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This is extremely long, sorry! I want to provide you with some support as I can understand a lot of your struggle and although some of your circumstances are different, I do relate to you in many ways. Firstly, your life matters. You, as a person, matter. Your health is more important than school. I know what it’s like to struggle with depression and suicidal thoughts because I have gone through that too. And my lowest, I felt like a total and complete failure and a disappointment to my parents, and that there was no reason to continue to cause them hardships. I also hated myself, and in my deep sadness, I told my dad all of this. It was life or death and I had nothing left to lose by telling him, and everything to gain by possibly getting some help. He told me that a parent is always proud. That he would never be disappointed in me, and that my life matters more than anything that I ever accomplish or achieve. He needs his daughter to be alive, talk to, hug, share memories with, and that he would support me in any way possible to get better. He told me that it would hurt him so much if I didn’t exist in this world. Just like your dad, my father immigrated to this country and has worked hard his entire life building a life for us from nothing, and that his life goal is me- seeing me succeed. But while I had thought that success was measured in achievements, the truth is health and happiness matter more. Each time I was suicidal, I put myself in his shoes. If my beloved father suddenly dies by suicide, how sad would I feel not to be able to talk to him, see him smile? And if he came to me saying this was his plan, I would tell him he would not need to do one more thing for me, I simply need him alive. And this is how I came to understand that my life is more important than anything else I do or that has happened to me. Telling my doctor was a big step and was important for me too- It helped to take the burden of having to live through this by myself away. I started writing with a washable marker on my arm- Waheguru. And the names of my family members. Basically, remembering what I was living for. Who I was living for. Please keep remembering the reasons you live- you have mentioned them, the pain it would cause your family, and Guru Gobind Singh Ji.

I know this is hard to talk about, thank you for allowing me to “hear it.” I want to remind you that you aren’t alone. A lot of people do struggle with depression and suicidal thoughts, but I know it can feel isolating. Depression and suicidal ideation are serious, though. There is help- remember your resources. There are crisis lines you can call if you don’t have anyone to talk to. If you are feeling at risk of suicide, please go to your emergency department at the hospital and get help. There is no shame in saving your life! I know its hard to get help with the amount of stigma around mental illness but It is important that you are safe. Writing down these options and keeping them with you, including the phone number of the crisis line, will take away the pressure of having to remember it in an emergency. Please seek help. Whether it’s someone you trust or a doctor. It helps to have the support and someone else to carry the burden. It helps to have someone help us think clearly when we are distressed. Sometimes well-intentioned family/friends can’t understand but don’t let them stop you from getting help to survive and heal. That’s the most important thing. You aren’t betraying your parents, you are doing the best you can.

Depression is a terrible illness that many people who have not experienced it fail to understand. I don’t know if you know this but a lot of what you have described is depressive symptoms- mood is obviously a part of it, but so is loss of interest in usual activities, sleep changes, feeling guilty/hopeless/suicidal, low energy, low concentration, and changes in appetite. There are treatments for depression- medications, counseling, self-management strategies. Counseling has really helped me. I found a counselor that taught me skills to cope with the struggles of surviving each day. Self-care is important in depression. (Establishing bedtime routines, exercising (really helped me), relaxation, getting up and taking a shower, brushing hair/teeth, social contact, hobbies, etc.). You could create a checklist (I started feeling bad when I didn’t accomplish stuff on my checklist so I didn’t find this useful) or just have these goals in mind. Start small and don’t feel guilty if you aren’t doing all of these things yet. Next, I am going to share some coping strategies that I learned in counseling in case counseling is not an option for you for whatever reason: Journaling and art can be useful in managing emotions; putting on kirtan in the background/relaxing music; breathing techniques (in through nose to count of 4, push belly out/ out 7 through mouth, pull belly in), saying Waheguru while you breathe. A technique called chunking the day- you choose a time period you feel you can do an activity (say 10 minutes) and you do it for that period of time. So I wash the dishes for 10 minutes, and then you decide if you can do more or need to rest or change activities. It helps take the overwhelmingness out of times when you feel like you won’t survive the rest of the day. Accomplishments list- celebrate what you did do. This is hard for high-achieving, goal-directed people sometimes. But you need to focus on the things that you HAVE accomplished, not what you haven’t. My list started with “1. I survived today. I am alive today.” Your list can include anything from “I woke up, took a shower, attended my classes” to “I passed almost 2 yrs of university despite my depression.” These accomplishments will help you start to feel like you can build on those. Remember, these aren’t minor, its just that your mind is comparing them to your dreams for yourself. There are a few types of meditation: mindfulness (just observing thoughts), focusing on breathing, doing Simran, etc. I have found the depression caused me to be too overwhelmed in the silence because I couldn’t focus, and so I listened to guided meditations on youtube where they say stuff to some relaxing music. If it doesn’t work for you, you don’t have to do it! There are a lot of different coping strategies and maybe meditation isn’t the one for you right now. Next, positive affirmations are something that have helped me a lot. They are things that you write about yourself (even if you don’t feel it, try to write about yourself as you would describe who you were in grade 10 or how people would describe your great qualities). Ex. Mine say “I am a fighter. I am a winner. I am a leader. I am a survivor. I am kind. I am resilient. I am honest.” Etc. Read these to yourself each day when you wake up and each night when you go to sleep. Next, low self-esteem/confidence. I’ve been through that too. The thing that really helped me the most was putting up quotes on my wall in my bedroom. I want to remind you of some things though: You are filled with the energy of God and He has made you perfect. Never give up. You are a princess, daughter of God, and Waheguru watches over you. He will help you through this. You deserve to be happy, you deserve to have your dreams come true. And you are doing your best right now. Try to stay connected to realize the power within you. Guru Gobind Singh Ji taught us to be brave. You can do this. You can succeed. It might be a long road and be hard, but you can do it. I know you can. You are so strong for making it this far. You are brave and courageous for surviving each day, a true warrior. You can fight this, and get your life back together. These struggles will make you a more compassionate doctor, one who understands her patient’s struggles. I am sorry about your struggles with your weight. It must be really hard- people can be cruel and I know it affects self-esteem a lot. You are beautiful regardless of what people say. Remember for all those people talking about how you look, they are being superficial. This body is a costume and the soul lasts.

I know what it’s like to have people put a target on you because you are successful. This happens in the Punjabi community and I have lost my Punjabi friends left because all their parents kept comparing them to me when we grew up. People get jealous. They start to hate you for your success and would love to see you fail. It’s not black magic or the evil eye. That’s just how it is in our culture. I spent a large portion of time fighting those people, proving them wrong by being successful, and finally I got tired of living for other people. My life isn’t about proving myself to them, they don’t deserve that status in my life. It has to be about myself. Those people don’t deserve your attention or time or thoughts. They cannot decide you are a failure, it’s not their right. Don’t let their words get to you. This is not forever. You are going to turn your life around, it’s going to take some time but it will happen. The hell you are going through will be worth it when you finally get there. Even though I don’t know you in person, remember that I am rooting for your success ☺

Now as for school. It is really unfortunate you didn’t have good teachers because it’s the basis for university science courses and its no surprise you had trouble adjusting. University is tough, but especially if you were in a big prestigious one and didn’t have a good base knowledge. (I went to a small university for undergrad and I’m currently a med student by the way! It is possible to get in from a small uni). Med school is hard to get in but there are still a lot of other great careers in healthcare- physiotherapy, x ray/ ultrasound/lab techs, etc. Don’t ignore those as options. I know nothing probably compares in your mind to your dream of getting into medicine. Remember though, that you can apply AFTER you have started working one of those jobs though. I know a medical office assistant, a nurse, an engineer, two teachers, occupational speech therapist, nurse and a personal trainer who all ended up going to medical school later! Sometimes the journey is long, but you can still get there. Have you thought about taking a break from school to take care of your mental health for a bit and reassess things (you can volunteer during that time too to build your application for med school)? Or changing programs (I know some friends who got into UBC Med from non-science undergrad programs by just doing required science pre-reqs. They had a higher overall GPA cause their courses weren’t as hard as the science programs). The other thing to look at is if study skills may be an issue. For some people they have a hard time adjusting to the different style of university courses. As the course load increases from high school to university study skills need to adapt. I’m talking about prioritizing tasks by urgency and importance, time management, etc. If this is an issue, maybe there is someone that you can talk to at the university for help. Have you thought about reducing your load to take 3 or 4 courses instead of 5 (plus labs) and seeing if things are better? If you feel it is helpful, remind yourself you don’t have to be perfect and aim for 70 instead of 90. Try to build up your goal slowly. If you always constantly aim for 100, you will set yourself up for disappointment and feel like studying won’t help. Remember, even if worst-case scenario you stay in the 60s you will at least have passed and have a degree at the end of four years. A degree opens doors for you for a job. Keep trying and don’t give up. If you don’t get accepted to medicine the first time, it doesn’t mean it’s forever. Keep trying. Medical schools are starting now to see that a good doctor is a kind and compassionate one, not necessarily the one with the top marks. They see that from your volunteer work and references. Unfortunately, they need cut offs to reduce the number of applicants. It doesn’t mean that you wouldn’t make a good doctor. They just cannot handle assessing all of those applicants. A good MCAT score (remember, you can write it multiple times!) can help to show the med school you have a good base knowledge of sciences if your prereq avg is low. In reality, undergrad chemistry and physics etc. isn’t all that relevant when you start medicine, so if you aren’t feeling all that interested it’s okay. They need to have some way of assessing whether you can handle the load of medical school and prereqs is sort of what it is right now. I think you are struggling from the fact that you feel that your dream is out of reach and the depression is impairing your motivation and concentration. But your dream isn’t over! P.S. you don’t have to be that good with dead bodies to be a good doctor. There were no coffins involved. The cadavers were hard to get used to, but everyone made it through by remembering that we are learning from them.

The mind is tricky. It is sometimes our own worst enemy. It tells us we aren’t good enough, we can’t be happy. Gurbani (and translations) help us to remember what is real and what is not. Remember, this world is an illusion. Guru Nanak Dev Ji taught us naam japo, vand shako, kirat karo. You don’t take your marks with you when you die. You take your good deeds and thoughts. That is value for your soul and a great accomplishment. Trying hard will pay off in the end. Sometimes you work hard and you don’t get a good score, but you tried your best, you gave it everything you had, and that is what Guru Ji asks of us. Fight for your dream. And slowly you will work your way up again. Its good that you are reading Sri Guru Granth Sahib and translations. I found the english translation of Jaap sahib (while listening to the musical jaap sahib) so moving that I cried. Sukhmani really helps. Try putting on prayers in the background when you are studying. Doing prayers will help you significantly, but I also know it is hard it is when you are going through depression. I know you hate yourself, but each time your mind tells you that, say to yourself I love myself. I love myself because God is in me and I love God. Guilt, self-hatred, these are powerful emotions. Some people say that you just need to think more positive to fix a depression, but that’s not true. Depression is more complex than that, but fighting the negative thoughts is a piece of it. It starts with finding what your negative thoughts are. For example, “I hate myself.” “I am not going to get into medical school.” “Working hard isn’t going to get me better marks.” Write down these thoughts and notice the thinking. And then try to think of an alternative thought that is going to help you feel better. It is hard often to let go of what we imagined our life to be. You have a goal and think it will be smooth sailing, but things don’t go well sometimes. It’s okay, it’s going to be okay. This is not where you imagined yourself to be, but its not who you are. Who you are hasn’t changed underneath. You are still intelligent, it’s just that you are in a hard situation. You are still God’s child. That doesn’t change. You will get back your confidence one day. May Waheguru help you heal and become successful. I know you can do it.