Maintaining wellness

5 ways to maintain mental wellness and avoid burnout

To mitigate the challenges of medical school and practicing medicine, Jessica Barber, MD, advises prioritizing self-care and stress reduction techniques.

If you’re in medical school, lamenting the endless hours of studying and stress and waiting for the light at the end of the tunnel, Jessica Barber, MD, has a message for you: Medical school is tough, but being a physician is also tough, so don’t wait to incorporate practical, everyday stress reduction methods into your daily routine.

“Personal wellness is as important as anything else you’re learning today,” Dr. Barber said in a recent address to members of the Student Osteopathic Medical Association (SOMA) on wellness during and after medical school. Dr. Barber, an emergency medicine physician, writes a weekly wellness newsletter for her employer, Mercy Hospital in Chicago.

The issue is real

The issue of mental wellness is a significant one for physicians. Burnout, depression and suicidal ideation within the profession are well-documented. In a recent Medscape survey, 42% of physician respondents reported experiencing burnout and 15% admitted to experiencing depression.

Respondents reporting burnout noted an excess of bureaucratic tasks as the main contributing factor, followed by too many hours at work and then by a lack of respect from administrators, colleagues or staff.  Among medical students, rates of depression are 15-30% higher than those of non-students of similar age and education.

Dr. Barber says addressing stress early on and finding ways to counter it can help medical students and physicians avoid burnout and mental health issues.

Wake-up call

As a medical student, Dr. Barber considered herself a “people pleaser” who cared a lot about what others thought. When she first began working as a resident, she’d often go home after her shifts and obsess over details, ruminating on what she didn’t know. She also stayed late to show her commitment while neglecting her own well-being in the process. Her wake-up call came in the form of a diagnosis: multiple sclerosis. With a husband and kids and a busy career as an emergency room physician, she knew she had to make some major changes to her lifestyle and put her own wellness first.

“I got sick and realized how unimportant I am,” Dr. Barber said. “I took three months off and the ER kept humming without me.”

For Dr. Barber, there are five critical components to personal wellness: sleep, nutrition, exercise, meditation and gratitude.

This is what she had to say about each:

Sleeping:  It’s not uncommon for doctors to work “wacky shifts” and work nights, which can lead to shift work sleep disorders. “Sleep as much as you need to. It’s more important than studying or worrying about anything in your life,” Dr. Barber said.

To get a good night’s (or day’s) rest, she suggests turning off your phone, getting blackout curtains if you sleep during the day and not drinking any caffeine for 6 hours before bed. If you have trouble falling asleep, try meditation.

Eating: Make healthy, nutritious meals a priority, whether that means paying for a meal delivery service, cooking in advance and freezing food, food-sharing with friends (taking turns cooking for each other), or just asking for help.

Exercise: Do what you like, do what you can, but do it. And do it for fun and health, not for six-pack abs.

Meditation: You can’t do meditation wrong. It’s not about “not thinking” but more about mindfulness. You can do it while walking or exercising or just sitting quietly. A good resource for beginners is meditationoasis.com.

Gratitude: Actively practicing gratitude is easier than meditation or exercise. Dr. Barber suggests starting out each day with these five simple steps.

  1. Express gratitude
  2. Set your intentions for the day
  3. Take five long, deep breaths
  4. Smile for no reason
  5. Let go of yesterday’s mistakes

Managing burnout

The term “burnout” implies inevitability to Dr. Barber, and she dislikes it. To conquer the stresses specific to physicians, she suggests checking in with oneself and asking why you’re feeling stressed, depressed or disengaged. To counter negative feelings about medicine, she advises securing a job or residency that genuinely matches up with what you want to do. While at work, take breaks. If you’re struggling, ask for help from family, friends, colleagues, or seek professional help. Engage with patients; talk to them, compliment them, get to know them.

“Patients are fun, so enjoy them,” says Dr. Barber.

More reading

Advice for physicians struggling with burnout or mental illness

‘Inner Strength’: AACOM, COSGP publish a book of DO student essays

Q&A: Arianna Huffington on physician burnout

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