College Stress and Mental Health

Have you noticed that Mental Health Awareness month coincides with the end of spring semester?  I hope that your finals went well; but, if you’re anything like me, then maybe they didn’t. Back when I was an undergraduate, it was difficult for me to be anything but hard on myself after a disappointing test…class…semester…  In hindsight, I was going through something more serious than I could acknowledge at the time; perhaps you are, too. College is brutal. Mental health suffers in the environment, where the stressors are many. Before diving into your summer plans, be they a new internship or some hardcore R&R, take some time to reflect on your semester.  Better understanding your stressors may help you to feel better about the semester and may even help you overcome these challenges in the coming semesters. Need some help getting started? See the inventory below.

There’s the workload, the reading assignments, the homework, the studying — none of this is new, but the volume and subject matter density seem to be growing exponentially.  This author had to completely relearn healthy study habits (because my old high school techniques were not cutting it).  Speaking of healthy habits, college is a lot of scheduling (hard) and self-discipline (harder).  “This is when I need to eat, and this is when I need to sleep.” Sleep! Dorm living, roommates, lack of personal space.  Friends eating up “free” time. Stressful romances. Diet and exercise? Oh right, and money. Some of us may be thinking, “That’s just life,” but our freshmen may be doing all this — alone — for the first time in their lives.  Overwhelming is an understatement.

stress comic 2

I’m here to say: rough semesters happen, and it’s alright.  Higher education may be the hardest four years of your life thus far, and you are doing your best.  Some days, your best may be better than other days. Sometimes, your best may not compete with your colleagues’ best.  It happens, it’s alright. College is brutal which is why it’s especially important to be forgiving of yourself. Once you forgive yourself for being a growing, learning human, then you can appreciate that what you learn in college is more than fact, theory, and practicum.  College is an immensely complicated experience, and what you are truly learning may not be apparent while you are in it. Yes, it can get messy, but it can be positive for those who learn to manage stressors and mental health (which is one very important lesson).

So what do we do now with this long list of challenges and new found appreciation for the capacity for growth in college?  Be kind to yourself and practice!. For many of us summer break is a low-stakes opportunity to practice self-care: at first it may feel scary, and it may feel silly.  In my experience, those were the two quickest ways that I talked myself out of doing something that I knew would be good for me. However, a little bit of self-care goes a long way, especially if you are (as I was at the end of spring) in a self-care deficit.  Start small and build up to lavishment. A bath, a gas station ice cream, a non-judgmental cry can be enough to be kind to yourself. Taking good care of yourself will not get rid of your stressors during the semester, but it may help you approach them and recover from them differently.  I suppose that’s what I learned about self-care in college: I did my best. It was all I could do, and it was enough.

stress comic 1

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Following Dream A and End up at Dream B(etter)

I’m the textbook stereotype of an overachieving first-born child. In high school, I was captain of the soccer team, one of the most decorated JROTC cadets of my school’s battalion, in the top of the class academically, and a member of various student organizations. I even paid for my entire undergraduate college tuition, fees, room and board entirely with scholarships. (This triggered an old bargain my Dad made with me in third grade that resulted in a new car before college.) I set high expectations for myself, and I was used to exceeding them.

The expectation I set for myself in college was medical school. That was the plan (and I’m a planner). You get a degree in biology, and then you move onto medical school. My grades weren’t as spectacular as they were in high school but, they weren’t terrible. I had varied and dedicated extracurriculars and a part time job. I volunteered at a Children’s Hospital, and I even continued to play club soccer. I studied abroad for two summer semesters and was able to complete my degree in four years. I had multiple awards and honors and a decent test score for entry to medical school. I knew medical school admission officers were going to love me!

But then they didn’t. I applied to at least ten different medical schools and was subsequently rejected from all of them. “Sorry, thanks for applying but we aren’t interested.” I started to panic. What in the world was I supposed to do now? I didn’t really have a backup plan (highly unusual for me) but I had always just known I was going to go to medical school.

During the last semester of my undergraduate program, I utilized one of my more eccentric talents and researched frantically to find something to fill what was now just going to be a gap year in my studies. I soon found a graduate school with a Master’s program that was essentially geared for people who couldn’t get into medical or dental school. They didn’t advertise it that way but it was pretty much the gist. I was surrounded by people all hoping to get into a professional school or move onto PhD programs. And they all seemed successful. This was the new plan. This was where I was going to gain a little more life experience. Just one small bump in the road, then medical school here I come. I could totally do this!

I had to repeat one of my courses and extend my program out an extra semester because in graduate school you cannot make Cs (even borderline, 1 point off C+s). I didn’t let that deter me, I went on to get a 4.0 the next semester and graduated in December instead of May. I applied for medical school again, this time being a little more selective of my choices. Everyone was on board with my plan – it was even quoted in a newspaper article. But again I didn’t get into medical school.

My family was super supportive the whole time. I admit that even they told me that no one ever said I had to go to medical school. The whole situation was devastating to me, and I felt like a failure. But I couldn’t hide behind school anymore, so I got a job. I went to work in a histopathology laboratory (the place they send specimens for testing after you have surgery) for some time. At least it was in the realm of science and was going to put to use some of the knowledge I gained from these two degrees. It wasn’t the fault of the hiring manager but my naiveté that I took the job without understanding that I wasn’t going to start off doing these great amazing things they promised during the initial interview. I was miserable for a good while working a 2 am shift just placing glass slides in a folder and ensuring names matched. I gained some basic skills and eventually they allowed me to do some more technical stuff but it still wasn’t enough.

Many laboratory people will tell you the reason they work in the lab is because they don’t like people, and while I may have been shy in my childhood, I still wanted to talk to people/patients as part of my job. I loved the science aspect of what I did and researched how to go further with that and how I could utilize my hard earned Master’s degree. I remember finding a book in the library of what to do with your biology degree. Everything I found interesting required me to go back to school. But I knew if I went back to school I wanted it to be for something meaningful and definitely a terminal degree.

I researched more careers and ran across physician assistants (PA) among other things. I kept coming back to the PA thing though. There happen to be a school in the area I worked and two others in the state, as well as a new program at the school where I had done my Master’s. I had a few friends from grad school who had gone into the field, and it felt right. Then I found out that I couldn’t apply right away. I actually set up my letters of rec beforehand, but I had to take two extra courses that they refused to waive. (Medical terminology being one, for goodness sake I had a Master’s in Medical Science!) A new plan was formed. I took the classes the next semester and started the application process. I found a PA to shadow and maintained my current job, although my employer may not have been too pleased about my future endeavors.

By the end of summer I hadn’t heard anything about an interview, but forum websites (that I stalked) said they were happening. I was starting to lose hope when finally I received an e-mail asking to come in for an interview. I have always believed in myself that if I could get the interview, I could make a good enough impression to land the job or position.  The PA school interview was all of 15 minutes but I did everything you’re supposed to do. I made a good first impression with the receptionist and talked with other applicants and current students in the appropriate manner. I answered the questions correctly regarding the profession. There was an exam at the end but I wasn’t worried. I had been told from previous students the scores wouldn’t factor into the interview but just serve as a baseline for the future coursework. I nailed the ethical question essay, and I was feeling fantastic. I knew this was what I was meant to do.

The next week after the interview, as I was creeping on those forum websites again, I saw that people were already getting acceptance e-mails, but I got nothing. About two weeks later I had a letter in the mail that stated, “sorry but we’re not interested.” I was upset. My now husband tried to comfort me as best he could. I remember he brought home pumpkins to decorate (something we never did) just to have a project to do and keep my mind off of it. Another two weeks later he would propose to me and confessed that he felt terrible when I found out I was rejected that he wanted to tell me his surprise right then and there just to make me feel better. He just knew I was going to get in and then he was going to propose and then our fairy tale would begin. I enjoyed the moment and felt reassured that at least I had a good man in my life even if I had no idea what I was going to do now.

Three weeks later, shortly before Thanksgiving I was on a weekly coffee/tea date I have with my friend before work and her classes and my phone rang. I let it go to voicemail because it wasn’t a number I recognized, and I didn’t want to be rude. They left a voicemail, and then thru a quick google search realized it was from the school that had rejected me. What could they possibly want? My friend encouraged me to call them back right then and there. They had called to offer me a spot on the waitlist. I said yes immediately, but I tried not to get my hopes up … I wasn’t sure I could stand anymore rejection at this point. Secretly in the back of my head I thought it kind of a cruel joke to offer a wait list spot to someone who was rejected outright at first but maybe there was a chance.

I went on vacation with my new fiancée to my parents’ home (stationed in Virginia at the time). At this point I had saved the PA school’s number in my phone. This time when the phone rang and I looked down to see the number, I knew who it was. I said the words out loud in the living room, “it’s the college calling.” I answered on the third ring as my parents and fiancée stared at me. As I was trying to listen to the woman on the phone explain that they were offering me a spot in the class, they continued to stare and mouth loudly, “What is it? Are you in?” I had to walk into another room and start shutting doors behind me to concentrate. I accepted on the spot and assured the woman that I would pay my seat deposit as soon as I returned from vacation.

When I got home, I turned in my letter of resignation at work and set myself up to start school in January. No lie, PA school was rough, and it’s no joke … learn ALL of medicine and how to treat patients … oh and do it in 28 months. It was draining, and I didn’t have an extensive social life. When I started seeing patients during my clinical rotations, I knew it was so worth it. THIS is what I was meant to do, this is truly my calling. Now, I have dozens of stories about patients who contribute to just how wonderful and proud it makes me feel to be a PA. I am honored to have been a part of those patients’ medical team. I intend to be the best PA that I can and advocate for my patients as I begin my medical career. The path to this point was not easy, but it has somehow been necessary to make the end result feel this satisfying.

I graduated towards the top of my class and passed my board exam with no issues … how’s that for someone who was initially rejected? I guess the other moral to point out here is don’t give up on your dreams even if they don’t look the same as when you first started the journey.