Everyone gets sad irrespective of what profession they are in. Doctors also get sad, like anyone else. And what do depressed doctors do to cope when these sad days turn into weeks, months and sometimes years? Are there any factors that make them especially susceptible to depression, unlike common people? Are physicians unique from the general population in dealing with and responding to depression? What treatments do depressed physicians seek or avoid?

According to a survey conducted with 200 physicians who experienced depression in their careers, they were asked what treatment they pursued. 33% of doctors chose professional guidance, while 27% took self-care. About 14% agreed about their self-destructive behaviours, 6% switched their jobs, 5% medicated themselves, 10% did nothing while 5% dealt with the ordeal.

A majority of doctors tried multiple treatments. Unfortunately, most of the physicians did nothing for years to curb the symptoms of the issue and finally took the decision to seek help; although taking professional help was actually not a first-line therapy. Physicians go through different circumstances during their careers which become factors leading to depression. Such factors include hazing, bullying, sleep deprivation and medical board investigations, and most importantly, repeated daily exposure to suffering and death of patients.

Common factors for depression among doctors:

Family history of depression: Physicians who have a family history of depression are at increased risk of developing depression themselves. About 44% of resident physicians have depressive symptoms.

Childhood trauma: Childhood trauma related to sexual, emotional and physical abuse increase the risk of depression in physicians.

Failing Marriage: A failing relationship destabilises everyone, and physicians are likely to lose their marriage because of their hectic schedules. Without a predictable work schedule, they are often out of their home.

Socially isolated: Loneliness might lead to social isolation, and this ultimately results in depression amongst doctors. Frequent training sessions and long working hours leave little time for friends and family. Being a medical expert is an independent risk factor for social isolation.

Financial stress: Doctors have great earning capacity compared to other professions, but they tend to save less and spend more on their education loans, cars, homes and cultural expectations.

So what do depressed doctors do?
What depressed physicians do when they are facing the above issues? Do they seek medical assistance? Most of them don’t.

A majority of physicians do nothing: As per their medical training, help-seeking is not a well-honed skill among physicians. Many of them deny or lack self-awareness that they are suffering from depression. They have normalised the misery of overworking, exhaustion and discontentment and pretend it is normal. They are okay with avoidance, denial and distraction tactics and do not seek appropriate care.

Some take medical guidance: When a depressed physician goes to a fellow doctor seeking help for a mental health issue, both the parties underestimate the severity of the crisis, as there might be higher chances of the physician’s suicide risk.

Self-treatment strategies:

Self-care: Most doctors are chronically sleep-deprived. So, their self-care strategy lies in sleeping in or relaxing on a vacation. Some of them indulge in obsessive exercise. It also includes reading self-help books, praying, meditation, listening to music etc. and in adverse situations, leaving a full-time job or quitting medicine.

Self-prescribing: Some doctors write their own prescriptions while others might prefer taking drug samples from their office or purchase online to avoid entry in records.

Self-distraction: Some physicians choose to ignore their own condition by obsessing over patients’ lives and their strife. This is a popular and incentivised method of self-distraction to turn into a workaholic. Many of them distract themselves with mindless computer games, binge-watch series, do all activities on social media or find an escape route into novels and mysteries.

Self-destruction: Doctor’s self-harm might take the form of self-destructive thinking patterns, addictions, and may also lead to suicide. Heavy alcohol drinking is also popular among depressed doctors which in turn can escalate into a dangerous routine.

Most doctors, unfortunately, continue to suffer in silence because of untreated or poorly-treated depression, fear of treatment in the medical environment that labels and punishes doctors with mental health issues. It is, however, highly advised to seek requisite help to prevent a long-term issue.

 

By Dr Anuneet Sabharwal, MBBS, MD Psychiatrist