1. How would you define mental health? What is its impact on a person’s well-being?

Mental health would be a state of emotional and psychological well-being and the person is able to cope with daily life stressors in a healthy and productive manner. That’s the textbook definition, anyway. Personally, mental health is being able to sleep soundly at night and wake up in the morning not feeling like crap or that the world is going to cave in on you at any minute. It’s looking both ways before crossing the road. People usually take mental health for granted. Even now when psychiatric disorders are recognized as debilitating health conditions, people still refuse to go see a therapist or to even talk about their issues. A person becomes dysfunctional in that he can’t deal with common stressors. This ultimately affects all aspects of a person’s life, their work, their relationships and even their physical well-being.

  1. What are the most common mental health problems that students and professionals are likely to encounter?

Anxiety, depressive1 and somatoform disorders2 are commonly seen in medical students and healthcare workers. PTSD can also be sometimes experienced by healthcare workers, especially those who work during calamities or in war zones, or even in high-stress departments such as in intensive care units or mental institutions3. People often think of the more escalated symptoms when they think of mental illness such as ideations of suicide or nervous breakdowns, but these usually manifest as more subtle symptoms such as insomnia, fatigue, irritability, panic attacks, erratic behaviour, forgetfulness, difficulty in concentrating and somatic complaints. They can also manifest as emotional exhaustion or “burnout”2. This can come from a wide variety of reasons such as inability to cope with the academic load, constant exposure to high-stress situations. It could be their personality, such as if a person is predisposed to rumination and worry, then they’re more likely to develop depressive disorders4. There is a wide, wide source of potential triggers whose interactions could predispose those who are constantly exposed to them to psychopathology. There is actually no published study that has focused on specific triggers for the Filipino medical student or health care worker. International studies have shown that being female5,6, being a scholar6 and those who perceived that they didn’t have adequate access to psychological support6,7,8 were more likely to develop mental disorders or have higher depressive scores. Curriculum and schedules were also reported to be perceived causes5.

  1. What steps or measures can medical students take to maintain optimal mental health? What can we do to promote better mental health among medical students?

For starters, raise awareness. Medical students and medical students-to-be should be prepared for not just an increase in academic load but in psychological load as well. Let them know it’s okay to be overwhelmed and to feel lost, that it’s normal. Foster an environment that doesn’t allow fear of being ridiculed or perceived as weak just because they are feeling this way. Raising awareness deals with all of that. It also makes it easier for the students to open up about their feelings, making them more open to the idea of therapy or of reaching out for help. Since the administration has recently reinstated the guidance office, they could encourage students to visit once in awhile. Another thing they can do is enforce the feeling of belonging, of being a community and to slowly erase the idea that this is a competition and that you have to beat everyone. It destroys the purpose of learning medicine.

Everybody copes differently and sometimes it takes a while to find your groove. What’s important is that you don’t isolate yourself. Allow yourself to connect with your emotions and open up about them. Vulnerability shouldn’t be perceived as weakness. As Confucius said, “The green reed that bends in the wind is stronger than the mighty oak that breaks in a storm.”

References:

  1. Jadoon NA, Yaqoob R, Raza A, Shehzad MA, Zeshan SC. Anxiety and depression among medical students: a cross-sectional study. JPMA. The Journal of the Pakistan Medical Association. 2010 Aug;60(8):699-702.
  2. Almeida AD, Godinho TM, Bitencourt AG, Teles MS, Silva AS, Fonseca DC, Barbosa DB, Oliveira PS, Costa-Matos E, Soares AM, Abade B. Common mental disorders among medical students. Jornal Brasileiro de Psiquiatria. 2007;56(4):245-51.
  3. Skogstad M, Skorstad M, Lie A, Conradi HS, Heir T, Weisæth L. Work-related post-traumatic stress disorder. Occupational medicine. 2013 Apr 1;63(3):175-82.
  4. de Jong-Meyer R, Beck B, Riede K. Relationships between rumination, worry, intolerance of uncertainty and metacognitive beliefs. Personality and Individual Differences. 2009 Mar 31;46(4):547-51.
  5. Kulsoom B, Afsar NA. Stress, anxiety, and depression among medical students in a multiethnic setting. Neuropsychiatric disease and treatment. 2015;11:1713.
  6. Mayer FB, Santos IS, Silveira PS, Lopes MH, de Souza AR, Campos EP, de Abreu BA, Hoffman II I, Magalhães CR, Lima MC, Almeida R. Factors associated to depression and anxiety in medical students: a multicenter study. BMC Medical Education. 2016 Oct 26;16(1):282.
  7. Sreeramareddy CT, Shankar PR, Binu VS, Mukhopadhyay C, Ray B, Menezes RG. Psychological morbidity, sources of stress and coping strategies among undergraduate medical students of Nepal. BMC Medical education. 2007 Aug 2;7(1):1.
  8. Guthrie EA, Black DS, Shaw CM, Hamilton J, Creed FH, Tomenson B. Embarking upon a medical career: psychological morbidity in first year medical students. Medical education. 1995 Sep 1;29(5):337-41.