Too Much Xanax, Depression, And What To Do About It

The other week, I had an 18-year-old guy who came in unresponsive after overdosing on Xanax and Tylenol. We stabilized the patient, and when he woke up, I asked him why he did it. He told me that he was just doing some dumb stuff with friends. However, when I asked the father later, he told me his son has been more depressed lately and attempted suicide just last month by cutting his wrists. They didn’t seek help at the time for a variety of personal reasons, and it’s fortunate that the patient’s suicide attempt failed the second time. Fortunately, I haven’t seen a lot cases like this at my hospital, but still, he was so young. The patient had so much to live for.

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Sunset in 2012 from my medical school campus, St. George’s University.

As most of you might know, although I am a doctor, I’m still going through residency. Residency training is the stage of graduate training between medical school and being a “real doctor.” As popularized by social media and real life, residency is tough. We work 80 hour work weeks, are usually understaffed, absorb very emotional patient experiences, and even have to study on top of all that. Somehow, I’m surviving. My co-interns, however, not so much. Every so often, I find myself listening to my co-residents, hearing them vent, and basically being there for them during our low points in residency. Which made me think, depression must be pretty common.

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Outside a Southern California hospital, an ER doctor is crouched down against a concrete wall grieving over the loss of his 19-year-old-patient. (Courtesy of KevinMD)

 

Depression in residency has been a hot topic in the medical world for quite some time. Recently, TIME magazine featured depression in residency in their article “Doctors on Life Support.” Young doctors, such as myself, are overworked, sleep deprived, and are in a culture that simply tells you to suck it up. This type of mentality doesn’t come without repercussions. According to the American Foundation of Suicide Prevention, about 400 doctors die by suicide each year — equating to about two or three students per graduating class. There even has been an extensive systematic review and meta-analysis which estimated that the prevalence of depression to be close to 30% — 1 out of 3 residents. With depression so widespread in residency, I wondered if depression was just limited to my profession.

Depression is a life threatening disorder that affects 17.6 million Americans each year (or 1 in 6 Americans). Depressed people are more likely to develop diabetes and/or cardiovascular disease as shown in this study. Depression is real and deadly, whether you like it or not. It’s personal, too. Somethingcatchy talks about burning out at her job from all the stress and anxiety — a job that she used to love doing. Perfectionhasaprice shares an intimate story with her battle with depression and made a great metaphor with a crab apple tree. Everywhere I look, it seems that depression is affecting all of us, whether directly or indirectly.

So how do we deal with depression? First, we need to determine if it’s life threatening. If you or any of your friends have suicidal ideation, intention, and/or plan, please see a doctor immediately. Another good resource is the National Suicide Prevention Lifeline (1-800-273-8255). Talk to a friend, family, or stranger. Write about it, post on Facebook, tweet it, blog it, whatever. Just find help.

For some basic treatments that we all can do at home, I recommend the following:

  • Meditation. There have been many documented effects of meditation including a positive increase on memory, sense of self, empathy, and stress. In fact, a study at Harvard showed that eight weeks of meditation can lead to an increase of grey matter in the brain. So how can we do it? There are several methods, but a simple one to start out with goes like this:
    1. Sit upright in a comfortable chair.
    2. Close your eyes and focus on your breathing.
    3. Imagine the air coming from the outside, into your nostrils, filling up your lungs, and slowly release back out to the environment.
    4. If your mind wonders, that’s OK. Don’t fight it and calmly refocus your attention back to your breathing.
    5. Try this daily for 2-3 minutes at a time and increase incrementally.
  • Live for a goal. I find that living for a goal works for me. There was a time in my life where I didn’t know what I was doing, where I was going, or what the point of my life was. As soon as I started figuring it out and thinking bigger picture, things started to fall into place. I talk about an excellent exercise that I used for goal setting here.
  • Be grateful. I’ve talked a lot about being grateful in this old post, but I just wanted to reiterate it. Being grateful allows us to step back and give thanks to our amazing lives. Being grateful feels good. In fact, a study showed that being grateful leads to more dopamine release from our brains (dopamine is the “feel good” neurotransmitter).

There are plenty of other ways people battle and fight depression. I’d love to hear a story on how you or a family/friend has fought depression. Also share any tips that might help the rest of us!

 

42 thoughts on “Too Much Xanax, Depression, And What To Do About It”

  1. perfectionhasapriceblog says:
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    Beautiful piece. It’s great to read something like this from a medical professionals point of view as well as from the point of view from someone struggling. Also, way to go on your residency and don’t forget to take time for yourself! ❤

    Liked by 1 person

  2. Healing through Photography says:
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    Thank you for sharing this and spreading the word.
    It’s scary how fast simply being overworked or just stressed out can evolve into depression. Although I am not clinically diagnosed with depression, I have struggled with my mental health and one thing I found to be really helpful is making time for something I love. For me that’s dance. (But for others it may be music, art, photography, running, whatever makes you feel good). Making time for dance regularly really helped lift me out of my ‘hole’ when I was struggling the most and keeps me going when things get rough.

    Good luck with your residency and take care!

    Liked by 1 person

    • doctormikesblog says:
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      Thanks for sharing! For a second there, I thought the something you love would be photography. Regardless, I’m glad you have something you love that you can rely on. I agree with you in saying that making time for something you love is an excellent way to feel better about yourself. For me, that would be working out. Looks like we all have different interests, but that’s what makes us so fascinating! Thanks for the comment!

      Liked by 1 person

  4. clearskies2016 says:
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    Dr. Mike I retired from the US Navy and my last tour was a teaching position at the Navy Nuclear Power School in Charleston SC. We teach 19-22 primarily. The schooling is extremely tough. 40-50% dropout rate. 80+ hour weeks. We take the top 10% of the top 10% that join the Navy. These young folks are cream of the crop. Use to being the best at science and math from wherever they come from. Now for the first time in their life they are facing competition. Some can not handle it. I’ve seen many suicide attempts from guzzling antifreeze, Tylenol is the biggest, cutting and so on. Some were successful some just needed help. That’s where I just wanted to add to your recommendation for help- Chaplains, Pastors, etc … The church does a fantastic job helping these young folks cope and see life’s possibilities.

    Great post.

    Liked by 1 person

    • doctormikesblog says:
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      Wow, the navy is no joke! Competition like that at the highest level could be really unnerving to some people. Especially when all your life you’re the top of the class and you reach a point where you are the average joe. It’s unfortunate, but that’s how the current system is. Regardless, religion and/or spirituality is a great resource for finding help. I find that a lot of my least anxious/depressed patients usually believe in something bigger than them, whether it be God, Allah, Spirit, whatever. Thanks for the comment!

      Liked by 1 person

    • doctormikesblog says:
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      Doesn’t surprise me! Being a surgeon is tough, and to be a heart surgeon on top of that takes a lot of dedication, time, and effort. I feel bad for the guy as well, and I’m sure he had a lot of stress going on in his life.

      Like

  9. enjoisundae says:
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    Great post, it is hard to write about such real situations such as this. Happy there are people out there like you who cover it in such a way that one learns about these issues in a way that non-medical people can read and understand!

    Liked by 1 person

  11. Anne Campbell says:
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    There is still such a stigma surrounding depression, which makes it even more difficult to be open and honest about it with even close friends and family. I have a family member with clinical depression. It’s hard to live with for both of us, and I have had learned to see the depression as a separate entity from the person in order to keep things in perspective for myself when I’m the one on the receiving end of the moods. This is a wonderful piece, and I appreciate your keeping the conversation going. We all need to be more open about it.

    Liked by 1 person

    • doctormikesblog says:
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      Thank you for sharing that! You are so right that depression not only affects the person afflicted, but the loved ones around them as well. I agree that it is very important to keep the conversation going. The more open we are about depression, the easier it will be to help those affected as well as people can come up with newer and better ideas on how to treat and prevent it.

      Like

  12. lastchance3 says:
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    I had no idea that the statistics for doctors that suffer from depression are so high. As someone with an anxiety disorder, I can’t imagine trying to care for others while going through an episode. You carry a lot of weight on your shoulders during residency, and I never thought to stop and think about what it does to a person. Glad to hear you are coping with it well. This is definitely a topic that needs awareness.

    Liked by 1 person

    • doctormikesblog says:
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      Thanks your comments mean a lot! Yeah, I agree we need to spread the word more on depression. I’m hoping that we are entering an age where it’s ok to talk about topics like this in public. That way, really, really smart people can figure out ways to prevent and/or treat depression.

      Like

  13. Amy says:
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    It seems obvious now but before I hadn’t thought of the emotional toll on a doctor. A blatant oversight by me. I am not surprised by the statistics. Depression is so prevalent, it kills me to still come across people who dismiss it.

    Liked by 1 person

  14. piezoradeon says:
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    Depression really is a bad phase of life, really!
    Been there and come out of it, it feels just so fresh once someone comes out of depression!
    It just is a state of mind which one has to choose, choose negative it’s depression time .. choose positive, that is the phase where you are a king and rule your life!
    It’s all about choice if I were to say about depression!
    Oh wait, you just got me an idea to post on! I will exactly post on my phase of depression !

    Like

  15. deblewisarbonne says:
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    In my practice I am seeing more depression and anxiety. Also, unfortunately everyone wants a pill for everything so we are creating more pill addiction. The U.S. healthcare system is a mess, there is really no mental health care and no one seems to really care that the whole system is falling apart.

    Liked by 1 person

    • doctormikesblog says:
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      Yes I agree! In the age of instant gratification, patients have this idea that there’s a miracle pill for whatever disease they have. Sadly, I would have to say there isn’t anything like that now nor will there be in the foreseeable future. I think the best thing we can do now is to spread the word and educate people on issues like these. That way, we will have a larger collective mind that can find a solution to the US healthcare problem. But for now, the best thing that we all can do is to make others aware. The more thought we put into difficult problems like these the more likely we will find an answer.

      Like

  17. Mia says:
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    I actually love this. I’ve known many people who have become addicted to Xanax and had been depressed, I hadn’t linked the two! As for me, I once tried a drug called K2, with friends, and was rushed to the hospital. The doctors there had never treated someone who had done this drug, and they ended up giving me medicine to sleep the night through in the hospital. I proceeded to go back to the hospital 3 times more that week thinking I was dying! They ended up telling me to try meditation/focus on breathing. It worked! I highly reccomend meditation for any funk someone may be in! Love this piece!

    Liked by 1 person

    • doctormikesblog says:
      Reply

      Thank you! Wow, what a crazy story. When I was in New York as a med student I’d always hear about these young kids in the ED for K2 intoxication. I’m glad you made it out OK. Meditation would definitely help for something like that!

      Like

  19. lupietrish says:
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    Another great read. Xanax & so many other antidepressants are so crucial for people with depression & anexity but combined with other meds is also so deadly. Thanks for bringing Awareness to this.

    lupietrish. wordpress.com

    Liked by 1 person

    • doctormikesblog says:
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      Thanks for reading. Too many medications leading to an adverse event is something we call “polypharmacy.” I have an elderly population near my hospital, and I see it all the time. It’s very unfortunate.

      Liked by 1 person

  20. redheadedhousewife says:
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    Amazing Post!! Thank you for writing about the stigma that is depression. As a woman who has suffered with depression & anxiety for years it is fantastic that you shed some light on what can be a very debilitating illness. Many people in our society believe you can just “Get Over It”. Unfortunately it doesn’t work that way as much as I wish it did. I can speak from personal experience that living every day with depression is something I wouldn’t wish on my worst enemy. Thank You for your hard work & taking good care of people.

    Liked by 1 person

    • doctormikesblog says:
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      Yeah, “getting over it,” isn’t the only solution. It’s a real disease just as heart attacks and diabetes are. First step is spreading awareness. Next is acceptance. Last is the solution.

      Like

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