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.
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.
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:
- Sit upright in a comfortable chair.
- Close your eyes and focus on your breathing.
- Imagine the air coming from the outside, into your nostrils, filling up your lungs, and slowly release back out to the environment.
- If your mind wonders, that’s OK. Don’t fight it and calmly refocus your attention back to your breathing.
- 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!