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Avatar universal

Depression in med student

Hi Doctor,
I am a 28 y/o female medical student with a long standing history of major depression. For the last couple of months I have been in an "episode", depressed mood, decreased concentration and energy, anhedonia, sleep/appetite changes and suicidal ideation. This has been an ongoing problem with me for many years, since childhood actually. I have tried therapy and I have tried various antidepressants without any success.

Recently I have begun to question my ability to perform, now as a student, and later as a doctor. I am in third year, mid IM rotation. I have been able to maintain my grades and continue to do well, but I am lacking the passion I once had and am finding it difficult to go in each day and even harder to study. I know I am doing well, but I can't help but feel that I am sinking. I feel, honestly, like I made a huge mistake going into medicine. I mean, I can't even take care of myself!

Anyhow, I guess I don't need medical advise, but would like your opinion on med students/doctors with depression. Do you think it compromises performance? Do you think it is even possible to be a good doctor when you are battling this monster? And what in the world do you say when your attending asks you to present your research topic and you can't, because instead of studying, you spent the previous night crying and wishing you were dead?
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Avatar universal
Thanks for that, that seems to make a lot of sense.
In that second opinion I had the doctor suggested Mitrazapine and at least twice weekly therapy sessions.  That seems to be in line with what you're saying.  (Just wish the MHS would follow that up.)

Thanks for asking this question.  It has helped me better undersatnd what I may have to do to get well.  Sometimes just hearing it a different way helps.
I hope you are doing OK and that med school is going well.
Helpful - 0
1308134 tn?1295187619
MEDICAL PROFESSIONAL
Pretty aggressive treatment means finding a good psychiatrist to treat the biological aspects of depression (medications, light therapy, healthy living) and a well trained cognitive behavioral therapist to do focused and intensive work on the thought patterns that come from depression and that also sustain it. My best model for what this looks like is contained in the manual for Cognitive Behavioral Analysis System of Psychotherapy and it begins with twice a week therapy visits... but the key to making this work is the systematic focus on thought patterns rather than on what I will call supportive therapy (problem solving and emotional support), because as wonderful as those are and as necessary as they seem to be, they don't ultimately help someone drag themselves out of chronic depression.
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Avatar universal
I agree about becoming one of the best.  I think that people who have gone through adversity tend to be more empathetic towards others and perhaps less quick to judge.

Doctors are human too and make mistakes, etc.  How many doctors have you seen who are overweight or smoke or work too much?  Is their work compromised too?  I guess if a person does have a weakness, and most of us do, then there is strength in acknowledging it and working towards addressing it.  I think that one key in life is balance.

My personal opinion is that yes, depression does comprimise a persons performance.  I think the most important thing to be aware of though are your limitations.  Parameters in which your and others health isn't jeopardised.

Is it possible to be a good doctor when you have diabetes or asthma or any number of other conditions?

I think you be honest with them.

What would constitute pretty agressive treatment?  Just "quite" good, not pretty good.  Just wondering.  I seem to be stuck in that same boat too.
Helpful - 0
1308134 tn?1295187619
MEDICAL PROFESSIONAL
I don't know whether depression compromises performance for you or not. But the fact that you have been maintaining your grades suggests that it is mostly having a profound effect on your confidence and motivation... which is very hard on you but less likely to have much of an effect on your patients.
I haven't found that many folks in my experience who can't do well with pretty aggressive treatment so, although you didn't ask, I would volunteer that you might want to seek a second opinion on treatment options.
Chronic depression requires pretty aggressive treatment, but the results can be quite good.
A long time ago a former supervisor offered this opinion, which I think is pretty true, those who have had problems themselves can either make the best doctors, or the worst, depending on their success taking care of themselves. I think you could be on track to being the best....
Peter
Helpful - 0

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