Mental Health in Medicine: Self-Nourishment as a Necessary Tool for Medical Students

Author: Donya Ahmadian

Let’s take a moment of pause together. I hope you can rest here with me, even if just for a few moments. I want to encourage you to take this time, however long it may be, to take notice of the space you are allowing yourself to fill and the expansiveness of the spirit which dwells inside of you. How have you nourished yourself today? What words did you use when speaking to yourself today? Were they kind, understanding, loving, forgiving? Did you water yourself, and did you do so with the enthusiasm and ease in which you so freely water others? As you take this pause, I hope you will allot attention to what rises within your chest, the answers which flow naturally and the ones which do not. Remember, above all, that not a single one of these answers, physical, nor emotional sensations are wrong- and that Grace still finds you here. That is the most beautiful part about her, this thing called Grace- she does not care where you think you are supposed to be, she cares only about where you are right now, and this is where she meets you.

I understand that it has been a long, winding, unpredictable (even the parts we may have thought we had predicted) road. Each twist, turn, and detour have all led you to this exact moment, the one you were always intended to experience, at precisely the time in which you were meant to experience it. This is the funny thing about life, no matter our plans, worries, and sticky-noted, highlighted 10-year plans, it somehow always takes us on the precise journey we were meant to embark upon, and rarely the one we had planned for. 

In medicine, we are quite familiar and romanticize having a plan- for it is these very plans, which we have had to meticulously follow, to allow us the space and opportunity to be presently working towards our chosen paths as future physicians.  Oftentimes, planning is so deeply embedded within us, that in the midst of checking off our daily roles and responsibilities, we often leave ourselves off of this list. Mental health and self-care is an acknowledged necessity- but a distant reality for many medical students. We are surrounded by external and internal pressures, all of which often compile and leave us feeling isolated, suffering from burnout, self-comparison, and heightened feelings of loneliness, depression, and anxiety (Pokhrel et al., 2020). 

Numerous  studies have focused on self-reported levels of engagement in self-care directed activities and monitored students responses and relationship to stress and presence in their daily lives. Findings suggest that those students who were able to place an emphasis on self-care showed a significant decrease in both perceived stress and an increase in quality of life (Ayala et al., 2018). Students who disclosed employing in a variety of  self-care practices, prioritizing their mental and spiritual health alongside their academics, “may also sustain greater resiliency and lower risk for higher levels of distress during medical education,” (Ayala et al., 2018). 


It is our hope that we can not only learn to nourish ourselves more fully for our own academic, spiritual, and mental growth, but that we may be able to fall so deeply in love with the practice of caring for ourselves, that when working alongside our patients, we reflect these ideologies naturally and can serve as more enlightened advocates of holistic health and wellness. The notion of mind-body medicine serves as just this- the building of a home within oneself, that is watered from the very roots and foundation from which it grows. The thoughts we allow to take space in our minds, the food in which we consume, the relationships in which we engage in and choose to grow in, the careers we invest in, the way we respond to ourselves and to others- all are factors in which play fundamental roles in the caring of our minds, bodies, and spirits. 

Thus, it is never easy nor convenient to place ourselves at the tops of our to-do lists, if we get a spot at all. However, when we do, something magical happens. We train and rewire our  brains to recognize the worthiness of our health, physical, and emotional safety above all else. We build a relationship that is rooted from within, that will slowly and steadily pour out to others- a beautiful,  generous well for friends, family, peers, advisors, etc, to drink from. However, we ourselves ensure that the well is full and that we are first to drink from it. 

We are each so much more expansive than the many boxes in which we place ourselves in daily. Yes, we are hard-working and yes, we are students of medicine and YES, that is a beautiful string of words to say aloud with pride and ease. However, we too are much more. We are daughters, sons, gender non-confirming children of strong families, of broken ones- we are aunts, uncles, friends, mothers, fathers, advocates, fighters, lovers, humans of many forms. 

I hope you can take a moment to acknowledge the many limitless, life-giving things that you are outside of the boxes which you have maybe placed yourself in. These boxes are allowed as well, for they serve purposes to keep us safe- but they do not get to dictate all that you are and all that you can be. During this journey, I also hope that you can take time to nourish and plant seeds of self-love and compassion, so that you may continue to feed each part of you- especially the ones that may get forgotten in the day-to-day rush of the shoes you must fill. Lastly, if the shoes feel tight around your feet, I hope you will know that you are far from alone- that you are surrounded by love, support, and people who wish to remain in your corner, no matter the season and the challenges they bring. 

We at the Wellness Center are here, in this very corner of yours, keeping a seat warm, if ever you desire to come take a pause alongside us. In addition to the private counseling services which we provide, we are also now thrilled to be providing group settings for healing and restoration as well. Group settings have been proven as a strong tool in providing emotional support and a sounding board with which students can learn more fluidly about themselves through the eyes and perspectives of another. In many ways, we are able to uncover “blind spots” and share in the work of healing (Orenstein, 2014). 

Wherever this road takes you, may you know a lighthouse is always here, grounded in the dirt, and ready to do the work with you. You should be so proud of yourself for this very moment- where you are today. For there is much of the future that although we plan, so tactfully, we cannot quite understand or prepare for. However, what we can always count to be everlasting and true, is that we were made to live a life of purpose, joy and presence-and that as we respond to our callings as future healers- that our true healing begins from within. 

Forever in your corner, 

AUC Wellness 

References 

Ayala, E.E., Winseman, J.S., Johnsen, R.D. et al. U.S. medical students who engage in 

self-care report less stress and higher quality of life. BMC Med Educ 18, 189 

(2018). https://doi.org/10.1186/s12909-018-1296-x.

Orenstein, W. B. “6 Benefits of Group Therapy for Mental Health Treatment.” Everyday Health (2014). 

https://www.everydayhealth.com/news/benefits-group-therapy-mental-health-treatment/.

Pokhrel, N.B., Khadayat, R. & Tulachan, P. Depression, anxiety, and burnout among 

medical students and residents of a medical school in Nepal: a cross-sectional 

study. BMC Psychiatry 20, 298 (2020). https://doi.org/10.1186/s12888-020-02645-6.

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