Article Review: Are You Feeling Depressed?

This article is wholly taken from The Differential: Medical Student Blog at Medscape. It is written by Joshua Batt, Medical Student from Touro University Nevada College of Osteopathic Medicine, Las Vegas, Nevada. No copyright and intellectual properties infringement intended. Posted here for sharing purpose. All credits to where it is due.

After writing my last post, Experiencing Happiness as a Medical Student, there was a lot of interesting feedback from readers. Even before reading their input I wanted to address the subject of depression among medical students for some time now. According to a recent study in JAMA, medical students are hesitant to seek help for depression due to an overwhelming stigmatization effect. We are high-strung, "type A" personalities that seek perfection in ourselves and everything we do. When there is a dent in the armor we are quick to hide the flaw in any way possible, in effect hiding the "imperfection" and living in denial.

Medical school is hard. We have worked endlessly to get here and we work even more just to stay here. The list of reasons why it is so challenging is long. We stress about the current work load in the classroom or clinic, the future residency or career we have not yet obtained, and our past experiences or grades that may keep us from meeting these goals. As if that is not enough, we have relationships to feed, family to nurture, and service or occupational responsibilities to fulfill. Mix it all together with little sleep, high expectations and the occasional public mistake and you have the perfect recipe for burnout or depression. The study authors state, "Medical students experience depression, burnout, and mental illness at a higher rate than the general population, with mental health deteriorating over the course of medical training."

Medical students are stubborn. We want to put forth the image that we can hold up the world even when everything inside is falling apart. Worry that peers, residencies or future employers will view oneself as inadequate if depressed simply compounds the problem. Rather than seek needed assistance, students will flounder alone to avoid stigmatization. Interpreted survey results "suggest the importance of developing a medical school culture in which medical students have the opportunity to discuss their mental concerns, irrespective of actual diagnosis or treatment, in a safe and confidential way." Finding help may not be hard to find, but is implicitly difficult to seek.

Experiencing firsthand the lack of energy and a non-euthymic state 100% the time, I ventured to find out what resources were available. Most schools have counselors or programs to assist students with such concerns. Mine has an Employee Assistance Program (EAP) that is independent of the school, free to use, and completely anonymous. In fact, EAPs are offered by many employers, but few people know that they exist. If your institution does not have this, find a mentor that can talk with you or at least point you to where you can find help.

As students, we can carry a lot on our shoulders, but this does not mean we have to do it alone. Medical school is intended to be difficult, because one day we will be responsible for the health of someone else. This education is difficult and can often lead to depression among students. If you need it, take time now to heal yourself so that you can function at your optimal level later. Hands down, this is the hardest thing I have ever done in my life. It is also one of the most rewarding experiences of my life. Focus on the positive and hang in there, you can do it.

Joshua Batt

December 19, 2010