The mental health of university students is becoming a major concern, and there are good reasons to be alarmed. In reference to Erik Erikson’s Stages of Psychosocial Development, adolescents between the ages of 13 and 21 may undergo identity crisis and role confusion, and young adults between the ages of 21 and 39 often have intimacy and isolation issues. Most university students belong to one of these two age groups, and thus have to contend with these peculiar challenges. While it is noteworthy that these challenges are overwhelming enough in themselves, so much that they often take their toll on an individual’s mental health, what happens if the individual concerned is not just any student? What happens if he or she is in fact a medical student?

The answer may be difficult to provide, but it cannot be far removed from what Shakespeare meant when he said, “Double, double, toil and trouble.” In comparison to others, medical students run busier schedules that are demanding and sometimes frustrating. Therefore, alongside other aforementioned factors that apply to their particular age groups, this workload predisposes them to more psychological stress. Interestingly, this is not even a Nigerian or African issue, as it appears to be a problem the world over. For example, studies from the United States, Australia and Britain place the rate of depression among medical students as high as 20%. Other surveys have confirmed that, of all students in institutes of higher education, medical students have more emotional challenges, psychosocial hazards, and mood disorders as they progress and think of their future and professional goals.

In Nigeria, there is a succinct way of defining insanity which I find very appealing. To refer to an insane man, one may hear the average Nigerian say, “That man is not balanced.” The word “balanced,” when used in the context of sanity, is instructive, as it reminds one that there must be a dynamic equilibrium of certain components of life under the control of the mind. Anything that attempts to upset this balance is a threat to one’s sanity, and medical students have such threats in abundance. First, there is the consuming curriculum that eats up the medical students’ time, leaving them with little or nothing for social activities. Unable to unwind often enough, some of them turn out to be socially awkward and oblivious of the goings-on around them. In more serious cases, which is not exactly rare, a few may discover they do not have close friends, meaning they are often lonely, and this all stems from poor communication and interpersonal skills.

Second, in the early years of medical school, which some argue are the most cumbersome, a good percentage of these students, who have hitherto never really felt the sting of disappointment before, get a sour taste of academic failure. This setback is often devastating enough to strip them of whatever pride they possessed. Soon, they find themselves wallowing in self-pity, their self-esteem shattered. Clinical training begins and it is their worst nightmare. The whole system appears to be programmed to frustrate them. In a developing country like ours, consultants pissed off by the state of facilities and working condition take it out on the senior registrars, who in turn transfer the aggression to the registrars, who then unleash hell on the poor medical students. And the sorry dance begins de novo. In the midst of such organised madness, the question is, how can anyone stay sane?

Different people have different coping mechanisms, so it’s no surprise medical students have adopted a variety of approaches in maintaining their sanity. A handful of my friends — and I am sure there are more out there — find solace in Stoicism, that ancient school of philosophy pioneered by the likes of Epictetus, Marcus Aurelius and Seneca. “Amor fati,” which is Latin for “love of one’s fate,” is one of the teachings of Stoicism. It encourages one to remain unmoved and unbothered by life circumstances, and teaches one to see whatever hand fate deals, whether good or bad, as necessary. Simply, “que sera, sera” — whatever will be, will be. This practice can be a huge source of mental strength, for it enables one to draw from within, thereby alleviating undue anxiety which seems to be a medical student’s default feeling. The materials for Stoicism are readily available online. For starters, “Meditations” by Marcus Aurelius is a good recommendation. It is the kind of ancient wisdom that many will find helpful.

There is also the option of religious fellowship — and this is the popular choice — which provides medical students not only with spiritual but also social support, and it has proven to be efficient over the years. The same goes for clubs and non-government organisations, equally capable of offering an entirely new environment for the medical students to make up for things they might have otherwise missed.

Ultimately, the life of a medical student vis-a-vis other regular students is a living hell, and whatever makes that hell a little more bearable, a little less miserable, is a welcome development. We all signed up for this trouble, all right, and we sure have to fire on all cylinders to pull it off. But that doesn’t mean we should allow ourselves burn out. Despite everything, we must always find ways to bubble with positive vibes.

After all, before anything else, we are first of all humans.