Intern Depression

There was a study a few months back that showed that a large percentage of interns meet DSM criteria for major depressive disorder. Of course, this statement is flawed in many ways; the DSM (psychiatric) criteria for depression include symptoms like weight change, appetite disturbance, insomnia, fatigue, difficulty concentrating. Every intern at some point feels these symptoms. The call schedule disrupts our sleep; we can't help but feel chronically fatigued and have poor concentration. Depending on our specialty, our meals are rushed or forgotten. It's no wonder that every intern can check off many of the criteria for depression.

But the two most central aspects of depression are a depressed mood or loss of interest or pleasure. How often do residents meet that criterion? Hopefully, most of us went into medicine because we enjoy it; we love seeing patients, we feel privileged in caring for people, we get a sense of satisfaction from the relationships and interactions that form. But to some extent, residency grinds a little of that out. I go into each call night hoping I don't cap on admissions. I don't necessarily go in hoping I'll admit zero (I feel like then that'd be a waste of time), but I'm not such a work-o-phile as to ache for more patients. When we realize we wake up before it's light out and leave the hospital after it gets dark, it's hard not to have a depressed mood. We see our friends outside medicine making more money, working fewer hours, having less stress, starting families, and cannot help but wonder did we make the right choice?

That being said, I don't think I really ever met the DSM criteria for depression. Despite days here and there where work really affects me, for the majority of time, I love what I do. I don't mind being in the hospital and I cultivate those things outside the hospital which make me happy. The friends I've made in the residency program are so wonderful and supportive. We help one another get through those long call nights, remind each other to take care of ourselves after work.

Image of Vincent van Gogh's "On the Threshold of Eternity" (1980) is in the public domain, from Wikipedia.