depression / manic depression in school

[GED MD]

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hey, I'm starting med school in a august too and I guess I'm getting cold feet. I'm manic-depressive. I'm working with my therapists to get stabilized and to find the right medications, but I haven't had too much luck yet and I'm really wonder if I will ever be truly "stable." I'm afraid of starting into this profession, getting into $100k worth of debt, and then finding out that there's no place in the medical profession for someone for a manic depressive MD. I've worked hard to get here and I there's no way in hell I'm going to quit, so I'd appreciate any comments, personal experiences, or motivational sentiments you others out there have had.

thanks

 

[Mossjoh]

Bi-polar disease is hard to deal with. I guess it depends on whether you are prone to rapid cycling. Usually, bi-polar episodes of depression of mania only happen once in a GREAT while, but with rapid cycling you can get 4 episodes in a year.
The depression would be especially hard to deal with if it was deep. I feel that your studying would be comprimised and motivation would be lacking.
Yet, medication should be able to stabilize the disorder or at least make the episodes less severe and shorter. Yet, many of the medications to treat bi-polar disorder can have bad side effects, such as lithium.

I encourage you to follow your dreams though.

Mossjoh

 

[medname]

GED MD-

Best wishes as you start medical school!! I had a friend in High School that had manic depression and I am aware of what happens. However, just be careful when you take advice from a non-doctor/counselor in this situation. Just talk with whoever is helping you through this and set up a plan to be successful in medical school. You will do it!!!!

 

[Iron Horse]

A 2nd year with bi-polar recently dropped out because he was having difficulty. My only recommendation is to stay on top of your work and if you encounter difficulty, to seek help ASAP. That could mean talking to a counselor, tutor, and/or your dean of medical student affairs. I believe the 2nd year let things spin out of control and did not seek help until it was too late. It's a shame; hopefully he'll return next year if possible. I would expect most schools to be supportive in any reasonable manner possible.

Best of luck and keep following your dreams!

 

[mamadoc]

Hi, you are doing all the right things - keep talking, keep working with your therapists, you're on the right track. Note that those of us who do *not* have bipolar had a lot of freaked-out feelings during the summer before starting medical school, too - work to sort out what is normal jitters and what is illness-related. (your therapist should be able to help with that)

Also, look for a book, I can't remember the title, written by Kay Jamieson (can't vouch for the name spelling 100%). She's a professor at Hopkins Medical School with bipolar, writes about her own experiences. I have not read the book but have heard rave reviews of it - I hope you would find it reassuring.

It sounds like you've learned to be a good self-advocate - that's good. The folks at your medical school are likely to be supportive *in theory* but don't necessarily expect them to know what to do *specifically* - you will be teaching them. They are most likely to be receptive. Good luck to you, you can do it!

 

[giddygirl]

The book that was referred to by the last person is "An Unquiet Mind" by Kay Redfield Jamison. Jamison is a psychologist who teaches at Hopkins who suffers from bipolar. The book is outstanding and she goes into depth about dealing with both the disorder and being a scholar. To me, it seems like a pretty good sign that you've made it this far--good luck!

 

[LaCirujana]

Because bipolar disorder can manifest so differently in different people, it is difficult to say "Hey, you'll be just fine." However, the other posters have been supportive, have given you an excellent reading recommendation (Kay Redfield Jamison is one of my personal heroes), and I think, told you pretty much what I would tell you: work with your psychiatrist, especially to get a good medication combo working for you so you are as stable as possible, remember that med school is stressful for everyone so freaking out isn't necessarily a sign that you are cycling, have a strong support group and talk to people you trust (caveat--there is still such a tremendous stigma attatched to mental illness that I would be extremely cautious to whom you reveal this information). There most assuredly is a place in medicine for a bipolar MD! Best of luck to you!

 

[Mindy]

This is obviously anectdotal, but...

I worked at a psychiatric emergency room for a portion of my psych clerkship. Apparently there was a surgeon in town who was bipolar. He was successful, well-respected, and most people were not aware of his illness. HOWEVER once every couple of months he would be brought into the Psych ER during a manic episode, screaming at the 5 people trying to restrain him "You can't do this to me, I am GOD!" He would be kept overnight, his meds would be tweaked and he would be back to his normal self the next day.

He was apparently, quite a successful man and surgeon in every other regard. (I say "apparently" because I did not want to know which one of my attendings he actually was.)

The point of this is, no matter what your setbacks are, 1) you're not alone, and 2) you can overcome them.

Mindy

 

[PimplePopperMD]

1. All surgeons think they're god.

2. Joking aside, I would recommend that upon entering med school, be sure to choose an advisor (see Iserson's book on getting into a residency... he recommends this for everyone)... in your case, regardless of what interests you, choose a psychiatrist that you like.

I say this because, although I don't suffer from mental illness, and am not going to go into psych (I think I'll do emergency medicine) my advisor is a psychiatrist, and it is great just talking to him about my career plans, etc. Further, if you have a mental illness, i suspect that you will get more empathy from one who deals with psychopathology daily rather than from a deity...er... surgeon.

my two cents.

 

[peabody]

Hi GED - you are in a challenging situation, but it is definitely something that can be dealt with successfully. Also, I sent you a private message. Clickon "my profile". Good luck!!

 

[squeek]

I would check with medical groups or support groups to see if there's anyone around in a similar circumstance...they'll be able to help you much more than anecdotal advice from this message board.

I have a bipolar sister, and while she is not in medical school, the meds that work for her are very sedating (she's bipolar II, so she's not taking lithium.). She's had a lot of difficulty focusing in undergraduate classes because of the medications--especially since she's used to her thoughts flowing so quickly. So it can certainly be tough for someone struggling to adjust meds, and medical school could throw some tweaks in your equilibrium.

You are doing the right thing, though--seeing if it will work for you. Medical school is a tough road, and you want to be sure you can weather it without doing detriment to your health. To be honest, I've thought of throwing in the towel numerous times.

I wish you the best! And I'm sure that you will make the decision that is right for you.

 

[gas-x]

I glanced at the previous posts briefly, and i think we missed an important point. I think it's very important to have a strong support group, friends I mean. Once you get to med school, try to find a nice bunch you can trust. Med compliance is probably pretty tough for some bipolars, so i would think that you need a close-knit group to watch your behavior. that way they can minimize any problems that you might run into. just a thought.

when i did my psych rotation, i met a very talented engineer that was bipolar. he actually had episodes during periods of extreme stress. besides, he stopped his meds well before his incident. this guy had a great friend that brought him into the hospital to get treated very early. this guy was successful, so i doubt you would have any problems.

 

[Katie]

I have bipolar disorder type II and just finished my first year of medical school. It was a hard road and at times I felt like I had no support. I would say that the 3 most important things are to work closely with your psychiatrist, always take your medication, and make sure you have friends and/or family members who can support you. good luck!

 

[peabody]

One thing I wanted to mention, and I'm sure you've heard this before, but it's really really important to try to get enough sleep and to stay on a regular sleeping schedule (hard as it sounds!).

 

[Starflyr]

•••quote:•••Originally posted by GED MD:
•hey, I'm starting med school in a august too and I guess I'm getting cold feet. I'm manic-depressive. I'm working with my therapists to get stabilized and to find the right medications, but I haven't had too much luck yet and I'm really wonder if I will ever be truly "stable." I'm afraid of starting into this profession, getting into $100k worth of debt, and then finding out that there's no place in the medical profession for someone for a manic depressive MD. I've worked hard to get here and I there's no way in hell I'm going to quit, so I'd appreciate any comments, personal experiences, or motivational sentiments you others out there have had.

thanks•••••I dont know if you're BP I or II or what, but I have been diagnosed with BP I since 1993 (freshman year of high school). I made it through college and first year of med school. The thing I will say is this: Go to a mood disorder specialist - preferably one on the faculty at your school. They know what it's like, what can be done in terms of accomodation and all that. I had one episode of rapid cycling - diurnal - during Neuro, mostly b/c of the stress (I was planning a wedding long distance too). So long as I keep my sleep cycles straight, IM fine. That means some modification to rotations, but deans are usually good about that sort of thing - plus, if you've been hospitalized (I have been twice), you qualify for "reasonable accomodations" under the ADA. You CAN do it. Just dont party (drink) too much and get your sleep. Feel free to email/PM me if you like.

smiles,
Star

p.s. check out: about.bipolar.com There's a great chatroom and stuff.

 

[womansurg]

Originally posted by Mindy
there was a surgeon in town who was bipolar... once every couple of months he would be brought into the Psych ER during a manic episode, screaming at the 5 people trying to restrain him "You can't do this to me, I am GOD!"

Hmm...how did anyone detect when he was manic? Sounds like half the people I work with on a daily basis...😛

 

[Starflyr]

Originally posted by FZISHN
For undergrad students with a mental disorder that is well controlled, do they need to divulge this information on application to medschool? Same with medical students, do they need to tell their program advisors, or are they required to say something in the interview? If something happens in med school or residency, isn't it better if a faculty member knows?

No, it is NOT necessary to divulge a disability of any type during interviews. I have just recently divulged the info to people at my school - and that was ONLY because Im applying for ADA accomodations to have in place as a contingency plan. Some of it STILL wasnt well=recieved, but the upper-level coordinators are awesome.

The first 2 years, nobody should have too much of a problem unless their episodes are triggered by stress (and Im not sure why anyone in that situation would go to med school). Mine are probably triggered by lack of sleep and so Im asking that I not be on for 36 hours IF (and ONLY IF) I end up destabilizing when I try to go it the regular way.

If I HADNT done this and something happened, I would've just taken a leave of absence. There was a person in my class who was diagnosed BP in our 2nd year, and she has taken an extended leave. Same thing if you ended up with any other major illness.

Star

 

[closertofine]

I too have serious concerns about this issue...I have episodes of major depression (not bipolar, though)...and actually am having one currently. It's been really hard this time because I'm trying to study for the MCAT, and also because there doesn't seem to be a good reason why I became so depressed so quickly (though I did miss out on some sleep before my mood went down).

So I've become even MORE depressed thinking that it can't be a great idea for me to go to med school...because I have had several days of not being able to function at all (i.e. no showering, not going to class, and crying constantly)...and I know this would be a huge problem in med school.

I am on medication, but like the OP said, it clearly hasn't been working perfectly...but I'm not especially "poorly adjusted" or suffering from major personal problems, so I do think the right medication would help a lot.

My medication has the possible side effect of drowsiness...but if that weren't enough, I talked to a doctor today who says I have all the symptoms of narcolepsy! Combined, this means I'm extremely sleepy throughout the day...even while on a stimulant medication to try to wake me up...

OK, that was WAY too much complaining for one post...very sorry! 😳 But I just needed to vent...and to let those of you who posted with problems know you're definitely not alone...I know med school would be hard for me, but I'm not yet sure if it would be impossible...

 

[closertofine]

Oh, yea, something ironic...I was supposed to start volunteering in the psych ward of a local hospital this week! But now I don't know what to do...I'm not sure it would be a good idea for me or the patients there now...

 

[andrea]

Originally posted by FZISHN
Anyone had any major side effects with lithium? Drowsiness, bloating, weight gain, cognition problems, etc?

Also, in residency, would BPD or depression be something a program director should know (as it may effect judgment, sleep, etc)? In residency, the level of responsibility is much greater than a medical student's.

I've gotten the main side effects - slight weight gain, nausea, diarrhea, drowsiness, even more pimples. But really, I'll gladly take it all in exchange for feeling suicidal. It's been like night and day since I've started it. There's no way I would have made it through the first two quarters of med school without medication.

As far as telling a director about being BP, I think I'm not going to say anything unless something requires me to. I think I'd rather keep it quiet if at all possible. Mostly I just don't want anyone to feel sorry for me.

Have you started taking lithium? How are things going?

 

[gwyn779]

karen, have you talked to your psychiatrist about this yet? i don't know what meds you're on now, but adding another might be helpful. for example, wellbutrin is usually stimulating and counteracts alot of the side effects of SSRIs (most commonly prescribed). anyway, my best advice is don't try to wait it out! if you fix meds now, they should be in effect by april. on a side note, sleep deprivation tends to improve depression in people who sleep too much. that might or might now be your case.

 

[et2008]

Im Bipolar II and I am gettting ready to start WVSOM in the fall. I have some of the same concerns but I have been stable for 5 years now and my medicine is Lamtical ( I am also determined that my bp will not stop me). My problem is that I will not be able to see my psych doc once school starts and that concerns me. I know that I have to get enough sleep but I also have to exercise ( great way to help prevent manic episodes!). Do any of you see one of the doctors at your school or do you go out into the community for treatment?

 

[Blade28]

Not sure if some of the posters in this thread will see this since the posts were written 5+ years ago, but we'll keep our fingers crossed. 🙂

 

[MossPoh]

Bi-polar disease is hard to deal with. I guess it depends on whether you are prone to rapid cycling. Usually, bi-polar episodes of depression of mania only happen once in a GREAT while, but with rapid cycling you can get 4 episodes in a year.
The depression would be especially hard to deal with if it was deep. I feel that your studying would be comprimised and motivation would be lacking.
Yet, medication should be able to stabilize the disorder or at least make the episodes less severe and shorter. Yet, many of the medications to treat bi-polar disorder can have bad side effects, such as lithium.

I encourage you to follow your dreams though.

Mossjoh

I just chose to quote you because I think you are trying to steal my SN. Thief! Even though you are a 5+ year member...

I think the biggest key is staying with the therapy. You are aware of your problem, which is a big step. My sister has a pretty extreme case of bi-polar but she still manages to raise her son and go to work every day...although she has screwed up other stuff. You've muscled through the process to get IN to medical school, so staying in should be doable. There will be tough times I imagine, but as long as you have a solid support network and continue to go to therapy, I imagine you'll make it through and be fine.

As a note to the other person. I suffer from pretty nasty depression and feel your pain. We won't go into details, but it was pretty bad. It can be really tough at times, especially those days where it takes all your will to roll out of bed. I was on antidepressants for a long time and recently weened myself off of them, mainly because I hate'em. Those days where it hits the most are really a muscle through effort. I try to force myself to exercise and get a little sunlight which seems to help. As stated before, recognizing when you are in that funk is the critical part. When you do that you can kind of tell yourself over and over again that it is just a phase....once in a while it actually works.

 

[GED MD]

Woah, this is a really old topic!

Hey et2008. Contrats on getting in. nicely done buddy.

As they original poster of this thread, I'll just add that I came out all right. So there's definitely hope. (I finally got stabilized on Lamictal too, crazy 'huh?)

We had a lecture at the beginning of our third year where they said about a quarter of US med students are on anti-depressants so your in good company.

So on your concerns - don't worry about getting in to see your doc. You're going to have hours in the day. This should be pretty easy the first two years because you'll have your class schedule well in advance and know which days are going to be shorter. In the clinical years it'll be a little harder, but just schedule your visits on the last day of each rotation (usually there's a test in the morning and you get the afternoon off).

One of the key things will be to actually GET a doctor since most of them are pretty booked. If you live in the area and already have your doc, bonus. At my school, we had a mental health counselor who sort of triaged us and then set us up with referrals to doctors in the insurance network.

I would recommend getting a community based doctor rather than a faculty member because you might end up doing a rotation with them later on. (Seriously, it's pretty funny in a really awkward way, but it's been known to happen.)

And if I can add a couple personal points: expect a good size ego drop once you get in. You may have been an all-star in undergrad (well, you probably were), but be prepared to roll with it if you fail a test or never get beyond the bell curve. It's cool. P=MD and all, but don't let it start you getting depressed.

Also, a philosophical point I learned on my psych clerkship - "I have bipolar disorder" vs "I'm bipolar" - these are master/slave arguments. Which person do you imagine is in better control?

Anyways, congratulations again, you should feel confident!! This isn't law school. Once you get in EVERYONE wants to see you succeed!!

You should do fine. 🙂

 

[HopesDefender]

This isn't law school. Once you get in EVERYONE wants to see you succeed!!

🙂

Haha

The finances seem crushing right now, so maybe there is a financial advisor you could arrange to meet with, or maybe someone in the financial aid office who would agree to sit with you on an appointed day (if you live near the med school you plan to go to) to help make the process less overwhelming.

In addition once school starts, I think that having a regular counselor to help you talk it out when it seems like you are not keeping it together would be a good idea. Someone who is not just as busy and stressed as you are to vent to.

 

[HopesDefender]

hd then finding out that there's no place in the medical profession for someone for a manic depressive MD.

thanks

so i thought we were supposed to be crazy to work this hard to work 80-110+ hrs /wk?

 

[musicaduceus]

Im Bipolar II and I am gettting ready to start WVSOM in the fall. I have some of the same concerns but I have been stable for 5 years now and my medicine is Lamtical ( I am also determined that my bp will not stop me). My problem is that I will not be able to see my psych doc once school starts and that concerns me. I know that I have to get enough sleep but I also have to exercise ( great way to help prevent manic episodes!). Do any of you see one of the doctors at your school or do you go out into the community for treatment?

I have rapid-cycling bipolar II and am doing alright in year 1, although I have had several episodes since starting. As other posters have mentioned, it is absolutely crucial to have a doctor/counsellor you trust. Mine has been invaluable in supporting me, even scheduling sessions outside office hours to accomodate my schedule. I wouldn't choose someone connected with your school if at all possible; I currently see a psychiatrist in a hospital I will not rotate through who is not on faculty at my school. Perhaps you could ask your current doctor for a referral or contact in the area.

And yes, sleep is crucial. Tell myself that sleep has to rank above studying. And take your meds! Learnt that the hard way.

 

[Blesbok]

I just wanted to note that this is an old *** thread. 😱

 

[et2008]

Thanks for the advice guys, I am going to begin working on finding a doc up there.

 

[adajim]

People suffering from anxiety, panic, stress and depression should consult a specialist and only then should use the medicine, as there can be various reasons behind the disorder. Medicines used to cure such disorders are habit forming and should be used for small duration. As per my personal experience, I have used Xanax and it helped me in getting over my panic and anxiety disorder. Along with medicine, the concerned person should take a break from his/her regular schedule, go out and take good sleep. Rather than going on drugs, one should look for the reason behind there problem . Keeping your self busy and changing the schedule also helps sometimes to get over stress and depression.

 

[ChemEngSoonMD]

hey, I'm starting med school in a august too and I guess I'm getting cold feet. I'm manic-depressive. I'm working with my therapists to get stabilized and to find the right medications, but I haven't had too much luck yet and I'm really wonder if I will ever be truly "stable." I'm afraid of starting into this profession, getting into $100k worth of debt, and then finding out that there's no place in the medical profession for someone for a manic depressive MD. I've worked hard to get here and I there's no way in hell I'm going to quit, so I'd appreciate any comments, personal experiences, or motivational sentiments you others out there have had.

thanks

1. man up
2. be happy you are in med school. there are other people out there working at mcdonalds.
3. work out, natural endorphin

 

[njbmd]

hey, I'm starting med school in a august too and I guess I'm getting cold feet. I'm manic-depressive. I'm working with my therapists to get stabilized and to find the right medications, but I haven't had too much luck yet and I'm really wonder if I will ever be truly "stable." I'm afraid of starting into this profession, getting into $100k worth of debt, and then finding out that there's no place in the medical profession for someone for a manic depressive MD. I've worked hard to get here and I there's no way in hell I'm going to quit, so I'd appreciate any comments, personal experiences, or motivational sentiments you others out there have had.

thanks

You take this profession one day at a time. You will paralyze yourself by worrying if you can or cannot do this job. The one that that you can count on is that completion of medical school will give you options. There are no guarantees for anyone regardless of diagnosis or no diagnosis. There are plenty of folks with controlled mental illness who make it through and there are plenty of folks who have no mental illness who don't. What every got you in will get you through but you can't live on the "what-ifs".

 

[Simmy]

Ive worked at a psychiatry ward this summer in a department with alot of people with manic depressions and psychosis. I had a 19 year old patient with manic depression who came in and he had been there for almost 4 weeks now. I have to say that seeing him beeing at his worst it was hard to imagin he would get far in higher education. He started economics studies last year but had to drop out because it was to much.

Take note that this was the first time he was diagnosed with it, so the medication period take alot longer to finde what works. I would say that its not good to put yourself in one of the most stressfull and mental challenging professions there is when you have this diagnose. It might work for some, but for others it will be impossible... But as I said, each case is indivdual and uniqe, so its hard to say when you dont know the patient.

Sorry about spelling errors, Im not english...

 

[The Angriest Bird]

I heard an anecdote about a manic physician who became so successful because his mania was manifested as reading every medical paper published in the last 10 years, something like that.

 

[Noirukiddingme]

I think the best thing you can do proactively is talk with your med school's mental health advisor/specialist. I'm not sure if every med school has one, but if yours does, I would suggest going to them in the beginning, not just after things get bad. Most likely, the school mental health advisor has advised similar students in the past, and possibly at the same school, so they will have a good feel for what to expect. Good luck!

 

[Van Chowder]

So the ops original post was in 02, in which case 7 years later hes certainly done with his schooling and maybe on the tail end of his residency as well.
lol I wonder how these threads get resurrected.

Congrats op! Im glad to see you made it !( prlly wont even see thishaha )

 

[mrmandrake]

To the OP: if this helps at all, my brother, who went to UCSF said that half of his friends were on ADHD/depression/anxiety meds and he was a popular guy so it was a lot of people. With the type of people that medicine attracts, I'm sure you aren't alone. Just keep working at it and know that you are a smart guy and you will be OK.