Various studies have reported substance abuse and alcoholism among medical students and junior doctors under

stress. Such behaviour cannot be ruled out in the medical community as access to drugs is relatively easier. This study did not explore substance abuse. Medical school curricula are demanding, extensive and require high levels of competencies. Evaluation of academic performance through continuous assessment and examinations are reported to be academic stressors. In light of the published literature, the prevalence of anxiety and depression in this study is high but consistent with other studies. Implications of stress including anxiety and depression are of serious concern resulting in inability to cope with curricular demands and deviant behaviour, impairment of functioning in classroom performance and clinical practice. Preparing medical students for life as doctors require more than acquisition of knowledge and skills. Constant monitoring of performance, professional conduct and behaviour associated with mental health is equally important. Although, the subject is of prime importance but unfortunately literature search done by Shapiro yielded over 600 articles discussing the importance of addressing the stress of medical education, only 24 studies reported intervention programs, and only 6 of those used rigorous scientific method. Therefore, it is important that medical educationists in Saudi Arabia conduct further studies to find the prevalence of anxiety and depression in other medical colleges, as well as, other disciplines offering graduate programs, identify the stressors and address the problem by instituting appropriate measures, (Inam, Bazmi., 2007).

Ref: Inam, Bazmi., 2007. Anxiety and Depression among Students of a Medical College in Saudi Arabia, Int J Health Sci, Vol. (2): 295300.

Girls had higher level of stress than boys as the girls have more challenges to follow Indian orthodox customs, prevailing in the society. When stress affects the brain, with its many nerve connections, the rest of the body feels the impact as well. So it stands to reason that if your body feels better, so does your mind. Exercise and other physical activity produce endorphins-a chemical in the brain that act as natural painkillers-and also improves the ability to sleep, which in turn reduces stress. Meditation, acupuncture, massage therapy, even breathing deeply can cause your body to produce endorphins. And conventional wisdom holds that a workout of low to moderate intensity makes you feel energized and healthy. Scientists have found that regular participation in aerobic exercise has been shown to decrease overall levels of tension, elevate and stabilize mood, improve sleep, and improve self-esteem, (Kumar, Sanjeev, Bhukar, J.P., 2013) Kumar, Sanjeev, and Bhukar, J.P., 2013. Stress level and coping strategies of college students, Journal of Physical Education and Sports Management, Vol. 4(1): pp. 5-11, Available online at http://www.acadjourn.org/JPESM The prevalence of depression in medical students which is especially in the first year medical students and marginally more in females. They should be supported by student counselling units in the first year of schooling itself as they may be able to cope up with stress in the later years.

By identifying the symptoms of depression and the stress inducing factors at an early stage hopefully the psychological morbidity among medical students can be prevented and the ones in morbid state can be helped to seek the professional, (Basnet B, et al., 2012) Basnet B, Jaiswal M, Adhikari B, and Shyangwa PM., 2012. Depression Among Undergraduate Medical Students. KATHMANDU UNIVERSITY MEDICAL JOURNAL, Vol. 39(3), PP: 56-59. Depression and anxiety were strongly associated with female gender, family dynamics, child environment, unsuccessful love affairs and among those with medical chronic disorders. A gradual decreasing incidence of depression and anxiety was noted with increasing level of education. A significantly strong association was noted between child mortality and maternal depression while no such association was found in males. There is a significant difference in the age of depressed and normal individuals. There was significant correlation between unhappy childhood and unsatisfying family relationships. However, no relationships were found between depression & anxiety and martial status, presence or number of children, absence of male offspring, living in joint family system, financial problems and any deficiencies that the respondents felt that he might have. This study suggests that anxiety and depression is a common psychiatric disorder even in remote village areas and contradicts the common belief that people those who live in the remote rural areas lead stress-free lives or have low rates of psychiatric morbidity, (Faraz, K.L., et al.,2009). Faraz, K.L., Ansari, B., Jawad, A., Dawson, A., AND Baig S.M., 2009. Prevalence Of Depression And Anxiety In A Village In Sindh, Journal of Ayub Medical College Abbotabad, Vol. 21(2), PP: 68-72, http://www.ayubmed.edu.pk/JAMC/68 PAST/21-2/Faraz.pdf

As conclusion, university students, regardless of local or foreign may encounter numerous stressors along their study life. The stressors may vary from meeting deadlines to reaching expectations and coping in a new environment. One of the highlights of this study is that local and foreign students are in fact stressed out. These findings called for measures to be taken to ensure that the needs of these students are met. In addition, as social support networks are important in moderating stress, every possible action should be taken to expand social systems. It is hopeful that findings and implications from this study could help keep stressors faced by university students at a minimum level,

Stress, Perceived Social Support, Coping

Capability and Depression: A Study of Local and Foreign Students in the Malaysian Context
Shamirah-Farah Faleel, Cai-Lian Tam, Teck-Heang Lee, Wai-Mun Har, and Yie-Chu Foo
World Academy of Science, Engineering and Technology 61 2012 PP: 75-81