Tips to fight depression during medical residency

Even though I love my job, I’ve been feeling a little burned out lately. I think it comes from being stretched too thin, which is something I’ve coped with off an on ever since med school.

As the saying goes, there are never enough hours in the day, and sometimes that really gets to me. While my practice is incredibly important, I also place a lot of value on my family. When I don’t get to spend much time with my husband and two children, I don’t just feel upset … I feel guilty, too, and those feelings wear on me every day.

In an effort to find creative ways to aid the situation, I was doing some research online when I came across this article by Christine S. Moyer from the American Medical News, which talks about an interesting study regarding depression in residency.

That got me to thinking back on my own experience in residency. It was one of the most overwhelming, stressful times of my life! There were literally times when I felt like it wouldn’t end. But it did, and even though I still struggle with feelings of burnout and blues, I sometimes wish I could go back to myself in residency and say, “Everything’s going to be ok!”

In reflecting on my own experience with residency, I’ve decided to dedicate this post to current residents who are dealing with burnout and depression in residency and too much stress in general. We’ll look at the facts, and I’ll share my own tips for coping towards the end.

But anyway, back to the study. Along with other researchers, Srijan Sen, MD, PhD surveyed 740 doctors entering 13 different residency programs between 2007 and 2008. The findings were pretty astounding: though fewer than 4% of doctors had major depression when they entered residency, about 25% did by the end of their first year. 

Those are scary numbers, and I can’t help but think to myself … if 25% are experiencing depression in residency by the end of their first year, how many are experiencing it by the end of their third year?

It really is a serious issue, and major depression in residency can be threatening not only to oneself, but to others as well. In order for patients to receive the best care possible, doctors need to be well cared for, too … especially when it comes to self-care.

Below are a few of the things that helped me through rough times during residency, and they continue to help me today. Though major depression is something that needs professional attention (see #4), there are always things you can to do make yourself feel better. Here are my tried and true:

1. Depression in residency? Talk about it. In my opinion, one of the worst things you can do when you’re having a hard time in residency is to keep your mouth shut. While it’s good to remain professional (no one appreciates a colleague who’s constantly bemoaning his or her job), it’s also important to find someone you can vent to in a healthy way.

Whether that’s a close friend, your significant other or a trusted family member, find someone who cares and will listen. I think it’s especially important for those of us in medicine. As doctors, we’re always supposed to act like we have everything under control, but the fact is, we don’t. We’re human, just like our patients.

2. Get some fresh air and exercise. I really wish I’d discovered the benefits of exercise during residency… it would have been a great stress reliever. To be honest, I didn’t really start making time for exercise until my patients began asking me what kind of exercise I was doing. That made me decide to get active.

About a year ago, I was invited to play on a women’s soccer team. Though I had no prior experience with the sport, I love it now! It’s definitely made an improvement on my morale, which has been a bit lower than usual. Plus, I find I have lots of extra energy throughout the day (and something to look forward to!).

For busy residents, working out for 30 minutes a day might not be manageable. But even if you can squeeze in just 5 or 10 minutes 3 times a week, you’ll get your blood pumping, which can do wonders for your mood. Don’t feel like you have to start running marathons just because you want to take up exercise. Even doing just a little is way better than doing nothing.

3. Take the time to eat right. If you stick with it and stay disciplined, you’d be amazed at what a healthy diet can do for your mood. When you’re stressed and pressed for time, it’s more than easy to fall back on vending machines and fast food. I like fruit (it’s portable, delicious and gives me a great energy boost), and when I can swing it, I make lunches in advance.

4. If you’re experiencing depression in residency, don’t be afraid to ask for help. Depression in residency varies. Sometimes, it’s something you can take control of with yourself and the support of loved ones, and other times, waiting to ask for help is the worst thing you can do. Taking that first step to seek help (whether that means counseling, antidepressants or a combination of the two) is always the hardest, but once you do, you’ll wonder why you waited. Check around your program for resources — many have services geared specifically for residents.

Finally, if you’re stressed about work/life issues or looming career decisions, I strongly recommend check out both the Life, Money & Career Priorities and Job Transition stages in the Adventures in Medicine Resource Library.

Adriana Tobar is a family physician and resident advisor for Adventures in Medicine.

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