Doctors suffering from Depression? You might think, how can a doctor become ill when they treat illness? Did you know, 1 in 15 adults in the UK have attempted suicide and 1 in 5 have considered it. For doctors, this number is between 2 and 5 times greater. Ironically, there are high rates of depression in the healthcare population, which is widely undiagnosed. Burnout, anxiety and Depression has also been known to affect approximately one – third of medical students
A Cambridge study found higher rates of depression in doctors compared to other professional groups and the general population. The rates ranged from 27% in medical students to up to 60% in practicing doctors.In the UK, 42.3% of Doctors suffer from depression. Doctors aged between 35 and 44 years specifically, suffer from high levels of anxiety and burnout as well.
Dr. Abhishtita Mudunuri, Internal Medicine Physician Diabetologist, beautifully penned down her journey of battling with depression and anxiety disorder. She thought finding a therapist would be easier due to her profession, but that was not the case. The struggles behind repeating her story to multiple therapists till she found the right one. The blogger concludes by expressing how beneficial therapy was for her. She concludes her blog by expressing how therapy has been instrumental in her journey towards self-love and recovery, even though she still faces challenges on some days.
With the spread of the coronavirus, these numbers have compounded. All the uncertainty and the news of death and despair brought the world down to its knees. Healthcare workers were and still are on the frontlines, putting their own lives at risk for everyone else. The world is extremely grateful for that. Even before covid, you saw blood and death all around but still continued on your journey to save people. Between all of this strength, a few moments of weakness are normal. Let’s look into a few causes that could potentially result in doctors struggling with their mental health.
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Risk Factors & Causes of Depression In Doctors
The Medical Protection Society found that 52% of UK doctors are dissatisfied with their work-life balance. 46% feel guilty about taking time off, and almost 40% believe their employer does not support them to do their job well. Doctors, due to the nature of their profession, are exposed to high levels of stress at work, which can make them more susceptible to mental health issues such as depression. A few factors of the stress:
- Long hours of work
Not having a work-life balance, overworking, long working can lead to conditions like stress, hypertension. The demanding nature of a doctor’s work can lead to high levels of stress and potential burnout, both mentally and physically. This can also have a significant impact on your personal lifestyle.
- Not being able to attend to their personal lives
Some Doctors have a difficult time dealing with stress at work, which can lead to depression, anxiety, or even a lack of sleep in their personal lives. As a result, they are not spending time with loved ones.
- Low levels of support and even a lack of autonomy
A lack of autonomy is risky because it is necessary to ensure that patients are actively involved in their diagnosis and treatment. Also, when doctors are having a difficult time, they should speak with a specialist doctor who knows what to do, but the majority of hospitals do not have enough members to help support their staff who are dealing with mental health issues.
- Financial Stressors
Most Fy2 doctors are still paying off their debts because once they qualify for indemnity, a large portion of their pay is used for insurance. Which can be truly stressful for junior doctors to face in the beginning of their careers. That’s why they need to keep working to pay off all the debts.
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Many psychological defences that include dissociation and depersonalization may also make it difficult to maintain or even create a large number of personal attachments. It may also become difficult for doctors to start realising when the emotional burden of work starts getting out of hand for them. This may lead to a spiral into distress and eventually depression in doctors.
Depression is difficult to diagnose and more than 30 – 50% cases are missed in the general population. It is even more difficult to diagnose doctors as they have an expectation to live up to the word ‘’perfect’’ in the community. They also have an enormous pressure to be seen as invincible. This may lead to feelings of anxiety in a doctor. Mental illness may also be misattributed to weakness or ineptitude and encourages doctors with depression to conceal their illness from others as well as themselves. A lot of doctors in the NHS may also suffer from depression and self – judgement which further compromises their access to care.
Doctor’s burnout which is one of the most potential cause that lead to depression diagnosis has also been called a risk factor for suicides in doctors. It has also received vast attention as an epidemic in medicine which results from a dysfunctional system rather than an individual failing. The culture stigma around mental illness also exacerbates the barriers which are faced by doctors and prevents them from getting the proper help and treatment which they need.
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Steps To Take To Address Doctor With Depression
- Work life balance:
Burnout is a major component leading to mental illness in doctors. They work long hours under demanding conditions, so their mental and physical health can be compromised. A systematic study taken over 20 years shows that in the UK, 31 – 54% of doctors feel overworked and drained. The effect of burnout is more significant in junior doctors as they feel insecure about their performance and can struggle in the competitive nature of the field.
- Talk to your Peers who can resonate with your struggles:
We came across an inspiring Instagram page called You Okay, Doc, which is about doctors who face difficult life and death situations on a daily basis. This company has seen a significant increase in mental health issues within the healthcare industry. That is why they want to help other doctors improve so they can concentrate on their careers.
- Get educated and overcome the stigma:
Workplace interventions that reduce mental health stigma and promote sharing and support for colleagues with psychological difficulties might improve help seeking behaviour and attitudes. Mindfulness practice has versatility and a strong evidence base in workplace stress reduction and is therefore a viable technique for groups or individual clinicians to manage stress during the COVID-19 outbreak.
- Don’t Isolate yourself:
Occupational stress resilience strategies include mindfulness,28 making time for exercise/hobbies/holidays, spending quality time with partners/family/friends, limiting alcohol use, self- monitoring, limit setting, and attitudes that promote constructive and healthy engagement with the challenges at work.29 Increased resources, collegial support, and a willingness to talk about vulnerability may enable doctors to feel less isolated and better able to cope with their emotionally demanding jobs.
- Practising mindfulness – CALM:
With over 1.5M reviews, CALM is the number one rated app for sleep, meditation, and relationships, guiding everyone on how to get their minds away from their professional lives. Also to assist in getting a good night’s sleep and living a healthier and happier life.
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Depression in doctors is harder to treat as other doctors look at them as professional peers and often engage in a lot of medical talk. There may also be social awkwardness which may further inhibit the treatment. Even after this, a road for treatment is available for doctors if they are willing to walk on it. Antidepressants and selective serotonin reuptake inhibitors are called the first line of treatment.
These treatments should also be monitored and a psychiatrist should be available for access at all times. Doctors are also in a lot of stress and making time for exercise, holidays and hobbies should help immensely. Spending quality time with partners and family is also likely to help a lot. This can also be done by becoming a locum doctor.
As a locum doctor, one is entitled to choose their own shifts and work as per their own timings so that they do not get overworked or burnt out. They also have more time to seek out help if they feel that they are undergoing problems with their mental health.
A few other things which could also help are identifying the emotion which you, as a doctor, are feeling. Understanding and accepting your emotion is also crucial. You should also think about what you can start doing in terms of action, to pull yourself out of the depressive phase.
Doctors are also vulnerable to depression but help is always available for those who need it. A UK registered charity initiative called You Okay, Doc? has the vision to improve mental health and wellbeing across the world.
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The NHS also has many services related to suicide prevention. You could also call other helplines such as the:
As a doctor, you are also entitled to help. Depression does not make you weak, it makes you human. Talk to a loved one, don’t let yourself lose the fight against depression.
Sources:
- Clinical Depression in Doctors: An Ironic Truth
- Gerada, C., 2018. Doctors, suicide and mental illness. BJPsych bulletin, 42(4), pp.165-168.
- I Am A Doctor And I Have Depression by Dr. Abhishtita Mudunuri
- Gerada, C., 2017. Doctors and mental health. Occupational Medicine, 67(9), pp.660-661.
- Ignacio Mora-Magaña, Sherman A. Lee, Isaac Maldonado-Castellanos, Carlos Jiménez-Gutierrez, José Mendez-Venegas, Azareel Maya-Del-Moral, Margarita D. Rosas-Munive, Amanda A. Mathis, Mary C. Jobe. (2022) Coronaphobia among healthcare professionals in Mexico: A psychometric analysis. Death Studies 46:2, pages 280-289.
- Doctors’ own mental health issues – the bmj
- When doctors ponder suicide, depression – not burnout – is key driver
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