Doctors and Depression: Suffering in Silence

Pamela L. Wible, MD

Disclosures

May 11, 2017

In This Article

What Do Depressed Doctors Do?

So what do doctors do when they're depressed? Do they just go to the doctor? Most don't.

Many doctors do nothing. Medical training teaches us to "suck it up," so help-seeking is not a well-honed skill among doctors. Many lack self-awareness that they are suffering from depression. Because the majority of doctors are overworked, exhausted, and discontent, they don't necessarily see themselves as outliers. They've normalized their misery and pretend that it's not as bad as it seems. Distraction, avoidance, and denial are popular tactics among depressed doctors. I believe that most physicians do not seek the appropriate care that they would recommend for their own depressed patients. "I think your assessment is, unfortunately, fairly accurate. And I'm a psychiatrist," confirms Dr Shannon Sniff.

Self-treatment Strategies

Self-distraction. As a physician who has been depressed, I chose to ignore my own condition by obsessing about my patients' terrible lives—plus I got paid for it! This is the most popular (and incentivized) method of physician self-distraction: workaholism. Even "after work," physicians distract themselves with endless charting, mindless computer games, Facebook (including doctor groups), binge-watching Netflix, or escaping into novels and mysteries. Younger doctors may go out partying with friends.

Self-soothing. Cooking and overeating may transiently ease depressive symptoms. Dark chocolate is favored, followed by other sugary snacks, such as donuts and pastries at nurses' stations and clinic break rooms. Earlier in my career, I recall drug reps covering my desk in Reese's peanut butter cups that I would use as mini-antidepressants while charting. Of course, self-soothing with food can turn into self-destructive weight gain.

Self-care. A surgeon once told me, "If you're depressed, you just need a deep rest." Some docs are chronically sleep-deprived, so sleeping in or relaxing on vacation is their go-to self-care strategy. Obsessive exercise is also extremely popular among doctors. Beware: CrossFit, running marathons, or powerlifting, although great for depression, may turn into an addiction and lead to injury.

Others read self-help books, pray, meditate, do yoga, sing, dance, listen to music, or play with kids/pets. Some docs keep a stash of thank-you cards from patients that they read when depressed. Remembering grateful patients is a form of self-affirmation that rebuilds confidence and self-esteem.

Self-care may include leaving full-time employment, or quitting medicine altogether. One doctor writes, "What did I do? I left my job! Haha." Another shares, "I have tried self-care, but was so unsuccessful that it hardly counts as an action. Ended up being more of an aspiration, and the daily failure at it led to self-destructive behaviors and thoughts."

Hobbies. I've been told, "There's a fine line between a hobby and a mental illness." Many physicians throw themselves into obsessive crafting to treat depression. As my marriage was failing, I created the most beautiful mosaic mural in my bathroom (that I lost in my divorce). Many female physicians seem to favor knitting. Ann Secord, a pathologist, shares, "I knit. A lot. I should have remembered how much I loved to knit when I was at my most depressed, back in my Navy days. Lately I've started playing ukulele. Like every day. I think it's impossible to be depressed and play ukulele." Retail therapy is a popular all-American hobby as well.

Emotional release. Physicians have disclosed crying under their desks between patients, closet crying, and crying themselves to sleep in the call room. A male physician actually sent me a photograph of himself sobbing on the bathroom floor. Other physicians admit to breaking things. Dr Michele Parker shares, "I used to go to Six Flags for roller coaster therapy and scream. Crazy."

Self-prescribing. Whereas some docs write their own prescriptions, others steal drug samples from their office or buy them on the Internet so that there's no record. Caroline shares, "I have abused my son's Adderall to try to be more efficient and survive on little sleep, and I self-prescribe Cymbalta."

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