Stressful month. Having 5 tests in 4 weeks will do that to you.

Yesterday a classmate asked me if I knew of any good therapists, and I asked her why.  She said, very slowly, “Well, because I’m not depressed or anything, but lately I’ve been thinking about how nice it would be to not be alive anymore.”

When I mentioned the mental health clinic we have at this school (totally confidential, none of the psychiatrists have any other affiliation with the school, and your records are kept at a different place than the rest of the med school’s student health records – pretty awesome and thoughtful), she was like, “Oh, that sounds serious!  I don’t need serious help.  I don’t like, have a problem.”

After a pause, I asked her what she would recommend if I told her that I had a friend who thought it would feel better to be dead.  She said, “Well, I guess they should probably see somebody official.  But I’m not sure I need to.  I just need to try harder.”*

I have another friend who doesn’t really believe in psychiatric disorders.  She’s pretty open about the fact that whenever any of her friends have been depressed, she’s been positive that they could “snap out of it” if they just tried.  I don’t know if our psychiatry class will ever get through to her – they did throw a bunch of neurotransmitter stuff at us last week, so I was kind of hoping that would make her realize depressed people aren’t just lazy.

You’d think somebody who can memorize the pathogenesis of hundreds of diseases would understand that sometimes, instead of having a ‘diabetes of the pancreas’ you might have something more like a ‘diabetes of the mind’ – sometimes things go wrong, and you need to fix or manage them as best as you can, even if you don’t totally understand why it went wrong.

Medical students and psychiatric issues.  Man.  I definitely can’t claim to be above the “I’m different!  I just need to try harder!” mantra of denial (It’s totally normal to get so stressed out you can’t move your neck, right?  Totally not indicative of an underlying problem?), but for what it’s worth, I did eventually decide to see somebody about that stress issue.

The corollary to “Doctor, heal thyself”:  Med student, see a damned doctor.

*  Because I know you guys may be just as concerned as I am:  I get the feeling that the more I push her, the less likely she’ll be to call the mental health service, so I’m not going to take that role,.  I’m going to take her to the stress management center, since that sounds less “mental health”-y, and let them push her to see someone – I think that will be more successful.
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9 thoughts on “Stressful month. Having 5 tests in 4 weeks will do that to you.

  1. Even after doing a psych rotation some people still didn’t “get” that depression is real and that patients can’t just “snap out of it.” I even asked a classmate once if she’d ever tried imagining feeling really sad, and then waking up every day and feeling like that all the time, and nothing could make her feel better, and not being able to see an end to it. She said no.

    Horrifying. No wonder patients hate us.

  2. Does your med school have their own psychologists for their students? Both UNL (where I went to year 1 and 2 of vet school) and ISU offer access to psychologists to their students for free and they are seperate from the ones at the student health center. The admin only get numbers of students who use the service and not the individuals names. Dr. R who over sees the program at UNL is doing studies on the impact of vet school on mental health. The results of our surveys during first year showed that 70% of our class was depressed. I freely admit I have issues with it due to the stress of vet school and the stress of always dealing with health problems.

    I’m glad you are trying to get your friend to seek help.

  3. Hopefully one day, many years down the line, that classmate [the arrogant/ignorant one] will realise that even for the stuff that we [medicine and science] think we understand, we have so little real idea. The pronouncement from the oracle to Socrates, “wisest is he who knows he knows nothing” would stump so many of ‘our learned friends and colleagues’.

    Good job though for spinning her line back to her. Ain’t much more you can do.

  4. I use the pancreas analogy all the time. “Just like a diabetic’s pancreas isn’t making enough insulin, your brain isn’t making enough of the right chemicals, and we need to help it.”

    It usually works. Some people, though you can never get to overcome a bias against mental illness that it’s “not real”.

  5. People can get some really weird ideas about psych issues. I have one friend who believes (despite his scary high IQ) that eating disorders are just part of someones personality. I have another friend who has expressed the sentiment that most people in therapy don’t need to be there. and another who thinks that substance abuse/addiction is solely a matter of self-discipline (this is how they justify their own occasional use of illicit substances – they would never *allow* themselves to become addicted).

    I hope your friend gets the help she needs, and that she recognizes mental illness is indeed an illness – it’ll help her and her future patients.

    • Our psychiatry module leader spent the first hour of the class talking about the public’s perception of mental illness and it’s effect on treatment.
      I think that so many people don’t get that there is a pathophysiologic basis for it (which admittedly isn’t entirely understood), and therefore think people with depression are just making it up, etc.
      The percentage of med students with signs of depression is really high, and it’s scary that so many of us don’t think it’s real.
      Hopefully your classmate gets the help she needs.

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