Medical school was the first time in my life that I suffered from debilitating anxiety. I was overwhelmed by the volume of information I was expected to learn, and the anxiety impaired my ability to digest it all.
I was unable to go to anatomy study sessions because I would have panic attacks when I was couldn’t identify structures. I struggled with performance anxiety during patient presentations when I started clinical rotations. And I would freeze when I was asked questions in front of large groups during rounds.
During medical school, I never felt like I had control over my anxiety; it had control over me. It was not until later in medical school and in residency that I started to feel control over the anxiety after seeking therapy and developing coping mechanisms. I later learned that many of my classmates dealt with similar challenges, and most of us waited longer than necessary to seek help.
Whether people choose to talk about it or not, many medical students and residents are suffering from some degree of depression or anxiety.
In finding control, I also found empathy. I started to realize that almost every patient in the clinic and in the hospital is anxious for one reason or another, and justifiably so. From a woman in clinic with bronchitis anxious about returning to work to a man in the hospital with metastatic colon cancer anxious about how long he has to live, in the clinical setting I found myself constantly interacting with anxious people.
For the first time, I started to recognize a true benefit of the anxiety that impaired me in medical school – I understood, at least to an extent, how many of my patients were feeling. I understood that pervasive, debilitating feeling of worry. And I found that this understanding enabled me to take better care of my patients.
Learning to cope with my anxiety gave me the tools to patiently listen as my patients expressed their concerns, and I was able to make extra efforts to explain a disease process or a management plan when I realized that a patient was nervous because he was unsure about what was happening.
I noticed that I was better able to manage my anxiety. I was actually able to think of the anxiety as something I had control over.
It is well known that medical students and physicians have far higher rates of anxiety and depression than the average person. Studies show that as many as one-fourth of medical students are depressed or anxious. Up to 10 percent report having suicidal thoughts. Part of the challenge of combating mental health problems in medical school and training is increasing awareness and promoting an environment in which people feel comfortable talking about it.
Another challenge is posed to the individual dealing with these issues – how to personally manage depression and anxiety. One approach may be applying lessons learned from experiencing these conditions to taking better care of our patients.
-By Holland Kaplan, M.D., internal medicine resident at Baylor College of Medicine