Appendix 13 - Depression

by Michael Greger, MD and United Progressive Alumni

[ Medical School Resources | Appendices | Discussion ]

An Academic Medicine pilot study reports 77% of interns interviewed felt "substantially depressed" during the year.[183] Almost 1 in 5 students were identified as abusers of alcohol.[184],[185] Two studies in particular have shown that about one third of interns have frequent or severe episodes of emotional distress or depression and that a quarter of these interns think about committing suicide. The suicide rate of physicians is equal to the loss of about two medical school classes yearly.[186]

For medical students, suicide is the second-leading cause of death.[187] And they kill themselves more often during third year than during any other time.[188]

J'ai des papillons noirs. (I have black butterflies) - neurologist describing his depression[189]

Quoting from "Mental Health of Medical Students," published in Pharos, "The experiences of medical school, often traumatic, always stressful, unmask psychiatric problems in those of us who are at risk; indeed, the environment may place nearly everyone at some risk."[190]

Conclusion from a study of medical students at UMass published 1997:

These preliminary data support the view that, upon entering medical school, students' emotional status resembles that of the general population. However, the rise in depression scores and their persistence over time suggest that emotional distress during medical schools is chronic and persistent rather than episodic. Also, the women had more significant increases in depression scores than did men.[191]

Studies have shown that half of female MD's may experience a psychiatric illness, most likely depression, during their lifetime.[192] Academic Medicine: "Women [medical] students experience more distress than their male counterparts in almost every measure, including stress, depression, daily alcohol use, and personal problems."[193] Female physicians have suicide rates significantly higher than those of male physicians and four times higher that of white American women of the same age.[194] The suicide rate for female medical students was similarly found to be two to three fold higher than their nonmedical peers.[195]

Crept a Shadow

One intern shares his experience:

Another problem strikes - my bowels. The irregular hours and rushed meals of residency give me frequent diarrhea, and it's that time again. When I come out of the washroom a few minutes later... I walk into the OR and the surgeon explodes. 'Where the hell have you been? Can't you see we're starting the case? You're the worst Goddamn resident I've ever had.'

The tirade continues for several minutes. The anesthesiologist and nurses are embarrassed for me and lower their heads or look away. The surgeon does the procedure himself, posturing himself to shield his work from my view. I arrive home an hour later and think how easy it would be to extinguish the pilot light on the furnace and lie down to a peaceful sleep. I go down to the basement but the furnace room doesn't have a door and I can't think of how to concentrate the gas fumes, so I trudge back upstairs.... I realize later that my judgment was impaired by lack of sleep at the same time my self-esteem had been shattered by the surgeon's caustic comments. A dangerous combination.[196]

Another resident,

My internship was in a good teaching hospital and I was doing acceptable work. Then into this picture of myself as a normal person crept a shadow, first slowly and then swiftly, the shadow of collapse, the nervous breakdown of the layman, and in a few weeks I was a crying and frightened child.[197]


[183] Sledge, WH, et al. "Distress among Interns." Academic Medicine 65(1990):608.

[184] Gordon, LE. "Mental Health of Medical Students." The Pharos 1996(Spring):2-10.

[185] Lane LW, et al. Archives of Internal Medicine. 150(1990):2249-2253.

[186] McCue, JD. New England Journal of Medicine 306(1982):458-463.

[187] Psychiatric News 17 July 199812, 21.

[188] Hays, LR, T Cheever and P Patel. American Journal of Psychiatry 153(1996):553-555.

[189] Youngson, RM. Medical Blunders New York: New York University Press 1999:265.

[190] Gordon, LE. "Mental Health of Medical Students." The Pharos 1996(Spring):2-10.

[191] Rosal, MC, et al. Academic Medicine 72:542-546.

[192] North, CS., et al. Postgraduate Medicine 101(1997):233.

[193] Toews, JA, et al. "Stress and Harassment." Academic Medicine 68(1993):S46-S48.

[194] Richman, JA and JA Flaherty. Social Science and Medicine 30(1990):777-787.

[195] Lane, LW, et al. Archives of Internal Medicine 150(1990):2249-2253.

[196] Patterson, R. Canadian Medical Association journal 159(1998):823-825.

[197] Duffy, JC. "The Young Physician and His Emotions." New Physician 1965(Sept.):244-246.

Add a comment | Add a link