Imagine the following scenario: A promising second-year veterinary student becomes ill with a condition that first presents lower back pain and general fatigue, but progresses to the point where she cannot concentrate well enough to study effectively, is having difficulty sleeping, and can barely muster the energy to get to class most days.
This scenario is a classic description of depression—an illness that affects 9.5 percent of the U.S. population in any given year, Milliman Consultants and Actuaries reported, and an illness that is of particular concern to veterinary students. A 2004 survey conducted by the American College Health Association reported that nearly half of all college students say they feel so depressed at some point that they have trouble functioning.
The report also indicated that 15 percent of college students meet the criteria for clinical depression, a figure that exceeds that of the general population. The ACHA study noted a 4.5 percent increase in the number of students who reported having depression diagnosed over the four-year period leading up to the 2004 study.
Veterinary students—who have a tendency toward high achievement or even perfectionism—bring a special twist to the issue of depression.
Carolyn Wyatt, PhD, a psychologist who counsels students at the Washington State University College of Veterinary Medicine, believes expectations are one of the prime triggers for depression. She pointed out that students come to veterinary school or college as high achievers and are suddenly grouped with a very special population of exceedingly smart, successful students. It can be difficult for some students to adjust and make sure their expectations for their own performance are realistic. Dr. Wyatt has also seen a tendency for some students to see admission of depression as a character flaw or personal weakness, rather than recognizing it as a treatable illness.
The classic signs of depression—persistent sadness, lack of interest in formerly pleasurable activities, hopelessness, guilt, fatigue, sleep disturbances, inability to concentrate, a substantial weight loss or gain, for example—can sometimes be difficult for a student to recognize because these feelings may come on gradually, Dr. Wyatt said.
She compared this onset of depression to Chinese water torture—a slow, steady wearing away.
"A depressed student may let go of things that are important—friendships, hobbies, exercise," Dr. Wyatt said. "This letting go is not only a symptom, but then becomes a trigger for continued depression."
As with nearly all illnesses, the earlier addressed, the better. According to Milliman Consultants and Actuaries, the average delay between the onset of depression and treatment is six to eight years. But like nearly all other illnesses, depression is generally easier to treat in its early stages, and if left untreated, often progresses to a more serious condition.
For veterinary students experiencing signs of depression, a talk with their school counselor is an excellent place to start. A counselor can help a student determine whether there is a problem and how to best address it.
Students who are experiencing the typical anxieties of school can take several proactive self-help measures to deal with the negative feelings.
"Exercise is the number one antidote to anxiety, stress, and depression," Dr. Wyatt said. "Exercise can offer some prevention and also relief."
Meditation may accomplish the same feat. Researchers at the University of California, San Francisco Medical Center have found that the regular practice of meditation can affect the amygdale—the hub of fear memory. Meditation on a regular basis has a calming effect that positively influences how the individual deals with daily life stresses.
"I also encourage students to put a little structure into their lives outside of the academic program," Dr. Wyatt said. "Make a schedule to exercise, make a plan to go out with a friend, make the time to shop for healthy foods, plan a little break—a day or a weekend away."
"But most importantly, don't get too far down in the depths before seeking help," Dr. Wyatt said. "Depression affects attitude, optimism, energy level, concentration—all the elements one needs to succeed in school."
Being well, physically and emotionally, is critical to the success of a veterinary student in school and later as a veterinarian. The AVMA Group Health & Life Insurance Trust supports its commitment to wellness in a variety of ways, such as co-sponsoring the AVMA Veterinary Leadership Experience.
The VLE was created to help students better understand how to balance medical and surgical competencies with life skills such as leadership, relationship building, collaboration, and work and personal life. The program, which began as an orientation camp for WSU veterinary students, is intended to empower students to take responsibility over their preferred future.
Employing the skills taught at the VLE may also help combat the stress, anxiety, and depression that so many veterinary students experience at one time or another.
"Clearly, the VLE helps students have a better sense of themselves and their values," said Dr. Richard DeBowes, department chair of the WSU veterinary college. "The call to personal leadership can be of help because it enables students to reflect on what is good in their life, what matters, and they gain some capacity for better balance—something that helps us when we are feeling down."
For more information on the AVMA GHLIT, call (800) 621-6360 or visit www.avmaghlit.org.