Depressed but scared of seeking help

[nets445]

Hello SDN. I am an incoming MS4. I have been struggling with adjusting to medical school on multiple fronts ever since MS1. Don't really want to go into the details but I feel totally burned out and am severely regretting why I chose to go to medical school when there were so many other careers I could have chose (I know it's too late to switch now). Anyways, I have pretty much 5 out of the 9 signs of MDD (depressed mood all the time, no longer enjoy video games, huge weight gain, decreased/trouble sleeping, have no energy to do things). I feel like I need to speak with someone but I am scared to do so because the school might mark me as someone who has psychiatric problems and therefore, would keep a "closer eye" on me. If I go to an outpatient psychiatrist, 1) they can't really relate to what I'm going through because a lot of the stuff is school-specific and 2) do they have an obligation to report MDD in a future medical professional to some upward entity? I just find it hard to believe that if I were to be diagnosed with MDD and started on a SSRI that it would have no effect on my future residency aspirations. Can anyone who has insight or struggled with something similar share their opinions on the matter? Thank you.

---

Members don't see this ad.

 

[Strider_91]

Having depression and seeking help will not hurt your career, being depressed and not getting help could. There are plenty of physicians on ssri's and there is no shame in it. When you apply for a license most states questions ask about mental illness in a way that says "have you in the last 5 years had any mental illness that effects your ability to do your job effectively." You can in good conscious say no to this question because controlled depression will not prevent you from helping patients. The suicide rate in medical school is higher than average and this false belief that your career will be ruined is likely a reason why. You should talk to an advisor who you trust and get the help you need.

It will get better. You are not alone.

@Goro may be able to chime in on this with better advice.

 

[Goro]

Let me ask you something: if you had hematuria, would you ignore it?

No? Then why are you ignoring these symptoms of a real disease...as real as bladder cancer?

Go get help, STAT.

My understanding is that your medical history is your business.

The learned @aProgDirector can give you a definitive answer. But if you don't get treated, it's unlikely that you'll ever be a resident. Hopefully some of our wise psychiatry residents and attendings can chime in as well.

Hello SDN. I am an incoming MS4. I have been struggling with adjusting to medical school on multiple fronts ever since MS1. Don't really want to go into the details but I feel totally burned out and am severely regretting why I chose to go to medical school when there were so many other careers I could have chose (I know it's too late to switch now). Anyways, I have pretty much 5 out of the 9 signs of MDD (depressed mood all the time, no longer enjoy video games, huge weight gain, decreased/trouble sleeping, have no energy to do things). I feel like I need to speak with someone but I am scared to do so because the school might mark me as someone who has psychiatric problems and therefore, would keep a "closer eye" on me. If I go to an outpatient psychiatrist, 1) they can't really relate to what I'm going through because a lot of the stuff is school-specific and 2) do they have an obligation to report MDD in a future medical professional to some upward entity? I just find it hard to believe that if I were to be diagnosed with MDD and started on a SSRI that it would have no effect on my future residency aspirations. Can anyone who has insight or struggled with something similar share their opinions on the matter? Thank you.

 

[673441]

All good advice here, but adding on I will say many of my colleagues do use SSRIs... I mean, no one airs their dirty laundry in the middle of the library but if I found out a friend was dealing with depression, I damn sure wouldn't ostracize them. I don't imagine your future superiors will do that as well.


Sent from my iPhone using SDN mobile

 

[Dro133]

Hey, current MS1 here who is currently seeing one of the therapists at my school. I understand the hesitation to seek therapy, especially on campus at your school. I feel the pang of anxiety every time I'm walking into the clinic, wondering if anyone I know will see me, and how that will affect their opinion of me. Or whenever I'm on my way to the clinic and I run into a friend or acquaintance, I'll be purposely vague about where I'm going. So I get it; there's a very real stigma, and it sucks.

The way I look at it is this: my therapy is essential for my well-being. Now, it's my understanding (as Goro pointed out above) that our medical histories stay confidential. However, let's pretend this weren't the case, and let's pretend that every residency director in the country received an automated email every time I stepped into the clinic...I would STILL go to my therapy sessions. Why? Because I would rather be a happy and healthy person who didn't match at the most competitive place than a miserable person who did match. Besides, would you really want to end up at a place that doesn't value your health and happiness? If a residency ever blackballed me for seeking mental health treatment, then good riddance, I probably wouldn't enjoy working there anyways.

I wrote out a bit about my experience in therapy and how it has helped me, but I decided against posting it since it seemed a bit too personal. But if you're ever interested in hearing more about my experience I'd be more than happy to talk over PM. Best of luck!

 

[Goro]

If I could give this 1000 likes, I would.

Hey, current MS1 here who is currently seeing one of the therapists at my school. I understand the hesitation to seek therapy, especially on campus at your school. I feel the pang of anxiety every time I'm walking into the clinic, wondering if anyone I know will see me, and how that will affect their opinion of me. Or whenever I'm on my way to the clinic and I run into a friend or acquaintance, I'll be purposely vague about where I'm going. So I get it; there's a very real stigma, and it sucks.

The way I look at it is this: my therapy is essential for my well-being. Now, it's my understanding (as Goro pointed out above) that our medical histories stay confidential. However, let's pretend this weren't the case, and let's pretend that every residency director in the country received an automated email every time I stepped into the clinic...I would STILL go to my therapy sessions. Why? Because I would rather be a happy and healthy person who didn't match at the most competitive place than a miserable person who did match. Besides, would you really want to end up at a place that doesn't value your health and happiness? If a residency ever blackballed me for seeking mental health treatment, then good riddance, I probably wouldn't enjoy working there anyways.

I wrote out a bit about my experience in therapy and how it has helped me, but I decided against posting it since it seemed a bit too personal. But if you're ever interested in hearing more about my experience I'd be more than happy to talk over PM. Best of luck!

 

[cellsaver]

Anyways, I have pretty much 5 out of the 9 signs of MDD (depressed mood all the time, no longer enjoy video games, huge weight gain, decreased/trouble sleeping, have no energy to do things).

Be open to the possibility that you might be wrong about your self-dx and "need" for SSRI tx.

People who merely graduate from medical school are licensed to kill; they know alot about content but would be dangerous solo in the clinical application due to lack of training. An MD degree is testament to your perseverance. However you are no where competent to be dx nor tx anyone solo, but especially yourself. Your feelings are just that. Would you diagnose a patient with just a leukocyte count? you would demand more data. Your perception of your feelings are not enouh data to assess, dx or tx in your hands.

Give permission to yourself that you might be wrong and that you would benefit from having a trained credentialed professional give you their impression.

I feel like I need to speak with someone but I am scared to do so because the school might mark me as someone who has psychiatric problems and therefore, would keep a "closer eye" on me.

They would mark you if you failed medical school. Period. Otherwise there is no marking.

They would hold your hand and lovingly suggest whom you might see on or off campus to get a real assessment and dx if any, never mind rxing SSRI. Chances are they might tell you they "know people" who have felt like you

Can anyone who has insight or struggled with something similar share their opinions on the matter? Thank you.

I know many people who have told me they see a therapist, psychologist, psychiatrist, or social worker and say it with pride. It is a badge of courage to many people.

Last week during a church service for Holy Week, an elder woman whom I admire greatly, told me something that left me stunned and yet made me admire her more so. I already had her on a pedestal prior to her information. We were discussing one of the priests who delivers beautiful, moving sermons and she told me he is also a licensed therapist, doctoral level. She told me, "he is an excellent therapist, the best! He saved my life 10 years ago, literally!!!". She then embraced my husband and me and left. She did not bat an eye, and proceeded to walk off with such poise and class in her skirt, pumps and pearls. I stood there with my mouth open and told my husband, "I so admire her". He agreed.

Go see someone at your Student Services today. Walk to the office, tell someone on staff you need to see someone first available. Leave the pumps and skirt behind and show up in scrubs with pride

 

[Goro]

As someone who has had several bouts of depression severe enough to seek psychiatric or therapeutic help about 5x in the past 30 years, and be on anti-depressants 2x, I agree 100% with the bolded.

Too many people look at seeking help as a sign of weakness or a loss of face. I hope the OP is not one of them. Gawd knows s/he's going to have enough non-compliant patients in their career.

This thread also illustrates why mental health issues are more of concern to medical educators than are purely academic deficits.

I know many people who have told me they see a therapist, psychologist, psychiatrist, or social worker and say it with pride. It is a badge of courage to many people.

Last week during a church service for Holy Week, an elder woman whom I admire greatly, told me something that left me stunned and yet made me admire her more so. I already had her on a pedestal prior to her information. We were discussing one of the priests who delivers beautiful, moving sermons and she told me he is also a licensed therapist, doctoral level. She told me, "he is an excellent therapist, the best! He saved my life 10 years ago, literally!!!". She then embraced my husband and me and left. She did not bat an eye, and proceeded to walk off with such poise and class in her skirt, pumps and pearls. I stood there with my mouth open and told my husband, "I so admire her". He agreed.

Go see someone at your Student Services today. Walk to the office, tell someone on staff you need to see someone first available. Leave the pumps and skirt behind and show up in scrubs with pride

 

[cbrons]

Anyways, I have pretty much 5 out of the 9 signs of MDD (depressed mood all the time, no longer enjoy video games, huge weight gain, decreased/trouble sleeping, have no energy to do things). I feel like I need to speak with someone but I am scared to do so because the school might mark me as someone who has psychiatric problems and therefore, would keep a "closer eye" on me.

You should add irrational paranoia to the list of symptoms. How would your school even know that you went to a counselor or a psychiatrist? They don't have you under surveillance. And even if they did know, then what? A huge percentage of med students are on psychiatric drugs - there is nothing unusual about it.

 

[cbrons]

Be open to the possibility that you might be wrong about your self-dx and "need" for SSRI tx.

People who merely graduate from medical school are licensed to kill; they know alot about content but would be dangerous solo in the clinical application due to lack of training. An MD degree is testament to your perseverance. However you are no where competent to be dx nor tx anyone solo

Speak for yourself. I feel pretty confident about diagnosing and treating common things as a result of medical school alone. It's one thing to not know how to manage complex inpatient problems, quite another to graduate having never seen or treated unipolar depression in the outpatient setting. But I do agree that one shouldn't attempt to diagnose or treat themselves, not that you even can legally speaking.

 

[cellsaver]

As someone who has had several bouts of depression severe enough to seek psychiatric or therapeutic help about 5x in the past 30 years, and be on anti-depressants 2x, I agree 100% with the bolded.

I have no data but I firmly believe depression is a part of life. There are bright moments and then there are some really really dark moments. Saint Mother Teresa of Calcutta experienced the latter for much of her saintly life. Read "Come Be My Light", a biography of her by her Spiritual Director based on her personal correspondence with her SD and other high level bishops and Confessors/ Jesuits. The Saint experienced darkness in a fierce way.

Amazon product

Abraham Maslow comes to mind- self-actualization is the ideal but few reach it.

Too many people look at seeking help as a sign of weakness or a loss of face.

And yet they will drink ETOH to oblivion, do crystal meth, shoot up heroin, sell their mother for fentanyl and beg for opiate rxs from ER physicians and not bat an eye. crazy sons of beaches

This thread also illustrates why mental health issues are more of concern to medical educators than are purely academic deficits.

Pope Francis lived two years in a private cell in Argentina at a retreat house to battle his demons. Look at him now.
The Pope's Dark Night of the Soul

We, who are honest, experience darkness in life and it is utterly normal. Healhy people seek light while unhealthy people live in secret darkness.

There is so much reason to have hope but you gotta wrestle with your dark side. Make it your friend and not your enemy. That's what my therapist told me

OP, please let us know how your visit went to your university student counseling services

 

[Saxappeal1]

OP you need to seek counseling. It is ok not to be ok. Nothing bad happens if you take SSRIs careerwise. Most of the people in my class go to a psychiatrist and a decent amount of them take SSRIs or even more. Med student and physician depression is a real thing and is nothing to be ashamed of. Get help while you still have your control. My colleague died from it. Please listen to the SDNers.

 

[Light at end of tunnel]

I cant recall the exact number, but in a prior thread I think it was mentioned that up to 2/3 of healthcare professionals (including med students, residents, attendings) experience depression.

You are in the majority with this issue. Nothing to be ashamed of. But you gotta remember to take care of yourself if you want to be well enough to take care of others.

 

[Scrubs101]

Be open to the possibility that you might be wrong about your self-dx and "need" for SSRI tx.

People who merely graduate from medical school are licensed to kill; they know alot about content but would be dangerous solo in the clinical application due to lack of training. An MD degree is testament to your perseverance. However you are no where competent to be dx nor tx anyone solo, but especially yourself. Your feelings are just that. Would you diagnose a patient with just a leukocyte count? you would demand more data. Your perception of your feelings are not enouh data to assess, dx or tx in your hands.

Give permission to yourself that you might be wrong and that you would benefit from having a trained credentialed professional give you their impression.



They would mark you if you failed medical school. Period. Otherwise there is no marking.

They would hold your hand and lovingly suggest whom you might see on or off campus to get a real assessment and dx if any, never mind rxing SSRI. Chances are they might tell you they "know people" who have felt like you



I know many people who have told me they see a therapist, psychologist, psychiatrist, or social worker and say it with pride. It is a badge of courage to many people.

Last week during a church service for Holy Week, an elder woman whom I admire greatly, told me something that left me stunned and yet made me admire her more so. I already had her on a pedestal prior to her information. We were discussing one of the priests who delivers beautiful, moving sermons and she told me he is also a licensed therapist, doctoral level. She told me, "he is an excellent therapist, the best! He saved my life 10 years ago, literally!!!". She then embraced my husband and me and left. She did not bat an eye, and proceeded to walk off with such poise and class in her skirt, pumps and pearls. I stood there with my mouth open and told my husband, "I so admire her". He agreed.

Go see someone at your Student Services today. Walk to the office, tell someone on staff you need to see someone first available. Leave the pumps and skirt behind and show up in scrubs with pride

I find this story interesting because i recently found out my therapist is also a priest, im not religious in the slightest but man does he have a way with words and putting things in perspective.

To OP: Seek out help for sure, it's nothing to feel bad or weak about. As a future medical professional its important to know to get help when help is needed. Best of luck OP


Sent from my iPhone using SDN mobile

 

[MusicDOc124]

Go get counseling. There is nothing wrong with doing so. I have a few classmates who go, and I know of others at other schools and similar fields who go. Absolutely NOTHING wrong with it.

 

[NotAProgDirector]

Responding to the question: Will this need to be reported in the future?

Short answer: Doesn't matter, get treated anyway. Else, you risk failing out of school and that's not something your career will recover from. Plus you'll be better off.

Long answer: Maybe, probably not. Won't be an issue in the residency application phase, there's no questions about it on ERAS. When you apply for a license, you might need to report it. It's very state dependent, some ask for ALL mental health treatment, some only ask you to disclose if it impacted your ability to practice safely. In any case, no board will care about depression treated with meds (or ECT, or any other modality). They are hunting for substance abuse, and psychosis. So it might slow down your licensing process, but won't stop you from getting a license.

 

[TennisShoeChic]

Talk to your pcp, start a med.
Talk to you med school, sign up for counseling.
It's confidential, it can only help you enter residency with better mental health

 

[Redpancreas]

Hello SDN. I am an incoming MS4. I have been struggling with adjusting to medical school on multiple fronts ever since MS1. Don't really want to go into the details but I feel totally burned out and am severely regretting why I chose to go to medical school when there were so many other careers I could have chose (I know it's too late to switch now). Anyways, I have pretty much 5 out of the 9 signs of MDD (depressed mood all the time, no longer enjoy video games, huge weight gain, decreased/trouble sleeping, have no energy to do things). I feel like I need to speak with someone but I am scared to do so because the school might mark me as someone who has psychiatric problems and therefore, would keep a "closer eye" on me. If I go to an outpatient psychiatrist, 1) they can't really relate to what I'm going through because a lot of the stuff is school-specific and 2) do they have an obligation to report MDD in a future medical professional to some upward entity? I just find it hard to believe that if I were to be diagnosed with MDD and started on a SSRI that it would have no effect on my future residency aspirations. Can anyone who has insight or struggled with something similar share their opinions on the matter? Thank you.

Since you specifically ask, I have never seen a Psychiatrist... but have you even attended a medical school orientation? The number of times they say that they are there to help and that all struggles are confidential...It won't be reported anywhere. The only way programs will come to know is if you had to take time off they may suspect it, which is why they give you a chance to elaborate if needed. Your MSPE though is not going to say "student suffered with MDD, will not make a reliable resident". That would be absurd.

 

[Peach Newport]

Since you specifically ask, I have never seen a Psychiatrist... but have you even attended a medical school orientation? The number of times they say that they are there to help and that all struggles are confidential...It won't be reported anywhere. The only way programs will come to know is if you had to take time off they may suspect it, which is why they give you a chance to elaborate if needed. Your MSPE though is not going to say "student suffered with MDD, will not make a reliable resident". That would be absurd.

Not true. "Confidential" means nothing when it comes to licensing.

As my advisor told me (and was corroborated by a psychiatrist who works with physicians):

Most state licensing requires you to reveal all/any psych diagnoses. If you list any, it may delay licensing - which means you need to report it to any residency program as a "factor which could prevent or delay licensure."

It's a lot worse if you were ever treated for alcoholism: you have to sign up for a "physician health program" meaning that you're closely monitored, regularly drug tested... and of course, you need to tell your prospective employers.

 

[cbrons]

Not true. "Confidential" means nothing when it comes to licensing.

As my advisor told me (and was corroborated by a psychiatrist who works with physicians):

Most state licensing requires you to reveal all/any psych diagnoses. If you list any, it may delay licensing - which means you need to report it to any residency program as a "factor which could prevent or delay licensure."

It's a lot worse if you were ever treated for alcoholism: you have to sign up for a "physician health program" meaning that you're closely monitored, regularly drug tested... and of course, you need to tell your prospective employers.

No they do not. They want you to disclose psychiatric or really any medical problems which could interfere with your ability to practice medicine. Thats the key part there. They do not require you to disclose any psych diagnosis. What's more, they do not have access to your medical records.

Substance abuse history does require disclosure, though if you dont have a criminal record because of it, theres no good way for them to find out.

Stop scaring people. If you have mental illness you need to be treated before going into residency.

 

[Nephro critical care]

Depression to me seems to be such a controversial area. On one hand everyone encourages you to get treated for depression but then you hear these horror stories about a med-mal lawyer digging up any records of you being treated for depression and using them as a weapon to smear you in court.
I can just imagine standing in the docket and being asked :
1. Doctor, have you ever been diagnosed with depression or being treated with medications for
depression ?
2. Can you prove that your depression/anti-depressants were not impairing you while you were treating my patient ?
3. Do you think my patient would have had a better outcome if a doctor who was not depressed was treating my patient ?
4. Doctor why were you practicing medicine if you had a condition that could impair your ability to take care of my patient ?
5. At this point probably my lawyer would say something like " Objection your honor , these questions are irrelevant but the judge might say " Overuled , answer the question Dr so-so. Would you say your depression impairs your ability to see patients "

Maybe I am just a worrywort but a med-mal lawyer's job is to be a scumbag so if he can't find anything else in my management I would'nt put it past him to do some something like this.

So disclosing to the board leaves a paper trail that can be used against you. Better to suffer in silence than have a record.

 

[ACSurgeon]

Depression to me seems to be such a controversial area. On one hand everyone encourages you to get treated for depression but then you hear these horror stories about a med-mal lawyer digging up any records of you being treated for depression and using them as a weapon to smear you in court.
I can just imagine standing in the docket and being asked :
1. Doctor, have you ever been diagnosed with depression or being treated with medications for
depression ?
2. Can you prove that your depression/anti-depressants were not impairing you while you were treating my patient ?
3. Do you think my patient would have had a better outcome if a doctor who was not depressed was treating my patient ?
4. Doctor why were you practicing medicine if you had a condition that could impair your ability to take care of my patient ?
5. At this point probably my lawyer would say something like " Objection your honor , these questions are irrelevant but the judge might say " Overuled , answer the question Dr so-so. Would you say your depression impairs your ability to see patients "

Maybe I am just a worrywort but a med-mal lawyer's job is to be a scumbag so if he can't find anything else in my management I would'nt put it past him to do some something like this.

So disclosing to the board leaves a paper trail that can be used against you. Better to suffer in silence than have a record.

This is wrong on so many levels.

Not sure how they'd ever find this out. You should answer no for depression or anxiety unless it's actively impairing you, in which case you should be taking a leave and getting help rather applying for a license at that point in time.

Also, depression/anxiety can be reliably managed where it does not impair your ability to practice.

It seems that bipolar or schizophrenia aren't as reliably well controlled, but I'm no expert so couldn't tell you how to answer that.

Either way, your last comment encourages people to protect their career at the detriment of their well being... Not good advice. Not ethical either. It's a lot more likely for unmanaged depression to ruin a person's career and life than the scenario you describe where getting treatment and having well managed depression being used against someone to ruin their career. So if you want to be a "worrywort", you should be more worried about letting depression go unmanaged - i.e. It's much "safer" to seek help and get better than to "suffer in silence".

 

[cbrons]

Depression to me seems to be such a controversial area. On one hand everyone encourages you to get treated for depression but then you hear these horror stories about a med-mal lawyer digging up any records of you being treated for depression and using them as a weapon to smear you in court.

How would a lawyer go about "digging up" confidential HIPPA-protected medical records?

This is just pure paranoia and totally unrealistic.

 

[Nephro critical care]

I may be a 'worrywart' but I worry about paper trails. If you 'suffer in silence' no one knows about your depression other than you. But if you get treated by a psychiatrist then obviously someone diagnosed you with depression.In which case if a board asks you about ALL mental health treatment you can't in good faith say no. And then when you list anxiety/depression the board will most likely give you the license but now there is a paper trail.
Can't a lawyer request a copy of your license application from your state board and then using the info in the records to get a subpoena about your mental health treatment ? HIPPA won't protect you from a subpoena. And use that info to rake you over the coals in front of a jury.

 

[OrthoTraumaMD]

I may be a 'worrywart' but I worry about paper trails. If you 'suffer in silence' no one knows about your depression other than you. But if you get treated by a psychiatrist then obviously someone diagnosed you with depression.In which case if a board asks you about ALL mental health treatment you can't in good faith say no. And then when you list anxiety/depression the board will most likely give you the license but now there is a paper trail.
Can't a lawyer request a copy of your license application from your state board and then using the info in the records to get a subpoena about your mental health treatment ? HIPPA won't protect you from a subpoena. And use that info to rake you over the coals in front of a jury.

As another choice, you could just go to a psychologist and pay out of pocket. No one would ever need to know about your treatment, and since it would only be therapy and not meds, no insurance company, pharmacy, or anyone else would ever find out.

 

[PlutoBoy]

When you apply for a license, you might need to report it. It's very state dependent, some ask for ALL mental health treatment, some only ask you to disclose if it impacted your ability to practice safely. In any case, no board will care about depression treated with meds (or ECT, or any other modality). They are hunting for substance abuse, and psychosis. So it might slow down your licensing process, but won't stop you from getting a license.

I may be a 'worrywart' but I worry about paper trails. If you 'suffer in silence' no one knows about your depression other than you. But if you get treated by a psychiatrist then obviously someone diagnosed you with depression.In which case if a board asks you about ALL mental health treatment you can't in good faith say no. And then when you list anxiety/depression the board will most likely give you the license but now there is a paper trail.
Can't a lawyer request a copy of your license application from your state board and then using the info in the records to get a subpoena about your mental health treatment ? HIPPA won't protect you from a subpoena. And use that info to rake you over the coals in front of a jury.

With all due respect, your approach to this problem is terrible.

If someone needs treatment for depression they should go get it, doctors included. Your "advice" is literally putting lives at risk. I like to think that most doctors are reasonable people, including the ones overseeing the medical boards. They would understand it if a colleague says "yeah, i struggled with depression for a while", particularly since this is so common.

We should stop putting our careers ahead of our well being. We cannot treat others appropriately if we are not well.

Seek help, folks. There are resources out there.

 

[togaedere]

To piggyback on this - I just want to add that I've been treated for depression and OCD both before and during residency. I did not disclose to my program prior to needing too (when I discussed with my program director that I was having a flare), but now that I have I have access to getting treatment and I have my program's back. Part of this though is making sure I have a psychiatrist (I went a few years without one and it wasn't a good idea).

You have a right to treatment and you certainly should have it treated. If I have to disclose to any medical board later on I will and I'm actually not worried about my future licensure because I do not think my illness is putting any patients at risk, and I have people to back me up on this. Untreated depression certainly has the risk of that though.

With all due respect, your approach to this problem is terrible.

If someone needs treatment for depression they should go get it, doctors included. Your "advice" is literally putting lives at risk. I like to think that most doctors are reasonable people, including the ones overseeing the medical boards. They would understand it if a colleague says "yeah, i struggled with depression for a while", particularly since this is so common.

We should stop putting our careers ahead of our well being. We cannot treat others appropriately if we are not well.

Seek help, folks. There are resources out there.

 

[NotAProgDirector]

I agree with the overall sentiment on this thread.

All states have some type of question about this on their licensing apps. Most are not a big deal, only require disclosure of major psych issues -- hospitalizations, psychosis, that sort of thing. A few states do have ridic rules -- Florida, I believe, requires that you release all psych records no matter how minor. I think this is insane, and it has been a deciding factor for some of my residents as to what fellowship they attend. Although the board should keep your records private, there's always the chance they would leak out.

I agree that the risk of not being treated is much greater than the risk of treatment. If you're not treated and then get hospitalized, that's now a much bigger issue -- it's definitely reportable. If you lose your job, especially a residency spot, because of untreated mental health issues, it's a huge problem. If your personal life falls apart, it's a huge problem. These are all much more likely than the scenarios above.

Regarding Medmal risk, first of all the chances of actually ending up in a courtroom is low, most of these cases get sorted out long before a trial. I'm not convinced that a routine diagnosis of depression, ADHD, OCD, or basic bipolar will make any difference. Atty asks if this diagnosis would effect your performance - the answer is no. Were your meds impairing you? No. The basic treatment for most mental health is safe and doesn't cause impairment. In fact, I think the bigger risk is being sued when you've refused to get care for a major problem -- then it would be much easier to say you were impaired and delivering bad care.

 

[Peach Newport]

I agree with the overall sentiment on this thread.

All states have some type of question about this on their licensing apps. Most are not a big deal, only require disclosure of major psych issues -- hospitalizations, psychosis, that sort of thing. A few states do have ridic rules -- Florida, I believe, requires that you release all psych records no matter how minor. I think this is insane, and it has been a deciding factor for some of my residents as to what fellowship they attend. Although the board should keep your records private, there's always the chance they would leak out.

I agree that the risk of not being treated is much greater than the risk of treatment. If you're not treated and then get hospitalized, that's now a much bigger issue -- it's definitely reportable. If you lose your job, especially a residency spot, because of untreated mental health issues, it's a huge problem. If your personal life falls apart, it's a huge problem. These are all much more likely than the scenarios above.

Regarding Medmal risk, first of all the chances of actually ending up in a courtroom is low, most of these cases get sorted out long before a trial. I'm not convinced that a routine diagnosis of depression, ADHD, OCD, or basic bipolar will make any difference. Atty asks if this diagnosis would effect your performance - the answer is no. Were your meds impairing you? No. The basic treatment for most mental health is safe and doesn't cause impairment. In fact, I think the bigger risk is being sued when you've refused to get care for a major problem -- then it would be much easier to say you were impaired and delivering bad care.

APD, can you please elaborate on the part where you say "psych records determine where to apply for fellowship?"

Also, a good friend of mine (a malpractice atty) says that a malpractice lawyer will need a very good reason to get into your psych records. I.e. - the incident in question often needs to obviously point to you having a psych problem.

Make a typical mistake = probably can't get to your psych/medical records

Make a typical mistake while smoking meth on the wards and screaming about how you're the son of Jesus = they can probably get your records

 

[cbrons]

APD, can you please elaborate on the part where you say "psych records determine where to apply for fellowship?"

Also, a good friend of mine (a malpractice atty) says that a malpractice lawyer will need a very good reason to get into your psych records. I.e. - the incident in question often needs to obviously point to you having a psych problem.

Make a typical mistake = probably can't get to your psych/medical records

Make a typical mistake while smoking meth on the wards and screaming about how you're the son of Jesus = they can probably get your records

How difficult is it for you to understand basic privacy laws? Attorneys do not have any special powers that allow them to violate the law and obtain your medical records without your permission. Suing you is not a legitimate reason for your records to be disclosed without your permission. (This is civil cour, eg where malpractice cases are tried I'm talking about, not criminal court)

 

[Crayola227]

Responding to the question: Will this need to be reported in the future?

Short answer: Doesn't matter, get treated anyway. Else, you risk failing out of school and that's not something your career will recover from. Plus you'll be better off.

Long answer: Maybe, probably not. Won't be an issue in the residency application phase, there's no questions about it on ERAS. When you apply for a license, you might need to report it. It's very state dependent, some ask for ALL mental health treatment, some only ask you to disclose if it impacted your ability to practice safely. In any case, no board will care about depression treated with meds (or ECT, or any other modality). They are hunting for substance abuse, and psychosis. So it might slow down your licensing process, but won't stop you from getting a license.

I would add that they absolutely can be fishing for bipolar affective disorder, even with no hx of psychosis, and good compliance. If it has affected you during school, or to practice medicine, it absolutely can do more than slow down your licensing process.

Think PHP and mandatory visits with the psychiatrist of the medical board's choosing, as well as regular UDS to check for med compliance.

I would just be wary if your depression is more than depression and is BPAD, as those physicians face different challenges.

I would also caution people to try to avoid inpatient treatment if they can at all safely. That is the other question that most boards ask.

I agree simple depression well controlled on meds with no hospitalizations, psychosis, or self-harm, is not likely to be an issue. I just needed to point out the other two things they fish for (BPAD and inpt tx for any reason).

 

[Crayola227]

No they do not. They want you to disclose psychiatric or really any medical problems which could interfere with your ability to practice medicine. Thats the key part there. They do not require you to disclose any psych diagnosis. What's more, they do not have access to your medical records.

Substance abuse history does require disclosure, though if you dont have a criminal record because of it, theres no good way for them to find out.

Stop scaring people. If you have mental illness you need to be treated before going into residency.

Actually, some of the licensing apps do require you to list ANY psych dx.

Also, and I can't say how widespread this is, medical boards absolutely can subpoena ALL your medical records.

If you apply and say you have a psych dx, part of "slowing down" your app process absolutely can be the board now asking for a release to review all your records. If you refuse, you will not be licensed.

Now, if you're already licensed, you've already agreed to whatever terms are involved. So if you're practicing with that license, and later they want to review your medical records, you don't get to say no. They subpoena if they're inclined.

 

[Crayola227]

With all due respect, your approach to this problem is terrible.

If someone needs treatment for depression they should go get it, doctors included. Your "advice" is literally putting lives at risk. I like to think that most doctors are reasonable people, including the ones overseeing the medical boards. They would understand it if a colleague says "yeah, i struggled with depression for a while", particularly since this is so common.

We should stop putting our careers ahead of our well being. We cannot treat others appropriately if we are not well.

Seek help, folks. There are resources out there.

Interestingly enough, quite a few of the people involved in the medical board side of investigation are NOT doctors. I was surprised to find out that many of them are former LEOs. Which explains why some docs when dealing with the med board feel that they are being treated as criminals. Because they are!!!

 

[Crayola227]

Ultimately, if you have a mental health condition, like any other condition, it needs to be appropriately treated.

Did I see my friends treated poorly and have consequences at work because of cancer and DM1? You betcha.

Weakness in medicine isn't well tolerated. Being sick and treating it, is slightly better than being sick and not treating it.

Now, it's not all doom and gloom. You can get treatment. You will have people who support you. You can get better. You can have this have very little if any impact on your career.

But you need to figure out what's wrong with you, and how to address it. Then you need to figure out how to carve a space in your professional life (which even eats up the minutes you need to piss) to get that treatment effectively, and discreetly.

I recommend my past posts on topics about how to get school accommodations for disabilities, when to seek care at Student Health vs other avenues, considerations for answering questions on licensing apps, employee health forms, disability accommodations in the workplace, discreet psychiatric care, and how to obtain it during the busy-ness that is residency.

I also have some posts on self-care directed at the busy med student/resident, likely helpful for burn out vs depression.

 

[Nephro critical care]

+

 

[ACSurgeon]

Yes , I want to be treated for depression. But having my medical records subpoenaed and going through PHPs is a nightmare that I would rather avoid if I could help it. Oddly enough while at work I am focused/happy/unstressed while taking care of patients and those demons that have haunted me since my childhood are not there. I have already given signout and I am still sitting in the hospital trying to find any excuse not to go home to see my wife and kids. Nurses ask what I am still here. I am just trying to keep the demons at bay for a couple of hours until I can go to bed to a unrestful sleep. My wife and I seldom talk and we have an autistic son who some days I try to teach but it is a losing battle. Unlike the hospital I am very withdrawn from my family at home. Although I have never touched a drop of ETOH in my life I think I am destined to be a raging alcoholic over next few years.

You should get the appropriate level of help.

Mild blues- try to manage on your own

True MDD- get professional help, therapy or rx

Psychosis or suicidal ideation- get whatever treatment necessary.

Ultimately, the hurdles by licensing agencies are there for a reason. While not always reasonable, these hurdles are a smaller price to pay than trying to be a doctor while the voices run loose in your head (extreme cases of psychosis). Do the right thing for yourself = doing the right thing for patients too.

 

[ACSurgeon]

Yes , I want to be treated for depression. But having my medical records subpoenaed and going through PHPs is a nightmare that I would rather avoid if I could help it. Oddly enough while at work I am focused/happy/unstressed while taking care of patients and those demons that have haunted me since my childhood are not there. I have already given signout and I am still sitting in the hospital trying to find any excuse not to go home to see my wife and kids. Nurses ask what I am still here. I am just trying to keep the demons at bay for a couple of hours until I can go to bed to a unrestful sleep. My wife and I seldom talk and we have an autistic son who some days I try to teach but it is a losing battle. Unlike the hospital I am very withdrawn from my family at home. Although I have never touched a drop of ETOH in my life I think I am destined to be a raging alcoholic over next few years.

And sorry about your "real life" issues. That must be really tough while going through training.

Maybe getting help will allow you cope.

 

[cbrons]

I would add that they absolutely can be fishing for bipolar affective disorder, even with no hx of psychosis, and good compliance. If it has affected you during school, or to practice medicine, it absolutely can do more than slow down your licensing process.

Think PHP and mandatory visits with the psychiatrist of the medical board's choosing, as well as regular UDS to check for med compliance.

I would just be wary if your depression is more than depression and is BPAD, as those physicians face different challenges.

I would also caution people to try to avoid inpatient treatment if they can at all safely. That is the other question that most boards ask.

I agree simple depression well controlled on meds with no hospitalizations, psychosis, or self-harm, is not likely to be an issue. I just needed to point out the other two things they fish for (BPAD and inpt tx for any reason).

This is false. Medical licensing boards cannot obtain any of your medical records for the simple purpose of licensing without your permission. You can answer how you want, but they arent going to be able to prove it one way or the other unless you grant them access to your records freely.

 

[Peach Newport]

So I looked up some medical license application forms to find out the answer. I'm pretty sure this is definitive, but I'd like input.

California requires you to reveal ALL psychiatric diagnoses, ever.

Texas was confusing and I couldn't figure it out.

Florida required you to reveal psychiatric conditions that impair your ability to practice medicine, and only those in the last five years.

New York seems to have no questions regarding psychiatric history.

 

[Crayola227]

This is false. Medical licensing boards cannot obtain any of your medical records for the simple purpose of licensing without your permission. You can answer how you want, but they arent going to be able to prove it one way or the other unless you grant them access to your records freely.

Yes, you do have to give your permission initially to be granted a license, if that is what they ask for.

Of course you can lie on your medical license application. Could that bite you in the future? If for any reason in the future they had cause to subpoena your records, the deception would be immediately apparent.

 

[PlutoBoy]

Yes , I want to be treated for depression. But having my medical records subpoenaed and going through PHPs is a nightmare that I would rather avoid if I could help it. Oddly enough while at work I am focused/happy/unstressed while taking care of patients and those demons that have haunted me since my childhood are not there. I have already given signout and I am still sitting in the hospital trying to find any excuse not to go home to see my wife and kids. Nurses ask what I am still here. I am just trying to keep the demons at bay for a couple of hours until I can go to bed to a unrestful sleep.

I'm sorry, man. Sounds tough :/

Don't hesitate to seek help. In all honesty, you are overthinking this. You will get a license.

Do you think that the board requests the medical records of applicants? How would they know who to call? Is it even legal to to deny licensure based on a controlled medical condition? It just doesn't happen, my friend.

Take care of you first. Don't let this affect your loved ones. They suffer just as much as you do.

 

[chemdoctor]

Hello SDN. I am an incoming MS4. I have been struggling with adjusting to medical school on multiple fronts ever since MS1. Don't really want to go into the details but I feel totally burned out and am severely regretting why I chose to go to medical school when there were so many other careers I could have chose (I know it's too late to switch now). Anyways, I have pretty much 5 out of the 9 signs of MDD (depressed mood all the time, no longer enjoy video games, huge weight gain, decreased/trouble sleeping, have no energy to do things). I feel like I need to speak with someone but I am scared to do so because the school might mark me as someone who has psychiatric problems and therefore, would keep a "closer eye" on me. If I go to an outpatient psychiatrist, 1) they can't really relate to what I'm going through because a lot of the stuff is school-specific and 2) do they have an obligation to report MDD in a future medical professional to some upward entity? I just find it hard to believe that if I were to be diagnosed with MDD and started on a SSRI that it would have no effect on my future residency aspirations. Can anyone who has insight or struggled with something similar share their opinions on the matter? Thank you.

First of all relax. I'm sure once everyone's been through the rigor of medical school, they wonder why they chose it. Try to find some enjoyment, make study groups, etc. maybe seek some counseling if you need it.

 

[Crayola227]

keeping in mind this is the same person who was able to point out every caveat by which the medical profession can bone you for having a mental health condition -

Get treated. Don't be scared. Be smart. That's it.

 

[WingedOx]

So I looked up some medical license application forms to find out the answer. I'm pretty sure this is definitive, but I'd like input.

California requires you to reveal ALL psychiatric diagnoses, ever.

Texas was confusing and I couldn't figure it out.

Florida required you to reveal psychiatric conditions that impair your ability to practice medicine, and only those in the last five years.

New York seems to have no questions regarding psychiatric history.

I had a few sessions back in med school with school counseling because med school sucks and I was burned out. I have no idea what diagnosis the visits were ever coded as.

 

[togaedere]

I sort of but also kinda sort of don't understand the hesitation behind not seeking help cus it will lead to subpoenas and health care records and such. Seems like without treatment you are on a road that leads to some pretty bleak outcomes... that could eventually lead to things that affect patient care (which then could lead to investigations, theoretically). But with treatment and adherence, you build a track record of seeking help and may even build back the skills to be able to--like some people said up there--cope more readily with what life throws at you. It's a lot harder to work through a marriage and have a kid with special needs when you're depressed, and that stuff is hard for anyone regardless of mental health diagnosis. The absolute best thing you can do for your life and career is get help now.

Yes , I want to be treated for depression. But having my medical records subpoenaed and going through PHPs is a nightmare that I would rather avoid if I could help it. Oddly enough while at work I am focused/happy/unstressed while taking care of patients and those demons that have haunted me since my childhood are not there. I have already given signout and I am still sitting in the hospital trying to find any excuse not to go home to see my wife and kids. Nurses ask what I am still here. I am just trying to keep the demons at bay for a couple of hours until I can go to bed to a unrestful sleep.

 

[cbrons]

Yes, you do have to give your permission initially to be granted a license, if that is what they ask for.

Of course you can lie on your medical license application. Could that bite you in the future? If for any reason in the future they had cause to subpoena your records, the deception would be immediately apparent.

Yeah.... medical boards can't actually "subpoena" a physician's medical records.

 

[Crayola227]

Yeah.... medical boards can't actually "subpoena" a physician's medical records.

lol, actually, they can

I won't make claims they can do this in every state

you'd be surprised what they can do in some

 

[Crayola227]

Yeah.... medical boards can't actually "subpoena" a physician's medical records.

sounds to me like you've never had your medical records subpoenaed by the medical board, so I don't think you really have the experience to talk here

 

[cbrons]

sounds to me like you've never had your medical records subpoenaed by the medical board, so I don't think you really have the experience to talk here

When you apply for a medical license you think a state board of medicine can just get your hippa protected medical records without your consent?

 

[Peach Newport]

When you apply for a medical license you think a state board of medicine can just get your hippa protected medical records without your consent?

no, but they don't have to let you have a medical license either.