what keeps you going everyday?

[hippocampus]

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med school makes me want to kill myself. i would not kill myself though, i just want to disappear from earth (without suffering any pain). i think i have dysthymia or something...i cry almost every night...

besides exercising (there's no time to!), what do you do (think about) to trick yourself that you are happy and want to go to your rotation in the morning? what keeps you motivated and energetic? what do you guys think about?

 

[Ashers]

Being done with M3 year.

I disliked nearly every rotation I was on. I only really enjoyed 2 months of the whole year, so that made it hard (there were good parts of each rotation, but on the whole, I disliked most of them). I'd try to see friends whenever possible, and if I saw someone in the hall on a different rotation, I'd walk out of my way with them just to talk, if I wasn't too busy. I also got a Wii, so I started playing video games if I didn't have to study or sleep.

 

[pincheeric]

Everyone has difficult days and those moments when you say "what am I doing here." But if you spend every night crying about medical school maybe you should reconsider your decision. You shouldn't have to trick yourself into feeling happy. When I'm feeling overwhelmed, though, I just think about May 2009. But remember, while your role changes as you rise in the ranks, it doesn't really get easier.

I think you might benefit from seeing a mental health professional. Medical students are people, and people get depressed. You wouldn't be the first, and won't be the last. Chances are you aren't even the only one in your class. Get help so that you can enjoy just how amazing of an experience medical school is. And so that you can appreciate yourself for being a success.

 

[JaSam]

Everyone has difficult days and those moments when you say "what am I doing here." But if you spend every night crying about medical school maybe you should reconsider your decision. You shouldn't have to trick yourself into feeling happy. When I'm feeling overwhelmed, though, I just think about May 2009. But remember, while your role changes as you rise in the ranks, it doesn't really get easier.

I think you might benefit from seeing a mental health professional. Medical students are people, and people get depressed. You wouldn't be the first, and won't be the last. Chances are you aren't even the only one in your class. Get help so that you can enjoy just how amazing of an experience medical school is. And so that you can appreciate yourself for being a success.

"But remember, while your role changes as you rise in the ranks, it doesn't really get easier."

I think that's the truest and also the most depressing line in your whole post. I mean its sucks but when I look at the people above me, they have horrible work schedules and their responsibilities are so much greater. It just makes me really pissed at those people or upperclassmen who lie to you and go "oh yea it gets better next year". Bull sh+t! First year was probably the best and its gotten only worse and worse every year and I'm not guilible enough to fall for that again. I already know it gets worse, just gotta get through it man. Just keep the train on the track and just keep a choo choo chooing.


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[persia]

Hey, sorry to hear you are having a hard time. 🙁 Just know that whatever you are going through other people have also gone through it, too. You will survive and come out the other side.

This is not an easy path, and there are so many variables involved in every situation. Sometimes, there are personality differences or styles, gender issues, racial or whatever. Basically, whenever you have a whole ton of people all stuck together but changing roles all the time it can get to be overwhelming. It is stressful for students and then also for interns, residents and yes! even for attendings. Then, patients also are stressed when they come in.

We are not prepared really for the overwhelming emotional impact of all this stuff.

I can only recommend listening to your instincts and doing what seems right for you. Crying can be helpful, don't apologize for that. But think about what nurtures you - friends, family, your favorite grandma, church/temple/etc., your pets, a journal or whatever!

I think alot of depression is situational and that when we are in weird or upsetting situations then we feel weird or upset - naturally. Counseling with an experienced person who understands medicine can help with decent coping skills and being able to blow off steam. Hang in there, you can make it ! 👍

 

[futuredo32]

I agree with others who have suggested seeking help from either your family doctor or a mental health professional.

Overall, I try to make the best of all of my rotations. I try to find something to like about every rotation. During my two week out patient OB/Gyn rotation, the medical assistant in the office was really nice and that was the only thing I really liked about the rotation, but, it was something. During the less busy rotations, I try to find some time, even if it's just a half hour a day, to do something not related to medicine- watching tv, listening to the radio, talking to a friend who isn't a med student. I've known early on that I wanted to do a psych residency, and I was lucky that I was able to do a psych rotation early in my rotation schedule. I keep the good memories of my psych rotation in the back of my mind and remind myself that in addition to all of the learning that occurs on various rotations, my rotations are stepping stones to a future in a field that I really love, each rotation is only four weeks long, and anyone can survive almost anything for four weeks.

 

[Mayhem]

I've been very lucky to have awesome friends on almost all my rotations...and not by chance either. They are probably 50% of my motivation to go to the hospital everyday. We just get along really well and in no time we're laughing about something and I forget all the crap that happens on a regular basis. It's all about the distraction. I don't think I could make it without my friends because no one else gets what we have to deal with. On the few times I've had to be alone (parts of IM and on Labour Ward) it was torture but even then I still tried to keep in touch with my friends, even if it was just a text, and I'd spend my time counting down till the rotation ended.

Maybe you need to find someone to talk with. It could be a friend, a family member or even a counsellor. If you're crying every night then obviously something is bothering you.

 

[MrBurns10]

Besides advising you to seek help, I will add that I think it gets a lot better once you figure out what you do and what you don't want to do. Maybe it's surgery, maybe it's psych, hell maybe it's consulting. I liked my rotations okay, but it was really disheartening until I found something I could see myself doing the rest of my life. Good luck, and don't suffer alone.

 

[QofQuimica]

med school makes me want to kill myself. i would not kill myself though, i just want to disappear from earth (without suffering any pain). i think i have dysthymia or something...i cry almost every night...

besides exercising (there's no time to!), what do you do (think about) to trick yourself that you are happy and want to go to your rotation in the morning? what keeps you motivated and energetic? what do you guys think about?

I agree with the previous posters that you do sound depressed and you should get help. Of course third year is very stressful, but you shouldn't be crying yourself to sleep every single night. See if your med school has a counseling service for students; some schools do.

Beyond that, I think the most important thing to remind yourself any time someone yells at you or brushes you off or whatever makes you feel bad is that it's almost never personal. What I mean is, these people usually aren't out to get you. They either want to teach you something and somehow missed the memo that most people don't learn well when being yelled at, or they are overwhelmed themselves and don't want to be bothered with you at all. If any other student were there instead of you, they would be dealing with pretty much all the same BS that you are. If you're working with new interns or residents who just started this month, that could definitely be a huge part of the problem.

 

[AlternateSome1]

Life gets much better. Intern year is a blast! I was miserable most of my 3rd year and much of my 4th year of medical school. As a medical student you exist in this quasi peasant role where you are paying money to do the worst jobs, get evaluated constantly, and be nearly useless, but be forced to stick around for no reason. Many interactions with patients are interrupted as busy residents charge in and take over, ignoring the work you have done and simply repeating it. Patients get aggravated by you being around, the staff gets aggravated by you being around, and you know much of your learning is at the expense of your patients' time. Your 4th year is nearly the equivalent except that you at least have some freedom of what you are learning and you can leave when you are done without fear of a bad evaluation. Intern year is worth it. Yeah you have to deal with tons of crap work and bureaucratic nightmares, but you have a well defined role. When you see a patient, you ARE the doctor. You get to make decisions about their care, you are notified when things change, and no one questions you being there. While you still get evaluated, you don't have to fear "not being able to get into the residency program that will define your career and thus your LIFE." While I am not saying that less paperwork and early morning rounds wouldn't be nice, it feels awesome to belong and have a real sense of purpose.

 

[Doctor Bagel]

Life gets much better. Intern year is a blast! I was miserable most of my 3rd year and much of my 4th year of medical school. As a medical student you exist in this quasi peasant role where you are paying money to do the worst jobs, get evaluated constantly, and be nearly useless, but be forced to stick around for no reason. Many interactions with patients are interrupted as busy residents charge in and take over, ignoring the work you have done and simply repeating it. Patients get aggravated by you being around, the staff gets aggravated by you being around, and you know much of your learning is at the expense of your patients' time. Your 4th year is nearly the equivalent except that you at least have some freedom of what you are learning and you can leave when you are done without fear of a bad evaluation. Intern year is worth it. Yeah you have to deal with tons of crap work and bureaucratic nightmares, but you have a well defined role. When you see a patient, you ARE the doctor. You get to make decisions about their care, you are notified when things change, and no one questions you being there. While you still get evaluated, you don't have to fear "not being able to get into the residency program that will define your career and thus your LIFE." While I am not saying that less paperwork and early morning rounds wouldn't be nice, it feels awesome to belong and have a real sense of purpose.

You just brightened my day with your post. I just started 3rd year, but so far my biggest gripes are feeling pointless and getting pushed to the side when anything else is happening because everything takes priority over you.

To the op, definitely seek out resources available to you through your school. You deserve to feel better than this, and there are things that do help, a lot of which have been suggested in this thread. And keep reminding yourself that this is not the rest of your life. 🙂

 

[persia]

If you do decide to go an talk to someone, do it privately and away from your school. While you may be in a supportive environment when it comes to these things, it still is wise to take care of yourself in a private way.

To find someone you can trust, talk to other people you can trust. Your personal physician might be a good place to start, or clergy or someone equally private and confidential.

What you are experiencing is completely normal - and maybe even a very healthy reaction to a weird situation - but you still need to protect yourself when it comes to taking care of your feelings. Doing it away from your school can help you to relax and trust the person to genuinely help you. 😉

 

[MrBurns10]

If you do decide to go an talk to someone, do it privately and away from your school. While you may be in a supportive environment when it comes to these things, it still is wise to take care of yourself in a private way.

I have to disagree with this. All schools have psychological services that are separate from the medical school. These places can be very helpful in treating depression while understanding the stresses that students have to deal with (and I guarantee you, they've seen several medical students). These services are usually free and are confidential (they will not appear anywhere in your records when you apply for residency). I would recommend starting here, personally.

 

[Ypo.]

Life gets much better. Intern year is a blast! I was miserable most of my 3rd year and much of my 4th year of medical school. As a medical student you exist in this quasi peasant role where you are paying money to do the worst jobs, get evaluated constantly, and be nearly useless, but be forced to stick around for no reason. Many interactions with patients are interrupted as busy residents charge in and take over, ignoring the work you have done and simply repeating it. Patients get aggravated by you being around, the staff gets aggravated by you being around, and you know much of your learning is at the expense of your patients' time. Your 4th year is nearly the equivalent except that you at least have some freedom of what you are learning and you can leave when you are done without fear of a bad evaluation. Intern year is worth it. Yeah you have to deal with tons of crap work and bureaucratic nightmares, but you have a well defined role. When you see a patient, you ARE the doctor. You get to make decisions about their care, you are notified when things change, and no one questions you being there. While you still get evaluated, you don't have to fear "not being able to get into the residency program that will define your career and thus your LIFE." While I am not saying that less paperwork and early morning rounds wouldn't be nice, it feels awesome to belong and have a real sense of purpose.

Wow. You just summed up PERFECTLY how I felt about third year. Since we obviously think alike, it gives me hope that I will l like intern year a lot better. 👍👍

 

[hippocampus]

-cant go to school counselor. dont want anyone (the school) to find out how i feel
-no time to see psychiatrist. also, they will only prescribe me meds. meds are expensive and have side effects
-i hate exercising, hate sweating
-while it is good to be positive, things do not necessarily need to get better... worse can become worse...

do we really have control of our own lives?? what do you guys think?? hm... i feel things happen for a reason... like i have no control over fate... or is it chance (ie. being at the right place at the right time; wrong place, wrong time, etc) or luck (ie. being asked a question u know the answer to)...?? hmmm

 

[AlternateSome1]

-cant go to school counselor. dont want anyone (the school) to find out how i feel
-no time to see psychiatrist. also, they will only prescribe me meds. meds are expensive and have side effects
-i hate exercising, hate sweating
-while it is good to be positive, things do not necessarily need to get better... worse can become worse...

do we really have control of our own lives?? what do you guys think?? hm... i feel things happen for a reason... like i have no control over fate... or is it chance (ie. being at the right place at the right time; wrong place, wrong time, etc) or luck (ie. being asked a question u know the answer to)...?? hmmm

I feel like we have a very high level of control over our lives. What we do not have is the opportunity to pick and choose the consequences of our decisions. Choosing to be a doctor means putting up with crap for several years, and that is part of the bargain. However, the opportunity to just walk out, hop in your car, and drive to Mexico will always exist. So is the opportunity to quit, get a different job and struggle with loans for years. The consequences will be high, but at least the choices can be made. The sense of having no free will tends to come out when you focus on the consequences attached with a choice rather than the choice itself.

 

[futuredo32]

-cant go to school counselor. dont want anyone (the school) to find out how i feel
-no time to see psychiatrist. also, they will only prescribe me meds. meds are expensive and have side effects
-i hate exercising, hate sweating
-while it is good to be positive, things do not necessarily need to get better... worse can become worse...

do we really have control of our own lives?? what do you guys think?? hm... i feel things happen for a reason... like i have no control over fate... or is it chance (ie. being at the right place at the right time; wrong place, wrong time, etc) or luck (ie. being asked a question u know the answer to)...?? hmmm

I am 99.999999999% sure that you wouldn't be the first student at your med school to seek advice from a counselor. I can think of 7 people off of the top of my head who either got counseling at my med school and/or were taking an antidepressant. Medical school is rough at times. Medical students aren't immune to any diseases, including depression.

It wouldn't take that long to see a psychiatrist. If you don't want to see a psychiatrist, how about a family practice doctor? Perhaps you have another condition that is mimicking depression (hypothyriod, anemia, etc).
Many times FP docs or psychiatrists have samples that they can give out(if you needed them) and it might not cost you a dime. If you are depressed due to an imbalance of chemicals in your brain, is it all that different from seeking help for another medical condition like hypertension? Would you consider hypertension to be fate?

Whatever you choose to do, I wish you well.

 

[QuikClot]

med school makes me want to kill myself. i would not kill myself though, i just want to disappear from earth (without suffering any pain). i think i have dysthymia or something...i cry almost every night...

besides exercising (there's no time to!), what do you do (think about) to trick yourself that you are happy and want to go to your rotation in the morning? what keeps you motivated and energetic? what do you guys think about?

What gets me through the day is thankfulness for the gift of this calling and delight in practicing it in whatever capacity, even as a scutmonkey. I also avoid sabotaging myself with negative self-talk and learned helplessness, for example:

* Constantly telling yourself you are bound to fail.
* Telling yourself that you have no control over your situation (poor self-efficacy).
* Telling yourself your life is terrible, your work sucks, and you're bored.
* Dwelling on how long you've been sad, how sad you are, or how unfair the world is.
* Resenting others.

I think you'd benefit from some CBT. You've got some depression there, no question, but your mood is only half of why you are crying every day and have been posting versions of "I'm thinking of killing myself" for the past three years on SDN. You have an unhealthy thought process and poor coping skills, and while I'm sure the stress of medical school is affecting you in undesirable ways, I would imagine we could put you on a beach in Maui with a trust fund and you'd be thinking about suicide.

Changing your internal ecology is more important than the stuff happening to you as a med student. If you change that, you will feel better; if you don't, you won't.

 

[Roy7]

If you can, call someone and just talk about it. Be your parents, siblings, or classmates. Most (with the exception of classmates) wont understand, but just getting that off your chest will make the world feel way better. And with your classmates, knowing you're not the only one makes it far far easier.

 

[Doctor Bagel]

What gets me through the day is thankfulness for the gift of this calling and delight in practicing it in whatever capacity, even as a scutmonkey. I also avoid sabotaging myself with negative self-talk and learned helplessness, for example:

* Constantly telling yourself you are bound to fail.
* Telling yourself that you have no control over your situation (poor self-efficacy).
* Telling yourself your life is terrible, your work sucks, and you're bored.
* Dwelling on how long you've been sad, how sad you are, or how unfair the world is.
* Resenting others.

I think you'd benefit from some CBT. You've got some depression there, no question, but your mood is only half of why you are crying every day and have been posting versions of "I'm thinking of killing myself" for the past three years on SDN. You have an unhealthy thought process and poor coping skills, and while I'm sure the stress of medical school is affecting you in undesirable ways, I would imagine we could put you on a beach in Maui with a trust fund and you'd be thinking about suicide.

Changing your internal ecology is more important than the stuff happening to you as a med student. If you change that, you will feel better; if you don't, you won't.

I very much agree with this post. I had some CBT a few years ago, and it was super helpful and still is.

 

[JaSam]

I very much agree with this post. I had some CBT a few years ago, and it was super helpful and still is.

What do they do at CBT sessions for depression, is it like just learning to think positively or learning to ignore stressors and anything that instigates bad thoughts? Is it common for people to get CBTs for depression treatment instead of just being slapped on with meds? Sorry, I'm just very curious about this CBT thing for depression. You don't have to answer if you're busy or think this is a dumb question.
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[QuikClot]

What do they do at CBT sessions for depression, is it like just learning to think positively or learning to ignore stressors and anything that instigates bad thoughts? Is it common for people to get CBTs for depression treatment instead of just being slapped on with meds? Sorry, I'm just very curious about this CBT thing for depression. You don't have to answer if you're busy or think this is a dumb question.
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From Wikipedia:

The objectives of CBT typically are to identify irrational or maladaptive thoughts, assumptions and beliefs that are related to debilitating negative emotions and to identify how they are dysfunctional, inaccurate, or simply not helpful. This is done in an effort to reject the distorted cognitions and to replace them with more realistic and self-helping alternatives.

An example will illustrate the process: Having made a mistake, a person believes, "I'm useless and can't do anything right." This, in turn, worsens the mood, leading to feelings of depression; the problem may be worsened if the individual reacts by avoiding activities and then behaviorally confirming his negative belief to himself. As a result, a successful experience becomes more unlikely, which reinforces the original thought of being "useless." In therapy, the latter example could be identified as a self-fulfilling prophecy or "problem cycle," and the efforts of the therapist and client would be directed at working together to change this.

There is a lot of academic-speak in there, but what it boils down to is this: CBT targets dysfunctional thinking, including but not limited to the nasty things we say about ourselves and the gloomy things we say about our lives in the privacy of our own brains.

If you reflect on it a little bit, you'll probably realize you say things to yourself that you would be shocked and devastated to hear out of the mouths of anyone else. A little of that is normal. For some people, though, this gets out of control, and they end up with a non-stop, 24/7 commentary on the ****iness of life in general and themselves in particular; what CBT calls "automatic thoughts." My father called them the demon voices.

You don't have to be depressed to hear them; they have nothing to do with mood. Some people who hear them are very high-functioning, although anxious and unhappy. They are highly destructive.

CBT is about controlling those voices and other forms of self-sabotage (so are AA and NA and probably most good pastors, imans and rabbis; CBT is just a codification of some basic, common-sense strategies.)

 

[slb]

Just a premed here, but I have personal experience with CBT. It helped me a great deal and I highly recommend it.

The nice thing about it is that it is practical. The approach is: what are the problems you are having right now (as opposed to how was your childhood, etc), and what are the concrete ways we can start to fix them? They often give homework assignments. For example, if you are cripplingly shy, your assignment might be to talk to one stranger in a week.

As the previous poster said, the depression treatment can focus on stopping the negative self-talk, and trying to see things in a less negative light. You will also likely be encouraged to think logically about your desire to kill yourself, and why you are having such an extreme reaction to your situation.

CBT appeals to science-minded types, I think, because it's big into examining emotions with logic and reason. You get to use the analytical part of your mind to help keep the emotional side in check.

If you would like more info, try this book:

http://www.amazon.com/Feeling-Good-Handbook-David-Burns/dp/0452281326

Good luck to you.

 

[Sarafml]

I'm also having a hard time. I'm almost half way through my first rotation (Family Medicine) and although I really like my attending - he's very nice and laid back, I'm just not happy at all.

He doesn't take students with him to the hospital. I'm only able to work with him when he's in his office - which means I'm only getting about 20 hours a week in. I feel like I'm missing out/not learning anything. And it's making me feel pretty miserable.

I don't know if I should say something to my student director, because my attending is really cool, and I don't want to step on his toes or anything like that. I just don't know what I should do.

 

[Depakote]

I'm also having a hard time. I'm almost half way through my first rotation (Family Medicine) and although I really like my attending - he's very nice and laid back, I'm just not happy at all.

He doesn't take students with him to the hospital. I'm only able to work with him when he's in his office - which means I'm only getting about 20 hours a week in. I feel like I'm missing out/not learning anything. And it's making me feel pretty miserable.

I don't know if I should say something to my student director, because my attending is really cool, and I don't want to step on his toes or anything like that. I just don't know what I should do.

Is it a "students can't come to the hospital with me" situation or a "just come to clinic" situation? Have you expressed your interest in seeing more to your preceptor? He might be under the impression that he's giving you more time to study by not making you come to the hospital with him (family shelf tends to be rough as the first one).

Before talking to the clerkship coordinator, I'd make sure this isn't a situation that couldn't be simply handled by asking your preceptor if your could come to the hospital a few times.

 

[Sarafml]

Is it a "students can't come to the hospital with me" situation or a "just come to clinic" situation? Have you expressed your interest in seeing more to your preceptor? He might be under the impression that he's giving you more time to study by not making you come to the hospital with him (family shelf tends to be rough as the first one).

Before talking to the clerkship coordinator, I'd make sure this isn't a situation that couldn't be simply handled by asking your preceptor if your could come to the hospital a few times.

He said that the hospital he rounds in doesn't allow him to take students with him. Either it's not a teaching hospital or what - but I know it isn't affiliated with my particular rotation site.

You're probably right in that I should ask him about it first. But I just don't exactly know how to ask him about it - I don't want to make it seem like I'm bored/not satisfied with him.

 

[nlax30]

Well if he's already told you that the hospital doesn't allow students with him then there's not much else you can do.

Personally, I'd take this opportunity to do some extra studying and have a little extra "free" time during the week, may feel like you're not seeing a lot now but I've wished for those type of days after rotations where I was basically stuck in hospital at least 12 hrs a day and found it difficult to get a lot of reading done during the week.

 

[nope80]

Glad to hear others feel the same that I do - I'm not depressed per se but I find myself constantly counting down the days the rotation will be over, counting down the hours in a day, hating sunday nights, and just starting to wonder how I will ever survive residency if I hate the hospital environment so much? I'm only on my first rotation, a notoriously disliked rotation, so I really hope it gets better and that this is just typical third year...🙁

 

[ensuii]

1.) Massive debt

2.) The knowledge that there are people that would kill to be where I am

3.) Memories from actually working a 40-100hr week job.

 

[Ashers]

Being done with M3 year.

I disliked nearly every rotation I was on. I only really enjoyed 2 months of the whole year, so that made it hard (there were good parts of each rotation, but on the whole, I disliked most of them). I'd try to see friends whenever possible, and if I saw someone in the hall on a different rotation, I'd walk out of my way with them just to talk, if I wasn't too busy. I also got a Wii, so I started playing video games if I didn't have to study or sleep.

Wow, this is reminding me of this year so far, and it's what I'm doing to get through intern year. 🙁 That and I started a countdown on facebook to show many how many more days left I have.

 

[283412]

I'm in a similar situation. I just finished my PhD and am starting the 3rd year clerkships. My gf dumped me last month and my performance/grades are tanking. I don't know any of the medical students, but they all know each other, so I feel completely isolated. Basically all my friends have left the state for residency. Plus my manuscript keeps getting rejected from top journals. So yeah, if I think about performance I feel terrible. Everyone around me is succeeding in multiple aspects and I'm not. What keeps me going? I've felt like this before and got through it and then things got better. It always sucks to start new things and be terrible at them. But understanding that this phase occurs for about 1-2 years every time I switch fields (seems like too many times now), seems to help and keep me going.

 

[Futuredoc1364]

I am an MS3 and currently doing medicine. I actually like going to work everyday and I like seeing patients. My biggest complaint at this stage is the amount of studying we gotta do for the shelf exam. I had my psych shelf in july and I thought I studied pretty well for it and ended up not doing as well and bumped my grade down. I still passed but could have gotten a higher grade had I scored better. I guess that's part of the learning which makes third year rigorous. We all get tired of school at times...Especially when I see my non med school friends going out every weekend and making fun of me because I am "still catching up."

It's funny my attending thinks I am too hard on myself and I need to take more time off. I have the shelf in 5 weeks and I think I have only gone over 30% of the material. Our medicine is 8 weeks and I am currently doing inpatient. the last 4 weeks of the rotation will be outpatient so I am hoping I'll have more time to study for the shelf. I heard medicine shelf is by far the hardest. I am very scared...

I have to say the isolation part of med school has been and always will be the toughest part of dealing with the stress.

 

[cbest]

Trying to steer this back to the original topic of, "What keeps you going every day?" I'm gonna have to say it's a combination of a fear of failure, a hint of type A personality, and knowing that there's no other career out there that I'd truly be passionate about so I may as well be good at what I do for a living!