My Experiences of Depression at Medical School

I was on top of the world. I was about to start Medical School. For me, that had been a dream that was finally coming true. After so much hard work in my exams, so many entrance tests, so many interviews and a failed attempt one year, I was finally there. I was finally about to meet new people, make new friends, be able to move on with my life. My life, as far as I was concerned, was sorted. Oh, how wrong I was!

Many people start Medical School, or indeed University, with the same naive optimism that I did. My guess would be that it comes from the deceitful nature of Freshers week. Everyone is excited at the prospect of finally being free from their parents or guardians, feeling free from the so-called chains that they have been held back by at school that they tend to overlook the real nature of Medical School. All the introductory mental health, “we are here to help” talks go unnoticed. I doubt that will need this’, I remember thinking to myself rather stupidly. But the truth is that approximately one in four of us will experience mental health problems. That includes Medical Students and Doctors – mental health does not discriminate one bit.

So what went so wrong for me?

(I have tried to finish on a positive note, so please bear with it)

Term One

During Term One of Medical School, I just remember feeling on top of the world. Everyday, I would get out of bed full of energy no matter what time I would sleep. I would attend all of my lectures and tutorials. I was always talking to anybody and everybody, not afraid to make a joke or have some good ‘banter’ with my closes friends. Just typing this right now fills me with a very bittersweet type feeling. It is hard to explain. On the one hand, typing this makes me feel on top of the world, reliving these memories in my head and remembering how amazing things were. On the other, it fills me with deep sadness. Sadness that things have changed. Sadness that I’m no longer the same person that I once was. Sadness that now here I am, sitting all alone in my room, abandoned in my illness. It is funny what depression can do to people.

“You need to accept change!” some of my friends always told me when things started going wrong. How can I accept this state that I am in? It makes me angry when people make comments like that – for them, they’ve all moved on to new friends, been able to keep themselves positive so of course it is easier for them to accept change. Me? I got trapped in my depression. I could not move on like they did. Their comments to me seem almost…annoyed at my lack of illness. Again – how can I accept the change of going from on top of the world to suddenly feeling as though the whole world was against me?

When Term One did eventually finish, I remember thinking to myself: “Wow, I really can’t wait to start the next term! I’m loving it here at Medical School!” Oh, how my thought changed as things progressed…

Term Two

Term Two began and almost as though it were a sign, it didn’t get off to the best of starts. By the best of starts, people are probably thinking that I failed some sort of exam or something, or ended up breaking a leg. But no. What I actually mean is that…I had a bad dream.

On the night before Term Two was about to start, I found myself doing something that I’d not done in a long times. I found myself awake far earlier than usual. Even more unusual – I found myself crying very sadly, with no signs of wanting to stop. Our Medical School thought it would be a good idea to place an exam on the day second term started, so perhaps that’s why I was feeling unusually upset, I thought to myself. But no. I’d never felt THIS down about an exam before. Then I remembered.

For most people, New Year’s Day is a time of massive celebration. For me, it’s hell. It’s the birthday of my Granddad. My Granddad who I’d seen weaken and die before my eyes. My Granddad who had helped raise me, teach me many things, who lived with us before I moved to Medical School. And I dreamed about him the day before Term Two. My dream was very strange. In my dream – you guessed it – I saw my Granddad. He was alive and standing next to me. I knew he was dead at the same time, however. I don’t fully remember what we were talking about but what I do remember is me hugging him all of a sudden, begging him not to go and saying that I missed him so much. That resulted in me crying in my dream. That resulted in me crying in real life too, which is why I found myself awake that day.

At the time, I remember shrugging this dream off as though it were nothing. It’s just a dream, I thought to myself. And perhaps I was right, but things didn’t improve from their either. Suddenly, in my lectures, I found myself unable to concentrate or listen to what was being said. I would always start thinking about my recent bereavement. Then things got worse – one of my closest friend’s (well, ex-closest friend – we ended up falling out) family member had died. Not only did this bring back, rather selfishly, memories of my own bereavement, but it made me feel rubbish seeing my closest friends in tears like that. I hate seeing anyone in pain, let alone my best friends!

This feeling of not being able to do anything for my closest friend led to me feeling useless. Of course, I tried my level best – from staying up nights for her, to buying her treats from time to time. Having been through a bereavement, it is true that nothing can magically make someone recover from the pain of it. It is a pain like no other. You just feel your whole world fall apart. Despite that, however, I found my self-esteem lowering. I found it even more painful when it seemed like they appreciated everyone’s efforts apart from mine. Slowly, my self-esteem started to drop.

Then matters got even worse. With this closest friend, we made a deal to live with each other the next year, and find a couple of other potential housemates. For various reasons, this didn’t end up working and I found myself kicked out of the group of people. As my Psychiatrist put it a few months later – “But you were one of the people who helped ‘found’ the initial group!”

Suddenly, I was no longer feeling on top of the world that I once was. I now had trouble sleeping at night. I had begun to lose my appetite. I was losing weight dramatically, and very fast (my BMI had dropped to about 15 at one point!). I wasn’t enjoying things as I once was. Times were spent in my tiny room in halls, just crying my eyes out. Bereavement, check. Feeling unwanted and underappreciated, check. Low self-esteem, check. Messed up housing, check. Exams approaching fast, check.

Term two ended. And this time, I couldn’t wait to leave and have a break. For the first time, I didn’t feel like going back to Medical School.

Term Three

Term Three. The last term. This was also meant to be the hardest, with lots of lectures, anatomy teaching, dissection and of course – final year exams. Everyone around me seemed to be stressed out. Opening up to anyone about how I was feeling, therefore, seemed almost futile. “Oh we’re all feeling this way – it’s exams!” people would say to me. It was as though people didn’t understand that it wasn’t exams that were the top of my concerns at the time. Slowly, I felt more and more isolated from everyone, as though I didn’t belong.

For the first time, I decided also to speak to my GP about how I was feeling. Perhaps unsurprisingly, she immediately diagnosed me with severe depression and prescribed me on antidepressants. Well, the antidepressants were…interesting to say the least. A very rare side effect of the antidepressants I was taking was confusion. With my luck already as bad as it was, I was one of the few who ended up experiencing this side effect. I found myself walking alone for hours at night with memory lapses, walking in the rain, not knowing what I was doing. In one extreme case, I got so confused that I ended up almost getting run over by a truck. I had to go to A&E at least five times a week at one point. I remember feeling very embarrassed going – I felt as though I was taking time away from patients who actually needed help. This is what stigma has done – it has made even us suffering from mental illness treating it as though it’s not a ‘real’ disease.

Eventually, I ended up referred to a psychiatrist who referred me on to a crisis support team. I was grateful for all the help but at the same time, my ex-friends started losing their patience. “We can’t get on with our own lives because of you” some of them would end up telling me when I asked for their help. Ironically, not one of them visited me while I was in A&E or when I was eventually admit into a psychiatric ward. My already crushed self esteem was getting lower. I wonder – if it was something severe like cancer which I was suffering from, would they have said the same thing? I felt betrayed too – after all I did to help them even when I wasn’t feeling my best, they had the audacity to come and say that. Still, they don’t understand why I ended up upset at their comments and that is why, unfortunately, I am now left friendless at Medical School. My Psychiatrist feels that this is for the best – I am still not so sure.

After I came out of the Psychiatric Ward (on my birthday, ironically), I was slightly upset to see that not one person was waiting to see me or welcome me back, or even say happy birthday to me. Usually, I wouldn’t have cared. The nature of this illness, however, meant that I was feeling constantly on edge, constantly suspicious of everyone. Sadly, this upgraded version of ‘fight or flight’ has done me no favours! Not only was this, but I had my exams in a week. I still had Anatomy of Abdomen, Anatomy of Pelvis, Gastrointestinal, Urinary and Neuroscience to revise. All in a week.

Then, suddenly, late at night, I started hearing voices. My depression had become so severe that I was now experiencing psychotic symptoms. This was the final straw, I decided. I was not going to let this illness, or what had caused the illness beat me. I was going to fight even harder. Sure, there was no way I could get rid of the symptoms or the feeling as though I were crap, but I had to somehow ignore it. So I worked my butt off. I worked like I’d never worked before for my exams. My Dad was ultra supportive – being a Doctor himself, he still remembered much of the pre-clinical stuff that he had learned and stayed up all night with me after his own work, looking through my lectures that I had missed while I was in hospital and going through them all with me. To my Dad – thank you. Thank you for being the one person who never once left my side.

Exam Day. I was nervous. To make matters worse, it appeared as though I had no seat in the exam room. Well, I did, but I couldn’t find it because it wasn’t placed alphabetically like everyone else. My Medical School had kindly decided to give me a seat near the back of the room, in case I needed to rush out if I had bad symptoms. I am thankful to my Medical School for all their support. I did the exam, and I thought it went terribly. Throughout I was hearing negative voices, trying my level best to ignore them. When we were told to put our pens down, I rushed out to go and talk to my crisis support team in tears. I’ve messed everything up, I told them.

Months later, came results day. I was immensely nervous – so nervous, that I told my tutor beforehand about how bad I felt. His text was very reassuring:

“Hey mate. I’m sorry you’re going through a tough time at the moment, but we will make this work even if you have failed one or two. Actually, the most important thing right now is yourself.”

This alone made me trust my tutor immensely. But he didn’t stop there. On the day before results, knowing how nervous I must have been, he phoned me early in the morning to tell me that, I had passed. Despite my results being due at 5pm that day, and him being a busy plastic surgeon, he managed to phone me early in the morning to ease my nerves. What he said was even nicer:

“It’s a credit to your character to succeed whilst struggling with so much adversity. Very proud of you mate – well done.”

Then it sunk in. I had passed! Somehow, despite everything, I was going into second year. I had managed to fight my depression. Sure, it was still there (and badly), but I had managed to put it to one side and do it. Wait, what? I was going to second year!

How am I doing now?

The honest answer? I am still feeling very down these days. Many people think depression is something that just goes away easily like that, but sadly it requires more patience. Yes, I have managed to pass but I am still scared of Medical School next year. I am going friendless, after my depression caused my friends to leave me. What if it happens again? Will I be able to cope? Will I still be able to be a doctor?

Those questions constantly run through my mind. But then I tell myself – I could overcome such adversity once. Therefore I can do it again. I will keep fighting.

Thedepressedmedstudent

12 thoughts on “My Experiences of Depression at Medical School

  1. Thank you for such an honest and brave account. I have been through very similar experiences and know what it is like to lose friends because of the components of mental illness. Take good care. Zee

    1. Thank you for your kind words, Zee. I’m sorry that you too have gone through similar stuff – losing friends absolutely sucks. It’s a shame that they’re not willing to look past the illness that takes over us, or don’t seem to want to try to stand up for us but that is life I guess.

      I hope you’re feeling better at least!

  2. Hi, it’s Great you have put it all down here. V brave and a good positive thing to do. Many students, not only med students, can face such depression at anytime during the course. I would like to say to you is if you feel it’s taking too much of a toll, why not change course? You are young, intelligent enough to pass such difficult exams w just a week of revision …you can do just about anything! Take the pressure off yourself, and save yourself all the agony. It’s for you to work through this yourself. Medicine is a vast field, you got yourself a whole bunch of related professional courses you can do. There must be something you would like to do but not so high pressure? Maybe something completely different? If you do change course no one will blame you. The aim is for you to be Happy whatever you are doing. Friends are important, if you are unable to keep your med friends, have friends outside the med circle. Maybe cousin or some others….true good friends are worth it. Maybe some older relative. You got a friend in me already, ok? No need to torture yourself w Medicine, million other things in the world!You are going to be alright, ok.

    1. Thank you for your kind words – they genuinely do mean a lot!

      You ask a good question, and it’s one that many people ask me. I’m tempted to make a blog post on it now actually, so that I can fully explain things. The truth is that I am in love with the Medicine course, and it’s very much a distraction to me from the other stuff that upsets my mental health. Sure, there are times (e.g. exam time, when I’m busy with work, the guilt of having to take time off etc.) where things can get a little worse but I honestly can’t see myself doing anything else. Not yet, anyway. 🙂

  3. Hi TDMS,
    Thank you for your brave and honest account about the first year(s) of your medical journey. Easy it’s not. And no, you’re not a failure, weak, or incompetent.
    I agree with Dr. Lynn’s suggestion—consider a course change, or rather, explore the options. Again, you’re not a failure if you do this! It can be medically related, e.g. physiotherapy, nursing, kinesiology (go on and get a PhD in any of these … if you so feel.
    You need frieds—true friends. Loyal people. Find them inside medicine, AND especially outside—e.g. musical field, sports, gym, reading clubs, hiking etc.
    Easy? No.
    Get out of your room, when not studying.
    Your tutor, the plastic surgeon sounds like a vital contact.
    Exercise. Is there a gym you can join/attend? Or walk, or cycle. It’s another place where you can build up friendships.
    Reach out to people such as Dr. Linda Girgis (@DrLindaMD), Dr. Pamela Wible (@PamelaWibleMD and Dr. Bart Andrews (@bartandrews)
    Life is hard. Filled with pain. Often not easy.
    I don’t say this lightly—I’ve been a final year med student 35 years ago. Many of those years have been glorious—some less so. But, even as older MDs, we, including myself, experience abuse from inside the medical community. That’s why I’ve become an activist myself.
    We have to help heal our profession. (http://bit.ly/2mJAiUb)
    And yet, life is also filled with wonder and beauty.
    Yes, it may require you to switch direction, career-wise.
    There’s no shame in that.
    You have a unique purpose for your life.
    And, don’t go alone! There’s many of us around—reach out. (Fellow travelers on the journey—who haven’t figured it all out—it just looks that way!)
    Again, thank you for your post!

    1. Hi there!

      Thank you for your insightful comment. You’ve given great advice and I’ll definitely bear it in mind, and look into the people who you’ve mentioned.

      It’s good to see that you’ve become an activist yourself too – it’s nice to connect and I’ll definitely have a look into some of your work.

  4. Hi,

    I am nearing the end of a 2 year LOA due to being hospitalized for a manic episode. I need to decide whether to go back within the next 2 weeks, and wanted your opinion. Although I am bipolar, what affects me most is my depression, and honestly though Ive had no mania in the past 2 years, Ive been in a state of depression that has progressed to straight anhedonia. Not sad, not happy, but functional, and living day by day.

    I have started a career as a software engineer and it has been going pretty well. Its a career with a lot of flexibility in that I am given the time and space to work on my mental health. I feel like I could make some gains in finally getting control over my mental health because of the time and space that it offers for me to work on myself. But something is missing. I know that I will never be a great software engineer, not because I cant, but because I dont care for it like I did for science and medicine.

    But is going back really worth it? Would you do it over again? Did you feel you were given the time and space to maintain your mental health? In the end, is the stress and pain you had to endure worth it? Or is the path to take a more comfortable route? Ive been hoping to get of some of the meds Ive been on as side effects and mental dulling have made me uncomfortable with them, however is it worth loading back up on them and even more just to get through this passage?

    As you might feel, we are in a unique position where our experience could be a huge benefit to others in similar positions, especially with all the shitty psychiatrists out here who have no understanding of what its like to experience depression. I love pharmacology and psychology with a passion, but am not sure if what I have to endure to make my passion into a profession will be worth it. I feel like if I dont go back, i will have more time to dedicate to myself and learn how to really work with my illness, however the road to medicine is not closed (blacklist if matriculated and decide to not go). If i do go back, I feel it will be a struggle of doing all I can do such that I dont go down, with no ability to dedicate time to my improvement.

    Sorry for all the thoughts, but would love to hear your opinion.

    Thank you.

    1. Hello, thanks for your comment.

      I’m sorry that you’ve gone through such difficulty. Depression is not nice at all, and I can’t imagine how horrible bipolar must be too.

      In terms of going back – I think the most important thing to consider is if YOU feel like you WANT to go back. You say that you don’t care for software engineering as much as science or medicine. To me, it sounds like that, despite it helping with your mental health slightly, you feel a little trapped in the software engineering role as a result, and perhaps that’s something you need to consider. I guess another option you could consider could be some sort of science field related to medicine, but not actually medicine if you feel the latter causes a great burden on your mental health.

      Would I do medicine again? Yes, I would. Despite everything horrible that happened, I do overall love medicine much more than the negatives of the drawbacks of it. Obviously I would hope that I wouldn’t end up in hospital or depressed again, but even that’s not enough to put me off it. I guess you need to decide if you feel that it’s worth it for you personally too, as everyone will have different opinions and thoughts.

      Good luck – I hope it all works out for you.

  5. Can I speak to you in private? I’m a 4th year med student and I’m going through a hard time, kind of like yours but not entirely, have no one to speak to about this so.

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