My very first anxiety attack occurred midway through Thanksgiving break during my first semester of PA school. I had been relaxing, hanging out with my family, the dog, and friends I hadn’t seen in months. At dinner that night with my family, I slid into the middle of a large U-shaped booth and immediately thought “I have to get out of here. I can’t be here.” I excused myself to the bathroom, locked the stall door and started bawling. I couldn’t breathe, I had no idea what was wrong, and I couldn’t make it stop. It was terrifying.
The beginning of PA school was rough for me. I’d moved away during undergrad and lived by myself before, but this was the first time I’d ever been lonely and homesick as a result of it. I had a hard time finding my place amongst classmates and adapting to the master’s level classwork that was being thrown at me for 8 hours a day.
After Thanksgiving I reached out to one of the resources that my PA school offered: Campus Mental Health Counselors. In a presentation during orientation, one counselor encouraged all graduate level students use the mental health counselors to make sure they were coping appropriately with the stressors that come with grad school. I met with a counselor and listed all the feelings and experience from the past few months. I had been on the verge of crying all day long, not being able to sleep at night and falling asleep in class as a result, had nausea and tension headaches, worrying and overacting at very small inconveniences or events, procrastinating, and eating poorly or not eating at all.
The counselor concluded that what I described were indeed classic symptoms of anxiety and depression. We went on to discuss different ways to relieve my mind and body of these feelings. It was a bit of trial and error, but we worked together to find what was best for me. Talking with a counselor was the first of many important resources and techniques that I have used in the relationship with my anxiety. The resources I used and continue to take advantage of include:
Campus Mental Health Counselors – Schools are increasingly becoming more aware of the need to have mental health professionals on campus. If your program has not mentioned them, a quick search online can get you enough information for an initial session. You could also go one step further and ask for one of the counselors to come by and speak to the entire class!
Mentors – Instead of or in addition to a campus counselor, having a mentor that is a professor, currently classmate, friend, or student that is a year ahead of you are wonderful people to have in your life. They know the stresses you are under and the work you put in during school. I lucked out and found a professor that knew what I was feeling and had no problem letting me cry it out in her office on many occasion.
Non-school friends and activities – It is very hard to have relationships outside of school, since 99% of your time is spent there. However, I found that having some people in your circle that are not school related can help you get out of that mode and de-stress when you need it. For me, it was a local community swim club. I tried to designate at least 1-2 evenings a week where I worked out some stress in the pool and chatted it up with the coaches that had absolutely no medical background.
Exercise – I cannot stress enough, pun intended, how important it is to get out and move. I have been a swimmer and runner my whole life, but when I got to PA school, everything stopped. The days that I went for a run or spent an hour in the pool always left me feeling relaxed and energized. My mom liked to call it “good exhaustion” where we were younger, but I know now that all those feel-good endorphins were flowing through my blood.
Study groups – One things that was a big issue for me was how anxiety provoking studying was for me and I still have no answer as to why. However, I did find out that having at least one other classmate and accountability partner to help you stay on track with work and studying is a life changer!
Medication – Even with all the behavioral changes with lifestyle, sometimes we still need a little help. There is nothing wrong with talking with a counselor about getting medical help. If there is anything I have learned during my time learning medicine and struggling with anxiety, it is that the stigma of psych medication is absolutely ridiculous. We all know (or will learn soon!) that the best treatment for psychological illnesses like anxiety and depression is a combination of behavioral and medical therapies.
One of the most important things to realized and remember is that you are not alone. In a study done on Berkley graduate students, 45% of students experienced “an emotional or stress-related problem that significantly affected their well being and/or academic performance”. Ten percent of those students “seriously considered suicide”. Female students, specifically, were more likely to feel hopeless, exhausted, sad, or depressed.
Dr. Jerald Kay (2008) stated that graduate students we are faced with stressors specific to their academic endeavors that other students are not presented with. All of which put us at much higher risk for experiencing stress and developing mental health issues.
We have more demanding studies
We are learning in a less formally structures and supervised environment
We are struggling with more serious relationships compared to undergrad students
We are more likely to have children
We usually do not live in a supervised residence
We are more financially stressed
Based on those risks and statistics, it is easy to understand why I was diagnosed with Appropriate Situation Anxiety (which I think is an oxymoron). It makes sense that half of my classmates were, and still are, working with their anxieties brought about by PA school. It also means that I’m not crazy to request we all receive T-shirts with “I survived PA school” in that Tower of Terror font at graduation, along with a diploma. I think it’s appropriate.
My struggle with anxiety is ongoing. I continued to see a therapist when I moved home and was dealing with the transition from student to real world adult. Now I attend a weekly Women’s Empowerment group where I share my story and learn from other women in similar situations.
Although I survived PA school, passed my board exam, and somehow got my dream job right out of school, I still have anxiety and occasional anxiety attacks. The difference now is that I acknowledge it and know how to manage it appropriately. I recognize the signs of a pending attack, I have developed ways to prevent them when I find myself in stressful situations, and most importantly I know to forgive and take care of myself when it doesn’t work.
Going to PA school has changed me in ways I had no idea was possible. Although I was in survival mode for majority of it, I am more confident and sure of myself. It taught me to set boundaries with others and with myself. It helped me developed a firm grasp my anxiety and realize that it will not be a reason to stop chasing my dreams.
Kay, J. (2008, May). The State of College Mental Health. Presented at the American Psychiatric Association Annual Meeting in Washington, D.C.
Tartakovsky, M. (2016). Highlighting Mental Health in Grad Students. Psych Central. Retrieved on August 23, 2018, from https://psychcentral.com/blog/highlighting-mental-health-in-grad-students/