The College Fix

Depression rates for young Americans are higher than ever. New research, however, has found a surprising group of students may be particularly averse to seeking counseling: medical students.

Medical students experience depression at a higher rate (14.3 percent) than the general population (10 to 12 percent) and attach high levels of stigma to the illness, which subsequently causes depressed students to avoid seeking treatment according to University of Michigan research to be published in the Journal of the American Medical Association.

“Students seem to have significant concerns that they’re just not safe…if they reveal this to students or to counselors or to faculty members,” said Dr. Thomas Schwenk, a professor of family medicine at Michigan and one of the researchers involved in the study. “That’s of course the most worrisome concern by far — that we have not helped them, despite all the things that we have done to try to make psychiatric services confidential.”

According to the study, 53.3 percent of medical students who reported high levels of depressive symptoms were worried that revealing their illness would be risky. Almost 62 percent of the same students said asking for help would mean the student’s coping skills were inadequate.

Researchers have discussed a number of possible causes for the stigma, including some students’ belief that peers and faculty members will be overly critical of their condition, and depressed students will be viewed as incapable of dealing with the high demands of medical school. Another possible explanation is that students may fear that seeking treatment could in some way harm their future careers.

“It’s very possible that they have good reason and that they are responding to what they see,” Schwenk said. “All of these (concerns) may be very real, and we certainly would not want to tell students, ‘Oh no, it’s fine.’ I think they may have legitimate worries.”

Katherine Ellington, chair of the Student Life and Wellness committee at the American Medical Student Association (AMSA), said that she has heard of cases where a medical student’s past or present psychological disorder ended up being a barrier in his or her quest to become a doctor.

She cited a 2005 article from the New England Journal of Medicine, which reports on a study involving a survey of residency directors, and seems to confirm medical students’ worst fears.

“Residency directors said they were less likely to ask a hypothetical applicant to interview if he or she had a history of psychological counseling,” according to the article.

However, Ellington noted that the issue goes both ways.

“I’m sure there have been cases that warranted such action,” she said. “You do want people to be safe when they head into their residency training. But at the same time, you don’t want people to be penalized, especially if they have worked hard to overcome (a mental health disorder).”

“A lot of the issue comes down to differentiating diagnosis from performance,” Schwenk said.

He said that a severely depressed student probably does not perform to his or her full potential, but said that the situation is not really all that different than if the student were afflicted with a more conventional illness without being treated for it.

“But once someone is treated,” Schwenk said, “they should be able to demonstrate performance at an equal level to where they were before.”

Researchers are not entirely sure how they ought to go about convincing medical students to seek treatment, according to Schwenk.

The study on medical students comes on the heels of an increasing amount of data that says student depression rates are higher than ever.

Research presented in August at the annual meeting of the American Psychological Association found that of students who sought counseling, the share of those students diagnosed with moderate to severe depression increased to 41 percent in 2009, up from 34 percent in 1997.

Last year, a study in the Clinical Psychology Review concluded young people in general are more prone to suffer from anxiety disorders than older generations were at the same age.

“The stress induced by college is not a major explanation,” said Daniel Eisenberg, an associate professor of health management and policy at Michigan. “It might be a part of it, but there seems to be a broader societal trend.”

According to Eisenberg, though, the campus setting differentiates student depression from most of adult life.

“When I think about what’s special about college students in terms of mental health, it’s not so much about the causes or the treatments,” Eisenberg said. “It’s more about the opportunity to identify people who might benefit from treatments, because college campuses have so many resources and so many ways of reaching out to students.”

Andrew Kalenkiewicz is the managing editor of the Michigan Review and a student at the University of Michigan. He is a contributor to the Student Free Press Association.

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