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”

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”

A Lighter Take on Mental Health | Finding Audrey by Sophie Kinsella

If you’re a regular here, you know how much I care about mental health, not just in the medical sense (although I do LOVE psychiatry!) but also in terms of the way it is presented in popular culture. Including books. Books count as popular culture, right?!

I must admit that before Finding Audrey I had never read a book featuring any of the anxiety spectrum disorders (I think…). Weird I guess. But I’ve had a good number of patients with Generalised Anxiety Disorder and Social Anxiety Disorder (with and without agoraphobia) so at least I’m not entirely unschooled.

Sophie Kinsella is kind of a big deal, and this is her first foray into YA. To be honest, I’ve heard of her but I’ve never read her before.  But it could have been anyone who wrote it really, I was still going to request it on NetGalley (thanks, Penguin Random House Children’s UK!). Continue reading “A Lighter Take on Mental Health | Finding Audrey by Sophie Kinsella”

Dear Doctor, From A Med Student

Dear Doctor

I’m writing to ask you please to not do that thing.

You know what I’m talking about.

It’s a Saturday morning, or the middle of the night on an overnight call, or whatever: it is a time of day that nobody wants to be working. And we are working. Maybe we are working on the same service, maybe I don’t know you from a bar of soap.

I am sitting in the doctors’ room writing notes for the latest patient that arrived in our care. You come in and sit next to me, looking for results on the computer or making notes for your own patient or maybe just drinking a coffee.

You see the design of my name badge so you know that if everything goes well, I will graduate by the end of the year and be one of your colleagues.

Then: you let out a long sigh and say loudly, “You know, it’s not too late to walk away and change your career.”

Crick-crick…

Continue reading “Dear Doctor, From A Med Student”

A Tale of Two Sisters (and Grief and Mental Health)

Two little sisters had an extended stay in the small rural hospital. They were the stars of the Paeds ward. The little one was absolutely shining and brightened up the whole ward. I spent ward rounds with her in my arms, on my hips, and eventually falling asleep on my back. She was loved. The older one was a regular little mother-figure. No nurse was allowed to clean or feed her sister: SHE did it.

They were no longer ill, but had lost their parents in quick succession, followed by neglect and abuse by the relatives who took over their care. So, as they lived in a region with a single over-worked social worker, they were staying at hospital until placement could be arranged.

a tale of two sisters 2 Continue reading “A Tale of Two Sisters (and Grief and Mental Health)”

Psychiatry: The Best 7 Weeks of Med School

I’m a little sad. Today we finished our final psychiatry rotation. We had four weeks theory in third year and four weeks practical in fifth, but this year’s rotation was much more amazing.

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