Doctors and Depression

Short, quick, barely edited — so apologies. Longer one to come.

There’s this idea that depressed physicians — or any other professional with high-stress, high-stakes jobs — just ticking time bombs, waiting to detonate.

In some ways, this is true — but not ‘because they are depressed.’

Rates of suicide among male and female physicians are nearly 1.5x and 2.25x higher, respectively, than in the general population. These facts are particularly harrowing because physicians who attempt suicide are also more likely to complete it, due to their superior knowledge of human anatomy and access to prescription drugs. Rates of depression, alcoholism, and substance abuse are, likewise, particularly high among physicians.

It’s very likely that, sometime during my medical school interviews, I will be asked if I think someone with a history of depression should be allowed to pursue medicine. Many site these same statistics as reasons why someone with a history of depression cannot handle such a high-stress, high-stakes job (they also site concerns about the well-being of patients, which is a bit misfounded — again, I’ll write about it later).

And what will my answer be?

A big, resounding YES.

The reason that depressed physicians — or any physician — detonates is not simply that they ‘can’t handle’ the pressure. Yes, chronic stress, sleep deprivation, proximity to tragedy, and toxic organizational structures can certainly aggravate depressive symptoms or cause feelings of burnout. And yes, negative mental well-being of physicians have been linked to an increased number of medical errors (although, please proceed with a grain of salt — the evidence isn’t overwhelming).

Obviously, depression is implicated in a number of suicide cases. But the answer isn’t to discriminate against students with histories of depression.

Why? Because every single person, regardless of previous history, is susceptible to depression. It’s not the ‘weak’ ones. It’s not the ‘least competent’ ones. It’s ‘every’ one. If you tell medical students that they can’t be depressed and be good doctors — if you tell them that they will be seen as incompetent or unfit for medicine if anyone finds out they are depressed — you’re not stopping depression from entering the ranks of medicine. You are raising the amount of untreated depression that accumulates among bright, competent, and eager young medical students/residents who need help but cannot seek it without fear of stigma or — worse — someone else deciding they aren’t fit to continue with their education or practice.

So yes, if you keep building and building the pressure in someone while blocking any efforts to seek the help they need — if someone feels like all their hard work (because the path to medical school IS hard) will go out the window if they admit they need help — then, yes, it’s no surprise that some medical school students/residents/physicians eventually detonate. And that’s our fault. Not theirs.

Author’s note: I realize that, before I publish this, that this is not a post that directly relates to my current state of mental health. It is a criticism of a problem that exists in the world of providing healthcare.

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3 Comments Add yours

  1. updownflight says:

    I have heard of many doctors who suffer from depression. Though the ones I’ve heard of/known have had to sometimes take leaves, the depression did not make them any less of a doctor.

    My only concern sometimes is indeed what you briefly mentioned. That they do not readily seek out help. I know that in the case of my sister-in-law (a general practitioner) she has semi self-medicated her bipolar disorder for years. She doesn’t do it completely. She seems to do so in a way that allows her mood elevations to stay (only slightly checked), but more treats her depressions.

    Liked by 1 person

    1. Thanks for adding that. There are so many reasons that people in the medical field don’t get help, and the ability to self-medicate (more than others — self-medication is a widespread problem, but, like you implied, doctors have more access to prescriptions) is definitely one. I’ll make sure to address that in my longer piece. It’s nearly 2000 words (I’m debunking myths, too, like the idea of doctors “snapping” and killing patients like that co-pilot’s mass homicide/suicide a few years ago) so maybe it’s be a multi-part thing… I just couldn’t pass up writing something shorter for the “detonate” prompt.

      I’m also glad you know people who have taken leave. There’s stigma around leave, which sometimes makes it hard for people to take it. Even for those I know who DIDN’T suffer a particular, diagnosable condition like depression I think needed to take a moment to breathe once and a while. I’ve seen people’s bodies literally change from the stress — which is one reason I think that premedical societies should be more honest with their students about what they’re getting into.

      So that’s my long, rambling comment. Sorry, haha. Thanks for reading!

      Liked by 1 person

      1. updownflight says:

        I will look forward to reading your longer piece, or series. Don’t feel reluctant to write a series if there is a lot of important content to cover.


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