My name is Issy, and I’m a 3rd year (CP1) medical student at the University of Nottingham.
I wanted to study medicine because I've always been slightly obsessed with all things to do with the human body – my parents had to hide a first aid book from me when I was five, as I started trying to diagnose my siblings with various ailments!
I also had a really excellent GP back home. She was so kind, caring and made me feel like the way I was feeling was completely valid. On days when I’m working with patients, I think about what she would do in the situation. I really aspire to be like her.
What was it that I needed this GP to support me with? I can seem confident and happy on the outside, but as people get to know me, they will find that I really struggled with my mental health.
I have been receiving treatment for a severe anxiety disorder since I was 11. It first presented as debilitating phobias, and then progressed into a more general fear of everything. Further down the line, I’ve suffered with depression and self-harm, all stemming from the original anxiety.
Support for student mental health is life changing
The way I felt used to really limit what I could do. But, with the right mix of medication, talking therapies, support from my university and more than a little tough love, I’ve begun to use my experiences for good. I love to speak out for myself and others like me as much as possible, especially using social media. I am keen to prove to myself and others that I can be just as good a doctor as my peers – boosted with a heightened sense of empathy, I can personally relate to those going through a similar experience to mine and it makes me feel like what I’ve been through is worth something.
I know I can achieve my goals in life, such as studying medicine. In the past, I was often told I wasn’t cut out for it or wouldn’t cope. Now I think, “if only you could see me now”. I’m genuinely proud of how far I’ve come. Sometimes, I just need a bit of extra support and adaptation, and that’s completely fine. But I am certain that I am not the only medical student who feels like this – as if nobody cared, as if I was ‘weak’ and as if I was wasting peoples time if I tried to reach out. I never want anyone to ever feel like I did at that time.
Medical school is competitive and that can have a negative effect on some students. Studies show medical students report higher instances of depressive symptoms than the general population. In a 2015 Student BMJ survey, 30% of students said that they had received treatment for a mental health condition while at medical school. Researchers studying the prevalence of depression among medical students list contributing factors as stress, sleep deprivation, academic rigour, exposure to traumatic clinical situations, debt, and moving away from loved ones.
A sketch by Issy
Photo credit: Isobel Walker
There are lots of potential triggers for those of us who experience mental health problems. You may compare yourself to everyone all the time, having so many contact hours. You see how many notes people have written or how they spend their free time. There’s a lot of pressure to constantly be top of your game, perform highly and study whenever possible. It can lead to a poor work/ life balance. My work/ life balance is what I can really struggle with in medical school. It’s a constant battle of knowing that I need to take time out to relax, and not wanting to get behind on work, as I know it will stress me out more. When I relax, there’s this constant guilty feeling that I should be working, which makes my ‘relaxation’ impossible.
Talking about what was going on changed my life for the better. And it was a friend who reached out during my lowest point and informed the university. The uni was able to take action quickly. I wouldn’t be where I am today if it weren’t for others supporting me. People do not realise how much a simple check in can support someone if they are struggling. I really want to encourage and promote a culture where talking about our mental health is just as normal as talking about our physical health. Especially when it’s so common amongst my peers at medical schools: just because we might not talk about it, doesn’t mean it isn’t happening.
I am certain that I am not the only medical student who feels like this – as if nobody cared, as if I was ‘weak’ and as if I was wasting peoples time if I tried to reach out. I never want anyone to ever feel like I did at that time.
How I manage my mental health
Through plenty of trial and error, I’ve learned the best way to deal with the way I feel is to talk about it with others. Say, "Hey, I'm not feeling great today, can we go for a coffee?" It helps. Even if I decide I don’t want to directly talk about it, being with others makes me feel less alone and can act as a good distraction.
Distractions are helpful, like getting out the house for some fresh air, even if it’s just to walk to the post box. I’m also a strong believer that a tidy space equals a tidy mind, so keeping my surroundings as clean and organised as possible means I have one less thing to stress and worry about!
I often repeat to myself something my doctor told me – you don't have to be perfect, just good enough. It makes me feel better when I don’t get the top grades, and remembering being a good medic isn’t just about getting the best grade.
Managing my mental health during the coronavirus outbreak
Unprecedented is not a word that can be used often, but times like this really are just that. It’s important to recognise that our mental health may take a hit due to this, and that that is completely understandable. I’m someone that works best when I have a routine that I can follow, so suddenly losing that was difficult for me, but I’ve worked to make a schedule for each day, ensuring to include things I enjoy, such as artwork. It means I don’t have as much time to ruminate and worry.
I’m also making sure to keep my family close, and appreciate those I have around me – this situation is making us see the true cost of illness on a scale none of us could ever have imagined. Although I am quite an introverted person, and value my time on my own, I do find that I miss chatting to my friends, and we regularly catch up on video chat. A fun thing we have been doing is setting each other challenges to video and complete – such as 'handstands in the most inventive places' or 'least hat-like hat'. It keeps us distracted and the results provide a much needed laugh!
Medics struggle with mental health too
Like my peers, when I leave medical school and enter the workforce, I want to be able to do the best for my patients and myself. If you aren’t feeling your best, you could compromise patient care without meaning to, which is the last thing I want. Having people to talk to is second to none in terms of helping you feel more you. You're not alone because there are always people who want to help, from your university to your friends and family. The bigger a support network that can be built, the better the outcomes will ultimately be, for both you, colleagues and patients alike.
If you’re experiencing mental health problems, there are places you can turn to for support.
All UK medical students should have access occupational health services through their university. Many universities, like Issy’s, will signpost the mental health support services available to students.
The GMC has produced guidance for students who have mental health conditions.
The NHS has an online hub with information about NHS mental health services.
We've developed a new free open access e-learning module on health and wellbeing. Written by MDU advisers with the assistance of key experts, the course will help you link your existing knowledge with your own wellbeing, and give you the confidence to take the first steps in ensuring your colleagues' wellbeing too. Find out more about the course and some of the techniques used.
Issy is a 3rd year medical student at Nottingham and originally from London. She has a particular interest in the wellbeing and mental health of her fellow students, and actively engages to work towards promoting it in various aspects of uni life alongside her studies. Her aim is to keep her options open for her future as she undertakes clinical teaching. Aside from medicine, she spends her time doing artwork, sailing or coaching rowing.
She tweets about mental health in medicine @issywalker.
See more by Isobel Walker