Depression is more common than many people think: one in five people will suffer with the disorder. Winston Churchill called his depression his ‘Black Dog’, a metaphor I quite like. See this great video from WHO which explains a bit more.
I am currently 25 years old, and when I was 19, I was diagnosed with major depressive disorder. I was in my second year at university at the time. Although I had suffered with depressive symptoms since my early teens, the added stressors of university life had significantly affected my ability to function. I’m known as the bubbly, funny one within my friendship group, but at the age of 19 I had no social life, struggled to stay awake, and was struggling to attend lectures despite being a very studious person. I knew full well I had depression from my third month of university (I was studying psychology and mathematics, so knew a lot about the disorder), but couldn’t bear the thought of seeking help until more than 18 months in. When I eventually did, I was put on medication, which helped. This, along with using techniques such as mindfulness and learning how to deal with my cognitive distortions, helped me come out of the deep pits of depression, and I completed my bachelors degree, followed by a masters a year later. I came out of my masters feeling like I was almost back to ‘normality’ and spent the next two years travelling and deciding what was to become of the rest of my life.
When I decided to study Medicine, I was in the middle of having the time of my life travelling the world. I had never been in a better mental state, and after considering all the other implications of studying Medicine as a graduate, such as the financial worries and the fact I will be 29 when I’m finished, I had to seriously consider the impact it would have on my mental health. Will it make me go back into that pit? Will my black dog, my own personal hateful pet, re-appear with vengeance, bigger than ever? Will I be able to stop it this time? It took me at least two weeks to mull this all over, which ironically, brought out some of my symptoms: insomnia, distraction and fatigue. Ultimately, I decided that if I didn’t do Medicine, then the depression had won. I would be prevented from pursuing my dream because of it, and I couldn’t let that happen.
So here I am, seven months into my medical degree, and I can very proudly say that I am coping well. I’m heading into the final term of my first year, and despite having a few issues along the way I am doing well. One such issue is the fact that we cover a lot about stress and anxiety in the medical course; I have only let this get to me once in the academic environment, during a simulated patient session in clinical skills. During my consultation with her, the simulated patient said something akin to, “I just feel nothing, an emptiness. I sometimes think when I’m driving how easy it would be to end it all.” My mind went blank, and all I could think of was how I felt during my darkest moments. So I cried, a lot. But that’s the good thing about being surrounded by people who are training to be doctors – they are naturally empathetic. So I felt comfortable just crying and explaining why I was so upset, and everyone understood. I have bad days like that every so often, maybe once a month. But now I have such a good support system that I can declare, “I’m having a D Day, but it’s OK and I will be over it tomorrow,” and my friends say, “If you want to talk about it, I’m here,” and that’s that.
There are a few things that trigger my ‘D days’ that are not exactly unique to medical students. One is stress due to workload. I also have a job and work three nights a week, alongside lectures and self-directed learning. This means not much time to myself and a lot of running around. My advice to anyone who is going through the same thing as me would be to make sure you get some time to yourself. I aim to set aside 10 minutes every day where I sit and do some mindfulness exercises, or listen to music. I know it works for me – and you need to do what works for you. I have a bit of a reputation as an obsessive list writer too, and that’s all to help with my anxiety. I try to keep a notepad by my bed so if something is keeping me awake at night I can write it down and it goes out of my head. I have lists on my wall of things I need to do for the week and something this simple really keeps me on track.
My advice to medical students in my situation would be to try and make some friends outside of medicine. It’s very easy to get caught up in medical student circles – we’re all working very hard towards the same goal. But I have my friends at my job and it’s so refreshing to do something where you don’t have to talk about medicine. Another option is to take up a sport, or get a hobby where you can take your mind off it. In my first degree, one of the best things I did for my mental health was joining the jazz band, where I could just make music and not be reminded about the stress of everything else.
My final piece of advice would be for goodness sake, tell someone. I went to a walk in nightline once in my first year of my first degree, and just sat there and cried in front of two strangers who weren’t judging me and were just listening. There are so many sources of support (e.g. The Samaritans, Nightline) that there is no need to bottle it up. Even if you’re just slightly stressed about something, ring them up and have a chat. I’ve made a point of telling my fellow medics they can talk to me about anything if they are feeling stressed, and I have also made most people well aware of my previous problems. I’m an advocate of the philosophy that being open about mental health is the best way to extinguish the stigma associated with it, and I hope that this blog post has made a step towards that.
Samaritan’s National Phone Number: 116 123
Charlotte Hall is a perpetual student already on her third, but hopefully final, degree. She likes the outdoors, singing at any opportunity and talking until somebody stops her.