MD How to combat the "Med School blues" for Year 1

[Anatomaster91]

Hi there,

I'm an M1, second term student and I've seen many other posts and threads about how first years are usually struck the hardest by med school depression due to isolation, long study hours, lack of sleep, etc. And I was wondering how anyone was able to overcome this to try to help focus better and do better in school? I seem to have my days where I'm ok and am really focused, then I have days where I'm not ok, don't want to study, cry, think about everything bad that's ever happened to me and I get very overwhelmed. I don't talk much to anyone at school and I don't really interact or go on campus much because I have enough to keep me busy. What are some recommended things to do to overcome med school blues without getting totally unfocused?

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[Goro]

Hi there,

I'm an M1, second term student and I've seen many other posts and threads about how first years are usually struck the hardest by med school depression due to isolation, long study hours, lack of sleep, etc. And I was wondering how anyone was able to overcome this to try to help focus better and do better in school? I seem to have my days where I'm ok and am really focused, then I have days where I'm not ok, don't want to study, cry, think about everything bad that's ever happened to me and I get very overwhelmed. I don't talk much to anyone at school and I don't really interact or go on campus much because I have enough to keep me busy. What are some recommended things to do to overcome med school blues without getting totally unfocused?

Practice mindfulness techniques
Exercise
Develop a support network

 

[Oso]

I would also consider speaking to a counselor/psychologist at school to see if there's a deeper depression going on.

 

[DO2015CA]

Also don’t be 100% serious mode. Go out for drinks with classmates

 

[MD-2021]

Practice mindfulness techniques
Exercise
Develop a support network

This honestly. The main thing that gets me through med school is my classmates. It's nice to know that a lot of people are in the same boat as you.
And start lifting bro. Pumping iron at least 3-4 times a week makes you feel so much better.

Also don’t be 100% serious mode. Go out for drinks with classmates

Keep in mind that many students may have religious or personal reasons to not drink. There are lots of ways to be social that don't involve alcohol

 

[Detective SnowBucket]

Keep in mind that many students may have religious or personal reasons to not drink. There are lots of ways to be social that don't involve alcohol

Unfortunate to limit yourself regarding a great way to unwind with friends. Also, lol this is not "many students".

Anyways, yes, drinks, exercise, sleep.

 

[DO2015CA]

This honestly. The main thing that gets me through med school is my classmates. It's nice to know that a lot of people are in the same boat as you.
And start lifting bro. Pumping iron at least 3-4 times a week makes you feel so much better.

Keep in mind that many students may have religious or personal reasons to not drink. There are lots of ways to be social that don't involve alcohol

Can go “out for a drink” without it being alcohol. Unless you are against being in the presence of classmates having a beer and you iced tea

 

[Lannister]

Find a hobby, spend a few hours per week doing it. Sometimes I find that I just need a few hours where I'm not a med student, to remind myself that there's more to life than medical school.

 

[Crayola227]

seek professional help

 

[Prometheus123]

1. See a mental health professional.
2. Go outside when the sun is out (use sunscreen as appropriate to avoid burning). If you don't have time for a proper outdoor adventure, go to a nearby park. Take off your shoes. Walk around in the grass barefoot. Spend a significant amount of time looking at the blue sky and the green trees and grass. Sit down (still barefoot) and breathe as deeply as you possibly can into what feels like the bottom of your belly. Inflate your belly with force. I like to listen to music I enjoy while I do this, but that part is optional. I know this sounds a bit odd, but it's backed up by some excellent science, plus it really does work. I'm not making any medical claims here, but I will say that this is a great way to prevent burnout in my personal experience. Try it. It only takes 20 minutes, and if it works as well for you as it does for me, it will be the most worthwhile 20 minutes you've spent in a long time.

P.S. By the way, I did not just make this up. This practice is based on an ancient Qigong breathing exercise. The other aspects of it are supported by scientific research, as well as the simple logic of evolutionary biology. I don't have time to properly cite my sources, but you probably don't care about that right now anyway. Just try it. See how it makes you feel.

 

[Crayola227]

Unfortunate to limit yourself regarding a great way to unwind with friends. Also, lol this is not "many students".

Anyways, yes, drinks, exercise, sleep.

I think most psychiatrists and other physicians (and certainly this one) would advise against any alcohol whatsoever if someone is having mood issues.

Possibly if someone has a "simple" case of burnout, unwinding with the amount of alcohol that is within medically acceptable limits is likely fine.

But it can be difficult to tell, which is why overall I think avoiding it when you're not in a good frame of mind is likely the conservative course of action to take.

Even 1 drink, even quite a bit before bedtime, has been shown to have negative effects on sleep quality. Obviously, many people tolerate this. However, as I said, if one is struggling with mood or burnout, sleep quality is a high priority. I urge anyone to pay particular attention to whether or not alcohol does more good than harm to their well-being.

going out with friends is great, and it absolutely does not have to involve alcohol

When I have been depressed, I cut out alcohol completely. It doesn't get me down because I know that it's most likely not a forever change, it's one that will allow me to get better more quickly and get back to enjoying all the things I enjoy, including the occasional drink.

When I go out and don't drink and people wonder why, I say that I notice even 1 drink affects my sleep quality and sorta makes me feel "down" the next day (100% true) and I have never had any social issues whatsoever with that explanation. You get bonus points if you still hang out, mix drinks at the partay, buy a round (non-alcoholic for you) or act as DD (designated driver).

This isn't about me trying to say no one should drink ever. However, I don't think we should discuss it like it's a must-do. It isn't.

 

[Prometheus123]

I think most psychiatrists and other physicians (and certainly this one) would advise against any alcohol whatsoever if someone is having mood issues.

Possibly if someone has a "simple" case of burnout, unwinding with the amount of alcohol that is within medically acceptable limits is likely fine.

Even 1 drink even quite a bit before bed time has been shown to have negative effects on sleep quality. Obviously, many people tolerate this. However, as I said, if one is struggling with mood or burnout, sleep quality is a high priority. I urge anyone to pay particular attention to whether or not alcohol does more good than harm to their well-being.

going out with friends is great, and it absolutely does not have to involve alcohol

When I have been depressed, I cut out alcohol completely. It doesn't get me down because I know that it's most likely not a forever change, it's one that will allow me to get better more quickly and get back to enjoying all the things I enjoy, including the occasional drink.

When I go out and don't drink and people wonder why, I say that I notice even 1 drink affects my sleep quality and sorta makes me feel "down" the next day (100% true) and I have never had any social issues whatsoever with that explanation. You get bonus points if you still hang out, mix drinks at the partay, buy a round (non-alcoholic for you) or act as DD (designated driver).

This isn't about me trying to say no one should drink ever. However, I don't think we should discuss it like it's a must-do. It isn't.

Amen.

 

[Coupd'Cat]

See a psychiatrist and get thee some evaluation +/- medical treatment. Has worked wonders for at least 10 people I know in our class (who are open to talking about it).

Edit: and also be good to yourself & know that there are probably a lot of structural/institutional deficiencies that have contributed to how you feel now.

So even as we say "go seek help" we acknowledge it's not easy & not the panacea for a medical education system/environment that has a long way to go

 

[DiscusKeeper]

From personal experience, I highly recommend talking to a mental health professional. I had seen a therapist for 3 years in undergrad and worked a lot on my depression. I thought I was managing it well on my own, but the stress of med school started making it a lot worse. So I decided to use my school's counseling center, which has clinical psychologists as well as psychiatrists, and I'm starting back in psychotherapy and started on an SSRI. I haven't been on it long enough to receive a therapeutic benefit, but just having taken the steps to improve my mental health has helped me to feel more hopeful and a little less depressed. Even if you just do talk therapy, it can be very helpful in learning how to cope with the stress of med school and any depression you're experiencing.

Also - This is bad if you have anxiety, but if you're struggling with just depression, I find that caffeine helps on days where I can't focus and feel too tired to get out of bed. I think one of the things that makes it more difficult is the weight of the responsibilities I have from being in med school, so on those days I've learned to not be so hard on myself and to just get done what I can, even if it takes me longer than usual. And I usually start those days off with a coffee to give myself something pleasant in the morning that also helps me to focus on studying. A huge part of coping with feeling like this is to learn to not feel guilty for not being okay. Allowing yourself to take things a little easier on days like that can actually help you to be more productive.

 

[justkeepswimming]

A huge part of coping with feeling like this is to learn to not feel guilty for not being okay. Allowing yourself to take things a little easier on days like that can actually help you to be more productive.

I like this. You have to give yourself space to feel down sometimes. You are in the most boring and unglamorous part of school where you feel more like a reading robot than a real doctor, and it can be hard to draw inspiration from anywhere. Just remember that it's OK to have good and bad days, and the bad days do pass. When you're having a rough day, treat yo self a little bit and be kind to yourself. It's often way more helpful than trying to push through the pain. Med students are used to pushing themselves to the limit but you have to remember that you are a normal human who is allowed to have feelings, good and bad, and you don't need to feel guilty for days where you are a little slower or feeling down.
This may sound ridiculous, but sometimes I was so stressed that I had days where I needed to cry for no reason. Rather than holding it in, I would watch those YouTube compilations of military homecomings (where there's the emotional music and the little kids run to their parents and it's so happy...sigh), which never fail to get the waterworks going. After a couple of videos, I was all cried out and I felt better. It was very cathartic. Not sure that's necessarily a healthy solution haha, but it was effective for me. And I feel like I still turned out to be a relatively normal person in the end.
Also, I agree with other posters about needing friends. Make sure you have some outside connections to keep you grounded.

 

[Anatomaster91]

From personal experience, I highly recommend talking to a mental health professional. I had seen a therapist for 3 years in undergrad and worked a lot on my depression. I thought I was managing it well on my own, but the stress of med school started making it a lot worse. So I decided to use my school's counseling center, which has clinical psychologists as well as psychiatrists, and I'm starting back in psychotherapy and started on an SSRI. I haven't been on it long enough to receive a therapeutic benefit, but just having taken the steps to improve my mental health has helped me to feel more hopeful and a little less depressed. Even if you just do talk therapy, it can be very helpful in learning how to cope with the stress of med school and any depression you're experiencing.

Also - This is bad if you have anxiety, but if you're struggling with just depression, I find that caffeine helps on days where I can't focus and feel too tired to get out of bed. I think one of the things that makes it more difficult is the weight of the responsibilities I have from being in med school, so on those days I've learned to not be so hard on myself and to just get done what I can, even if it takes me longer than usual. And I usually start those days off with a coffee to give myself something pleasant in the morning that also helps me to focus on studying. A huge part of coping with feeling like this is to learn to not feel guilty for not being okay. Allowing yourself to take things a little easier on days like that can actually help you to be more productive.

Thanks. I actually do have anxiety though, but I can't stay awake and survive without coffee around 6 and 11pm. It won't happen lol

 

[Anatomaster91]

I like this. You have to give yourself space to feel down sometimes. You are in the most boring and unglamorous part of school where you feel more like a reading robot than a real doctor, and it can be hard to draw inspiration from anywhere. Just remember that it's OK to have good and bad days, and the bad days do pass. When you're having a rough day, treat yo self a little bit and be kind to yourself. It's often way more helpful than trying to push through the pain. Med students are used to pushing themselves to the limit but you have to remember that you are a normal human who is allowed to have feelings, good and bad, and you don't need to feel guilty for days where you are a little slower or feeling down.
This may sound ridiculous, but sometimes I was so stressed that I had days where I needed to cry for no reason. Rather than holding it in, I would watch those YouTube compilations of military homecomings (where there's the emotional music and the little kids run to their parents and it's so happy...sigh), which never fail to get the waterworks going. After a couple of videos, I was all cried out and I felt better. It was very cathartic. Not sure that's necessarily a healthy solution haha, but it was effective for me. And I feel like I still turned out to be a relatively normal person in the end.
Also, I agree with other posters about needing friends. Make sure you have some outside connections to keep you grounded.

Haha, I agree with this completely. Sometimes it's nice to just cry and I actually have tried to help my motivation with watching and reading things I enjoy and motivational things that remind me why I'm here. I remember when medicine was all I ever wanted to do since I was a kid, like most of us. And it is still my only livelihood. It just sucks to get through the hard years first before the best years come. I know it's a stressful and hard field and I've actually been in medicine for about 7 years in nursing prior to med school. I love everything about it and yeah, I've gone through many tough life turns (illnesses, divorce, parent issues, etc.) But I think everyone does have their own issues and we deal with it as it comes. Thanks for this!