Inspired by some recent reddit lurking to make an "AMA" style thread (no pun intended.... ). Just bored at the moment and feel like I might have some insight to offer on the disease itself & on being a med student with a mental illness. Ask away if you care to!
I'm a med student with bipolar disorder - ask me anything.
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Do you worry about the side effects of the medications you are on?
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How low do you millennials set the bar these days to qualify yourselves as someone to be asked anything?
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do you think people are curious enough about your situation to do an AMA?
I worried about side effects when I started taking meds, but learned fairly early on that the disease itself is worse than the medications. But I've also been fortunate to have very few noticeable side effects. I do worry about potentially being on them for decades but I don't know what the future holds in terms treatment options or my life situation. Essentially, cross that bridge when I come to it.
At my school we run a panel where students speak to their peers about experiences with mental illness, so I a lot of the student body knows (definitely all of my year, and a lot of the year above me). A couple members of the administration know as well as a couple of faculty mentors - I actually erred on the side of disclosure when I started because I wanted to make sure I had proper supports in place and could act quickly if I needed to use accommodations/take time off/etc (none of which happened, fortunately!). I've had very positive experiences with this and have no regrets.
And yeah, this is pretty narcissistic. Every now and then I just get in a mood to bust some misconceptions. If it bothers you, rest assured that 99% of the time I never post on here.
At my school we run a panel where students speak to their peers about experiences with mental illness, so I a lot of the student body knows (definitely all of my year, and a lot of the year above me). A couple members of the administration know as well as a couple of faculty mentors - I actually erred on the side of disclosure when I started because I wanted to make sure I had proper supports in place and could act quickly if I needed to use accommodations/take time off/etc (none of which happened, fortunately!). I've had very positive experiences with this and have no regrets.
And yeah, this is pretty narcissistic. Every now and then I just get in a mood to bust some misconceptions. If it bothers you, rest assured that 99% of the time I never post on here.
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here's a general question about mental illness in higher education. do you think you should be treated the exact same as others or accommodated to by your school? I don't know what accommodations exist currently for students with mental health issues, so I was just curious
Actually I think a question like this would be more suited towards learning disabilities (I don't know if that falls on the spectrum of mental health). But I'd still like to hear your answer
Actually I think a question like this would be more suited towards learning disabilities (I don't know if that falls on the spectrum of mental health). But I'd still like to hear your answer
Accommodations exist both for learning disorders and mental health diagnoses. Typically a specialist works with students to determine which accommodations are reasonable, then the administration approves it without learning the students' diagnosis. At this level, it seems students are trusted to not abuse the system (and from what I see, they don't). I know some get extended time on exams for ADHD or other reasons - they're all bright, capable people I have no doubt will make good physicians, so if they, their doctors & a disability expert at the school deem such accommodations appropriate, I frankly have no problem with it.
I had the option to delay exams should I have a mood episode and while I did have episodes that put me behind, I always managed to bust my ass and catch up. I don't think it would've been unfair to use accommodations in those cases because it's not dissimilar to getting any serious major illness before an exam, but I personally wouldn't use them unless I was on the brink of failing specifically and directly due to symptoms of my bipolar disorder.
Clinicals are an entirely different story. As you likely know, sleep is king in bipolar disorder and obviously lack of sleep isn't great, but flipping your sleep schedule around is a whole other ballgame. It's ironic, because I CAN stay up for days on end sometimes and it actually feels really great but that's obviously a very slippery slope. So it looks like I will have the option to work more days per week in order to do more day shifts, and also stay at my home institution since travel and setting up shop in new locations gets iffy. I wasn't nuts about taking the school up on these initially, and yeah it's possible I might do ok without them, but with patients in the mix there's just no good reason not to be cautious.
I had the option to delay exams should I have a mood episode and while I did have episodes that put me behind, I always managed to bust my ass and catch up. I don't think it would've been unfair to use accommodations in those cases because it's not dissimilar to getting any serious major illness before an exam, but I personally wouldn't use them unless I was on the brink of failing specifically and directly due to symptoms of my bipolar disorder.
Clinicals are an entirely different story. As you likely know, sleep is king in bipolar disorder and obviously lack of sleep isn't great, but flipping your sleep schedule around is a whole other ballgame. It's ironic, because I CAN stay up for days on end sometimes and it actually feels really great but that's obviously a very slippery slope. So it looks like I will have the option to work more days per week in order to do more day shifts, and also stay at my home institution since travel and setting up shop in new locations gets iffy. I wasn't nuts about taking the school up on these initially, and yeah it's possible I might do ok without them, but with patients in the mix there's just no good reason not to be cautious.
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Given the number of students in medical school that suffer from some form of mental illness, whether it be depression, an anxiety disorder, or some other issue like ADHD or dyslexia, I don't think having a general AMA on mental health is unwarranted. Especially given how rigorous and stressful med school and residency can be and the number of students who develop these conditions during that time.
@sylvi
What year are you and when were you diagnosed with bipolar disorder? When did you start taking medication, and did you have to start/adjust the dosage while in medical school? Do you feel you get adequate support from your school and rotations (if you've done them) with keeping your condition in check? Have your symptoms ever become so severe or unmanageable that it significantly interfered with your education or patient responsibilities, and has it ever been bad enough that you seriously considered pursuing a different career?
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Thanks Stagg. I'm a second year and I was diagnosed in early 2014. I was already on an antidepressant (fortunately not an SSRI), but we didn't start adding mood stabilizers till about a year before I started school. I've had to adjust my dosages more than once since starting, but I'm always in close touch with my psychiatrist here and can get a hold of him pretty much whenever I need.
I haven't started rotations yet, but my school is incredibly supportive. I had a sense it would be, which is ultimately why I chose it. I had a couple of instances where I was starting to veer into an episode but caught the symptoms early (those were the medication adjustments). In those cases, I maybe lost a few days of being able to pay attention & study, but it was recoverable. I had a somewhat longer period of hypomania once that went unchecked for awhile, but lo and behold I got my highest grade in med school yet in that class... However in hindsight I was unhappy that it had happened - it wasn't so extreme that I think it would've impaired my ability to care for patients, but it was good to get a reminder to track things pretty closely.
I've been the healthiest psychiatrically that I've been my entire life since starting medical school. It really seems to help stabilize me and keep me committed to my self-care. The two years before, though, when I wasn't yet stabilized and on my current med regimen, were hell. So yes, it was very, very bad. But to be honest, no, I never considered pursuing a different career. Making it here was a major motivator in my getting well.
I haven't started rotations yet, but my school is incredibly supportive. I had a sense it would be, which is ultimately why I chose it. I had a couple of instances where I was starting to veer into an episode but caught the symptoms early (those were the medication adjustments). In those cases, I maybe lost a few days of being able to pay attention & study, but it was recoverable. I had a somewhat longer period of hypomania once that went unchecked for awhile, but lo and behold I got my highest grade in med school yet in that class... However in hindsight I was unhappy that it had happened - it wasn't so extreme that I think it would've impaired my ability to care for patients, but it was good to get a reminder to track things pretty closely.
I've been the healthiest psychiatrically that I've been my entire life since starting medical school. It really seems to help stabilize me and keep me committed to my self-care. The two years before, though, when I wasn't yet stabilized and on my current med regimen, were hell. So yes, it was very, very bad. But to be honest, no, I never considered pursuing a different career. Making it here was a major motivator in my getting well.
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Do you drink caffeine and what happens when you do? Anything to watch out for? With medications, do you feel there's a risk to make things even worse (I.e tolerance builds to the medication)
Has your academic potential improved on medication?
How do you motivate yourself to wake up every day lol, especially during rotations.
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I don't this is narcissistic at all. This is a very real issue and there's a lot of people out there who need reassurance that having mental illness is something to overcome, not something that limits you.
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Thanks for posting on here. I'm about to start M1 in a few weeks, and I've been diagnosed with severe OCD, which I'm on meds for.
Can I ask why you said that about SSRIs? I've been on an SSRI for a few months now and feel lukewarm about it.
Not tying to hijack this thread and turn it into a psych discussion lol, but I'm a little bit curious.
I probably drink more caffeine than I should.
It's usually pretty uneventful, but I am careful not to have it late in the day so my sleep doesn't get too messed up, and I try to keep it to a reasonable amount. When I'm hypo I looooove caffeine and would happily live on coffee with no food or sleep, so that is a time when I would try to cut it out completely.As far as I know, people don't build tolerances to antidepressants or mood stabilizers. There IS a risk of meds "pooping out" in bp, but that tends to happen more when folks go off their meds and then attempt to go back on them later. Far down the road when I'm completely done with training, if my life is in a good place and I've been consistently stable for a long time, then I would be interested in working with my doctor to reduce my medication. When I was first coming to grips with going on my meds, I read a lot of literature on bipolar and when I realized how damaging mood episodes are to the brain, I became much more afraid of the disease itself and much less afraid of the meds.
I can't say whether or not meds have affected me academically to be honest. When I was at my sickest, academics were always literally the last thing to go. So I could be almost completely unable to take care of myself but like... still do calculus. I definitely have more capacity to get work done and pursue all my interests on meds and they've helped prevent depressive episodes in school, so they're a definitely plus in that regard. I recall being very worried that my memory or cognition might be affected, but if so then it's so minute that it's imperceptible.
I'm a freak and love getting up at the crack of dawn, which is neither here nor there with regards to being bipolar. So I'm not sure I have many tips for you there hahaha. When I was severely depressed for long periods in the past, I sometimes had success with a checklist method in which I'd print physical checklists that I'd made up in advance when I was well listing every single task needed to accomplish the bare minimum of existing for that day - things like "get out of bed", "brush teeth", "drink a water", "eat something", etc. So they weren't very ambitious, but they made things less overwhelming because I could figure out exactly what needed to happen next without thinking too much. Hopefully I won't need those again - though I still do a version of the same thing using the app HabitList.
SSRIs can precipitate mania in bipolar people. So if a patient comes in appearing to have unipolar depression and the doc doesn't dig enough to uncover any potential signs of bipolar disorder, they're likely to prescribe an SSRI since it's a first-line antidepressant - the resulting mania that can occur is not only dangerous in and of itself, but (I think especially per proponents of kindling theory) can possibly accelerate the course of the disease overall.
Long story short - SSRIs can be dangerous specifically for bipolar people, was not trying to make any comment on the class of drugs overall.
FWIW, I actually also had OCD! It was mild to moderate at worst though and a course of exposure response therapy back in college did the trick. Good luck with starting school and with treatment, and feel free to PM me!
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Did you talk about this at all on your applications as adversity that you have overcome? I have heard that this is something that will black ball you at med schools and was just wondering if you hid it or not until you got in.
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@strider or anyone else with minor to major mental issues, I would highly suggest not talking about it at all during the admissions process. It'll turn off those not attune to mental health issues and it may even roll the eyes of someone suffering from mental health who did not see it as a barrier and will see it as you playing the pity card. I know of an outstanding physician at another institution in charge of residency applications who actually suffers from mental illness who every now and then goes out of his or her way to help other students. One time she or he was giving a talk and he or she offhandedly mentioned Schizophrenics were in XYZ medical class, students laughed, and then she or he had to like act serious and say it's not funny, there really are and medicine is really diversely that way. That being said, I also have a family friend who has a position of power in the medical school admissions committee who told me a few years ago that she actively looks for signs of mental illness in students and tries to weed them out because in her own words..."medicine is not for the mentally ill".
Since we're on a mental health thread, I'll take a bit of a tangent here.
As open and politically correct as medicine may be, I still feel it doesn't necessarily like accepting those with mental health problems (if they can help it), nor does the general culture in medicine look kindly upon those who wear their disorders on their sleeves. If you find that you have a disorder you should fortunately feel no anxiety about opening up to your school though because since they accepted you, most will not judge you and will get you to seek medication indicated, but you will be expected to keep your disorder managed and to yourself (which makes sense in my opinion).
I know a girl on the ASD scale who I try to talk to and calm down (she's always so nervous) who is going through absolute hell right now to get through rotations. I'm not on her track so I don't know of her performance besides the fact that she comes out of them and has to cry herself to sleep every night , but when I was around her in pre-clerkships everyone from her classmates to her own counselor acted unhelpfully uncomfortable around her when she wasn't even doing anything that wrong...she was just talking really loud (they could have just ignored it). Instead people make fun of her behind her back and her own counselor (one time she approached her in the hallway to say hi) openly patronized her in front the whole hallway.
I feel like the critiquing nature in medicine makes everyone a little insecure of how normal they are... and that's acceptable because at the end of the day we're treating patients and our professionalism needs to be solid. We need to be given feedback (don't tap your foot, change the intonation of your voice, etc). It's just that I feel too many of us who are still learning are secretly happy to see others more awkward or worse off than themselves get criticized.
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Thank for the the thorough reply but I don't actually have a mental illness myself I just remember my advisor telling us not to talk about one if we did and I found that strange. Kind of sucks that it's okay to overcome adversity as long as it is the type of adversity they care about. Either way, good for you and good luck getting through.
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I don't either. That whole tangent was for everyone reading the thread, not just for you.
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I did not. It's unfortunate that it's to be avoided, but applications are a game and you just play to get where you need to be. I'm very open at my school and have spoken publicly about my disorder there, but I already have my seat and trust the student body and administration. I published a blog post last year about a psych hospitalization I underwent and made the decision to do so anonymously, even though I was incredibly proud of it and wished I could put my name to it. It wound up getting picked up by a more widely read site, so ultimately it was the right call. At this stage in my career I choose my battles and applications are just not the place for advocacy work.
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Link? If it's anonymous and you wouldn't mind attaching your SDN throwaway to it.
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Ever tried ketosis as a treatment? The high fat epilepsy kind, not the chicken breast and atkins protein bars kind.
I have a friend with bipolar in med school who it's helped a lot.
I have a friend with bipolar in med school who it's helped a lot.
You know, I have been trying on and off for YEARS to eat that way but have a raging sugar addiction. I would really really like to give it a go though. I never seem to be able to get through withdrawing from carbs.
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Chances are that you're a millennial, bub.
To OP, thanks for the thread. There needs to be more awareness and less stigma surrounding mental health issues in the medical profession. I'm definitely on some spectrum of an anxiety disorder, but am too afraid that meds will fog my mind.
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CharakaComplex
I haven't tried a ketogenic diet with the specific ratios recommended, but cutting back on added sugar and upping the proteins and fats has certainly helped reduce the severity of the depressive episodes in my type 2. Further, the manic episodes don't last more than a couple of weeks anymore (and even then they've become infra-radar thanks to my naturally choleric personality). YMMV, however, because I'm vegetarian + geographic differences.
(Also completely cutting back sugar actually makes me really weak and unable to think properly, though that may be the addictiveness of sugar speaking.)
(Also sorry for hijacking this question)
With due respect the circlejerking is just enough to overcome the crippling self-esteem/mental health issues left us by the previous generation's 'little children are to be seen and not heard' attitiude. Crippling self-esteem that aforementioned previous generations now blame us for by citing 'laziness', unamusingly ironically.
You're a HCP. How are you /not/ curious about a patient's experience? How does it make you a good practitioner if you are /not/ curious about how someone feels?
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I've actually had success with a similar diet myself, but am always kind of curious to see how keto would affect things. I think fat is really important for most psych disease. Thanks for sharing your experience.
Thank you so much for writing this. I have BP type 2, and I've had a tough time deciding if I wanted to go into medicine. I'm most nervous about sleep. You mention that you could work more day shifts so that you could have a better sleep schedule. Were these accommodations? Or was this something your school offered?
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I think there's not enough concern/attention brought to what it is to go through residency with BPAD. School is a totally different ballgame, and frankly, much easier. You are there to learn, the actual doctors can care for the patients without your help (not that med student help isn't just that, help). Therefore, it's much easier for the school to accommodate you.
Once you become a resident, you are there to learn to be a unit of production. There's much less that a program might be able to do for you. Some programs might be able to do a lot, and others not so much. It will depend on structure of # of bodies, shift set ups, etc. Other constraints that the program can't control are the boards that accredit them. The boards stipulate all sorts of rules about the clinical exposure they have to put you through to be eligible to sit for the board, and a program can't do much about that.
You gotta treat 'em and street 'em. Every intern year now, and every residency, is marked by a lack of sleep and consistent schedule and a higher than ever pressure to perform up to standards speedily, seeing the maximum number of people possible "safely." People with BPAD do get through it all, but it will depend on their disease, the individual specialty, individual program, leadership, psychiatric care needed, medications, schedule, on and on.
Some will do well. Some might have a dangerous mood episode. Some will lose their jobs. Some will die. It sounds dramatic and it may not be common, but it's true. Since when in medicine do we dismiss uncommon disastrous outcomes?
I think the whole thing is a gamble for anyone, the healthy and the controlled BPAD sufferer alike. Just be aware that for a healing profession, don't expect anyone to give that many damns about you. You gotta keep your head down and do just as well as the guy next to you even when all your smiles are faked.
Yeah, you gotta focus on getting through med school first. Unless you're feeling pretty confident about a non-clinical career, you need to be just as concerned with surviving residency.
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cellsaver
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grapefruit17
Im curious about the manic episodes you have OP. What have you done while manic, in the past?
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Thanks for thread! Have you stated your clinical rotations yet? How had/will your condition effect how people see you?
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Just wanted to say thanks for writing this. Chronic illness, mental or otherwise, is something many struggle with, and everyone could use a bit of advice (or at the very least commiseration) from someone going through it within the context of a rigorous environment (med school), particularly mental illness where there is such a stigma against it. It's not narcissistic at all to offer advice on something you're experiencing firsthand, and no different than me offering advice to aspiring surgeons. I went through med school and residency in total silence, without meds or therapy for my anxiety. The scars from that were not small. So if anyone can see a student who is open about their illness, and that it isn't different from cancer or diabetes in that you can't "get over" it, maybe they can get help sooner. Kudos.
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I have MDD and I am doing one of those bridge postbaccs to get into medical school.
However, I am not getting good grades and I am depressed most of the time.
Psych upped my meds and I have been in therapy the entire time. Things got a little better but my grades
are too low still.
I am ready to quit, I am just afraid to let depression make decisions for me.
However, I am unhappy and frustrated. I dont know what to do anymore.
However, I am not getting good grades and I am depressed most of the time.
Psych upped my meds and I have been in therapy the entire time. Things got a little better but my grades
are too low still.
I am ready to quit, I am just afraid to let depression make decisions for me.
However, I am unhappy and frustrated. I dont know what to do anymore.
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Thanks for doing this. Do you have any concerns about applying for residency? I’ve heard that a lot of residency apps will ask if you have or ever have been diagnosed with any psychiatric illness or learning disability and that sometimes you are sort of forced to disclose even if you don’t necessarily want to
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Time to take a break and heal. You're not helping yourself academically with poor grades.
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Yeah, this seems like a huge barrier to med students seeking help. I know there's no way I'd ever get a formal eval or even talk about anything present tense as long as this isn't clarified. I'd rather continue slogging through than risk my career in even the smallest way.
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Search my post history on the topic of licensing apps and mental health, there were some recent threads where I go into exquisite detail about most potential (but not all as equally likely) outcomes, and ways to address them, of various ways of filling out the applications.
As with any career, the key is to try to keep yourself as healthy as possible. Your health must always come first (ideally, in reality, give it all you can!). To that end, it behooves you to be proactive, seek care as soon as you think you need it, reach out for help, and try to have some thought for your privacy.
Inadequately treated mental illness is a far greater threat to your career than anything else.
There's some caveats, it's true that most boards aren't thrilled if you have a history of non-adherence, substance use disorder, psychotic symptoms, violence to self or others, or psychiatric hospitalization. However, even a history of these don't put licensing off the table most of the time, most places.
I write posts meant to fully inform people about all the potential horrors, and I'm here to tell people,
GET TREATED.
Just read my posts and then do it, so you can do it career smart.
As with any career, the key is to try to keep yourself as healthy as possible. Your health must always come first (ideally, in reality, give it all you can!). To that end, it behooves you to be proactive, seek care as soon as you think you need it, reach out for help, and try to have some thought for your privacy.
Inadequately treated mental illness is a far greater threat to your career than anything else.
There's some caveats, it's true that most boards aren't thrilled if you have a history of non-adherence, substance use disorder, psychotic symptoms, violence to self or others, or psychiatric hospitalization. However, even a history of these don't put licensing off the table most of the time, most places.
I write posts meant to fully inform people about all the potential horrors, and I'm here to tell people,
GET TREATED.
Just read my posts and then do it, so you can do it career smart.
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