I am depressed

[Annoyances]

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It's funny half way into intern year and every day I rush home wanting to cry like a baby. I m doing my ICU and don't get home post call until 1pm and the whole night there I want to be at home and become so depressed and scared as patients begin to cry. Whatever happened to that little kid who wanted to be a doctor and wanted to help and change the world?? Well that kid is gone intern year has officially killed me. I am soo depressed. Me a grown adult, going home to cry makes me realize how depressed I m. I am not that type of person but the fear I feel each night, and deep depression and dealing with so many insensitive people each day it's just too much at times. I remember how exited I was about the prospect of residency last year and yet now I can't wait for it to end. I just hate it. I look foward to my vacation in mid march for two weeks so I can get away from the hospital for a short bit. I just can't take it anymore. I think I am going to break down.

 

[MDgonnabe]

the fear I feel each night

fear of what?

 

[fantasty]

I'm sorry this has been such a rough time. I think a lot of people go through this - I'm just a med student, but one of my interns in medicine was on the verge of a breakdown, and she had to leave the hospital on a call night before.

I really can't think of anything to say that will make it all better, but I sincerely hope your program offers counseling services (or you have access to something else). It's really in your best interests to deal with this before it gets worse.

Best wishes. Hang in there.

 

[8744]

fear of what?

Fear of looking like a dumb ass, for one, like we inevitably do at the start of every rotation.

That's the worst part of intern year for me.

 

[Annette]

It's funny half way into intern year and every day I rush home wanting to cry like a baby. I m doing my ICU and don't get home post call until 1pm and the whole night there I want to be at home and become so depressed and scared as patients begin to cry. Whatever happened to that little kid who wanted to be a doctor and wanted to help and change the world?? Well that kid is gone intern year has officially killed me. I am soo depressed. Me a grown adult, going home to cry makes me realize how depressed I m. I am not that type of person but the fear I feel each night, and deep depression and dealing with so many insensitive people each day it's just too much at times. I remember how exited I was about the prospect of residency last year and yet now I can't wait for it to end. I just hate it. I look foward to my vacation in mid march for two weeks so I can get away from the hospital for a short bit. I just can't take it anymore. I think I am going to break down.

1) Get some help! WE ALL GO THROUGH THIS! And at times we need extra support. Often hospitals will have an employee assistance program that can give you referals. Is there an attending that you work well with? Speak with them about what you are going through. Talk to your program director, take some time off now if you need to. If you aren't getting off post-call until 1 pm, you may need to talk with your chief or PD about hours.

2) Get some help! Talk with your doctor. Will an antidepressant help you? What about psychotherapy? How about multivitamins? Regular exercise? Get some sunlight (I know, easier said than done- can try a "natural" light lamp.) Try taking a different way home. Try doing something different each day, even if it is only going a different way home.

3) Get some help! Find someone to talk to, even if it is your dog/cat. Or you can try writing things down. Ask the senior residents how they got through their rough times (THEY HAVE HAD THEM!).

4) Get some sleep! I know there is alot of pressure to make do with only 4-5 hours of sleep. You probably did it through college and med school. Fellow interns may be bragging that they don't need that much sleep. Hogwash. Get room darkening shades so you can sleep when you are post-call. Get a decent bed. Turn the phone off, or down. (Damn telemarketers and wrong numbers can make you really cranky post-call!) 😴

5) Do something fun that is NOT related to medicine. Residency, and especially internship, can become all-consuming. Did you like to read fiction before you started into this mess? Pick up a good novel. Movies? There ain't much out right now, but there are plenty of good movies available on DVDs. Go out to dinner with friends, but keep medicine out of the topics. Go out to dinner with friends and talk about nothing other than your frustrations (but you will want to watch out where you have this dinner- other diners may not understand why vomit coming out of an ET tube, splashing you everytime you do a chest compression is funny!)

6) Find something to laugh at. When you are depressed, this can be very hard to do, but if you can, you will feel much better.

7) If you feel like you want to kill or hurt yourself, go to the emergency department. You don't have to go to your hospital. You may or may not be hospitalized, but it will get you in contact quickly with people who can help.

 

[8744]

8) Put your head down and tough it out. You're half-way through intern year! This is a positive thing.

9) You really don't need that much empathy. People get sick, they die, and it's not your fault. It's easy to say but you need to stop bringing work home with you from the office. What I mean is that when you sign out your patients you need to forget about 'em until you go in the next day and they become your responsibility again. You do have a life, after all. Heck, maybe I'm a bad person but one of the greatest pleasures in life is sign-out, particularly if you have been managing a particularly difficult and/or obnoxious patient. It is a relief after an exhausting day to temporarily free yourself from that kind of responsibility.

10) By all means seek proffessional help. Don't be embarrassed about it either. We are all in the same boat as you, some of us just handle it differently.

 

[8744]

11) Eschew your social life if it is cutting into your sleep. Sleep is your friend. Sacrifice almost everything for a good night's sleep. I am doing s pretty intense cardiology rotation right now and all I do is work, go home, sleep, repeat. My wife is very understanding.

When you are post-call, out by one or two, for gosh sake's take care of important "business of living" like banking and grocery shopping and then hit the rack.

 

[8744]

12) And for the love of Moses, remember, you're only an intern and the MICU is going to function just fine in your absence and can even withstand your (and my) ignorance. Getting a good sense of your true importance as an intern will calm you down.

 

[MDgonnabe]

Fear of looking like a dumb ass, for one, like we inevitably do at the start of every rotation.

That's the worst part of intern year for me.

you never felt like a total idiot in med school? you're blessed. in retrospect, feeling inept in med school had its pluses since i've come to realize that making mistakes is part of the learning process for everyone. and even beyond education seasoned attendings still occasionally make mistakes. we're all only human.

but the above advice is certainly a great starting point for the op. and remember, people frequent these boards very often if you need someone to talk to but can't find anyone else. much to you.

 

[Selznick]

I'm saving these 12 advice-oids for the future - just in case. 😱

Thanks. 🙂

 

[grunermann]

Everyone makes some good points. Just try to get help! You can't do it alone. I think I speak for everyone that we appreciate your airing your feelings here. Just also do it somewhere in private where you can work on them.

 

[Winged Scapula]

Fear of looking like a dumb ass, for one, like we inevitably do at the start of every rotation.

That's the worst part of intern year for me.

From a Chief resident....that feeling takes a LONG time to go away.

 

[Orange Julius]

!

 

[Teewinot]

Hey -
I've also had a hard time this intern year - I still can't imagine being an R2. Sometimes I wonder whether I can handle the stress for another 2 years. At this point in time, I don't know what I would do next year because it's kind of late to change programs.
All I can say though is that I was near a breaking point last month and nearly called for help from a number provided by my residency program. Instead I pulled myself together and went to see a private doc and got an ssri. My continual anxiety got to the point where I couldn't sleep or eat and spent my entire time off worrying about mistakes I made/could have made. It was crazy. I definitely don't feel 100% or even close, but at least now I have some coping mechanism back in place. You are definitely not the only one going through this - meds can help.

 

[KatieJune]

Question for all you who are having a hard time. Do you think that this is because of your specific program or is this how intern year is for everyone. I'm just a med student, but it sure would be nice to know which programs to NOT apply to or which ones to....anyone know how to tell????

 

[tiene dolor?]

Seek out the Fat Man's advice.

 

[tiene dolor?]

Question for all you who are having a hard time. Do you think that this is because of your specific program or is this how intern year is for everyone. I'm just a med student, but it sure would be nice to know which programs to NOT apply to or which ones to....anyone know how to tell????

Residency will hurt you. Sorry.

 

[KidDr]

Residency will hurt you. Sorry.

Agreed. It pretty much sucks sometimes. Doesn't matter what specialty/which location.

 

[ccthedoc]

Well that kid is gone intern year has officially killed me.

Everyone feels this way during intern year (and at plenty of other times during residency!), no doubt. And if they tell you that they don't... they are lying to you. All I can tell you is... it get's better and easier... it really does. Just make sure that you have some close friends (maybe fellow interns) who understand what you are going through, whom you can vent to when you are really feeling down. If you don't want to share these feeling with people you are close to then take the good advice that you would give to your patients and find a couselor that you feel comfortable sharing your feelings with. Even doctors need a little TLC sometimes... we're only human!

Take care,
CC

 

[quark]

Ditto...I think that most people feel this way at some point (probably multiple times) during medical school and residency. I can't even count the number of times I've seriously thought about quitting. But I stuck to it and now that I'm almost at the end of residency, I'm glad that I did.

 

[PatrickBateman]

.

 

[Annoyances]

.

Thank you for the advice I finally had time to come back it's glad to know others understand. I am trying hopefully I can survive until the end of this ICU month. Rounds take forever and the intern on call presents ALL patients the day post call and if u make a mistake depending on the attending u can be made to feel like a complete fool. The stress of the ICU is just too much for me. During my call I am exausted and frankly scared when multiple people start crashing it's horrible. I have found intern year as a whole to have been pretty much hell for me. It's soo stressful, the long hours, the annoying attendings who for some reason always think you aren't doing enough not to mention some very unsupportive senior residents who I have found to be not helpful at all and making my work twice as hard. Not getting home until 1pm post call is horrible. I just pray I survive untilt the end of this year. I have felt many a time like quiting. But you know it is good to hear that others can relate some what. I find in my program a lot of interns like making it look like its soo easy and hearing them talk to the people interviewing right now for internship I think to myself oh my god how can they sit there and claim its soo easy. Maybe something is wrong with me when I feel so sad, exausted and depressed most of the time...



Luis

 

[Annette]

Another thing to keep in mind when an attending starts yelling at you is realize HE IS THE ONE WITH THE PROBLEM! You are in a residency program. Your job is to do the best you can, and you will screw up. Seriously. If you knew all this stuff already, you wouldn't need to do a residency. Their job is to teach and guide you. Unconstructive criticism isn't helpful.

Never say you know something when you don't. If you think the lab value is something, but are not 100% certain, say "I think the lab value was . . ." When you screw up, say so. Never say you have done something when you have not.

Talk to your chief about your hours. If you are over the limit, you don't want to get the program into trouble should someone check. Don't expect much, as it sounds like you are at a "suck it up" kind of residency instead of one that cares about its residents.

 

[8744]

Another thing to keep in mind when an attending starts yelling at you is realize HE IS THE ONE WITH THE PROBLEM! You are in a residency program. Your job is to do the best you can, and you will screw up. Seriously. If you knew all this stuff already, you wouldn't need to do a residency. Their job is to teach and guide you. Unconstructive criticism isn't helpful.

Never say you know something when you don't. If you think the lab value is something, but are not 100% certain, say "I think the lab value was . . ." When you screw up, say so. Never say you have done something when you have not.
.

Word. I'm on night float for cardiology this week and I am cross-covering about 90 patients, none of whom I know anything about. The potential for screwing up is immense, especially as most of the patients have some kind of unstable heart condition.

What can you do? You just have to do your best.

 

[8744]

Thank you for the advice I finally had time to come back it's glad to know others understand. I am trying hopefully I can survive until the end of this ICU month. Rounds take forever and the intern on call presents ALL patients the day post call and if u make a mistake depending on the attending u can be made to feel like a complete fool. The stress of the ICU is just too much for me. During my call I am exausted and frankly scared when multiple people start crashing it's horrible. I have found intern year as a whole to have been pretty much hell for me. It's soo stressful, the long hours, the annoying attendings who for some reason always think you aren't doing enough not to mention some very unsupportive senior residents who I have found to be not helpful at all and making my work twice as hard. Not getting home until 1pm post call is horrible. I just pray I survive untilt the end of this year. I have felt many a time like quiting. But you know it is good to hear that others can relate some what. I find in my program a lot of interns like making it look like its soo easy and hearing them talk to the people interviewing right now for internship I think to myself oh my god how can they sit there and claim its soo easy. Maybe something is wrong with me when I feel so sad, exausted and depressed most of the time...



Luis

Luis, we all feel like you do to varying degrees at one time or another during intern year. Tough it out. Ten years from now you will look back and laugh.

 

[tiene dolor?]

Word. I'm on night float for cardiology this week and I am cross-covering about 90 patients, none of whom I know anything about. The potential for screwing up is immense, especially as most of the patients have some kind of unstable heart condition.

What can you do? You just have to do your best.

I find it helps a lot if you just stop giving a ****.

 

[Orange Julius]

I find it helps a lot if you just stop giving a ****.

😱

 

[gwen]

ICU is one of the toughest rotations as we all know. just take it one day at a time and it will be over. after residency, you'll never have to deal with it ever again (i'm taking a random guess that you won't subspecialize in pulm-cc).

i think almost 90% of interns go through tough times like these. if you feel though that this depression is getting out of control, you really should seek help, or take time off or re-consider your career options (at least make a shift to FP or psych or path if you are crazy about medicine but not necessarily about the IM lifestyle...wait, i'm assuming you're IM).

i hope you feel better.

 

[needsadvice]

I think Panda_Bear's point #12 is particularly important. Although it's great that you bear the responsibility of the patient's well-being onto your own shoulders, realize that you DO have the cushion of an upper-level resident and an attending behind (or above? 🙄 ) you. Try to relax a little bit. If you do your best for your patients, in most circumstances, it turns out ok. Good luck.