I couldn't even tell you.

My skin is torn, right down near the edge where it and and my nail came together in a once-perfect fit, edging around the white half-moon and the blaze running through it that is uniquely mine. It hurts, but I rub at it again, distracting myself from my discomfort, my worry, and the disjointed flow of my words as they describe the inner twists of my mind to a perfect stranger.

The beginning panic is mostly gone, now, taking the first chunk of cuticle with it. I don't know what I was so afraid of--what I'd hear, perhaps? That I'd break down and cry in that small office? It's not like me, I know, but then again, none of this is--or didn't used to be, at any rate.

They say that around 40% of medical students experience a major depressive episode at some point during their years here. They also say that, if it's happened once, chances are extremely high that it will happen again.

There is a specific period in my past that doesn't have many memories. I've tried to find some, but I just recall being...dark. Tired, all the time. Hopeless, and completely alone. Someone very dear to me recently described it as a kind of anger--if your life is good, even great, why should your mind tell you otherwise? It's not logical, not reasonable, it can't be talked around, and that made him furious. Me, it just makes me more tired. You can only argue with yourself so much before you stop believing what you're saying.

I notice a bit of blood under the nail of my left hand. We're talking about possible mental strategies to use to combat my negative self-talk--I wonder, is self-talk part of the psychobabble?--and I'm perking up a bit. This is why I came, after all. I hate acknowledging that I might actually have a problem; I'd rather chalk it up to laziness, or lack of efficiency, or timing my sleep cycles wrong. But the idea that someone could help me change how I look at life, and that this could go a long way to solving my problems, that was an idea I could have hope for--a great deal of it.

Then he said, "You seem like your head is in the right place--owning your problems and such--and I don't think counseling is going to do you much good, although we'll certainly meet a few more times. But here's an appointment for a psychiatrist, and we'll get you started on an antidepressant tomorrow."

You don't know what it's like to hear that. Depression carries such a social stigma; somebody recently compared it to being diagnosed with an STD. If you announce that you have heart failure, nobody is going to give you that funny sideways look and say, "Riiiight..." If something goes wrong with the body, you fix it. You may get sympathy for it and, if you're lucky, somebody will bring you warm soup and bread to eat while watching movies from the comfort of your oh-so-shnuggly bed...perhaps that's just my own immediate fantasy. But if something goes wrong with your head? People get really uncomfortable, really fast.

It's more than that, though. It felt like something in me froze. What? Medication? Can we not talk about this first? What about the side effects? What is it going to feel like? Are there other options to try? Is this really the first step? I don't even know you, and you're saying I need to start a series of meds that will last indefinitely? Do you even know how I feel about medication?

I tell him I'm not entirely comfortable with the idea of drugs and he seems to shrug it off. I realize I need to quit playing with my hands--my thumb really hurts now. I know, I know I'm showing significant discomfort with the idea, and while I'm not doing it on purpose--it really is freaking me out--he doesn't pick up on it.

Our time is up, and he ushers me out of his office. I decide to wait and take my concerns to the person who would actually be writing the hypothetical prescription, so my questions will hold until tomorrow. Yet as the day has worn on, predictably, I've been unable to focus my attention for too long without it coming back to the session. I should feel relief, right? That there's a plan in place, that I'm going to feel better, focus better, sleep better, eat something, anything. That I will stop losing weight, that I won't struggle so hard to be happy when I'm stressed; that I will learn to cope with stress in a way that's healthy.  Even if I don't decide to go on meds, I can learn to focus on being strong in areas I'm weak. These are all good things.

It feels sick, though; and devastating in its own way. It feels broken--it feels shameful. Less. Empty. It feels like tears that I'm too tired to care about.

It feels like something I wish nobody else knew. Especially the people closest to me. Which is odd, writing about it here. But I needed to do something. I don't think I would have been able to sleep tonight if I hadn't gotten it out somehow.

Our first set of tests for second year starts tomorrow. I'm not ready for them--hellishly unprepared is a better description. What with my lack of concentration and various illnesses in the past few weeks, I'm seriously asking God for miracles on my behalf. For now, all I can do is sleep and study more in the morning.