When "Perfect" isn't what it seems

Portrait de Eliza Ahmed

Since there is a biological basis for depression, we need to realize that there does not need to be anything “wrong” for someone to be depressed. There does not need to be a trigger such as the death of a loved one, lacking basic necessities such as food, or a violent experience. Sometimes, the brain becomes ill, and compromises our abilities to regulate our emotions, for no specific reason. 

*Trigger Warning: This blog post contains content related to suicidal ideation

I recall as a Grade 10 high school student how motivated I was to excel in my academic studies. I was a high-achiever and always aimed for perfection. I regularly managed to reach the high standards I set for myself, as my grades were consistently in the 90’s range. I strived to do well in any task that I attempted, and was generally a happy-go-lucky girl. My goal was to become a doctor and serve the community. I had a passion for volunteering in my school, and was very much involved in extracurricular activities like Cross-Country, School Debate Team, Student Council, and many others. I received accolades and awards for my community service and academic performance, and I felt proud of my accomplishments. I was also fortunate that I was blessed with caring parents and supportive siblings, whose love encouraged me to further succeed.      

My life unexpectedly took a turn for the worse during my Grade 11 school year, as academic work became more strenuous and challenging. I recall becoming devastated when I received marks that were even slightly below my lofty expectations. I would cry for hours on end and question why I did not do better. This sadness culminated into feelings of anxiety and depression, and eventually manifested in skipping meals, school absences, and social isolation. I worried that I would not reach medical school, and began questioning the purpose of my existence, as I genuinely believed that I was a failure and did not deserve to live. Inevitably, this detrimental thinking perpetuated negative thoughts, and propelled my downward spiral.  

After a mental breakdown in school, one of my teachers observed the changes I was going through and recommended that I seek immediate counseling. Attending therapy and meeting with doctors led to my diagnosis of depression and generalized anxiety disorder. This diagnosis led to the beginning of my journey towards treatment. I started seeing counselors, who were able to assist me by using cognitive-based approaches to change my thinking and help me identify strategies to help me cope with my stresses. 

The help I received allowed me to handle the challenges that came forward over the remaining years of high school and undergraduate years. I was accepted to an Ontario-based medical school, and began to pursue my goal of becoming a medical doctor. Although I believe that I have come a long way over the years and no longer deem myself as a failure, depressive thoughts still occasionally consume my mind. I often become angry at myself because I have successfully reached my desired career path and yet I still feel this way— and so I ask myself, ‘What is my reason to be sad now?’. 

When this happens, I remind myself that just like the heart, kidneys, and liver, the brain is also an organ. The brain is the most complicated entity in the universe, and there is still so much we do not know about it. Lyall Watson, a respected biologist, once eloquently stated, “If the brain were so simple we could understand it, we would be so simple, we couldn't”. Even if a small part of the brain experiences damage, whether that be from genetics, chemical toxins, severe stress, or even a virus, it can drastically change how we feel, think, and act. Yet technology is not advanced enough to detect the small but significant brain abnormalities that can cause illnesses like depression. So, while we may not have definitive investigations like blood tests that can diagnose depression, it still exists and has a biological foundation. It is important we realize this and avoid minimizing the suffering that individuals experience, just because their disease cannot be proven with a standard medical examination. 

Since there is a biological basis for depression, we need to realize that there does not need to be anything “wrong” for someone to be depressed. There does not need to be a trigger such as the death of a loved one, lacking basic necessities such as food, or a violent experience. Sometimes, the brain becomes ill, and compromises our abilities to regulate our emotions, for no specific reason. 

Unfortunately, I am not the only one that questions my reasons to be depressed. Others also wonder why I become upset, when my life is seemingly “perfect,” because I am becoming a doctor. They may operate on the false assumption that since doctors generally have a high socioeconomic status, their life must be going well, and they do not have significant psychological issues— yet studies have shown the rates of medical students experiencing depression is 7x higher than those of the general population (Institute of Health Metrics and Evaluation, 2022). There is an impact of ignoring depression in high-achievers, especially those with so-called "perfect" lives. Ignoring the fact that Physicians experience depression contributes to the problem of physician burnout and suicide. Physician suicides are higher by rate than the general population (Albuquerque & Tulk, 2019). So while a physician’s life may appear “perfect” due to their prestige and wealth, they can still become depressed. 

We need to recognize the complexity of depression. There is not always a direct relationship between how good or bad someone’s life is and the development of depression. Anyone can have depression, regardless of their background. Therefore, we need to change the common narrative we have around depression, and instead focus on validating and supporting those struggling. Everyone with depression deserves and needs support to get better, because although sometimes their illness is invisible to outsiders, their pain is very real. 


Albuquerque, J., & Tulk, S. (2019). Physician suicide. CMAj, 191(18), E505-E505.
Institute of Health Metrics and Evaluation. Global Health Data Exchange (GHDx).  http://ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/afa6db0df6d7256cb8b43a269ea4e996 (Accessed 9 Feb 2022).
Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA. 2016;316(21):2214–2236. doi:10.1001/jama.2016.17324

Portrait de Eliza Ahmed
About the author

Eliza Ahmed is a second year medical student at an Ontario university. She is a passionate advocate for mental health, and has started unique mental health clubs and two Ontario universities. When she graduates, she aims to become a compassionate physician who can effectively help patients with mental health concerns.
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