Wednesday, April 18, 2012


According to wikipedia: "sundowning, also known as sundown syndrome, is a syndrome involving the occurrence or increase of one or more abnormal behaviors in a circadian rhythm. Sundowning typically occurs during the late afternoon, evening, and night, hence the name. It occurs in persons with certain forms of dementia and psychosis, such as seen in Alzheimer's disease. Although not widely surveyed, sundowning has been estimated to occur in 45% of persons diagnosed with Alzheimer's disease"

I feel like my current emotions reflect a sundowning effect.  I seem to get more frustrated, more teary, and more depressed as the night wears on.  My guess is it relates to the point in the evening where I used to trade in studying to video chat with the [now ex-]girlfriend.   I have cried more the last few nights then I have over the entire past year combined.  I have even succumb to sending desperation text messages to her before I could think better of it.  Thankfully my lovely roommate has agreed to take my phone away before I belligerently text her again.  My emotions are unyielding as my new reality begins to sink in.  I'm nearly as emotionally liable as my patients on the inpatient, locked, psych ward. 

The hardest paradigm shift to accept relates to my future.  I no longer have a magnetic force pulling me towards residency in a specific geographic location.  I no longer have a built in support system that will accompany me to wherever I happen to match.  It is both a relief and a curse.  It takes some pressure off of the decision to take next year off.  However, I used to be able to tell people that I was hoping for certain residency programs because it would allow my partner to have a job though I also used to worry that I'm not competitive enough for the state she is BARed in.  Now I worry that I wont match in a location with a viable singles community, a community with dating options.  How many cities are there that have large, intellectual, activist, queer, Jewish, communities?  When ever I would freak out about not matching, and ramble about some crazy scenario of scrambling into some super conservative [and boring] location, she would affirmatively respond that "we'll be okay there", "we'll make it work".   I don't know that I can do it on my own.  

At the conference last weekend, when I was asked over and over again where I was hoping to go for residency, I fought back tears while trying to explain that my perspective was recently flipped and I no longer know.  I'm pretty sure that all 1000+ conference participants were exposed to my verbal vomit about recently being dumped.  I sincerely hope that I can pull off a slightly more composed persona at the conference I'm going to this coming weekend, though I'm not holding out much hope.  When my current psych patients respond like I have been, they get dinged for over-sharing and missing social ques.   At least I still have my insight and perspective intact.  I am learning first hand that a very fine line divides the process for accepting a major life change and the diagnosis of a mental illness.

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