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Backwards Through The Stress

The Traditional Stress Curve

We’ve all seen this little depiction of the levels of stress before and we always get lectured on how we need to maintain our stress level in the “optimum” area to ensure that we have the righ amount of stress to keep us motivated from day to day.  We all hear the warnings about what might happen if we get too stressed out and go over the wrong end of the curve, right?  Well, I know I have heard that lecture many, many times.  Despite that, I was not very good at making sure I didn’t go over the deep end.

I am fairly certain (110% certain) that for the last 3-6 months I have been hovering in the red zone.  Burn-out.  I know that because my anxiety levels have been at an all-time high for a long time now.  I have been extremely irritable, grumpy, angry, tearful, hopeless… you name it.  I was looking forward to being done my exam because it meant that I would finally be able to relax and de-stress.  However, I had the very wrong misconception that after the external stressors were eliminated, my internal stress level would dial right back to zero.  Really, when does it ever happen like that???

On Monday I wrote my exam – I am sure at that point, I was at the far right of the curve, hovering over the breakdown.  On Tuesday I woke up and felt great about having nothing to do but “relax.”  Of course, I didn’t do a whole lot of relaxing.  Instead I ran around the city getting a bunch of little things done that I’d been putting off.  That night we went out of dinner because I didn’t want to cook and I was feeling pretty good.  Later that night, however, I had some indigestion – and I started to “panic” – why am I not feeling well?  Am I going to be sick? What’s wrong with me?  Am I going to be up all night?

No matter what I said to myself, I was psyching myself out and having a full fledged anxiety attack about if I was going to be sick all night.  Stupid, right?  Well, as I’ve mentioned before, I would consider myself an emetophobe.  Therefore, I had pretty much entered a horrible, irrational cycle of anxiety and panic for no reason.  Almost exactly at midnight, I woke up suddenly feeling “funny.”  I went to the washroom, fearing the worst, and I began having this horrible full-body sympathetic response:  I was getting hot and flushed, my mouth was getting very dry, I was getting very nauseous, my legs were tingly and numb, I had an acute sensation of needing to urinate and was almost sure I was going to lose control of that.  My husband asked me if I was okay.  All I could mutter was, “I think I’m going to throw up.”  I was sure that my 13 year no vomiting streak was coming to an end.  And just like that the feeling passed.  I managed to gain enough strength to actually sit on the toilet and not pee on the floor.  I then took a gravol.  And then I started shivering uncontrollably.  I was scared to go back to bed, I was scared to turn the bathroom light off.  I just sat on my bathroom floor shivering and irrationally scared of what was going on.  I finally got enough strength to leave the bedroom so my husband could sleep and I spent the next two hours sitting on the couch cycling through less intense episodes of flushing/hot/nausea and then uncontrollable shivering.  I didn’t want to do anything but sit there.  Finally, I felt exhausted enough to lay down on the couch and fall asleep.

Yesterday, my brain felt all cloudy and distant.  I was able to eat small meals without feeling sick, so I knew I didn’t have some kind of gastroenteritis or something.  But I was still very anxious and fearful of what was going on with my body, and that in itself would make me nauseous.  I collapsed in the middle of the day to take a nap and when I woke up, I forced myself to go for a run.  Unfortunately, I had to quit just after 3K because I felt like my legs couldn’t carry me anymore.  I was sheerly exhausted.  I spent the rest of the day in a ridiculous state of anxiety and panic about being sick, not feeling like myself, and worrying about if I was ever going to feel normal again.  Right up until I fell asleep in bed last night, I was using every last ounce of energy I had to focus on not feeding into the panic cycle.

Then, when I woke up this morning, I felt like I couldn’t move.  I couldn’t even get out of bed.  My husband and kids were running around me like a whirlwind and I didn’t even get up to help them get ready. I can’t remember the last time I ever felt so utterly exhausted.  And that’s when I realized that I am slowly moving backwards through the stages of stress.

It is foolish to think that I could just wake up one morning and feel relieved of stress.  It took me months, if not years, to get to this point of burn-out and writing one exam and having nothing left to do will not alleviate all of that.  As nice as it is to day-dream about vanishing all the burnout, there has to be a recovery stage – just like everything else.  I’m hoping that the last two days were the worst of it.  Perhaps this morning’s feeling of exhaustion is a sign that I have moved out of the anxiety/panic/anger (burnout) phase into the overload/exhaustion phase.  There is still a long way to go to get back into the healthy zone, but hopefully this is all a sign that I am moving in the right direction.

4 thoughts on “Backwards Through The Stress

  1. You are coming down from the emotional rollercoaster you’ve been on. I remember something similar happening to me about 9 months after my first child was born and the PPD hit its peak. The episode you described having experienced the other night is something I went through when I was just starting therapy. In fact, word for word, my experience was identical. It was my first full on panic attack and it was awful.

    So, hugs to you, my online friend. This too shall pass.


    1. Thanks! It make me feel better to know that I’m not the only person in this position to go through this kind of experience. I’m just hoping that I can avoid getting to this point again in the future. I know residency will be tough, but hopefully it will be a different kind of “tough…”


  2. I’m not quite to that point yet, but I can totally understand where you’re coming from. I feel my anxiety levels steadily building as I maneuver through clerkship, to the point where I asked my doctor to start me on a trial of fluoxetine. I’m sorry you’re feeling so awful, and I hope that it does pass soon!!


    1. Thanks! I am already feeling a little bit better. I’m sorry that you’re noticing the effects, but I guess it’s just a normal part of med school these days 😦


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