Raising awareness of depressed physicians in honor of Suicide Prevention Awareness Month

I once told a fellow physician who was suicidal to go to the ER and that there was nothing I could do. I was on call. I was also burned out and depressed, though I didn’t know it at the time. My immediate thought in that moment was “Why would a doctor be depressed and suicidal?” This happened during my first job out of residency back in 2012, and it remains one of my biggest regrets.

I didn’t fully understand the severity of depression and suicidal ideation among my fellow peers until I realized that I was depressed myself.

I researched day and night trying to find answers to questions that flooded my mind: Am I the only one who feels this way? But I’m done with residency — why would I be depressed? I’m a doctor — shouldn’t I be able to fix these feelings myself? Shouldn’t I be stronger? I need to keep these feelings to myself. Everyone will judge me and think I’m weak.

We are only human

But we are not weak. Our training teaches us that we can’t show weakness; that we can’t be vulnerable. But we are still only human.

National Physician Suicide Awareness Day is on September 17, and September is Suicide Prevention Awareness Month. Many of you already know that we have one of the highest suicide rates of any profession.

But what the general public doesn’t know are the many factors at the systems level that contribute to our profession having these high rates, such as being constantly overworked, lacking adequate support staff, feeling like cogs in a wheel of corporate medicine, battling insurance companies for approval of treatments and fair reimbursement, silencing or gaslighting for speaking up and especially fearing the ramifications of seeking support and psychiatric treatment.

Let us honor those we have lost by continuing to fight for change and rid the health care system of factors that prevent many of us from seeking help.

Here are some ways we can take action:

• Volunteer for the Physician Support Line. At the beginning of the pandemic, Mona Masood, DO, led a fervent team of psychiatrists to create a free, confidential peer support line for physicians and medical students. Since its creation, the hotline has provided a safe space for many physicians and medical students to open up and receive support from a peer who understands the unique circumstances we face in our profession. If you are a psychiatrist interested in volunteering, you can sign up here or contact Dr. Masood at drmonamasood@physiciansupportline.com.
  
• Make small, consistent changes in how we discuss mental health. According to Dr. Masood, these changes “can lead to sustainable outcomes in suicide prevention.” She provides the following as examples of questions to consider: Do we have implicit biases, such as associating mental health with violent people or physicians with mental health struggles as poor or incompetent physicians? If we are in a position of power, such as in academia or teaching hospitals, how do we treat our medical students and trainees? Do we take time to know them outside of their clinical roles? Do we take time to acknowledge their contributions outside of formal evaluations? Do we express to them that we understand that they are human?

• Advocate for your peers. Medical students, residents and attendings have advocated for more resources, programs and initiatives to prioritize mental health at their respective schools or place of employment. We can also advocate for policies to eliminate the punitive risks of seeking psychiatric treatment, particularly policies that aim to revise license and credentialing applications to remove questions asking about mental health history. For example, both the AOA and the Federation of State Medical Boards have policies urging boards not to ask applicants about their mental health history and instead focus on current impairments. 

• Spread awareness about the problems within our health care system that are detrimental to not only physicians, but also to all health care professionals and patients. We tend to be scapegoats for greater systemic issues within the health care system, which forces us to practice in ways that aren’t consistent with our standards or ideals. Many of us are also pushed to practice without adequate support and resources. Let’s educate the public because these problems not only impact health care professionals, but also the patients we treat.

• Share our stories of struggle and survival (if you are at a place in your life where you feel comfortable to share). Many physicians have opened up about their mental health struggles, including several who shared how they survived a suicide attempt. I know I personally found it validating to read about and relate to fellow physicians who have opened up. As cliche as it sounds, it truly helps to know we’re not alone.

We must support each other

And to my fellow medical students, residents and attendings — though the pandemic cast light on the mental health struggles of health care professionals, in addition to publications and social media providing an outlet for physicians to open up about their personal experiences, some of us are still so quick to judge our peers, as I once did.

Let’s come up with ways to support each other instead. Many of us are struggling, yet we are the best at hiding it. If you are struggling – please, please don’t isolate. Ask for support and reach out to someone you trust. We have lost and continue to lose so many of us. Depression makes us feel like we don’t deserve to be helped, but fight that feeling as much as possible. I don’t want you to die. I don’t want you to go through this alone.

For support, please don’t hesitate to reach out to the Physician Support Line at 1 (888) 409-0141. You can also call the National Suicide Prevention Lifeline by dialing 988.

Related reading:

Physician burnout and the transition to nonclinical careers

Is burnout the correct term to use?