Depression vs Stress – Comparing two exam seasons
A few days ago, I had my last exam. Well, I have another exam in about two months but we’ll pretend that doesn’t exist right now. The problem with medical school exams is that there is simply far too much to know. It is practically impossible to have time to cover everything. Anatomy, neuroscience, musculoskeletal, psychology, pharmacology, endocrinology…plus lots of other modules.
The past few weeks have been anything but easy with revision. It’s been constant work. In fact, I don’t think it has ever been so long in which I’ve not made a blog post. I was simply far too busy with revision. It got to the point where even going to do the groceries was a leisure activity. I don’t think I can complain, however, when thinking about what exam season was like last year.
Last year during exam season, I had only just come out of psychiatric hospital. The very next thing I knew, I was climbing a steep mountain with exams while feeling utterly miserable. Feeling utterly miserable…what an understatement. No words can do justice to describe my feelings of despair at that time. This year, my depression – whilst not fully there – has been much better. I would even describe myself as simply stressed rather than depressed.
Many people seem to be confused with what the difference is between things like depression and stress. I therefore thought I would write a blog post about my different feelings through both exam seasons. Hopefully it can highlight the differences between the two.
Last year, depression made revision rather difficult to say the least. A major problem with depression is that it can lead to anergia – a lack of energy – and anhedonia – loss of pleasure in things. Even though I loved studying medicine in general, my motivation for the subject had gone down dramatically. I simply had lots of other things on my mind to be worrying about. Things like coping with bereavement and keeping myself out of A&E for more than a week.
As a result, I had a very carefree attitude towards depression. I simply couldn’t concentrate on my work with everything going on. Nor did I care about not being able to concentrate, really.
People say that a little stress is good for you, and I can’t disagree with that. Although I was feeling stressed about my upcoming exams, it kept me motivated to work towards my goal. Unlike with when I was depressed, I was actually taking my revision much more seriously. This time around, I actually did care about my exams coming up. Of course, it was important to keep the amount of stress managed – the last thing I wanted was for my stress to progress to anxiety.
Physical and cognitive symptoms
With depression comes a lot of physical symptoms. Thinking back to last year, there were times where I felt severely nauseous, was not eating, was not sleeping, felt confused…the list can go on. Many people also forget about the cognitive features of depression – things like memory loss can happen, and this is extremely distressing.
In fact, in one of my exam modules, we were looking at cognitive examinations in geriatrics. Apparently these examinations are meant to help physicians identify if a patient is beginning to show signs of things like dementia. According to one of our lecturers, one of the disadvantages with these types of examinations was that the symptoms of depression could masquerade as dementia symptoms, thus potentially making it seem as though a patient had dementia when they were in fact depressed.
I feel this example shows just how sinister depression can get.
I almost wish I could say that there were no physical symptoms with stress, but that isn’t true. Stress too can provide physical symptoms – although I would argue that the symptoms are no where near as bad as with depression. In fact, the physical symptoms can be rather similar to depression. This is why it can be so difficult to distinguish the two.
In my own experience, however, I didn’t have nearly as much trouble sleeping as I did with depression, I didn’t feel nauseous at all until the day of the exam and cognitive symptoms were not there. Please take note of the in my own experience bit – things could be different for others, and the stuff that I am writing is very much anecdotal rather than solid fact. I also had regular headaches with stress, although perhaps this was more down to me working ridiculously late into the night and ending up sleep deprived.
The feeling of escape
Depression can last a very long time. It has almost been a year now since I was discharged from the psychiatric unit, but I’m still on the road to recovery rather than actually having fully recovered. This is the big difference between depression and stress – mild stress can resolve fairly quickly, whilst depression can take much longer. The state of mind someone has when they’re depressed is also very different. The huge negative state in my case, for example, led me to severely overestimating how long I would stay severely depressed for.
At the time of my depression, I simply felt as though there was no way out. As though I were trapped in some box that kept getting smaller and smaller with each of my attempts to get out of it. As though this box would never allow me to escape.
With feeling stressed about exams, however, one thing always remained clear to me – I would end up feeling fine after exams again. This meant that, unlike with depression, I managed to remain rather optimistic. With depression, the optimism was very much a forced optimism, as a way to simply urge myself to go on. I had very little belief in the optimism with my depression. With mild stress, however, the optimism was very much a fact and so it was much easier to deal with.
Stress and depression can become very difficult to distinguish, and the two are not mutually exclusive. There are subtle differences but I would like to make it clear too that this whole blog post is comparing depression to mild stress. Severe stress will also have many horrible symptoms associated with it, to the point that it may progress to things like depression or anxiety. If you feel like you are struggling, please do seek help.
However, throughout exam period, the biggest way I kept myself going was by telling myself: “At least I’m only stressed and not as depressed as last year.” Let’s hope it can stay that way.