depression

I’m a perfectionist who tends to be very sensitive to criticism.  As part of my residency, I began seeing outpatients 3 months ago to manage medications and provide psychotherapy, which was extremely anxiety-provoking during the first 2 months.  My heart rate rose each time a patient burst into tears, told me they wanted to die, and disclosed traumatic experiences suppressed for years.  Each time I watched my patient unravel, I felt immense pressure to say the magic words to make them feel better and provide a brilliant synopsis of their entire life story after a 30-minute session.  Even more intimidating was knowing my supervisor was watching me through a 2-way mirror evaluating each statement I made.  I felt dumbfounded each time I paused too long and resorted to asking the most annoying question in Psychiatry: “So how did that make you feel?”

Despite being so hard on myself, a moment of clarity came this week when I saw two of my very first patients that I’ve followed regularly since my outpatient clinic started.  Three months ago, they isolated in their homes due to severe depression, had low self-esteem, and felt hopeless about life due to past trauma and abuse.  Having the opportunity to observe even the smallest changes they’ve made is rewarding.  Simple things such as going outside for a walk, cleaning the house, putting makeup on, and going on their first job interview in years, might seem like nothing to others, but for someone who’s reached rock-bottom to the point of suicide means the world.  Perhaps I contributed somewhat to their improvement by providing an outlet for disclosure of pent up feelings or gave insight into how past events effect their current emotions.  Ultimately, they gained inner strength to make such progress, which makes all the stress, palpitations, and criticism worthwhile.  They demonstrate my purpose and the reason I went into Psychiatry.