On Jan 9th 2026 around 11pm I said goodnight to my younger sister and my niece, both of whom had come by visit me this weekend, and turned in for the night with my husband. Two hours ago, I was jolted awake from sleep by an all too familiar sensation, albeit one I have not felt quite so acutely for some time. My throat was constricting, my heart was pounding, my entire body tingling, the baby elephant was sitting on my chest again: I was having an anxiety attack.

I have experienced a number of these over the past few years, ever since I started medical school. The sequence of events is almost always the same: I have a period of sleep deprivation or sleep debt, I accumulate real or imagined outstanding tasks,, which I begin to slowly worry about not completing. Towards the end of the day my worry about tasks devolves into existential concerns about time wasting and not having enough minutes in one lifespan to complete everything if I continue to procrastinate, which eventually results in the aforementioned signs and symptoms described above.

Today the inciting event was the fact that I just came off five days of night shift, and during my two days off I have to make the decision to either stay on or come come off. Previous experience has shown that it is hard to switch back to a daytime schedule in such a short period of time. I also knew I would not be able to keep my overnight schedule tonight. Yesterday Cameroon was hosted by Morocco for the African Cup of Nations, and I had earlier invited some family over for a watch party. My sister and my three year old niece came to spend the weekend. They arrived while I was at work, and I did not see them until noon after I woke up from bed this morning. I wanted to stay on the night schedule, but I also wanted to hang out with them.

My day began with me waking up at noon after going to bed at 9am to attend a fact finding meeting about an incident that had occurred at work at the end of last year, one which I did not really need to attend as I contributed almost nothing to the conversation. I then watched my home country get eliminated from the AFCON, which did not help matters. “Spending time with my family” ended up mostly consisting of us vegging out on the couch, my sister catching up on work, my niece watch her millionth episode of Baby Shark, and me, drifting in and out of consciousness and unsuccessfully trying to follow conversations with my husband who took pictures of us for our family Whatsapp group, made lunch and dinner, and organized the house around us. I was too exhausted to sleep. I was too exhausted to do anything else.

I carried that exhaustion into 11 pm, when I finally said goodnight to the girls and turned in for the night. Or tried to. As I climbed into bed, thoughts began to slowly stream into my subconscious mind-How many hours had I spent doing nothing today? When would I finally write something in my journal this year? What had I studied? Would I get crushed by the ABSITE (and yes, the word was Crushed, as though the ABSITE was a hammer coming down on me with unapologetic force)?

From there it got worse-the focused questions now becoming broader, existential type questions that one had no answers for at any godly hour of the day, much less at midnight. The last thing I remember was asking myself Is this how you want to say you spent your time? The next thing I new, it was as though someone had pulled me by the front of my shirt after my face was submerged in water for a few minutes. I was struggling to breathe, my entire body was pins and needles. I jolted up from bed, disoriented for the first few seconds. The abrupt movement woke my husband, who has been blessed with the glorious ability to fall asleep instantly and stay asleep in every possible situation.

“What? What is it? Are you ok?” He asked, equally disoriented.

“I’m ok, I think I am having an anxiety attack but I am ok.”

I was not, in fact, ok. I waited five, then ten minutes for the feeling to pass. In that time I took deep breaths, spoke to myself about the irrationality of this particular worry, that not studying today because I was exhausted after a long week of work did not mean I was lazy, or wasting my time. I lay awake in bed, waiting. It did not pass. I got up, threw on my robe and went to the living room, where I found my little sister, equally awake.

My mother, my sisters and I all share one common trait: We are terrible insomniacs. Mine stems from seven years of boarding school study nights, and six years of night shift work. My mother’s, from working overnight since she came to the States, and my youngest sister from the numerous anxieties that plague Millennials and Gen-Z folks today. My middle sister used to be the one who slept through storms, but now being a mom to newborns, toddlers and young children, she has inevitably joined the club.

I knew I needed this feeling to go away or I would have to call my Saturday wasted as well. I sat with my sister and told her I needed a distraction from what was happening with me. She is a generally private person, but she talked to me about things going on in her own life. Whether she did it for me or for herself, I do not know. I do know that we had a good 2-hour long conversation, and I was able to forget the thoughts swirling in my brain and focus on her instead. As we continued to talk I could feel the pressure coming down, the tingles slowly dying out, the elephant slowly standing up from my chest.

At the end of the conversation I returned to my room, and as he does every night, I got a quick massage from my husband. Very early in our relationship, on a particularly stressful day in medical school I had asked him for a massage. I had woken up the next day after almost six hours of interrupted sleep, and we had added that to our nightly routine. There is nothing like feeling tension dissipate from your own tightly coiled muscles. It is a shame people take advantage of the vulnerability of massage therapy to inflict harm and mental distress, because as a regular massage therapy receiver I can say it has changed my relationship with sleep dramatically. I have been a chronic Melatonin user, even when I knew it did not improve any aspect of my sleep at all. Six months of bedtime massages and I was finally able to get melatonin free sleep starting in October, and have been free of it since. I am not saying the massages were the sole thing that did the trick, but they played a huge role.

But I digress.

As it usually happens, I fell asleep soon after the massage. I woke up with the feeling gone, and ready to face the new day. But I have been thinking about it. This is not the first time I have had an anxiety attack. It was not even my first one that week. I understand that the triggers are irrational, things I should not stress over because I have no control over them. What I cannot understand is why my body cannot follow that logic. Why is it so difficult for our bodies during these circumstances to listen to and obey our brains?

I have a good friend with whom I catch up on life with every few months. They always tell me to seek a therapist, which I support, and find a psychiatrist, because there is no shame in trying medications to help manage these feelings. I know they are right, but I have always been hesitant about starting psychiatric medications. When I was in third year of medical school, I did my Psych rotation at a Child Psych facility. In my first week there, I had a total of ten hours of sleep. I stayed awake most nights going over the things I had seen, so much so that by the end of the week I had to ask my preceptors for recommendations for a Psychiatrist to go see. I met a very kindly doctor who started me on Trazodone. I took Trazodone the entire month on my Psych rotation, and then I self-discontinued it because every medication has side effects and I did not want to become dependent on medications.

Life as a resident is quite stressful on its own without the added stressors of existential crises and unanswerable questions. I know a few residents like me who manage their anxiety with medications, and sometimes I wonder if what is stopping me is that I would think of myself as incapable of dealing with this on my own. I grew up in Cameroon, where the concept of mental health was not even a point of discussion until recent years, and there have been no real strides in providing mental health services to people who need it. Sadly the only difference with Cameroon and the US is that the services are theoretically available, but not affordable or accessible especially for those who need them.

As far as I know, I am doing all the right things – I exercise regularly, I try to eat as clean as I can tolerate, I have come to understand my body enough to know when it cannot take it anymore, and to give myself breaks when I need it. But is this enough? Do I need hormone regulation? Will it help or hurt? Am I avoiding it because I worry I will see myself as weak? Will my close friends and family scorn me if they heard I was managing myself with medications? I frankly have no idea. There is also the added concept of Psychiatric medication and being Active Duty in the military, the gray areas of which I am not very familiar and frankly do not wish to expend the energy trying to navigate.

At the end of last year I decided to started a daily video series where I talk about my day at the hospital and circumstances that impacted me one way or another. In the earliest episode I say that I firmly believe every person in residency, in the healthcare field, deserves mental health services. As residents, I believe this should be a part of our curriculum. We should be assigned therapists for regular check ins and support, to help direct us to psychiatrists if we need medications to give us a hand. I believe we need to be actively encouraged to seek help, not only with the emails and flyers and generic messages with phone numbers and websites, but with personalized check in messages from designated folks whose job it should be to ensure we are in the right headspace to do our jobs.

I feel much better today than I did yesterday. In the spirit of taking better care of myself I had scheduled my first PCP appointment in more than 6 months. During that visit I was given some recommendations for mental health services, including https://www.meetmarvin.com/, whose flexible evening and weekend hours work for medical professionals, and which he believed we might be able to get through our program. I intend to use them, because I know this is going to happen again, and I would really love to be prepared for when the hurricane makes landfall this time around.

My goal this year is to actively try to be less stressed. I know I cannot control the stressors that come with being in Surgery residency. I am, however, committed to ensuring that all other aspects of my life are as stress free as the Universe and I can allow. My hope is that these anxiety attacks get better as I continue to fins ways to improve my mental health.

Below is a link with mental health hotlines in case someone out there reads this who needs them.

https://www.apa.org/topics/crisis-hotlines

If you do, I hope you find them helpful, and please remember you are not alone.