MD & DO NYU med student hangs herself in dorm room

[MSTPlease]

On the topic of depression, has anyone seen physicians discount depression in patients? It seems like in my experience the only type of depression that was taken seriously were those people that were completely wiped by it and couldn't put a smile on. Meanwhile, any patient who was able to talk and hold a conversation was said to not be that depressed by the psychiatrists I worked with. I always found it odd and it certainly doesn't help when assessing others. Is it a stretch to say med students have to show some fakeness on the outside when they're feeling down b/c they're always being evaluated or maybe they're working for a letter. There really isn't a time to show their true depression unless it's in the comfort of their own home. I'm sure this student was able to keep a firm exterior and fooled a lot of people around her. To anyone on the outside she may not have qualified for SIGECAPS but a lot of good that did for her.

It's also really frightening to see how quick many physicians are to dismiss/minimize women in pain if anxiety or depression are mentioned anywhere in the chart.

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[Mad Jack]

“The United States spends significantly more on treating mental disorders than it does on any other medical condition—a whopping $201 billion in 2013. (Heart conditions, for which the U.S. spent $147 billion that year, rank a distant second.) But even with these resources and the tremendous efforts of dedicated scientists and physicians, mental illness remains deeply enigmatic, its causes generally unknown, its cures undiscovered. Despite the overwhelming body of research on mental illness to which new findings are added almost every day, we scientists still don’t understand what happens in the brains of mentally ill people. We don’t really know yet which brain regions and connections are malformed or undeveloped or why the brain goes awry”​

Excerpt From
The Neuroscientist Who Lost Her Mind
Barbara K. Lipska

And yet in many cases we do, and we can provide tangible, measurable results in outcomes and quality of life. Your quote also does very little to address anything I posted, as I was not addressing treatment, but rather the nature of what it is like to experience depression, which you clearly do not understand, and why many of your recommendations fly in the face of both what we know about depression and the subjective experiences of people who themselves have depression

 

[mistafab]

What is sad is that there are many cases of depression that aren’t as extreme but still ride on people’s back for years at a time - just weighing them down in every single thing they do.

 

[Oso]

What is sad is that there are many cases of depression that aren’t as extreme but still ride on people’s back for years at a time - just weighing them down in every single thing they do.

Yes, what some call ‘functional depression’. Your life doesn’t have to be falling apart on the outside for you to be struggling, you could even be very outwardly successful while depression rages on inside you.

You wake up, you feel empty, hopeless, alone, but you manage to get up from your bed, make your coffee, and do well enough socially and at work to get through the day and be able to go back to sleep without anyone asking questions. Repeat.

But the amount of effort it takes can be tremendous and leave you exhausted. Your motivation, concentration, and patience are shot. Vitality drained. Just enough left to walk around as a functioning robot.

 

[ortnakas]

@Mad Jack and @OrthoTraumaMD both did an eloquent job explaining some of the intricaties of depression on the previous page. I’ve never been suicidal, thankfully, but I do have some personal experience with depression, and often it’s not the sadness that gets you, it’s the anhedonia. Realizing that you do have many reasons to be happy— whether those reasons are hot girls, being a radiologist, your future Mercedes or your current cat— but not being able to FEEL happy takes a number on you.

***************************

If anyone reading this is struggling with suicidal thoughts or even “just” not really having a good handle on your depression or anxiety, suicide is not your only option. Say something. If you don’t feel comfortable talking to people you know in real life or random SDN strangers, here are additional free, confidential options:

1-800-273-8255: suicide hotline
741741: text crisis hotline

 

[NeurologyHopeful2018]

Its interesting you guys talk about med students hiding depression very well...I know almost no one who put on a happy face in med school...everyone seemed stressed out and miserable.

 

[Mad Jack]

Just to make sure. Is there such diagnosis in DSM V?

persistent depressive disorder aka dysthymia

I meant depressive, not dysthymic, was trying to rattle the new name for dysthymia out of my brain because I used a good deal of benadryl to sleep the night prior

 

[mybluedog]

This is so heartbreaking.... I feel so sad for the family and friends. Most of the med students in the articles were pretty young, entering school around ages 21-23.
I have definitely been depressed in the past and thought about suicide through my first application year + personal stuff. I feel sometimes people try to toughen up and have this fake face on. It's sad how one can look so happy but be so broken inside.

If anyone reading this needs someone to talk to, my PM is always open.
In addition to the free hotlines above, I do know free crisis textlines/apps that are good:
-7cups
-crisistextline.org

I think it might even be a good thing to ask the Mods to create a short and sweet sticky with some resources + sdn users that pre-meds->attending+ can reach out to.

 

[ERDOC555]

Its interesting you guys talk about med students hiding depression very well...I know almost no one who put on a happy face in med school...everyone seemed stressed out and miserable.

What you're seeing is actually their "happy face" and they seem absolutely miserable. Now imagine how bad it would be if they didn't hold back and behaved and looked how they really feel.

 

[sliceofbread136]

What you're seeing is actually their "happy face" and they seem absolutely miserable. Now imagine how bad it would be if they didn't hold back and behaved and looked how they really feel.

Would probably get expelled...

 

[TattedMed]

Not sure if serious or joking but since this is a serious thread...
This “but how can YOU be depressed?” bulls**t is exactly the reason depression is so underdiagnosed. It can strike anybody—rich, poor, happy (robin williams? anyone?), sad, introvert, extrovert. It is an insidious monster that nearly took my life after a traumatic personal event. I never thought it would happen to me. It makes life, even a good life, seem meaningless. It turns you into your own enemy. I did not want to die, and no one with depression actually does. Death is an escape from the pain, and seemed, for a while, like the only way out, until I realized what was happening to me and took serious steps to get help.
What someone posted earlier about jumping from a burning building is 100% true. An orthopaedic trauma surgeon i knew took his life a few months ago, he stabbed himself in the chest. He was the chief of ortho trauma at HSS/Cornell Presbyterian. He had young kids. No amount of wealth, power, or love will save you if depression is allowed to take root inside.
And while we are on the subject of the good life, you seem to have a very skewed view of what Ortho actually means. I don’t make a million, and that Mercedes was bought on 80 hrs/week of hard work, which I still very much do.
Oh, and I’m a woman, so the “banging tall models” comment doesn’t apply (not that any male orthopod i know has ever dated models either, they’re all married to doctors, nurses, or teachers).



Sent from my iPhone using SDN mobile

This.

 

[peridotthecat]

Yes, what some call ‘functional depression’. Your life doesn’t have to be falling apart on the outside for you to be struggling, you could even be very outwardly successful while depression rages on inside you.

You wake up, you feel empty, hopeless, alone, but you manage to get up from your bed, make your coffee, and do well enough socially and at work to get through the day and be able to go back to sleep without anyone asking questions. Repeat.

But the amount of effort it takes can be tremendous and leave you exhausted. Your motivation, concentration, and patience are shot. Vitality drained. Just enough left to walk around as a functioning robot.

So true. This describes me for most of high school and college. I managed to get schoolwork done and seem reasonably put together, but I went to bed most nights wondering how long it would be until I couldn't take it anymore. For the most part, I didn't feel actively suicidal, but I spent several years convinced that at some point in the future I would take my own life. It's a horrible place to be, and meeting external milestones of success doesn't make it any better.

My heart goes out to this student and her friends and family and to everyone else suffering from depression. My inbox is always open if anyone wants to talk!

 

[curbsideconsult]

I had a friend who killed himself when we were in undergrad, and he seemed like a happy guy with lots of social support among our group of friends. His suicide caught us way-off guard.

Halfway through my first year of medical school, a very friendly, charismatic, and upbeat girl in the class above mine took her life. I actually met her during my orientation and would run into her from time to time. She was always very sweet and genuinely interested in how school was going for me so far. I was so caught off guard when I found out what had happened. I remember overhearing some of her closest friends taking about how they were absolutely shocked. It was a tragic loss for our whole school. We never know what demons others are silently battling.

What you're seeing is actually their "happy face" and they seem absolutely miserable.

In a way, it's the always happy ones we have to look out for. Obviously, we have to help those who are outwardly depressed as well, but those people are pretty easy to spot. The always cheerful/positive ones are hard to crack because they tend to be the type of people who never want to let anyone down and want to be there for others because they don't want to be a burden to other people.

I remember one time in college I ran into a high school friend. She was extremely bright, very talented, beautiful, etc. etc. basically one of those girls every girl is jealous of but also wants to be her bff. From an outsider's perspective she seemed pretty happy. But I distinctly recall having a funny feeling in the pit of my stomach when she said something in particular (I don't remember what it was) and I thought that maybe she wasn't ok. I was going to followup but I thought I was just being overly sensitive and that she would think I was nuts so I didn't say anything after that. Then a couple of weeks later she had committed suicide. I'm not saying that I could have prevented it, but I at least could have talked to her. Who knows what the outcome would have been. My point is that you should always trust your spidey senses and reach out to someone who you think, even if it's only the inklingest of inklings, might be depressed but shows no outward signs of it.

 

[apoplectic]

Values are meaningless past a certain point of suffering. Some Christians have a fear of hell that ...

You also don't seem to understand depression...

Values are what keep you going when life falls apart. Viktor Frankl wrote brilliantly about it in his savage takedown of living in Nazi concentration camps and how his sense of purpose “Man’s Search for Meaning” kept him alive. For reasons unknown to him as a neurologist and psychiatrist, many of his fellow Jews gave up on life and they escalated their murder. The Nazis targeted Jews in the camps who appeared weak, not viable for slave work and unproductive. Dr Frankl would not allow that to be hung on him even if interiorly it was tempting. So yes, values, faith, belief in yourself or your roots.....all crucial to existence. One can argue that today’s rampant nihilism and dictatorship of relativism have exacerbated our unhinged toxic culture in America.

I dont know a single person who fears “hell”. Your broad brush statement is antiquated and reflects your animus. I am also Catholic and hell isnt part of our daily lexicon, but supplication to God for help is...at least for me

As for your other claim....you missed the few posts I have authored where I indicate I have a therapist, I take psych meds and I am having mental health issues....connect the dots. Additionally my aunt committed suicide (a nurse), another aunt (also a nurse) underwent Electroconvulsive Shock Therapy, my father battled depression all of his life and refused to seek help, plus my brother, during medical school, attempted suicide. I had to get a court order to have him committed involuntarily to a CSU to stabilize him. Then there is me: I tried to end my life years ago but my doctors told me it wasnt a true suicide attempt but rather trying to stop the pain. So yeah, I know depression up front and personal. The neuroscientist I quoted, Dr Barbara Lipska, is 110% correct. We do not understand mental illness and treatment success is multipronged, success is hit and miss, and it will always be a challenge. If we face it and deal with it, it actually makes us better healers...like Dr Lipska argues in her excellent book. I recommend everyone to buy it. It is surreal and a quick read. She is the leading brain researcher in the world and director of NIMH

The Neuroscientist Who Lost Her Mind: My Tale of Madness and Recovery Hardcover – April 3, 2018, by Barbara K. Lipska Ph.D (Author), Elaine McArdle (Author)

I started this thread because I was (and am) very upset. I have self-regulated since then, used my various resources (refer to my reply above) and more or less landed. Step 1 is making life anxious, miserable and the fear has paralyzed me, e.g. fetal position on floor in darkness, unable to move...you get the picture (or should). My therapist and associate dean are totally behind me but they know it is ultimately in my hands to overcome this....

I dont understand why the NYU medical student committed suicide as improbable as that may sound coming from me. But I choose to get up, eventually, from my dark moments, I choose to see my therapist, I choose to have real friends in the flesh and I choose to surroud myself with loving, affirming, supportive people. The internet, social media, texting or making 50k posts on SDN, IG, FB are no substitute. I think the latter has underminded our mental health as many studies have already stated

I will be OK. I just wish everyone who is at that dark, awful precipice like the NYU medical student, could make that pivot. When they dont, and succumb to it, it really rattles me, hence this thread. For the life of me it could just as easily be me but I labor to not have that happen. Ironically many who commit suicide dont show any signs to their friends like the NYU student, or me for that matter, so it behooves us who fight with this monster mano a mano to be real, authentic and transparent with ourselves and our support system. I tell my husband and he is aware. But there are days when the floor, a dark room and clutching my pillow while I whimper are the best I can do for that moment. Step 1 prep has made that really clear

For anyone who is in this type of dark throes, definitely reach out in real life to those around you, be vulnerable, get help, do the daily work and get up! because life is worth living, and your life is treasured by many even if you think otherwise.

 

[Mad Jack]

Values are what keep you going when life falls apart. Viktor Frankl wrote brilliantly about it in his savage takedown of living in Nazi concentration camps and how his sense of purpose “Man’s Search for Meaning” kept him alive. For reasons unknown to him as a neurologist and psychiatrist, many of his fellow Jews gave up on life and they escalated their murder. The Nazis targeted Jews in the camps who appeared weak, not viable for slave work and unproductive. Dr Frankl would not allow that to be hung on him even if interiorly it was tempting. So yes, values, faith, belief in yourself or your roots.....all crucial to existence. One can argue that today’s rampant nihilism and dictatorship of relativism have exacerbated our unhinged toxic culture in America.

I dont know a single person who fears “hell”. Your broad brush statement is antiquated and reflects your animus. I am also Catholic and hell isnt part of our daily lexicon, but supplication to God for help is...at least for me

As for your other claim....you missed the few posts I have authored where I indicate I have a therapist, I take psych meds and I am having mental health issues....connect the dots. Additionally my aunt committed suicide (a nurse), another aunt (also a nurse) underwent Electroconvulsive Shock Therapy, my father battled depression all of his life and refused to seek help, plus my brother, during medical school, attempted suicide. I had to get a court order to have him committed involuntarily to a CSU to stabilize him. Then there is me: I tried to end my life years ago but my doctors told me it wasnt a true suicide attempt but rather trying to stop the pain. So yeah, I know depression up front and personal. The neuroscientist I quoted, Dr Barbara Lipska, is 110% correct. We do not understand mental illness and treatment success is multipronged, success is hit and miss, and it will always be a challenge. If we face it and deal with it, it actually makes us better healers...like Dr Lipska argues in her excellent book. I recommend everyone to buy it. It is surreal and a quick read. She is the leading brain researcher in the world and director of NIMH

The Neuroscientist Who Lost Her Mind: My Tale of Madness and Recovery Hardcover – April 3, 2018, by Barbara K. Lipska Ph.D (Author), Elaine McArdle (Author)

I started this thread because I was (and am) very upset. I have self-regulated since then, used my various resources (refer to my reply above) and more or less landed. Step 1 is making life anxious, miserable and the fear has paralyzed me, e.g. fetal position on floor in darkness, unable to move...you get the picture (or should). My therapist and associate dean are totally behind me but they know it is ultimately in my hands to overcome this....

I dont understand why the NYU medical student committed suicide as improbable as that may sound coming from me. But I choose to get up, eventually, from my dark moments, I choose to see my therapist, I choose to have real friends in the flesh and I choose to surroud myself with loving, affirming, supportive people. The internet, social media, texting or making 50k posts on SDN, IG, FB are no substitute. I think the latter has underminded our mental health as many studies have already stated

I will be OK. I just wish everyone who is at that dark, awful precipice like the NYU medical student, could make that pivot. When they dont, and succumb to it, it really rattles me, hence this thread. For the life of me it could just as easily be me but I labor to not have that happen. Ironically many who commit suicide dont show any signs to their friends like the NYU student, or me for that matter, so it behooves us who fight with this monster mano a mano to be real, authentic and transparent with ourselves and our support system. I tell my husband and he is aware. But there are days when the floor, a dark room and clutching my pillow while I whimper are the best I can do for that moment. Step 1 prep has made that really clear

For anyone who is in this type of dark throes, definitely reach out in real life to those around you, be vulnerable, get help, do the daily work and get up! because life is worth living, and your life is treasured by many even if you think otherwise.

Your idea that your particular values-based ethos has kept you going and is therefore a broadly applicable truth, the denial of which is at the root of the failures of others, is an example of survivorship bias at its finest. I guess that's what my rub with your previous statements is.

Survivorship Bias

Frankl's tale also suffers from this fallacy. Interesting personal anecdotes and opinions are not truths. His book ignores much of the science we have in regard to starvation and what it does to the mind, effects that strike the stable and faithful as surely as they do the feeble and godless, something we know from actual research studies that examined the mental and physical effects of extreme starvation. His conclusions about human nature and survival are his opinions and experience, but do not constitute scientific evidence.

Do what works for you but don't be so quick to judge others, for you no nothing of their inner motivations, their faith, their fear, or their failures. Being a devout Christian didn't help with my depression any more than my preference in socks, it was completely inconsequential. My depression was not a matter of faith, effort, or purpose, it was a matter of wiring. I got through it but I don't presume to have the recipe by which others might, for each of us has different demons and different ways by which we might survive.

 

[imtheman25]

This is so awful, my heart aches for her family and friends, especially considering how close she was to graduating. I really hope medical schools and the profession do more to tackle this. My school doesn't have any student suicides, but the dean once said "its a matter of time before a student takes his/her life". Everyone warned me that the career I am pursuing would be depressing, but I didn't realize I was depressed until I kept wishing a car would run me over. I didn't have time to spend with family and friends because I was too busy trying to prove myself and study for boards. I felt broken, and constantly had empty pit in my stomach. My perspective of my classmates and peers became negative. My relationships had all fallen apart and I had nothing to hold on to for happiness. Everyone around me was negative and noxious ... myself, my classmates, faculty, mentors, and other doctors I worked with were all miserable. My school offers free mental health services and while I am not a believer of therapy, my classmate urged me to go (best decision I made in a while haha). I was immediately diagnosed with major depression and was given medication. It's been a month, and I don't have depressing thoughts anymore, but I still don't feel happy...I really do not feel anything. I hope that one day my life has more meaning. I pursued medicine so that my life has more of a purpose and that I am needed by my patients, and I just hope I can experience that pleasure one day. Rumor has it that 30% of my class is on SSRI's....unbelievable.

 

[IMApplicant18]

This is so awful, my heart aches for her family and friends, especially considering how close she was to graduating. I really hope medical schools and the profession do more to tackle this. My school doesn't have any student suicides, but the dean once said "its a matter of time before a student takes his/her life". Everyone warned me that the career I am pursuing would be depressing, but I didn't realize I was depressed until I kept wishing a car would run me over. I didn't have time to spend with family and friends because I was too busy trying to prove myself and study for boards. I felt broken, and constantly had empty pit in my stomach. My perspective of my classmates and peers became negative. My relationships had all fallen apart and I had nothing to hold on to for happiness. Everyone around me was negative and noxious ... myself, my classmates, faculty, mentors, and other doctors I worked with were all miserable. My school offers free mental health services and while I am not a believer of therapy, my classmate urged me to go (best decision I made in a while haha). I was immediately diagnosed with major depression and was given medication. It's been a month, and I don't have depressing thoughts anymore, but I still don't feel happy...I really do not feel anything. I hope that one day my life has more meaning. I pursued medicine so that my life has more of a purpose and that I am needed by my patients, and I just hope I can experience that pleasure one day. Rumor has it that 30% of my class is on SSRI's....unbelievable.

There is absolutely no way anyone can know 30% of class is on SSRI - that is protected HIPPA.

 

[middchild6]

On the topic of depression, has anyone seen physicians discount depression in patients? It seems like in my experience the only type of depression that was taken seriously were those people that were completely wiped by it and couldn't put a smile on. Meanwhile, any patient who was able to talk and hold a conversation was said to not be that depressed by the psychiatrists I worked with. I always found it odd and it certainly doesn't help when assessing others. Is it a stretch to say med students have to show some fakeness on the outside when they're feeling down b/c they're always being evaluated or maybe they're working for a letter. There really isn't a time to show their true depression unless it's in the comfort of their own home. I'm sure this student was able to keep a firm exterior and fooled a lot of people around her. To anyone on the outside she may not have qualified for SIGECAPS but a lot of good that did for her.

Yep, it’s often listed as “inappropriate affect” on notes. It really sickens me!

 

[curbsideconsult]

There is absolutely no way anyone can know 30% of class is on SSRI - that is protected HIPPA.

Isn't that why it's a "rumor?"

HIPAA doesn't preclude med students from gossiping with one another unless the information was found out while they were working in a clinical setting. Also, I'm pretty sure anyone talking about numbers with absolutely no personally identifiable information is not a HIPAA violation.

 

[MSTPlease]

27% of Medical Students Are Depressed

Not much of a stretch to imagine 30% of the class on SSRIs

 

[Candidate2017]

How can you possibly get depression as an Ortho attending? You pulling in nearly $1 million a year, banging tall models left and right, driving a Mercedes-Maybach, and living in a castle dining on Foie Gras and Caviar Q3 daily!

Maybe I should feel like a bad person but I legit LOL'ed at this.

 

[Candidate2017]

Yep, it’s often listed as “inappropriate affect” on notes. It really sickens me!

Inappropriate affect is a real psych/medical term that is not what you imply it means. I hope you're just a psych patient who peeked at their chart. Because if you are a med student or doc, it's depressing to see how poor psych education is.

 

[Candidate2017]

On the topic of depression, has anyone seen physicians discount depression in patients? It seems like in my experience the only type of depression that was taken seriously were those people that were completely wiped by it and couldn't put a smile on. Meanwhile, any patient who was able to talk and hold a conversation was said to not be that depressed by the psychiatrists I worked with. I always found it odd and it certainly doesn't help when assessing others. Is it a stretch to say med students have to show some fakeness on the outside when they're feeling down b/c they're always being evaluated or maybe they're working for a letter. There really isn't a time to show their true depression unless it's in the comfort of their own home. I'm sure this student was able to keep a firm exterior and fooled a lot of people around her. To anyone on the outside she may not have qualified for SIGECAPS but a lot of good that did for her.

I discount depression all the time and will roll my imaginary eyes at you and think about where I would like to have lunch while you drone on about how depressed you are. Especially if you're having coffee, complaining about the food, sitting and chatting with me. Even if you endorse all sigecaps criteria. Maybe you have borderline personality disorder or a handful of other psych conditions that acutally puts you at higher risk of killing yourself than a truly depressed patient (this is why it's wrong to assume suicides are the result of depression).

What I will not discount or underestimate, is your risk to yourself.

 

[wholeheartedly]

There is absolutely no way anyone can know 30% of class is on SSRI - that is protected HIPPA.

This is false. BTW it's HIPAA not HIPPA.

HIPAA in no way precludes people from knowing this information. Everything from IRB approvals to Quality Assurance type projects can allow for access to this information. Given the enormous gravity and prevalence of physician suicide, it isn't unreasonable to think someone at various schools are researching this. It also doesn't mean privacy is necessarily compromised as health systems generally have the means to pull data in a way the de-identifies it.

But let's not stray off topic.

This has for the most part been a great discussion and I appreciate the contributions people are making here.

 

[The_Sunny_Doc]

Just a hunch, but I tend to think people who are more openly cynical and “whiny” are not as at risk of bottling up their emotions till they become all consuming as people who are cheerful go-getters who never let others see them sweat. Nobody is happy all the time. We are so hellbent on being likeable and getting high marks for our positive attitude that we suppress our pain instead of working through it and dealing with the messiness that work entails.

That any of us feel the need to paper over our negative emotions to save face is a sad commentary on our society, and how we view vulnerability and dealing with negative emotions as weaknesses. I imagine the social pressure for men is even worse.

 

[LuciusVorenus]

Values are what keep you going when life falls apart. Viktor Frankl wrote brilliantly about it in his savage takedown of living in Nazi concentration camps and how his sense of purpose “Man’s Search for Meaning” kept him alive. For reasons unknown to him as a neurologist and psychiatrist, many of his fellow Jews gave up on life and they escalated their murder. The Nazis targeted Jews in the camps who appeared weak, not viable for slave work and unproductive. Dr Frankl would not allow that to be hung on him even if interiorly it was tempting. So yes, values, faith, belief in yourself or your roots.....all crucial to existence. One can argue that today’s rampant nihilism and dictatorship of relativism have exacerbated our unhinged toxic culture in America.

I dont know a single person who fears “hell”. Your broad brush statement is antiquated and reflects your animus. I am also Catholic and hell isnt part of our daily lexicon, but supplication to God for help is...at least for me

As for your other claim....you missed the few posts I have authored where I indicate I have a therapist, I take psych meds and I am having mental health issues....connect the dots. Additionally my aunt committed suicide (a nurse), another aunt (also a nurse) underwent Electroconvulsive Shock Therapy, my father battled depression all of his life and refused to seek help, plus my brother, during medical school, attempted suicide. I had to get a court order to have him committed involuntarily to a CSU to stabilize him. Then there is me: I tried to end my life years ago but my doctors told me it wasnt a true suicide attempt but rather trying to stop the pain. So yeah, I know depression up front and personal. The neuroscientist I quoted, Dr Barbara Lipska, is 110% correct. We do not understand mental illness and treatment success is multipronged, success is hit and miss, and it will always be a challenge. If we face it and deal with it, it actually makes us better healers...like Dr Lipska argues in her excellent book. I recommend everyone to buy it. It is surreal and a quick read. She is the leading brain researcher in the world and director of NIMH

The Neuroscientist Who Lost Her Mind: My Tale of Madness and Recovery Hardcover – April 3, 2018, by Barbara K. Lipska Ph.D (Author), Elaine McArdle (Author)

I started this thread because I was (and am) very upset. I have self-regulated since then, used my various resources (refer to my reply above) and more or less landed. Step 1 is making life anxious, miserable and the fear has paralyzed me, e.g. fetal position on floor in darkness, unable to move...you get the picture (or should). My therapist and associate dean are totally behind me but they know it is ultimately in my hands to overcome this....

I dont understand why the NYU medical student committed suicide as improbable as that may sound coming from me. But I choose to get up, eventually, from my dark moments, I choose to see my therapist, I choose to have real friends in the flesh and I choose to surroud myself with loving, affirming, supportive people. The internet, social media, texting or making 50k posts on SDN, IG, FB are no substitute. I think the latter has underminded our mental health as many studies have already stated

I will be OK. I just wish everyone who is at that dark, awful precipice like the NYU medical student, could make that pivot. When they dont, and succumb to it, it really rattles me, hence this thread. For the life of me it could just as easily be me but I labor to not have that happen. Ironically many who commit suicide dont show any signs to their friends like the NYU student, or me for that matter, so it behooves us who fight with this monster mano a mano to be real, authentic and transparent with ourselves and our support system. I tell my husband and he is aware. But there are days when the floor, a dark room and clutching my pillow while I whimper are the best I can do for that moment. Step 1 prep has made that really clear

For anyone who is in this type of dark throes, definitely reach out in real life to those around you, be vulnerable, get help, do the daily work and get up! because life is worth living, and your life is treasured by many even if you think otherwise.

I wouldn't say he survived because he believed / was stronger emotionally. I think he survived because he was lucky.

I remember reading some papers when I was on psych about how religion can be protective when it comes to suicide risk, but I also remember the research being not very strong and focused purely on suicide risk. It's important to remember that just because someone isn't suicidal doesn't mean they're "cured." As you point out with your own personal experience, it's very possible to be just as depressed as someone who is a suicide risk without actually taking your own life. This becomes even scarier when someone is unfortunate enough to not have access to "loving, affirming, supportive" people.

This is not directed at you at all but there's still unfortunately a huge stigma with depression/mental illness - I wonder how people would feel if we treated other people with neurological disorders the way we treat people with mental health. Imaging telling someone with Alzheimer's that they're just not trying hard enough to remember.

Either way don't worry so much about Step 1. It might be easy for me to say since I've already taken it but in the end you kind of have to realize that the WORST CASE scenario is you don't get to do an uber-competitive sub-specialty.

 

[LuciusVorenus]

I had a fairly unusual sort of depression, what would have been called melancholic depression in the past but we now refer to as persistent dysthymic disorder. It's no exaggeration to say that I didn't feel a moment of happiness in my life until I was around 23 years of age, at which point it just kind of went away on its own, possibly due to a seizure I had at the time, oddly enough the last epileptic seizure I ever had (basically ECT'd myself I guess lol). Tried a few different drugs, they did nothing for me, and sometimes actually made things worse. I'm actually fine today, even if I do have rough days here and there like anyone else.

I'm really sorry but that part made me lol. I'm glad you're feeling better though.

 

[apoplectic]

I wouldn't say he survived because he believed / was stronger emotionally. I think he survived because he was lucky.

I remember reading some papers when I was on psych about how religion can be protective when it comes to suicide risk, but I also remember the research being not very strong and focused purely on suicide risk. It's important to remember that just because someone isn't suicidal doesn't mean they're "cured." As you point out with your own personal experience, it's very possible to be just as depressed as someone who is a suicide risk without actually taking your own life. This becomes even scarier when someone is unfortunate enough to not have access to "loving, affirming, supportive" people.

This is not directed at you at all but there's still unfortunately a huge stigma with depression/mental illness - I wonder how people would feel if we treated other people with neurological disorders the way we treat people with mental health. Imaging telling someone with Alzheimer's that they're just not trying hard enough to remember.

Either way don't worry so much about Step 1. It might be easy for me to say since I've already taken it but in the end you kind of have to realize that the WORST CASE scenario is you don't get to do an uber-competitive sub-specialty.

Thanks for the support

Dr Viktor Frankl survived because he had the internal resources to muster, he didnt allow his depression and fear to show to the Nazis, and he willed himself to survive on a day by day basis. Read his book. It is depressing! But it provides much insight from one perspective

Mental illness is a stigma only because people (patients) allow it. I talk about my Major Depressive Disorder as casually as I talk about flossing my teeth. To live life is to endure pain but ultimately we choose to wallow in suffering, a Buddhist, Jewish and Catholic precept

Thanks too for your Step 1 comments. I took a practice test yesterday - 90th percentile. I have struggled mostly with focusing given my ADHD. The content isnt difficult but rather having the internal resources to shut down the monkey babble has been my cross. It took a while but I have embraced it and have progressed nicely

If others can do it, so can you. Such is my motto

forward and onward. cheers

 

[apoplectic]

I had a fairly unusual sort of depression, what would have been called melancholic depression in the past but we now refer to as persistent dysthymic disorder. It's no exaggeration to say that I didn't feel a moment of happiness in my life until I was around 23 years of age, at which point it just kind of went away on its own, possibly due to a seizure I had at the time, oddly enough the last epileptic seizure I ever had (basically ECT'd myself I guess lol). Tried a few different drugs, they did nothing for me, and sometimes actually made things worse. I'm actually fine today, even if I do have rough days here and there like anyone else.

I just saw these posts:

“now refer to as persistent dysthymic disorder“
“basically ECT'd myself I guess lol”

you have no competence whatsoever in this arena.

this is a serious topic that deserves sober, informed and mature input. A medical student committed suicide, I have my own personal history therein, I created this thread to address this issue for others, and you have commented only to bring attention to yourself.

Your bullying me aside, your asenine “critiques” of Frankl and Lipka, two eminent scientists on this very topic, have done a disservice to this topic. No wonder mental illness is stigmatized with detractors like you.

shame on you

 

[curbsideconsult]

I just saw these posts:

“now refer to as persistent dysthymic disorder“
“basically ECT'd myself I guess lol”

you have no competence whatsoever in this arena.

this is a serious topic that deserves sober, informed and mature input. A medical student committed suicide, I have my own personal history therein, I created this thread to address this issue for others, and you have commented only to bring attention to yourself.

Your bullying me aside, your asenine “critiques” of Frankl and Lipka, two eminent scientists on this very topic, have done a disservice to this topic. No wonder mental illness is stigmatized with detractors like you.

shame on you

Not trying to add to any flames, but @Mad Jack specifically said several times that he has had some form of depression or other for a while and him lol'ing at his own circumstances is not, I believe, meant to be insensitive or making fun of anyone with depression. I read his laughing about ECT'ing himself as more of a mature defensive mechanism rather than anything malicious. I myself laugh at the insanity that is my life because it's therapeutic for me. Also, I believe he's going into psych residency soon? So combined with his own personal experiences I'm going to say that he has at least some competence with this.

I'm sorry for everything you're going through right now. Step studying sucks and the magnitude of the consequences of not doing well is something that I'm choosing to ignore (that's called suppression, not repression, right? Thanks for sharing your own personal and family struggles.

 

[Matthew9Thirtyfive]

I just saw these posts:

“now refer to as persistent dysthymic disorder“
“basically ECT'd myself I guess lol”

you have no competence whatsoever in this arena.

this is a serious topic that deserves sober, informed and mature input. A medical student committed suicide, I have my own personal history therein, I created this thread to address this issue for others, and you have commented only to bring attention to yourself.

Your bullying me aside, your asenine “critiques” of Frankl and Lipka, two eminent scientists on this very topic, have done a disservice to this topic. No wonder mental illness is stigmatized with detractors like you.

shame on you

Ignoring your last paragraph, it’s funny you’re trying to shame someone who just matched into psych and who has had depression himself for not viewing issues exactly as you do. People have different coping methods and different ways of talking about their own struggles. Try not to judge someone for how they deal with their own stuff, mkay?

 

[anbuitachi]

I don't see any news on it but it seems like a pgy2 resident at NYU also committed suicide this week?

 

[Mad Jack]

I just saw these posts:

“now refer to as persistent dysthymic disorder“
“basically ECT'd myself I guess lol”

you have no competence whatsoever in this arena.

this is a serious topic that deserves sober, informed and mature input. A medical student committed suicide, I have my own personal history therein, I created this thread to address this issue for others, and you have commented only to bring attention to yourself.

Your bullying me aside, your asenine “critiques” of Frankl and Lipka, two eminent scientists on this very topic, have done a disservice to this topic. No wonder mental illness is stigmatized with detractors like you.

shame on you

Some of us use humor as a coping mechanism, it's a form mature defense mechanism you should have studied in class and is psychologically healthy to possess. As to "no competence," you know nothing about me. I've been having a very serious discussion about the nature of mental illness and the frequent disconnect between perceptions of mental illness and research in the area, and how these misperceptions cause very real harm. You have countered with insults of character and utilized works of opinion and personal experience as appeals to authority while I have countered with basic research.

Frankl's work has been controversial in psychiatry and psychology circles for decades longer than you have been alive and is generally viewed as am excellent tale of survival and an interesting introspection, but hardly a universally applicable tome on the subject of psychiatry and survival, particularly in light of the fact that it ignored much actual research (the Minnesota Starvation Experiment, the Stanford Prison Experiment, the Milgram experiment, and many other landmarks in the field of psychological research) for an experiential and ultimately spiritual approach to suffering and coping that was anecdotally rather than evidence based. His views do much to harm, rather than help, patients, as his approach to therapy was basically more of the same old "mental illness is a flaw of resolve and character" that a great deal of research has told us to not be true.

Dr. Lipska would be the first to admit that she is not an expert on the diagnosis or treatment of mental illness, as she is not a physician. The point of your quote was that much of mental illness remains a mystery, not that current treatments are wholly ineffective or that or system is necessarily broken. She would also be the first to admit she is not an expert in the diagnosis or treatment of mental illness, as that is simply not what she does. It is quite amusing that you believe I am a detractor of mental illness, when I have been the one trying to explain to you that suicide is not, in fact, a weakness of belief, values, or character, and that depression is an often misunderstood but highly treatable disease that requires the proper help rather than throwing our hands in the air and saying, "well we don't 100% know what's going on, I guess you should believe in God more or something."

 

[OrthoTraumaMD]

I just saw these posts:

“now refer to as persistent dysthymic disorder“
“basically ECT'd myself I guess lol”

you have no competence whatsoever in this arena.

this is a serious topic that deserves sober, informed and mature input. A medical student committed suicide, I have my own personal history therein, I created this thread to address this issue for others, and you have commented only to bring attention to yourself.

Your bullying me aside, your asenine “critiques” of Frankl and Lipka, two eminent scientists on this very topic, have done a disservice to this topic. No wonder mental illness is stigmatized with detractors like you.

shame on you

Stop. Just stop.


Sent from my iPhone using SDN mobile

 

[EleanorAbernathyMD]

I don't see any news on it but it seems like a pgy2 resident at NYU also committed suicide this week?

I heard this as well. Happened yesterday I believe.


Sent from my iPhone using SDN mobile app

 

[MSTPlease]

Inappropriate affect is a real psych/medical term that is not what you imply it means. I hope you're just a psych patient who peeked at their chart. Because if you are a med student or doc, it's depressing to see how poor psych education is.

Just because it's a real term doesn't mean it's used appropriately. Saw lots of psych attendings write in their notes that patients have "cluster B traits" as part of their pathology which was clearly just a euphemism for "dingus" or "dick" or "[insert pejorative here.]" Having traits of a personality disorder is not a pathology - it's called normal human behavior. Literally everyone has traits of the clusters.That's why they are personality disorders and require multiple criteria to be met in the DSM - because they represent pathological extensions of otherwise normal personality traits.

EDIT: for the record, I did not write "dingus" but I love that SDN autofilters/corrects what I did write into dingus.

 

[imtheman25]

Why isn't this receiving more coverage?

 

[W19]

The take home message is: Stay the hell away from NYU. Joking!

 

[Oso]

Why isn't this receiving more coverage?

I haven't looked into it, but I sure hope NYU is taking a lot of active measures to re-evaluate their culture and address this issue. The number of suicides among health students/professionals at this institutions is insane ... it's so scary. I agree that it isn't getting sufficient coverage in the mainstream media.

 

[Matthew9Thirtyfive]

I haven't looked into it, but I sure hope NYU is taking a lot of active measures to re-evaluate their culture and address this issue. The number of suicides among health students/professionals at this institutions is insane ... it's so scary. I agree that it isn't getting sufficient coverage in the mainstream media.

Seriously, wtf is going on up there?

 

[0ncogene]

Physicians Experience Highest Suicide Rate of Any Profession

Medscape: Medscape Access

Check out the comment section of the article. There is a good discussion going on there as well.

 

[MSTPlease]

Physicians Experience Highest Suicide Rate of Any Profession

Medscape: Medscape Access

Check out the comment section of the article. There is a good discussion going on there as well.

"The results also showed that although female physicians attempt suicide far less often than women in the general population,"
That's certainly an interesting little nugget.

"The review also showed that of all medical specialties, psychiatry is near the top in terms of suicide rates."
Relevant given the NYU resident was in psych. Also, not totally surprising based on my experience on psych. Attendings constantly analyzing the residents in a way that made me feel uncomfortable. Future psychiatrists should obviously be required to have ongoing therapy during residency in order to handle the (counter)transference and other issues that come up when dealing with these patients but the therapists shouldn't be the same people who they are working with all day and who have a say in their ability to progress through the program.

 

[moggat]

Suicides cluster. It doesn't help that there was a lot of irresponsible reporting in the aftermath of the first suicide (looking at you NY Post). Columbia had a wave last year and Sinai too--my undergrad even did one year.

 

[Disciple of Sattar]

I just saw these posts:

“now refer to as persistent dysthymic disorder“
“basically ECT'd myself I guess lol”

you have no competence whatsoever in this arena.

this is a serious topic that deserves sober, informed and mature input. A medical student committed suicide, I have my own personal history therein, I created this thread to address this issue for others, and you have commented only to bring attention to yourself.

Your bullying me aside, your asenine “critiques” of Frankl and Lipka, two eminent scientists on this very topic, have done a disservice to this topic. No wonder mental illness is stigmatized with detractors like you.

shame on you

This is ironic considering most of your posts in this thread are to bring attention to yourself and how your "values" will save you, implying that those who do commit suicide didn't have the right values.

 

[Skiiiiiing]

very very upsetting! This is stressing me out and I hate this happening!
I dont understand how a 4th year MD student can do this right as they are about to launch!

God this is awful.

\\\\\\\

NYU med student hangs herself in dorm room

A distraught NYU medical student hanged herself inside a dorm, according to police sources Tuesday.

The body of Andrea Liu, 26, was found hanging by a rope inside Vilcek Hall at 334 E. 26th St. — an NYU-owned dorm — just before 11 a.m. Tuesday, sources said.

Police believe it was a suicide and say Liu left a note, according to sources.

Liu was a fourth-year radiology student set to graduate this year, according to friend and classmate Jing Ye, who knew her for four years.”​

NYpost

NYU medical student hangs herself in Kips Bay dorm
An NYU medical student hanged herself at a university dorm in Kips Bay Tuesday, police and sources said.

© Andrew Savulich/New York Daily News An NYU student was found by police after she hanged herself…
The 26-year-old student was found by police at Vilcek Hall, a residence for the NYU School of Medicine, at 334 E. 26th St. after someone called 911 just after 10 a.m.

Police recovered a suicide note at the scene, a source said.

NYdailynews
​

Its NYU. It may just be the coldest culture on the planet in conjunction with its neighbor...the mafia and boxing competitors frequently exhibit more interpersonal warmth than either of these places. I don't think you can generalize to all of medicine by highlighting incidents at a cultural outlier.

 

[CherryRedDracul]

Suicides cluster. It doesn't help that there was a lot of irresponsible reporting in the aftermath of the first suicide (looking at you NY Post). Columbia had a wave last year and Sinai too--my undergrad even did one year.

Basically, stay the hell away from NYC.

 

[anbuitachi]

"The results also showed that although female physicians attempt suicide far less often than women in the general population,"
That's certainly an interesting little nugget.

"The review also showed that of all medical specialties, psychiatry is near the top in terms of suicide rates."
Relevant given the NYU resident was in psych. Also, not totally surprising based on my experience on psych. Attendings constantly analyzing the residents in a way that made me feel uncomfortable. Future psychiatrists should obviously be required to have ongoing therapy during residency in order to handle the (counter)transference and other issues that come up when dealing with these patients but the therapists shouldn't be the same people who they are working with all day and who have a say in their ability to progress through the program.

Kind of off topic but just want to add that that research report saying psych is near the top in suicide rates used data from practitioners from England and Wales, and their system and US' is very different so may not apply for US.

 

[MSTPlease]

Kind of off topic but just want to add that that research report saying psych is near the top in suicide rates used data from practitioners from England and Wales, and their system and US' is very different so may not apply for US.

Oooh thanks. Especially given how differently they view talk therapy I don’t think it’s totally insignificant.

 

[IM-2019]

"The results also showed that although female physicians attempt suicide far less often than women in the general population,"
That's certainly an interesting little nugget.

"The review also showed that of all medical specialties, psychiatry is near the top in terms of suicide rates."
Relevant given the NYU resident was in psych. Also, not totally surprising based on my experience on psych. Attendings constantly analyzing the residents in a way that made me feel uncomfortable. Future psychiatrists should obviously be required to have ongoing therapy during residency in order to handle the (counter)transference and other issues that come up when dealing with these patients but the therapists shouldn't be the same people who they are working with all day and who have a say in their ability to progress through the program.

Lower attempt rate but higher completion is interesting. Maybe it's due to knowledge of which methods are most lethal, or maybe there are just fewer "cries for help" and physician suicides have stronger intent to complete.

 

[siliso]

Of course it is that physicians of both genders know what kind of suicide attempt is likely or highly unlikely to be lethal, far more so than the genpop. Which then erases the gender based aesthetic differences of genpop suicide attempt methods.