It’s taken me a while to get around to making this publicly known, not because I felt uncomfortable with the truth, but rather because it’s hard to write a sincere, personal post without coming off as dramatic or pitching for sympathy.

I began a year off from medical school this past fall because I was depressed AF. Coming off long distances hikes and being depressed isn’t uncommon. Nor is depression an uncommon phenomenon with medical students. When I hiked two thirds of the Appalachian Trail in 2009-2010, I came off and felt totally lost. Fortunately I needed some money so didn’t have much time to wallow in self pity. But this past summer, after attempting the Appalachian Trail unsupported record and tearing my calf three weeks in, I was pretty tremendously bummed out. I shamefully returned home, knowing that I would just get more and more down the longer I spent dragging out my slow and excruciating failure on the Trail. At home I could hardly walk and had to one leg hobble around the house while my calf healed. After a couple weeks I was able to go for short walks but I still had to worry about lasting damage I potentially had accrued on my 23 days of 35 mile days on the AT.

At home, I occupied myself with chores, tame adventures, and hung out with friends and family. I picked up racing triathlons again to keep in shape and enjoyed the rapid improvement after my three years away from the sport. But I couldn’t deny that the sport wasn’t giving me the same joy it did in undergrad. School started back up and I was having difficulty getting to class every day. I lived in Virginia Beach at my parents house for the first few weeks of class with all my stuff packed up in boxes. I felt homeless and being so far from school seriously discouraged my attendance of non-mandatory classes and made the mandatory ones a burden.

When I finally moved into my new apartment in Norfolk, it was a shell of a home. It’s a beautiful place overlooking the Elizabeth River and I felt there was no way I could possibly be depressed with all my luck and fortune. I lived in a condo on the water. I have a loving family and a great group of friends and I was privileged enough to be one of the few people who pursues a career as a physician who actually got into med school. But holy hell was I bummed out. And apparently denying that myself any right to be bummed out didn’t help me feel any better.

I hadn’t really experienced depression before. I grew up with some anxiety issues, and in my teenage years dealt with some existential angst, but never did I just wake up, eat breakfast and want to just crawl right back in bed and wallow. Never have I felt sick and bummed for no conscious reason whatsoever. I’m not sure what depression is for most people, but for me it wasn’t sadness. Rather it was like being ill. I was just down, down, down and couldn’t find my way back up.

So I denied it all to myself, not knowing what I was feeling, and not admitting that it was possible for someone so privileged to be so down. I thought maybe if I shoved it under the bed it would disappear. It didn’t. My friends were wondering what the hell was wrong with me, and I didn’t admit anything to them until my friend John asked if I was okay when we were rock climbing at the gym in Virginia Beach one day. The week earlier I discovered I had strep throat and an ear infection and basically at that point couldn’t take it all anymore and just laid in bed for a week. But when he asked me, I told him the truth and felt much better admitting it.

I told my parents and then went to go see some administrators and therapists at school. They all encouraged me to pursue what I thought was in my best interest and made me feel like it was okay to be bummed and that I wasn’t weak or less of a person for being depressed. And simply admitting that I was mortal made me feel a little bit better. And then I felt a little silly for having the conversations at all because I started feeling a little better. And then it all went wildly back down again and I admitted that I was trying to shove a warehouse full of issues under my twin size bed.

Thus the conversation about a leave of absence began. I was postponing exams and not getting work turned in, missing labs, and was blocks behind on lectures. A couple of the most wonderful people at student affairs let me work through the idea of a year off in my own head and gave me some time without pressing it on me. My biggest concern was losing all my friends. After a evening meeting on campus I asked my friend John if I could come over and play with his kitties. I walked back to his house with him and his wife and within minutes of getting in there, opened up about what I was considering and how scared I was of losing my friends. They listened and reassured me. They told me it was a common decision and made me feel again like I was allowed to be feeling this way.

I talked it through some more with my parents and then went in scared out of my mind to student affairs and told them my decision. I could see the relief on their faces knowing that I wasn’t just going to try to muscle through this. Their concern was that if I didn’t take care of it now it would simply escalate until it took over and ruined my chance of getting into residency. At this point they felt the harm to my record was minimal if not non-existent. I signed the paperwork and the second I stepped off campus let out a tremendous sigh of relief. Now my job was to fix this jank and get back to who I was. AKA, I needed to pursue every evidence-based treatment for depression including pharmaceuticals, therapy, and lots of play time with dogs (most importantly the last one). And throw in climbing big mountains, eating healthy, and hanging out with family and friends in there too and remember what it is like to be happy.

So here I am, some nearly nine months after this all began, still combatting the lows that I’m becoming more familiar with, but so much better than I was just a few months back. I’ve admitted to myself that sometimes things can suck even when things are great and that denial is not a very effective strategy for dealing with problems. Trust me, I was captain denial for a good four months-it doesn’t work. And for the first time in a long time, I can say with confidence that I actually am looking forward to returning to school in August after my mulligan last year.