It has long been known that physicians are at high risk of depression and suicide, and the problem is not getting better. A study published this July in Academic Medicine found that suicide was the second leading cause of death among resident physicians from 2000-2014 (the first in males). And it's clear that burnout can contribute to the problem, experts say. When Michael Myers, MD, was researching his book Why Physicians Die by Suicide: Lessons Learned by Families and Others Who Cared, he interviewed surviving family members of physicians who had killed themselves. "What they described was straightforward burnout," says Myers, professor of clinical psychiatry at SUNY-Downstate Medical Center in Brooklyn, NY, and specialist in physician health.
Despite the high risk, physicians are far less likely than those in other professions to seek help for emotional problems. "Physicians are programmed to think of themselves as being able to handle stress," says Clifton Knight, MD, senior vice president for education at the American Academy of Family Physicians (AAFP). "There is a kind of guilt and shame associated with it—'if I'm suffering from stress, I am weak and a bad physician,' the thinking goes." That attitude makes reaching out for help nigh impossible. It also compounds the suffering. Not only are you depressed, the very fact that you are depressed brands you as a loser.
Physicians, however, have a much more practical reason for keeping secret the same emotional problems they encourage their patients to seek help for. They are understandably concerned that having a record of mental illness could cause them to lose their licenses. In a recent study of 94.1 percent of medical licensure board applications, only one-third of states had questions that were congruent with policies of the American Medical Association, American Psychological Association, and the Federation of State Medical Boards, nor were they in compliance with the Americans with Disabilities Act. "The Federation of State Medical Boards is very concerned about this," says Myers. Despite the presence of mental health questions, the danger may not be as great as many physicians think. "It is very, very rare that a renewal is refused as long as you're being treated," says Myers.
A Safe Space
There are places to seek help where those in charge are aware of the special concerns of physicians. "The state medical association in each state has a physician wellness program," says Knight. While it may vary from state to state, most of these programs offer confidential self-reporting. In Dr. Knight's home state of Indiana, for example, as long as you have an evaluation and stay in a treatment program, you will not be reported to the licensing board. The AAFP also has a variety of wellness resources for family physicians.
The risks to yourself and to your patients is too great to ignore this problem. If your burnout has reached the point where you are suffering from depression, it's time to get help. And there are safe ways to do so.