on the scale this morning, not being able to take dance class due to being away from home, feeling mildly depressed and barely moving today, all the new things and changes happening in my life…

November marks the most difficult month of the year for me. I get depressed any time of the year, but November is pretty consistent since my teens. Being on the interview trail now has its pros and cons…I have a huge distraction to keep my mind off November and all it represents, but the pressure also has the potential to break me on a month I am already fragile to begin with.

Today was the Ex’s birthday. After waking up I checked facebook on my phone and smiled at some silly videos. But my smile instantly disappeared the second I noticed the date the screen was displaying.

Every year during the month of November I expect the Ex’s wife to pop into my life once again and call me a whore and threaten to ruin me. It’s tradition.

Ironically, November is the Russian’s favorite month of the year. Oh dear…

So far, 2015 has been different in a good way, so I hope November 2015 is no exception.

My first interview day yesterday went well. I think. I made some dumbass mistakes, but unfortunately I can’t turn back time.

I was really impressed with the program. It was a pleasant surprise. Everyone was so nice; the residents, the administrative staff, the faculty I met, and even the other interviewees. Everyone was very down-to-earth and welcoming. The only weakness I can think off the top of my head is the city the program is in.

So, during the first interview I was really nervous and the third interview was kind of unpleasant because it started off with “So, do you have any questions for me?”. The second interview was with the program director, who was ridiculously nice and genuine. He was the only one who asked about my leave of absence.

And he was so nice about it. I told him I took a gamble with my application, stating clearly that my leave of absence was due to mental health. I said to him that I was just not interested in being in a program that advocates for mental health but shuns its residents for having mental health issues. And I was pleasantly surprised to hear the following words from him: “I couldn’t agree with you more.” He then basically said he was glad I did that, that it was very smart of me to take that gamble, and that it was a strength I had, just coming forward with the facts. He went so far as to share his own struggles. I mean, seriously, it was awesome. He single-handedly gave me a much needed ego boost.

So, yeah, it was all a pleasant surprise yesterday. Unfortunately, I was very nervous and made a bunch of mistakes. Hopefully, that’s just me exaggerating in retrospect and I actually gave off the impression that I’m a decent human being who fits into their program.

And so was the beginning of the interview trail for me. Better than I was expecting. Thank you all for being so encouraging.

However…food has begun to be a big struggle again.

I’m fat. I’m the fattest I’ve been since losing all the weight I gained. Rationally, I know it’s only about 5-7 additional pounds, but my mind can’t bear with even a single extra pound. My week with the Russian was terrible food-wise and this week so far has been even worse.

I’m eating so fucking much. I’m using food for stress-relief, as comfort, distraction, and entertainment when bored. For some reason, the instability of not having a place to call home and being exposed to so much new stuff has me eating everything in sight. I feel more comfortable fasting when home, it’s easier to hide. When I’m away from home and around new people I feel the pressure to hide the eating disorder and thus, eat everything in sight. I guess it’s a way of saying See?! I’m not eating disordered! There’s your proof!, a way of avoiding the questions and the looks.

Also, the more food I have at my reach, the more difficult it is for me to not feel a strange urge to eat everything at once just to get rid of it all. That’s why back home and when I’m living alone I stick to basically the same food every day. Routine is safe, routine keeps me relatively thin. By having a routine I avoid the urge to eat things that are new to my taste buds just so I can make them disappear. Having food around is a trigger, so the more routine and boring the food I have close to me is, the less triggered I get. It’s when I’m in other people’s environments that all hell breaks loose, as I can’t control the food I have access to.

None of it makes any fucking sense, in spite of my rationalizing my way through the last two paragraphs. I just know I’m fucking fat and I need to do something about it.

Oh, and by the way, having to eat in front of potential employers and co-workers yesterday during the interview day was torture. I could feel them looking at me and thinking I was too thin, anorexic, so I felt the urge to eat in spite of my not being hungry.

I just want to have it all: be thin and match in a good psychiatry program where I’ll be happy. Is that too much to ask?

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