For context, we started dating 2 years ago in college, and then we were doing medium-distance when I started medical school last year (3 hour drive; we saw each other on most weekends), and now we're doing long distance (12 hours drive/short plane flight away) since she started medical school in another state (this was not something avoidable; she is an international student and had to take any acceptance she was given).
Our relationship has been amazing up until about 1 week into this long distance, where after about every 3rd or 4th facetime she will text me about how she feels undesired, drained, unappreciated, and upset about something I said or didn't say. It has varied a lot based on context, but most recently it is that I was "not excited at all about our future together" when she talked about engagement and marriage. In the past few weeks, it was similar feelings on her end, but has varied between things like I don't complement her/say loving things enough, don't make her feel wanted or attractive, or even that I'm not jealous enough if she is telling me about someone who tried to flirt with her. In the past, this has been something she has been angry with me about, but usually did not last very long and ended when we were in person together, which makes me think there is literally nothing I can do to make her happy while we're long distance. But the thing is, every time this conflict arises, I never see it coming, since I literally do everything I can to make her happy and for this to work. We are both med students now after all so we really don't have much time, but I am using all my effort to send thoughtful and meaningful texts, and being fully present while we call. If you aren't familiar with med school this sounds really bad, but I swear we are so busy that the energy I'm putting in is significant. And then what hurts the worst is that I finish a call being so happy I got to call her, and then get a text about how awful I made her feel. Every time this happens too, I don't even know how to fix it ("you should know" type of deal), and I don't feel comfortable asking how to improve because that shows I don't care apparently.
To be fair, our love languages are not very compatible for long distance at all… she needs quality time and physical touch, and mine is acts of service and physical touch. Also, both of us can admit that I have some personal issues (depression, anxiety, family conflicts, etc.) that I am working on and going to therapy for that may be playing a role in me seeming distant. But this is what hurts worse, because if I try to explain that maybe these things are playing a role, I'm told that 'yeah, they probably are, and I should figure that out soon'. For the most recent conflict, I tried to explain that maybe I didn't continue the conversation of our future together in a way she hoped for because I'm terrified of the conflicts that will arise from my family if we do get married, along with the fact that I don't know how I can afford a ring or a wedding, since I have -$200,00+ to my name with only half of med school down. Also for context, conflicts with my family have arose because of my relationship with her… it has exposed to them that I don't want to follow in their Christian lifestyle, and they don't want me to end up with her because she's not religious. My family is everything to me outside of my girlfriend, but I can't go to them for these problems and I can't go to her for my family issues.
After giving y'all all of that, basically my question is what can I do to save this relationship. Sure, I can totally see that maybe I'm too casual on facetime because I'm not a flirty person at all, so maybe she only feels loved when I can give her physical connection. Also, I'm trying my best to be more mentally healthy so I can be there for her and my family, because I'm sure this is a part of it. But its so hard when I am not supported by her, because she just wants me to figure it out so that I can be the person she wants me to be (and/or used to be, I'm assuming… I'm not at all accusing her of trying to manipulate or groom me). This is draining me so much and has been preventing me from so many opportunities for my career because I am so stressed I literally cannot get through the bare minimum every day, but I love her so much and I can't figure out how to fix it, so I go to Reddit obviously. I know I rambled, but if anyone understands do you guys have advice you can share with me? I would appreciate it so much.
TLDR – I am making my girlfriend feel unloved during our calls and texts when starting long distance, but I don't know the reason/how to fix this and am very lost on how to save our relationship. It's sending me into a spiral that is ruining my academic/future career, and her being my biggest supporter in the past is making it that much harder.