Dear Thelma: I'm struggling with med school, family issues and depression

I am currently doing fourth year Medicine, and I have moderate depression.

In high school, I was one of the class toppers and then I chose to pursue medicine, under the influence of my parents, as I did not have any idea about the future. And that is where the heartbreak began.

I have tried my level best to study and put in the effort, yet my results are super disappointing, considering that I am a scholarship student. I have no idea why I am not scoring well.

I am already disappointed with my results, but when my mum also vents her frustration at them, it makes me more disappointed in myself. I have also started hating myself and have distanced myself from my family.

I also can't cope with the double-standard treatment from my parents and family members. Just because I am a girl does not mean that I should be treated as someone who will just abandon the family after getting married. That is just plain stupid and old-fashioned thinking.

Sasha

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Dear Sasha,

I'm sorry you're having a bad time. There are three issues: your depression, your unhappiness with your course, and your relationship with your family, especially your mum.

First, you say you have moderate depression but you don't mention what you're doing to deal with it. As you are a med student and they are notoriously stubborn about getting proper help, do be certain to see a psychiatrist. Managing the condition is a must, as it will colour your perceptions and your energy level.

Second, let's talk about your mum and family. When we treat people meanly, they will avoid us. Yet for some parents and relatives, this reaction comes as a terrible shock. Sensible types rethink the relationship and amend their behaviour.

Sadly, many double down and move into emotional blackmail, using fear, obligation and guilt to try and get their own way. It comes from entitlement, the idea that they can be rude, just because they're older.

Living with or near toxic people makes us ill, and therefore you need to make a choice.

If you have never had a good relationship, then consider distance as your friend. When there is no foundation, and no hope for change, the only thing to do is to disengage as much as possible.

Distance covers lots of options. Some people maintain regular but reserved contact, like a courtesy visit on birthdays and some big holidays while others are happier with estrangement. It's entirely up to you. Do what makes you feel best.

If you have a good foundation, you might rescue your relationship by talking honestly. Start with your mother. You can dress it up in polite language, but make sure you get the point across that scolding will not magically make your results soar, but it will ensure that you avoid her.

Accept that her scolding might come from concern, but she has to learn to express herself appropriately. I assume she has manners when she talks to her friends; she needs to learn to treat you with the same respect.

Tackle the rest of the family the same way. They either treat you with respect, or you will absent yourself. If possible, get mum on board to help you deal with them.

You may be shocked by my forthrightness. However, this is not a one-off spat. Your family members are humiliating and bullying you for not living up to their expectations. That's cruel. They need a wake-up call.

Second, the course. You don't say exactly how your results disappoint you. Are you passing but not at the top of your class? Or have you decided you don't want to be a doctor?

Either way, you don't need to do a residency and become a doctor in the standard way. You might work in a research lab, health administration, drug company, health insurance, teach at university level, or take on other jobs.

As you are at uni where counselling is free, talk to the counselling department about all the issues and the career officer about opportunities.

Don't make decisions in a hurry. Think it all over, model conversations and options with the counsellors, and only make decisions when you feel comfortable with the outcomes.

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