Suicide Among Medical Students

6/13/12 06:50 AM

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Suicide Among Medical Students

Posted: 06/05/2012; Stud BMJ 2012 BMJ Publishing Group
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I suppose the symptoms had been there for yearsstinging self criticism, a feeling of being unworthy of my fellows company, and a destructive relationship with booze, to name a few. And more recently a darker side preoccupation with suicide; research, rumination, and plans. This vortex of self hatred and despair, coupled with a gallon of Guinness and a lovely bottle of a Barolo (my farewell to alcohol, and still my last drink), pulled me down to the Thames river in June with a pocketful of razor blades. Cut to ribbons I waded in, blacked out and, I will never know how, woke up in the emergency department. Cognitive theories of depression teach us how the mind skews and twists external information to produce a negative, hostile, and hopeless impression of the world. This worked against me again and again. I would never have seen depression in another person as something shameful, but looking inwards I reached the conclusion that extinction would be a better fate than admitting to my family and friends that I had let them down by being so pathetic as to be depressed. Further to this, the fact I am a medical student was key to my inability to seek help. Naturally, I was aware of the statistics about depression among doctors, but to be a statistic myself and not part of the tough, omnicompetent majority felt like letting the side down. One of the themes of the cognitive behaviour treatment that formed the mainstay of my treatment was that these negative feelings are experienced by everyone to a varying degree. Moreover, they are just thoughts, mere products of the mind, just like my more positive conceptions. The difference was that these negative thoughts are given undeserved precedence by the depressed mind. For example, one such thought that still recurs is that my illness makes me unfit to practise as a doctor. I worry that I will be unable to stand up to the emotional rigours of the job. I fear that in explaining the year I have had to take out of medical school to job interviewers, I will expose myself as an unemployable failure. The reality is that these fears are a symptom of my lingering self denigration rather than a reflection of reality.
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Suicide Among Medical Students

6/13/12 06:50 AM

During my illness, I have gained an intimate and invaluable understanding of how it feels to be a patient treated for a mental health problem. And during my time spent recovering, I have achieved a great deal, from volunteer work to rediscovering my musical talents. Far from my history of depression making me too emotionally fragile to practise, I see it as having directed me towards the career of general practice. The importance of a competent and sensitive GP is one I have only truly appreciated in the past six months, and is a role I now feel more equipped to fulfil. Besides being an interminable congregation of diagnostic criteria to learn for psychiatry OSCEs, mental illness is rife within the medical profession. Recent research implies that half of all medical students would not feel able to talk to their tutors if they felt depressed.[1] We need to get better at accepting that things go wrong for medical students and doctors in the same way that they do for all people. In the US alone, 400 doctors are lost to suicide every year,[2] a huge and needless toll. I was so nearly another casualty, and it is only through increasing the extent to which we make it more acceptable to share our experiences of difficulties with low mood that the number suicides among medical students will fall. References

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Competing interests: None declared. Provenance and peer review: Not commissioned; not externally peer reviewed. Stud BMJ 2012 BMJ Publishing Group

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