On Being a Medical Student with Depression

It’s almost midnight over here and I’ve decided to stop studying for today.

I’ve been thinking lately that I might have been depressed before in my life, especially during my teenage years. I guess I just thought it was a phase, and it would go away as soon as the bullying stopped. Unfortunately, the bullying never stopped until I got to undergrad. I just, always felt miserable, in a way. There was always this palpable sadness within me that didn’t seem to go away no matter what I did. At one point, I resorted for the first time to cutting, but I only remember doing it about 2 or 3 times during high school. I even remember the chilling suicidal thoughts I had back then, the plans, the ideas…

During undergrad things changed, I wasn’t that sad little girl anymore. That was the time I found my first boyfriend, who later turned out to have a tendency toward the abusive. The problem was I put my whole emotional stability in the hands of this boyfriend. Fast-forward to medical school and here I am, back to being that sad little girl after ending the relationship and having a few other things happen to me.

Med school opened Pandora’s box, to say the least. It was the spark that initiated my emotional instability. I do recognize I’m not the only person who this has happened to. I’m sure many of my friends are in the same situation and I’m not even aware of it. Med school is an added stress to your life, but not just any stress. It really has the ability to test your character. While you sit at your desk studying your whole life spins out of control right before your eyes and you can’t do anything about it.

So, it doesn’t really surprise me to realize that I’m depressed again at this point in my life. It makes me wonder if any other people in my class are in a similar situation and screaming for help silently.

Studying for classes like Pathology is no easy task while depressed. I’m sure others can relate to this when I say that I can barely focus when I try to study. I’ve lost interest in almost everything and constantly end up wasting my study time by sleeping. Still, somehow, I’ve made it through and survived first year and now am (barely) surviving second year.

You also lose interest in patients, which I think is the saddest part. You go to hospital activities and visit patients and wonder what the hell you’re doing. At least for me, I wonder why I’m not focusing on myself, on my recovery, rather than focusing on some other person I don’t even know. Of course, this affects me a lot because then I wonder why I’m studying medicine. And that’s where remembering why you’re doing it in the first place comes to play.

I don’t know, maybe I’m just rambling here, but the point I want to make is that I hope others can relate to this post. It really saddens me how few people in med school suffering with mental illness actually speak out. And I’m sure there’s a lot of us depressed medical students out there.

Finally, I really just want to say, if you’re depressed, please look for help. Nobody in medical school wins a prize for toughing it out. By no means does it mean you’re weak. Neither will it affect your career if you simply look for help. Quite the contrary, it will probably help you be a better person and your patients will be thankful for it.

So, I think I’ve talked enough about myself in this post. Anybody out there who relates?

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10 comments
  1. Anonymous said:

    I completely understand how you feel. I am a final year medical student and am returning for my last year. I recently took an intercalated year following my IPE exams and have enjoyed this year immensely. Now I'm about to go back and I realise that I took this year out to escape medicine because it made me constantly depressed and anxious. I'm dreading the return to that same hostile, asceptic atmosphere where the stress builds and weakness is sneered at. But I've gone too far now to quit and the rewards at the end should be worth it (at least that's what everyone keeps saying).

    Thank you for opening up. As you said, not enough people are honest about the stresses of medschool. I wish more people were like you. Hold in there friendo.

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  2. Anonymous said:

    I am also a final year medical student with final exams in June. I am experiencing everything you mentioned; the loss of interest in studying, school and my patients, the constant sleeping. Just tonight I was feeling to scream so loudly but I can't do that where I am so I just have to hold everything inside. I know I should be seeking help but the unit I'm on (for surgery) is so intense that even some time off is looked upon and negatively commented on. I'd love to speak out about medical students being depressed but I need the right forum to do so. Thanks for this post. It makes me feel less alone in the world.

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  3. Anon,

    Do you have a productive means of “screaming”, so to speak? Of letting out all the frustration and sadness? Listening to music, maybe? Or maybe dancing, talking to a close friend or family member? Don't keep it all inside, at some point you are bound to explode.

    Feel free to comment here or e-mail me at borderlinemed(at)gmail(dot)com. I'm here to listen.

    Please take care

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  4. Dear

    Thanks for this post. I have also been wondering about the other students in my course – surely I can't be alone? I am currently in 4th year and I have had some really severe ups and downs since the beginning of my medical career. I often wonder if it's worth it to carry on, but then I also feel like I'm “too far in” and that it should get better…my parents have also told me to stick it out and that my depression has little to do with what I'm studying, but that it's genetic and will be an issue regardless of what I do. I'm kind of at a loss…I started studying this partly because I am interested in science, and it seemed like the right thing to do, but also because I'm competitive and was told my intelligence shouldn't go to waste…but now I feel like I'm suffering emotionally and the pressure is just too much.

    Anyway, that's just my situation. Glad to know I'm not alone though. I'll be reading this blog more often now. Hopefully all falls into place for us. xx

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  5. Hey Hanstan,

    First of all, thank you for reading and commenting. I appreciate it a lot, and knowing of other medical students who feel the same makes me feel less alone.

    What can I say? I know perfectly well how you feel. I can tell you, however, that having depression is the result of many factors, not only genetics. And yes, it is possible to get out of depression. Have you looked for help? It's really difficult to push ourselves to do it, but to me it's been a life-saver.

    Hope to hear more of you,

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  6. Last year and the year before, I went to the Counselling Unit at our University and saw 2 separate counsellors. I haven't gone this year, although I've been tempted to, because it doesn't really feel like I get very many “answers” from them (not that that is their purpose of course), but I've always felt like I just happen to get my shit together after a few sessions (I've considered it being season- and timing-related with my motivation being at its lowest mid-year). Anyway, both times I've felt really pathetic for having to go and for not being able to just take control of my own behaviour. I've also been fearful that I would not be able to practice medicine if faculty or whoever find out that I'm actually “crazy” (lol). And especially not if I want to do psychiatry too (although I do agree that my sensitivity to such issues will make me more empathetic, as you've said). I've started taking fluoxetine now (both my mother and brother are also on it), but now instead of anxious, I feel rather indifferent.

    If you don't mind me asking (I have 2 questions): which country are you in? (Just for interest and context sake) And, do you ever feel inadequate/scared about not knowing enough i.t.o medical knowledge and how your patients might suffer as a result of that one day? Or how embarrassing it could be for you if something potentially goes wrong one day? I constantly have that fear because I have quite a big problem with procrastination, and my inability to stay awake in class means I miss quite a bit of information that isn't necessarily tested in our formative assessments (I still pass and that's fine), but would be very necessary to know in the long-run – in our clinical years. I feel like I'm just studying to pass at the moment, not to be a good doctor. And that lowers my self-esteem even more.

    Sorry for the long message! It's so great being able to read stuff you can relate to! Everyone in my class is very conscious of not appearing vulnerable/weak, and that annoys me, because it's almost like they're arrogant due to their competitiveness.

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  7. Hanstan,

    Great to hear from you again πŸ™‚ I'm a med student in the US, how about you?

    I think your insecurities about whether you know enough to help patients are absolutely valid. The truth is, everyone in med school has those same questions at one point or another. The fact that medical school is so fast-paced and pushes a lot of data and facts down your throat doesn't help either. However, even if you feel like you're not learning enough or don't know enough, the truth is you do. I completely understand where you're coming from, because I feel just like you do all the time (and I'm in my clinical years already). You might not know the right answers at first, but it takes practice. And if ever you feel that you don't know enough to help a particular patient, then that's the time to look for help or consult a colleague. You don't have to know everything, but trust me, you know a lot more than you think you do.

    As for falling asleep and procrastinating, again, I can totally relate. When I don't know the answer to something and I start panicking because all the other students seem to know more than I do, I think to myself: “It doesn't matter when you learn it. It just matters that you learn it”. That helps to calm me down a bit.

    As for the “studying to pass” part…think of it this way: to help patients, you need to pass your exams. You might not consciously realize it, but you're building your knowledge base so that you will be able to help patients in the long run and be a good doctor. Would you want to go to a doctor who is 100% empathetic but didn't pass his/her exams? At the moment, try to create a balance between studying and consciously wanting to be empathetic. Once you get into your clinical years you'll be able to “fine-tune” this and with time you will become the “good doctor” you envision. Don't be so hard on yourself, medical school is hard enough as it is πŸ™‚

    It's normal to have mixed feelings about going to the Counseling Unit, but don't feel pathetic. First of all, you are not pathetic, and second of all, you are making an investment in yourself. There is nothing wrong with asking for help and recognizing that you can't do this alone. Nobody gets a prize for “toughing it out” on their own. Medical school brings a lot of changes into our lives, and some people can handle them on their own, while others (like myself) cannot. But, it doesn't mean you're weak and pathetic, it just means that you have the insight and maturity to recognize that you need help.

    As for not getting any answers from the counselors, try to view them as a guide toward answers that are, surprisingly, within you (as cheesy as it sounds!). Sometimes we get lost in the way, but they are there to help. They're not the ones with the answers, YOU are. And, really, it doesn't matter that you have periods where you can manage on your own. What matters is that when the time comes that you need help, you go out and get it.

    Finally, don't compare yourself to others, remember that deep down everybody is just as scared shit-less as you are. And, really, appearances are just that: appearances.

    I hope I didn't bore you!

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  8. Dear

    Sorry for the delayed reply – I was writing exams in the passed week, and I'm finally on holiday – for the first time this year! Thanks so much for the advice – wow, we really do seem to have similar ways of thinking! And I just need to remind myself of some of the things you've said and what I've also said to myself countless times – NOT TO BE SO HARD ON MYSELF. I think I'll make a concerted effort in the coming block to do this.

    Anyways, I'm from South Africa. πŸ™‚ I have another question for you: do you have any religious beliefs/what are your religious beliefs? Just because I often wonder if it has any link to experiences with depression or whatever…I'd just like to know your take on that. It's something which I think of often…also because I have had some struggles with my sexuality and these 3 topics have been very interlinked for me in recent times.

    Looking forward to hearing from you again! (Also, tell me if I need to move this conversation elsewhere…I don't want to be hijacking this blog entry!)

    Hanstan

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  9. Hey Hanstan,

    Yes, please make an effort to not be so hard on yourself! It's something that M reminds me of all…the…time. And, as medical students, we tend to be pretty high on the perfectionist/hard-on-ourselves scale, so do keep that in mind.

    About having religious beliefs…I was raised a Catholic and went to a Catholic school, but nowadays I consider myself agnostic. From a young age I was never very religious and always questioned my religion teachers and why I had to pray in public or take the Bible for granted, etc. I've always found that my personality is wholly incompatible with structured religion. I know a lot of people find respite in religion during difficult times, like having mental illness, but to me it's neither superior nor inferior to any other support system/coping strategy.

    If you have any more questions or would just like to chat, feel free to email me: borderlinemed(at)gmail(dot)com. I'd love to hear more from you πŸ™‚

    Take care,

    Like

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