Medical students face a variety of mental health problems but could be reluctant to seek help. In fact, research reveals that medical students are more likely to experience anxiety, burnout, and depression.
Both the academic demands and the clinical environment are of concern for medical students, and some are overwhelmed, sleep-deprived, and experiencing ongoing stress and pressure.
Some medical students could be dealing with depression but masking the realities of their outward mental health. In a profession rooted in care and prevention, it’s advised that medical students should take reasonable measures to flag any dramatic signs that a peer could have depression. Here are action steps to take if you notice a peer struggling.
Signs to Watch for
The typical signs of depression — being visibly sad, stepping back from social activities, and a change in demeanor, can certainly be indicative of mental health challenges, but these symptoms can vary from person to person.
“Certainly, the above examples could indicate depression, but missing classes could also be a sign that a student is isolating or not functioning as per normal routine,” stated Anjali Kala, LISW, a therapist with behavior health at Cleveland Clinic, Cleveland. “If a peer is noticeably not performing up to their normal capacity, including grades and project outcomes, not showing up for classes, these could be red flags.”
She further noted that lack of interest is another symptom of withdrawal and could indicate that one is not motivated, has difficulty concentrating, and may be feeling hopeless. “The expression of hopelessness could indicate lack of support or even thoughts of ending one’s life,” she said.
Medical students should also notice physical shifts of peers which may be a sign their friend is depressed.
“Lack of sleep, looking fatigued all day, or a change in one’s hygiene and self-care can also indicate lack of interest in oneself and giving up,” cited Kala. “A depressed peer may have a change in appetite, where they do not eat regularly, or the opposite, eating more than usual, including significant weight loss or gain.”
Why It’s Important to Be There
Peers get a perspective that professors, staff, and administrators may not see. So if you believe a peer is spiraling downward with depression, it is advisable to act.
“The risks of not getting involved are that the individual may decline in their mental health, and they could be reaching a crisis,” Kala said. “It’s better to err on the side of caution and intervene, with hopes of helping and prevention.”
According to some studies, the prevalence of depression among medical students hovers around 19%, which means it’s affecting 1 in 5 students. “Since medical school often attracts high-achieving students, some students with depression may not feel comfortable seeking professional treatment on their own,” said Gregory Scott Brown, MD, psychiatry clerkship director at the University of Houston in Houston and chair, council on communications at the American Psychiatric Association. “Sometimes, a fellow student may be the first person a student feels comfortable speaking to about their feelings.”
Here are some guidelines:
- Approach the student. Initiating a conversation with a student you are concerned about can be helpful, especially if you are close to the student and you feel comfortable listening to their concerns. “However, if at any point you are worried about the safety of a classmate, conveying your concerns to a faculty member like your clerkship or pre-clerkship director can be useful as well,” Brown said.
- Elevate your concerns. If this needs to go further than the peer reach-out, refer your concerns to a dean, professor, or other staff, advised Kala with Cleveland Clinic. “Many medical schools are set up to advocate and promote wellness and have counselors in place or a path to refer a student,” she said.
- Tap resources. Some medical schools may have policies in place for how to report concerns about a classmate, so it’s best to check with your institution if specific policies are in place, Brown added.
Why It Matters
Mental health concerns like stress and burnout can quickly turn into depression if not caught early, Brown said.
“However, the good news is that with appropriate supports in place like student groups, campus-based counseling centers, and peer-to-peer check-ins — medical school, while challenging, can be an intellectually and emotionally rewarding experience,” he said.
With treatment, most people — including medical students — get better, Brown said. “No one has to suffer in silence.”
For any student reading this who is experiencing suicidal thoughts call the 988 Suicide and Crisis Lifeline.