significantly under-estimated number . To put that in perspective , the University of Louisville School of Medicine ( U of L SOM ) has roughly 620 medical students . If 400 physicians die of suicide per year , that ’ s like losing almost 65 percent of the SOM students to suicide , a preventable cause of death . When physicians die , patients also suffer because they lose their trusted doctors . There are thousands and thousands of patients who lose their physicians to suicide each year . These are bone-chilling statistics and should spur us to try to solve this problem better .
Though physicians are proficient at recognizing and treating depression and anxiety in our patients , physicians are often underachievers when it comes to recognizing , acknowledging and seeking treatment for depression for themselves and colleagues . Physicians are intelligent , successful and sometimes egotistical healers who often have a hard time admitting to and recognizing vulnerability in someone besides their patients . A physician may feel that he / she needs to maintain a façade of physical and emotional machismo at all times , even if slowly falling apart on the inside . Many of us feel the need to shrug off our depression and insecurities , keep a smile on our faces , and never let anyone know that we are struggling . For the sake of our own health and our patients ’ health , this is unacceptable .
The National Institute of Mental Health reports that the lifetime risk for depression in the general population is around 12 percent in males and 18 percent in females . In a review article on depression and suicide in physicians-in-training , Drs . Bright and Krahn of the Mayo Clinic note that rates of depression in medical students and residents are higher than the general population , ranging up to 30 percent . After residency , the risk of depression in physicians is still high but more comparable to the general population , with rates of depression in male physicians being 13 percent , and 20 percent for female physicians . However , as physicians are far less likely to admit to being depressed , these numbers are grossly under-estimated .
Untreated depression in physicians can lead to significant risks including minor and major medical errors , erratic behavior , and interpersonal conflict in the workplace . It can wreak havoc on both a physician ’ s personal and professional life . Simply put , unrecognized and untreated depression in physicians is dangerous for patients , and significantly decreases doctors ’ quality of life .
Even without depression as a complicating factor , physicians have stressful lives that can cause significant psychosocial stress . Each stage of training and practice has its own set of challenges . Medical students are required to absorb and retain exorbitant amounts of information throughout medical school . Most medical students and physicians are , by nature , high-strung and tend to have perfectionist “ type-A ” personalities . That alone increases their risk of significant anxiety and depression . Often , medical school provides these bright , achievement-oriented individuals with the first venue in which they fail or at least struggle to stay afloat . I remember feeling terribly overwhelmed and depressed through parts of my
Headshot of Dr . Drew for the 2017 GLMS Mug Book
own medical school career and wondered if it was really worth continuing my medical education . I know I was certainly not the only one who felt that way .
Residency provides a new set of challenges for physicians-in-training who “ magically ” went from having relatively minimal responsibilities as fourth year medical students to literally having patients ’ lives in their hands as interns . The stress of the new responsibility of relatively independently caring for REAL patients , particularly at 0200 when a patient is crashing and when supervising attending physicians are often at home , is frightening . The fear of making a medical mistake that could cause harm to a patient or even cost a life is very real and can invade one ’ s much-needed sleep . The work hours , while better than they used to be , still keep residents away from their family , friends and other support systems . As a result , they often miss out on the social aspect of their lives outside of work , not to mention necessary and rejuvenating sleep . I ’ m not an attending physician yet , but I hear that it has its own set of challenges that I will learn about in exquisite detail after I finish residency .
If mental health problems are acknowledged , still there are significant barriers to seeking treatment . Barriers may include fear of “ getting in trouble ,” fear of losing clinic / hospital privileges , inadequate time to seek professional care , and minimal time for self-care . We encourage good self-care , including proper nutrition , exercise , socialization , spirituality / religion , etc . in our patients , but it is something that many physicians ignore in their own lives . One is never the same after witnessing some of the incredibly sad situations
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