This is a post I wrote several months back, before therapy, before I would go on to achieve and push through everything in this last academic year. Looking back, it’s amazing to see how articulating this was a breakthrough into understanding how desperate I felt. From understanding came the power to make a change. I haven’t felt like this for several months and happy to say I feel like me again. Who knows if and when I’ll feel depression again but at least this time I can say I’ve been there before and come out the other side.

I’m back in bed in another funny state of depression. Sitting with grey clouds in my head, going through the motions and waiting till they pass. Today I answer to no-one. Airplane mode on. Today there is no mask – comfy clothes, no make-up. No nice outfit or armour of a decent CC cream, the bags under my eyes are clearly visible. The resting state of my face unhappy. No-one to impress – no doctors or patients or colleagues I have to show face to. Today I am allowed to be sad.

Superseding my state of despondency was the usual bubbling anxiety that seemingly came out of nowhere. The anxiety subsides, and I fall flat. I like the word depression because it so accurately describes the heaviness in my chest – depressed like a steel stamp imprinting into softer material. Flat like the half-finished bottle of my ever so basic prosecco in the fridge. I’m not even sure if I’m justified using the word depression. Have I even felt true depression? That scary dark black hole where you can’t even bear to shower. Months of endless fog. ‘Clinical depression’, the prolonged fortnight of inertia that lends itself to doctors prescribing SSRIs. In truth I feel depression in waves. Eventually I can get up and live my life accordingly, albeit dejected. I still manage to do a food shop and brush my hair. I’ve resisted medication and pushed through the fog. But my god that word just fits so accurately – a deflated balloon, a steel capped boot pushing down on your heart.

I’ve been on autopilot – my face jolting into a smile when I engage with another person when inside I feel like a light’s been snuffed out. I resume a state of ‘fine’, absentmindedly taking a car through the gears. I was completely unaware of how bad I felt or how mechanical my actions were until they felt unbearable. To every person who met or spoke to me the past few days could you tell? I hope not because I’ve been really working on my poker face.

Over the last few months I’ve grown more aware of the mask we humans put on to the world. How we present ourselves, the groups we interact with, the way we dress, speak and decide what we find funny or interesting. What is really going on behind our exterior?  I’d completely failed to acknowledge my own mask. I thought I’d left the pretence of ‘being cool’ behind a long time ago, and the mask I used to put up to impress strangers and find my place in the world absolved. But silently I had been putting up a very different mask to hide behind and protect. Inside I still harboured feelings of fear and inadequacy. I squashed down those feelings daily to appear confident and resilient, palatable to my peers. Nowhere is this more apparent than at medical school, where every day I dress the part and resume a level of competency. After years of falling asleep on placement, turning up to the wrong ward and generally feeling a fish out of water, I’m trying to display a front that I’m coping. My new mask encompasses a steely methodical exterior, so I can take some pride in my work and self and ultimately prove I deserve to be here.

Fear is an inevitable part of moving through the world. As a young twenty something, dissolving your naivety to become competent and resilient takes work and trial. Overcoming feelings of inadequacy is a great personal challenge, no-one teaches you how to confident and assured. On top of this we all carry our own personal traumas, unpredictable in how they will shape us. We all carry our own pain behind our masks.

At the time of writing this I felt dissatisfied and unhappy. Medical school felt like it would never end.  Life felt monotonous and mundane. I had a massive overhang of emotional upheaval from my repeated fourth year. It took so much out of me in terms of confidence and positivity. I felt like I was wading through treacle. I felt permanently flat. I suffered a garrulous tedium of headaches. I felt omnipresent guilt that I was both wasting time and not achieving anything. I consistently moulded myself to be the prescribed version of ‘doctor’, ready to stand in line whilst snuffing out all the passion that used to lend itself to living life so fully – reckless, spontaneous, a girl who could once dance all night.

I felt a slow squashing of life and soul. I was surprised at 24-years-old to no longer have a sex drive. The one area my battered confidence had finally waded itself into. My lust for life was replaced with weariness. My world became smaller and more insular as I dutifully tried to do all things I hoped would help – cutting out alcohol, eating sensibly, exercising often. I panicked at not getting regular sleep. All my spontaneity was gone. Becoming a doctor felt like a trade-off for fun. I felt a huge lack of autonomy or satisfaction in my life. ‘Get the degree, get the degree, get the degree’. I kept telling myself.

I missed my friends tremendously, feeling the solitude of being left behind in Leeds impenetrably isolating. I felt overwhelmed. I wanted to shut down and shut everyone away. Beneath all the difficulty, tedium and heartache there was a recognition that it was all part of the journey, a flickering hope that it WILL be worth it. But at the time that felt like nowhere near enough to pull me through.

I knew something had to give when I started calling The Samaritans. When you feel at your most desperate, wide awake at 4 am with no-one around, to have that partially relieved by someone patiently listening as you gulp back tears on the other end of the phone is magnanimous. It was a chink of light that saved me and prompted me to say I need help. It didn’t matter if other people suffered worse depression than me. It didn’t matter that I didn’t clinically match the NHS criteria. Who is anyone to say that I didn’t truly ‘know’ what it was like to be properly depressed. It didn’t matter that I felt awful but was still functioning. It was my depression and my suffering, and I deserved to get the help I warranted.

It was enough to prompt me to seek private counselling. I pushed aside connotations that it was a luxurious self-indulgence, that I was too young to need therapy and emailed a kind professional looking lady with a sharp haircut and wealth of experience listed on her profile. A process not unlike online dating. I cautiously placed my emotions and worries and hardships into her hands, and gradually I felt myself recover and grow. I felt able to deal with the adversities at university and I write this now having graduated with a degree in medicine. I’ll be practicing as a doctor in a couple of months. All aspects of my life improved thanks to therapy – my relationships with my family have reached greater strength and understanding and I have never felt this confident, calm and poised. Even my friends, upon a recent reunion, commented on how happy I looked. And to those wondering, yes my sex drive came back. That was nice.

The way you feel is nuanced and akin to you. No-one can tell you what is and isn’t depression. You are always worthy of help. You do not have to feel shamed or be subjected to silence. There is always someone no matter how alone you feel. The Samaritans – 116132.

Words by: Imogen Bicknell – LUU Mantality Society