Why doctors secretly suffer from depression in silence

In this month’s special issue of my Insiders’ Cures newsletter, I give you a comprehensive guide on how to make the most out of your doctors’ visits. (This is information no one should be without. So if you’re not already a subscriber, I encourage you to sign up today.) One of the first things I advise is to ask your doctor how she or he is doing. In fact, a new report, in a doctors-only source, reveals just how critical it can be to show your concern and compassion for your doctor — not just the other way around.

For the new report, a physician conducted confidential interviews with 200 other physicians who experienced depression during their careers. It was not a pretty picture.

Doctors are people too. They get sad, just like anyone else. But when the periods of sadness turn into weeks and months, how do doctors handle it?

Well, many doctors do nothing. Or — they try doing things that don’t help.

Only one-third of doctors chose to get professional help from their colleagues in psychiatry. But getting professional help was rarely the first step, even when ultimately sought. (Perhaps, like me, they can recall their medical school classmates who ultimately chose to go into psychiatry. It would give anyone pause.)

Twenty-seven percent of doctors chose self-care and five percent self-prescribed medication — which reminds me of the old admonition that “a doctor who treats himself has a fool for a patient, and a fool for a doctor.” Six percent of doctors pursued job changes. And just one percent prayed.

Alarmingly, 14 percent of doctors engaged in self-destructive behaviors, including substance abuse.

Most doctors eventually tried multiple approaches. But most did nothing at all for many months or years until they finally decided to take action — sometimes resulting in self-harm.

Common risk factors for depression

Doctors get depressed for the same reasons as anyone else, like a failed marriage or the death of a loved one.

Plus, being a physician can make depression even more risky…

Physicians face unique circumstances during their education, training and careers known to lead to depression. They also face human suffering and death on a near-daily basis. They also must deal with bullying, hazing, sleep deprivation, and deprived social life and family life. They also face investigations by government medical boards, self-appointed medical specialty boards, civilian hospital boards, health insurance companies, and often malpractice lawyers. They must always look over their shoulders and worry about every perceived step out of line.

Furthermore, all physicians face social isolation. And loneliness can lead to depression in anyone. Frequent moves for college, medical school, internship, residency, fellowship and jobs, coupled with 80-hour work weeks, don’t leave time and opportunity to make and keep friends and family close. Even when not working, physicians are busy trying to keep up with medical science and new medical practices, studying for examinations, or running to attend evening and weekend courses to satisfy state medical boards.

Physicians are by nature highly intelligent, existential thinkers. So they may find it difficult to relate to what passes for popular social discourse, activities and engagement, even when they may have the time.

These lifestyle circumstances also stress marriages. And physicians are more likely to lose their spouses due to neglect. They often don’t make it home for dinner, family events, or children’s activities. And they may be on call during evenings, weekends and holidays, which can cause disruptions at any moment. Even if the marriage does last, physicians may still develop depression over a prolonged period, since they lack the supportive social networks that others have had time to build.

You may be surprised to learn that financial distress may be a cause of depression for doctors. Although they earn more than average, they typically have higher student loans, and bigger mortgages for home and office. They spend their first 10 years of adult life in education and training, rather than earning a living. So they start work a decade behind peers in terms of savings and retirement. In addition, unscrupulous employers in the medical industry, business people, and even family and friends may prey upon physicians who aren’t business-savvy.

Many physicians experienced social isolation, neglect or even abuse during childhood. And they may enter medicine as a “wounded healer” so that they can help others. Then, they become further destabilized when they enter career training in a medical culture of self-denial and self-neglect.

Of course, retirement can be a depressing time for anyone as a major life event. For doctors, their identity is often wrapped up totally in their careers, since medicine was long a “calling,” as well as a job. Many have not developed a personal or social life. And some have not saved enough for a happy retirement.

So, remember to treat your doctors with concern and compassion, just as you would anyone else with whom you have an intimate connection. It may also help you realize that doctors are not the be-all and end-all source of health and wisdom about wellness. In some ways, doctors are the biggest victims of our toxic modern healthcare system.

That’s another reason why you need to educate yourself and take charge of your own health. Stay tuned to my Daily Dispatch and Insiders’ Cures newsletter to find all the natural resources doctors don’t know about and won’t tell you.



“Doctors and Depression: Suffering in Silence,” Medscape (www.medscape.com) 5/11/17