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Last week, we talked about three of the biggest causes of burnout and depression for residents. Debt, “coat envy,” career frustrations and lack of personal time are the main things that give residents and medical students the blues. Of course, this is by no means an exhaustive list.

So, what can you do to stay positive and combat feelings of depression and burnout? If you are experiencing these feelings, sometimes the last thing you want to do is read a cheerful list about ways you can be proactive about your situation and attitude.

But the fact is, negative thinking and feelings are things you have to actively work on. Positivity is the default for very few people.

That being said, if your feelings and thoughts are overwhelming, it’s important to talk to someone and seek help. This is especially true if you’re feeling suicidal or at an all-time low. Your school or program likely has mental health services; if not, seek out resources in your community. Clinical depression is not the same as feeling “down,” and should be treated by a professional.

Below are a few things you can do to boost your outlook and feelings of well-being. Stick with these practices to fight off “the black dog” (Winston Churchill’s pet name for depression).

Embrace Positive Self-Talk

If you have perfectionist tendencies (as many medical students and residents do), you can likely identify with negative self-talk. Negative self-talk is incredibly common, but perfectionists tend to do it more often.

Many of us beat ourselves up out of habit — it’s a practice we develop early on in our lives. The funny thing is, we often look at our negative self-talk as a form of motivation. We think, “Well, if I was nice to myself, I’d never get anything done and I’d let myself go.”

But positive self-talk, as awkward as it can feel when you first start practicing it, breeds a much healthier conscience. Repeating positive mantras to yourself or giving yourself an internal pat on the back can boost your outlook tremendously.

According to Dr. Maoshing Ni, author of Second Spring, we have about 60,000 thoughts a day, 80% of which are negative. Yikes!

For an in-depth look at the intricacies and benefits of positive self-talk, check out Dr. Ni’s book as well as Dr. Kristin Neff’s Self-Compassion.

Indulge in Guilt-Free Rest

Residents and medical students typically don’t get enough sleep. You’re probably shaking your head. Enough sleep? What’s sleep?

When you do get a chance to get some sleep, you probably feel guilty about it. You have so little free time to begin with, so spending that time sleeping probably feels like a waste. But life is much more fulfilling when you’re really enjoying it, not just coasting by on 5-Hour Energy shots.

The next time you get an opportunity to get a full night’s rest, give yourself that luxury, and push feelings of guilt to the side. Making sleep a priority doesn’t make you a slob. Your waking hours will be much more productive.

Practice Active Self-Care

In the finance world, the term “paying yourself first” means contributing to your savings or retirement account before paying your bills and making purchases. Over time, this practice yields huge results.

But what if you applied “paying yourself first” to self-care? Making healthy choices a priority instead of something you’ll “get to if you have time” can make an enormous difference in not only your attitude, but your entire life.

This week, challenge yourself to make one self-care activity a priority — something you’ll do first instead of later. Cook and freeze a week’s worth of healthy lunches. Go for a run. Devote a specific amount of time to doing something you love.

Pencil yourself in for a change! Start small and add more self-care “appointments” as you feel comfortable.

What are your tactics for avoiding burnout as a medical student or resident?