Okay sorry in advance, this is going to be a heavy one and a little more psych focused.
Mental health has taken a spot in the limelight in recent decades. A paper I stumbled upon estimated 20% of higher education students worldwide are quoted to have a mental disorder (Knipe et al., 2018). They surveyed a sample of 1139 UK medical, veterinary, and dental students and the results were alarming:
25% - moderate to severe depression
27% - moderate to severe anxiety
40% - engaged in hazardous drinking behaviors
1% - persistent suicidal thoughts (defined as ideation daily for >2 weeks)
7% - self-harmed in the previous year (2% of those had suicidal intent)
Only 21% sought professional help. Why such a low number? It was reported that students feared documentation on academic records, didn’t have enough time, or were afraid of undesired intervention. Many of them didn’t know where to get help or felt like there was no support (Knipe et al., 2018). While these numbers are alarming, this study is limited because it was run at only one university. There is also something to be said about translating the results to the US. However, it still highlights the importance of providing the proper resources and having quality support systems to survive the rigors of professional school.
In relation to depression, treatment mainly follows therapy and possibly medication. Some of the best medications include selective serotonin reuptake inhibitors (SSRI’s) and serotonin-norepinephrine reuptake inhibitors (SNRI’s). Both are reuptake inhibitors which prolongs the amount of time in the synaptic cleft by the respective neurotransmitters. SNRI’s prolong both serotonin and norepinephrine in a sequential way due to affinity (Sansone & Sansone, 2014). This can be more beneficial in controlling these neurotransmitters’ effects and boost mood and other behaviors as well. Medication is not always the best option as it can take months or years to figure out appropriate drug and dosage. Support from family and friends and health coping mechanisms can also tip the scale for individuals.
What is most important is that if you’re feeling depressed, anxious, or suicidal, please seek help and support. Talk to family, friends, or a professional. Take a break sometimes. Go outside and look at nature. I like to run and get the blood flowing, but what works for me might not work for you. Go figure out your strategies. As we progress to professional school, certain stressors are only going to get worse. Finding balance in life and having a solid support system is critical. Many still archaically think that mental health issues are a weakness and would never admit they need help. But reality is, professional school/life can suck sometimes and before the acronyms, we are all human and we all need a hand sometimes.
If you’re depressed, know that you are not alone and not a burden.
If you’re feeling overwhelmed and anxious, take a deep breath, hold it for 7 seconds, breath out, and repeat.
If you’re feeling suicidal or have suicidal ideation, please consider talking to a professional. Or save the National Suicide Prevention Lifeline call number in your phone (1800-273-8255).
Knipe, D., Maughan, C., Gilbert, J., Dymock, D., Moran, P., & Gunnell, D. (2018). Mental health in medical, dentistry and veterinary students: cross-sectional online survey. BJPsych open, 4(6), 441–446. https://doi.org/10.1192/bjo.
Sansone, R. A., & Sansone, L. A. (2014). Serotonin norepinephrine reuptake inhibitors: a pharmacological comparison. Innovations in clinical neuroscience, 11(3-4), 37–42.
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ReplyDeleteHello Steven,
ReplyDeleteThe issue of mental health within our society is truly heartbreaking. After reading your post I was interested to see what the numbers were in regards to mental health service utilization. A recent meta analysis of 44 studies detailed that out of those individuals who had committed suicide only 31% of them had used mental health services in the year preceding their death (Harmer et al 2021). This is an incredibly low number, highlighting the importance of increasing mental health utilization among those suffering from any sort of mental health illness. In addition, in 2017 the CDC found that out of the 1.4 million people who committed a suicide attempt, only 1/3rd of them sought prior help (Harmer et al, 2021). Unfortunately, there are many barriers in attaining help such as stigma, lack of education or health insurance. I think the battle in increasing mental health service utilization begins at decreasing or eliminating these barriers.
Harmer, B., Lee, S., Duong, T., & Saadabadi, A. (2021). Suicidal Ideation. In StatPearls. StatPearls Publishing.
Steven, thank you for writing about this heavy topic, I am sure the majority of us have experienced depression in varying degrees, which got me thinking. How often does one feel put off seeking help for depression thinking that it will pass with time and is one gender more affected than the other, if so, how? I went and did a little digging and here is what I found, on the gender part that is. It turns out that the molecular signatures in our genes can predispose us to major depressive disorders (MDD), women are twice as likely to be affected than men, (which is just icing on the cake to what we learned in TBL 2 about how women are not small men…). In this study, they performed a large-scale gene expression meta-analysis across three brain regions and a cell-type-specific analysis. Through those analyses, they found that there was no overlap in the transcriptional changes in brain regions of men and women, but they did find that women with MDD have an increase in synapse-related genes, whereas men had a decrease. They also found that there was a decrease in immune-related genes in females, but no distinct changes in the male counterpart. Another interesting find was that there is a decrease in the oligodendrocyte/microglia-specific genes in women who are experiencing MDD, but an increase in men. Altogether these findings indicate that there are specific molecular changes that may be causative to differences in MDD in men and women (Seney, et al., 2018).
ReplyDeleteMy questions to you are:
But if there is a molecular difference in MDD between men and women, why are people still experiencing the same symptoms, and what specific brain regions can depression impact? Is there a difference between men and women?
Also, if MDD is so prevalent among university students should we educate adolescents on how to mitigate/lessen their chances of experiencing depression later on, earlier in life? If so, should we cater MDD teaching/resources to specific sexes (i.e. resources for boys and what they can expect when experiencing depression and vice versa) or generalize the lessons to both sexes disregarding the predisposition in women?
Seney, M. L., Huo, Z., Cahill, K., French, L., Puralewski, R., Zhang, J., Logan, R. W., Tseng, G., Lewis, D. A., & Sibille, E. (2018). Opposite Molecular Signatures of Depression in Men and Women. Biological Psychiatry, 84(1), 18–27. https://doi-org.dml.regis.edu/10.1016/j.biopsych.2018.01.017