Can I Be A Depressed Doctor?

Ever since I wrote about how going for therapy was my biggest gift to myself*, I’ve met with a few medical students to talk about the topic of mental health. Many of them were worried about their ability to make it through med school with their illness. Many were worried about the viability of a career in medicine with depression.

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When I was a student, there was a rumour that students with mental illness would be excluded from the course. We were informed by our senior students, and they by theirs, and thus the rumour was propagated.

This may well have been one of the biggest reasons, besides financial accessibility, that I took so long to get help for my depression. (In case you’re still wondering, the rumour is false, as rumours are wont to be.)

The reality is that depressed medical students are often high functioning in nature. It’s the reason they get away without help for so long. It’s the reason their colleagues will say, “But we never knew.”

I got through most of medical school without therapy or medication. But I didn’t get through it happily, and I wish I had found help earlier. I’m still not sure if my brain has recovered from the years of deprivation.

Now that I am more open about my mental illness, I have met more doctors – young and old – who are open about theirs. We don’t advertise it, but if it comes up, we don’t shy away from it. So I can confidently tell my young friends that yes, you can be a depressed doctor. But try to be a depressed doctor in remission.

For medical students (and doctors!) with mental illness, I recommend finding a treatment team sooner rather than later.

Find a good psychiatrist – even if, for financial reasons, it means you find a government psychiatrist. Or maybe a really good family physician. If they suggest medication, take them religiously. Don’t be the stereotypical non-compliant doctor-patient. And, as hard as it may be, try to accept your role as a patient when you step into your psychiatrist’s office. Maintain involvement in your own treatment, but put some trust in the expertise of your doctor.

I don’t advocate pharmacological therapy on its own to my patients, and so I don’t recommend it to my friends. Therapy is another costly but valuable part of managing mental illness, and one I have found to be invaluable. Once you are a doctor, you’ll be able to afford it. As a student, you may need to pull some strings, put your name on a waiting list, or open up to your parents for funding.

As a doctor with depression, I have days that I can’t get myself out of bed. I have relapses. I have colleagues I trust, but I have days that I second-guess that trust, and days that I feel alone. I have days that I can’t connect with my patients, and days where the connection is too intense and I just want to cry.

I have not yet had days where my patient-care was compromised. But I am always on the lookout. And I know that my psychiatrist and therapist will step in if they think that is the case. This is also why I told my HoD – not for sympathy, but because it is important for her to know. Just as we know about our colleague with diabetes, in case he has a hypo and collapses at work.

I also know that I will never sign up for shift-based work like in the ER, because I don’t think my neurochemistry will be able to handle that. Being on call is hard enough. Some of my colleagues accept multiple shifts in a weekend so that they can have a greater total of uninterrupted weekends. I know that I can’t do this, because I know that my mood takes a dip.

Managing mental illness as a doctor has been challenging. Sometimes I stumble. Sometimes I fall. Sometimes I lie in the dust awhile before I get up. Sometimes, someone helps me up. But the more I strengthen my support systems, the less frequent the falls become.

We are not cookie-cutters. I cannot say that some doctors/medical students will not decide to leave the profession because they feel it is incompatible with their illness. But that is a decision that should only be made after careful thought. Probably also a decision that should not be made while experiencing a major episode.

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Whatever you decide, don’t be driven by internalised stigma. And remember: you are not as alone as you feel.

*Strangely enough, the post in question has disappeared from my blog. A few of my posts mysteriously disappeared a few months ago. Quite annoying. 

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Mental Health Begins With Medical Students

Every few months, the mental health of doctors/medical students makes it to popular media. It seems like these spikes in attention occur, and everyone shouts YOU SHOULD CARE FOR YOUR DOCTORS! and then we write blogs and we tweet and we make youtube videos and eventually we go back to work, and nothing has changed.

I think we are the missing link. And by “we”, I mean qualified doctors. And also, you, the older doctors. Continue reading “Mental Health Begins With Medical Students”

The Safe Working Hours Wristband Campaign is Missing the Point – Here’s Why

If you’ve been paying attention, working hours of doctors (especially junior doctors) have been getting some good airtime over the past few months. The Province of the Western Cape has committed to actively reducing maximum continuous working hours for doctors to twenty-four, the HPCSA has promised to “look into it” (not that we have too much confidence there), and our biggest representative, SAMA (South African Medical Association) has come out in our support.

One of the things to come from all this is the launching of an armband campaign. This has its origins, I believe, from a similar campaign in the UK – although I have not been able to find any source to this link.

608772084 Continue reading “The Safe Working Hours Wristband Campaign is Missing the Point – Here’s Why”

Threatened By The People We Serve

A few weeks ago, the community around one of the hospitals where I work picked up their torches and pitchforks (well, sort of) and protested again. I’ve written before about South Africa’s protest state of mind, and about working during a riot.

As it stands, when this specific community protests, they protest right outside the hospital. No matter the reason for protesting, they block all entrances to the hospital and threaten anybody who tries to circumvent them.

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Police told us to turn around. We called our superiors. They told us to come to work. Continue reading “Threatened By The People We Serve”

A Key To Disillusionment In Work And Play

disillusionment2The phenomenon of disillusionment is well-discussed in the world of medicine. Roundabout third year of medical school, students begin to realise that the medical world simply does not live up to what they envisioned.

It is easy to say, “Just don’t have such high expectations,” but in reality a doctor without vision becomes a mindless drone. Disillusionment is discussed so widely because even though by definition it seems simple, its origins and characteristics are complex.

Funnily enough, I began to really understand disillusionment when I started club-running. Don’t be mistaken: joining a club was the best decision I could have made. It introduced me to many like-minded people and provided ample opportunity to amp my mileage.

I joined a club because I felt that I loved running enough to do so, but not long after joining I started experiencing an emotion I recognised from the medical world. I was feeling disillusioned. Continue reading “A Key To Disillusionment In Work And Play”

Dear Medical Student: Med School Is Not Worth Your Self-Harm

[TRIGGER WARNING]

A while ago this secret appeared on PostSecret:

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“Medical School made me self harm. It better be worth it.”

Continue reading “Dear Medical Student: Med School Is Not Worth Your Self-Harm”

Self-Care Is Hard

As my first year as an adult (sort-of maybe I guess?) draws to an end, I find myself reflecting a lot on what has happened. Incoming interns ask for advice and I wanted to write a really cool and inspirational post but I find myself not knowing what to say. Almost as if I haven’t learned enough to offer advice.

facebook-social-promotion-13809-1451332812-16 Continue reading “Self-Care Is Hard”