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Effects of Stress on Medical Students Regarding Mental Health

Mary Lopez

Texas A&M University-Corpus Christi

1301: Composition I

Frances Johnson

19 November 2021
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Effects of Stress on Medical Students Regarding Mental Health

Stress is very common in students and is known to affect mental health if it is not

regulated. Medical students in particular undergo high amounts of stress and must face many

challenges between balancing school, work, personal life, and prioritizing their mental health.

Studies suggest the current educational process may have an inadvertent negative effect on

students' mental health, with a high frequency of depression, anxiety, and stress among medical

students (Dyrbye et al., 2006). The studies suggest a high prevalence of depression and anxiety

among medical students due to stress (Dyrbye et al,. 2006). Earlier review articles have

discussed the topic of the effects stress has on mental health, however, a more current synthesis

is needed and more research needs to be conducted for more accurate and precise results. The

present research works to analyze and clarify the current conversation among scholars on the

topic of the causes and effects of stress on medical students. The purpose of this literature review

is to provide the current conversation among scholars in the research of the effects of stress on

medical students and how it directly affects their mental health.

Stress Causes Depressive Symptoms Among Medical Students

One major outcome of high stress that is seen in some students is depression. Stress

levels may reach a certain threshold of intensity from daily stressors, acute stressful life events,

and chronic stress that can lead to depressive symptoms (Dalton et al., 2018). Past studies have

identified that academic stress, relationships, distress, inability to enjoy normal activities,

difficulties, facing situations, inability to overcome difficulties, and lack of concentration are the

major stressors associated with depression (Saravanan et al., 2014). Perceptions of stress have
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been found to correlate with depression and predict future risk of depression in students (Dyrbye

et al., 2006). A current study on prevalence of depression and anxiety caused by stress found that

34.9% of students were experiencing some levels of depression (Saravanan et al., 2014). Results

from this study also confirm the strong trend in the literature that medical students attending

private medical schools exhibit more depression than students attending public medical school,

which is due to additional pressures placed on students with high expectations (Saravanan et al.,

2014). Vala et al. (2020) states results from a study conducted at Shri M. P. Shah Government

Medical College that revealed depression in medical students comes not only from sudden

isolation as they are removed from their extracurricular activities which make them feel less

connected with their friends, but mainly stress they face during exam periods. The pressure that

medical students face on a daily basis, along with other personal problems, causes high amounts

of stress, which eventually leads to these depressive symptoms that can be found in some

students.

Stress in Correlation to Anxiety in Medical Students

Medical students develop anxiety due to the high stakes they are put under in medical

school. Some students differ in severity of anxiety, ranging from feeling nervous or restless,

feeling weak, trouble concentrating, or even having anxiety attacks. Alvi et al. (2010) reports a

study conducted in September 2007 to March 2008 that determined the frequency of anxiety

among medical students of Wah Medical College and the study concluded over one third of the

students were found to have anxiety that was associated with stress. The patterns of anxiety in

university students compared to that of medical students has shown a significant difference in

present studies. Asfaw et al. (2021) reports in Ethiopia, the reported prevalence of anxiety ranges
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from 30.1% among Addis Ababa University to 60.8% among Arsi University medical students.

In a study conducted in Nepal, researchers used the Depression Anxiety and Stress Scale (DASS)

to determine the prevalence of mental health issues among medical students and their results

found that out of the three, anxiety had the highest prevalence among students, with a percentage

of 41.1% (Kunwar et al., 2016).

Stress-Related Sleep Deprivation in Medical Students

Sleep deprivation has been seen in a number of medical students due to high amounts of

stress as well. Due to the stress students are under and the amount of workload, most students

stay up late at night studying or even stay up all night, which causes them to be severely sleep

deprived. Ahrberg et al. (2012) states sleep quality has significant effects on cognitive

performance and is influenced by multiple factors such as stress. In a cross-sectional study,

medical students in a Saudi medical school from 2011 to 2012 were involved in a questionnaire

in which they were measured on sleeping habits and sleep quality during clinical years in

medical school (Alsaggaf et al., 2016). This study concluded that sleep deprivation, poor sleep

quality, and EDS are common among medical students and the high levels of stress and pressure

had a big impact on their quality of sleep (Alsaggaf et al., 2016). Furthermore, Ptaszkowski et al.

(2021) reports results from a study conducted on medical students in Poland that showed

everyday stress was independently associated with insomnia in medical students and the cause of

the association between insomnia and stress is academic factors.

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Conclusion

Overall, the high stakes and high levels of pressure medical students are under during

medical school can lead to detrimental mental health problems such as depression, anxiety, and

sleep deprivation. There is a major correlation between stress and mental health problems in

students which is seen in multiple studies conducted over the years. According to a study

conducted at SAIMS Medical College, academics and examinations are the most powerful

stressors in medical students. (Sharma et al., 2011). The main correlation of medical students’

distress roots from stress and academic pressure (Azim et al., 2019). The purpose of this

literature review is to convey the effects of stress on medical students regarding certain mental

health problems such as depression, anxiety, and sleep deprivation.

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References

Ahrberg, K., Dresler, M., Niedermaier, S., Steiger, A., & Genzel, L. (2012). The

interaction between sleep quality and academic performance. Journal of Psychiatric

Research, 46(12), 1618-1622.

doi:http://dx.doi.org/10.1016/j.jpsychires.2012.09.008

Alsaggaf, M. A., Wali, S. O., Merdad, R. A., & Merdad, L. A. (2016). Sleep quantity,

quality, and insomnia symptoms of medical students during clinical years. Saudi

Medical Journal, 37(2), 173-182.

https://doi.org/10.15537/smj.2016.2.14288

Alvi, T., Assad, F., Ramzan, M., & Khan, F. A. (2010). Depression, anxiety and their

associated factors among medical students. Journal of the College of Physicians

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Asfaw, H., Fekadu, G., Tariku, M., & Oljira, A. (2021). Anxiety and stress among undergraduate

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Azim, S. R., & Baig, M. (2019). Frequency and perceived causes of depression, anxiety

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Dalton, E. D., & Hammen, C. L. (2018). Independent and relative effects of stress, depressive

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Dyrbye, L. N. M., Thomas, M. R. M., & Shanafelt, T. D. M. (2006). Systematic review

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Kunwar, D., Risal, A., & Koirala, S. (2016). Study of depression, anxiety and stress among

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Vala, N. H., Vachhani, M. V., & Sorani, A. M. (2020). Study of anxiety, stress, and

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