Medical residents and practicing physicians today are perhaps more stressed than any generation of their predecessors, with more to learn, patients to see, and charting to complete than ever before, all while still reeling from the Covid-19 pandemic. Unsurprisingly, this increase in stressors correlates with a rise in depressive symptoms among medical students and physicians. The inherent pressures of medical training can leave anyone feeling numb, overwhelmed, and hopeless, but the outlook is not as grim as it may appear. There is also more available support for a doctor with depression today than ever before.
Almost 30% of all physicians, double the rate of the general population, and up to half of all medical students and residents, face the potentially debilitating condition of depression. Significant in itself, these numbers are likely underreported, as doctors are reluctant to admit needing help, or even having a problem. Legitimate licensing concerns complicate matters, since some state medical boards still require disclosure of receiving treatment for even mild depressive symptoms.
Doctors are likely quite familiar with the symptoms of depression, but recognizing them in oneself and a patient are not the same thing. Take some time to examine your daily life, your thoughts, your emotions, and your mental and physical states. If you notice any of the below symptoms, seeking help may be something to consider.
- Feeling worthless
- Excessive Fatigue
- Loss of interest
- Difficulty concentrating
- Changes in appetite or unintentional weight changes
- Sleeping more or less than normal
- Physical illness
- Thoughts of death or suicide
Options for A Doctor with Depression
Medical residents and practicing physicians are working in the midst of much-needed change. Residency programs have begun the move to reform their programs to reduce strain on physician mental health, while the destigmatization of mental illness has given way to more research and treatment options. The five options below are all tailored to the unique needs of the physician:
The Accreditation Council for Graduate Medical Education (ACGME), which is responsible for monitoring educational and professional standards for GME programs, is setting the standard for not only lowering risk of depression, but promoting mental wellness among all residents and fellows. Recent changes to the ACGME’s accreditation standards emphasize resident wellness for all GME programs.
In 2019, the ACGME introduced their AWARE campaign to facilitate positive resident well-being. AWARE caters to physicians with on-demand resources, including videos, podcasts, and a mobile app. The AWARE curriculum is rooted in evidence-based cognitive behavioral therapy techniques that focus on coping skills, all with the goal of curtailing the intrinsic professional hazards of depression and burnout.
Born out of the Covid-19 crisis, the Physician Support Line is an anonymous, no-cost hotline supporting the mental health care needs of physicians. Volunteer psychiatrists are available to struggling physicians and medical students seven days a week, from 8:00 AM to 1:00 AM, Eastern Standard Time. The hotline provides a safe place for residents to seek support and does not require reporting to the medical board.
The Frontline Therapy Network, a division of The Battle Within, provides support to first responders and medical personnel in the form of six free therapy sessions. This option eliminates barriers to care, including flexible scheduling and providers specifically-trained in helping frontline workers.
The Green Cross Academy of Traumatology offers a directory of online support groups. While not considered therapy, these provider-led groups focus on developing individual coping mechanisms and self-care strategies. Listings include times available and provider specialty.
PeerRxMed is a program that facilitates one-on-one connection with physician peers, offering support and guidance for consistent “buddy” check-ins. The program’s purpose is to provide resources and guidance to physicians as they support one another. The only caveat is that you must come with your own partner, as they currently do not provide a matching service.
In addition to the above resources, talk to your residency director, who will have knowledge of any available program or institutional resources, which are becoming more common. Consider reaching out to your fellow residents as well. Since at least half are affected by depression, you may find a friend for whom you can provide mutual support.
Depression can be a serious and life threatening condition. If you are having thoughts of self-harm, suicide, or homicide, please seek emergency care.