I happened to read this article published int studentBMJ, I though you would also love to go through it.
Confessions of a depressed mind
For medical students to overcome depression may mean coping with the darkness, hopelessness and sadness while hiding the illness from a sceptical medical profession
We laugh about the patient who jumped off a building because she thought she could fly. We share stories about the bizarre voices and delusions that our patients try passionately to convince us are real. But do we stop to think about how mental illness is probably far closer to home than we're comfortable with?
Patients' lives seem a million miles away from our comfortable lives as students, yet as prospective doctors we badly need to begin to understand psychiatry from a patient's point of view. How else can we appreciate the mystery of an invisible disease that destroys people's lives?
It is not a joke. It is not made up, selfish, or attention seeking. It is the manifestation of an unwell mind, and we need to listen and learn.
Carer turned patient
I am a medical student, but I am also a patient. For the past one year I've been battling mental illness while studying, and I wish it was better understood by my peers.
There's a secret shame to being a medical student with depression. You don't want to be labelled as a crazy woman, as mental, or as lazy, so you try and hide it all, embarrassed at the diagnosis and yearning to be better and become the strong and contented doctor you want to be.
It's weird becoming the patient. The first step was admitting defeat to a general practitioner, describing how I couldn't cope and acknowledging that something was really wrong. Then I had to take my prescription to a pharmacy and accept that I needed to take drugs for a while. Over the next weeks and months I began to painfully pull out and analyse my past, and my problems, thoughts, and inner turmoil with a psychologist, a psychiatrist, and a counsellor.
Depression is hard to explain, and although the symptoms and signs do summarise aspects of it - lack of energy; feeling sad, hopeless, and numb; and having problems with sleeping - they are way too general. They completely fail to describe how it really feels, and explain the change in mindset that consumes you and changes you.
My experience
I find some days OK. I have to spend time convincing myself to face the day and fight off the mess in my head. Only then can I get on with things and distract myself from how I feel. I put on a happy, often overly hyper, front to people and you wouldn't know the suicidal thoughts that haunt me and the enormity of the effort put into things like laughing and appearing to enjoy nights out.
Some days, however, are horrific. I just can't get out of bed, am swarmed with a million thoughts, and feel disconnected to my surroundings. I feel slow and numbed to the good things in life and forced into endless depths of despair I never knew existed. Those days I try to just sleep and wait for the day to be over, trying hard to avoid the panic attacks and dissociative attacks that can take over.
The mornings are the hardest. I'm not just talking about the Monday blues or the fear of a long day of being humiliated by the consultant of doom; I'm talking really, really hard. The excitement, apprehension, or even slight dread of a fresh day that I used to feel, gets replaced by an overwhelming apathy and darkness.
Glimpses of how I used to be
Every so often I get a brief glimpse of how I used to be and will be again - feeling excitement, in control of my thoughts, positive, and empowered. The battle in my head seems a million miles away. I can't wait to feel better, to have good days and bad days like I used to, to be able to lift my mood and have a good cry over things, and feel a bit better at the end.
I struggle because I still don't understand why I feel like this, and I feel so out of control with myself. I didn't even think mental illness was real before this hit me; I guess this will be a case of "learning from experience".
ANDREW DAVIS/TREVILLION
The pain is only too real
It is a frightening experience for me, and I'm sure for other patients. I feel like I don't know myself any more, and have lost the person I used to be. Too often my mind is swarmed with negative thoughts and internal voices, and urges to hurt myself or end things seem to come from a place within me that I just don't recognise. I'll feel like I'm drowning in my troubled mind, constantly struggling against negative moods, hopelessness and urges, yet never actually managing to cheer myself up.
Unhelpful comments
Throwaway comments like, "pull yourself together," "you're really difficult and moody," and, "its not that bad" plunge into you like a knife. Do you not think I've tried? Do you not think I count my blessings? Do you not think I know how hard I am to live with? Because I live with myself, haunted by dark thoughts and moods, frustrated so much by not being able to make it better, and blaming myself because I think somehow it must be my fault.
What helps? The drugs seem to vary my moods more, but are in no way a cure. Therapy helps me manage my moods and deal with my thoughts in a more constructive way. My friends offer me the love and support that I need, and they put up with a lot. I really appreciate having people around to talk to if I want, sit with if I don't, and go out and forget about it all when I'm feeling OK. At a time that I can barely put up with myself, having people around me that care is a real blessing.
Medicine doesn't fully understand depression, and I try to combat its physical, psychological, and social influences, but the spiritual ones are so important too. Prayer offers me the hope and peace that keeps me going through my darkest times.
Nothing is forever
As for the future, I hope soon to get better; I know these times don't last forever. Until then I will work around this, trying as hard as I can to keep up with my studies and doing clinical placements when I'm OK. I try to keep pushing on, doing things, exercising, and putting time into friendships so that I may stay outward looking and not let the depression take over my life. I have the option to take time out and I may need to do this before I'm ready for fourth year studies.
Overcome the stigma of mental illness
So to all you medical students - drop the stigma; whatever the cause is for mental illness we need to acknowledge it and try our hardest to help. For all you know, the girl next to you in a lecture, your closest friend, or your next patient will be silently suffering, and one day you may be, too. And then I guarantee you'll see just how important it is that doctors are sensitive, non-judgmental, and willing to understand. Competing interests: None declared.
Source:
studentBMJ 2006;14:309-352 September ISSN 0966-6494.
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