Physicians dealing with mental issues?

[PlaqueBuster]

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So first of all this is not a troll post. Secondly, I am naive and so I am using this opportunity to learn about the role of physicians. Thirdly, I am not trying to criticize anyone.

Question: I see some posts of people talking about anxiety, depression, and panic attacks. If medical students are struggling mentally during their medical education and maybe during residency, then how does this translate to their later years when they are practicing medicine? Can practicing physicians be dealing with issues of more than just stress (i.e. mental illnesses)?

 

[DermViser]

There are many physicians who deal effectively with these issues and practice everyday. They are in no way "inferior" physicians (not saying you said that).

 

[Mass Effect]

So first of all this is not a troll post. Secondly, I am naive and so I am using this opportunity to learn about the role of physicians. Thirdly, I am not trying to criticize anyone.

Question: I see some posts of people talking about anxiety, depression, and panic attacks. If medical students are struggling mentally during their medical education and maybe during residency, then how does this translate to their later years when they are practicing medicine? Can practicing physicians be dealing with issues of more than just stress (i.e. mental illnesses)?

Hate to break it to you, but physicians really are mere mortals. This means they struggle with everything that other mere mortals struggle with -- stress, finances, weight and diet, and yes, even mental illness. One thing you need to realize is that someone who has a panic attack or two does not necessarily have mental illness any more than someone who has the stomach flu has GI disease. For the ones who do have mental illness, if they seek help and are on the proper treatment regimen (which doesn't always mean medication) for them, then there is no reason that they can't "be dealing with issues of more than just stress." Why would it?

 

[redpanda]

So first of all this is not a troll post. Secondly, I am naive and so I am using this opportunity to learn about the role of physicians. Thirdly, I am not trying to criticize anyone.

Question: I see some posts of people talking about anxiety, depression, and panic attacks. If medical students are struggling mentally during their medical education and maybe during residency, then how does this translate to their later years when they are practicing medicine? Can practicing physicians be dealing with issues of more than just stress (i.e. mental illnesses)?

Of course they can. In the midst of doing research for a recent presentation I gave, a particular paper cited the prevalence of depression in medical students as >20%, higher than the general population. Just like everyone else, medical students and practicing physicians struggle with their own psychiatric illnesses, including substance and alcohol abuse and dependence. In contrast to the rest of the population, many states have programs for impaired physicians (psychiatric illness, substance and alcohol abuse, etc.) to get them into rehab and recovery so that they can come back to practice once these issues are under control.

Pennsylvania example: http://www.foundationpamedsoc.org/PHP/PHPrograms.aspx

 

[Mass Effect]

Of course they can. In the midst of doing research for a recent presentation I gave, a particular paper cited the prevalence of depression in medical students as >20%, higher than the general population

Can you cite the paper please? Would love to read it.

 

[Promethean]

A dear friend is a brilliant scientist and physician. She is not currently licensed, due to chronic mental illness. She had been toying with the idea of returning to practice, looking for FM residencies near her support system and communicating with the program directors about her situation, finding some to be very receptive. Unfortunately, she has recently found that her illness is not stable enough at this time for her to manage the care of patients. Her issues may be serious enough to prohibit her from ever returning to a clinical role, because of the risk that the stresses of patient care could lead her to decompensate.

I say prohibit, but that implies some external control. This is a personal choice that she has made, not one being imposed on her externally. If she felt safe enough to move forward, there are ways for her to be supported in that. Certainly, if the local Board of Medicine was given cause to believe that she was unsafe to practice, they would take action to deny her license to do so. But her exercise of prudent restraint demonstrates that she is still within the bounds of making where making the decision herself is proper.

She will likely continue to write, teach, and do bench research until she retires or decides to pursue some other interests.

Her problems are a bit more serious than a simple mood disorder, and yet I believe that even they are not absolutely insurmountable, with adequate support. That last caveat is huge though. Medicine, especially during the training years, can be challenging for even the healthiest. Mental health stigma is very real, and it is much harder to be taken seriously with a mental illness than with a physical illness or injury. I believe one of the drivers of physician suicide is the perception that seeking help will inevitably lead to professional censure. I also believe this perception need not be reality. A physician with the insight to build robust coping mechanisms and make good use of a strong support system, to seek help and engage in good self-care... that doctor will be an invaluable resource to patients, especially those with mental health concerns themselves.

 

[redpanda]

Can you cite the paper please? Would love to read it.

Goebert et al. Academic Medicine, 2009: http://www.ncbi.nlm.nih.gov/pubmed/19174678

 

[pre med 2014]

Of course they can. In the midst of doing research for a recent presentation I gave, a particular paper cited the prevalence of depression in medical students as >20%, higher than the general population. Just like everyone else, medical students and practicing physicians struggle with their own psychiatric illnesses, including substance and alcohol abuse and dependence. In contrast to the rest of the population, many states have programs for impaired physicians (psychiatric illness, substance and alcohol abuse, etc.) to get them into rehab and recovery so that they can come back to practice once these issues are under control.

Pennsylvania example: http://www.foundationpamedsoc.org/PHP/PHPrograms.aspx

Naw that's all just puffery to make the life of a physician seem more mysterious. Rates of mental disorder and substance abuse is definitely lower in doctors. We are just more vulnerable to criticism due to having higher responsibilities.

Don't believe everything you hear! Or in this case what you read.

 

[NickNaylor]

I've personally been dealing with anxiety that came up at the end of MS3. I'm fortunate in that I've gotten on a regimen of therapy that has been pretty effective, and I have no concerns about my ability to practice going forward. However, the impact on your career will depend on the disease you develop and its response to treatment. For example, I can't imagine practicing with severe, treatment-refractory schizophrenia, but less severe mood disorders (depression, anxiety, and to some extent even bipolar disorder) wouldn't preclude you from practicing assuming you get treatment and are aggressive about managing your stress levels as much as possible. This might include recognizing that, as an example, doing an extremely rigorous, time-intensive, and stressful residency (e.g., general surgery) may not be the best idea. But ultimately only the individual can make that call.

 

[Mass Effect]

Naw that's all just puffery to make the life of a physician seem more mysterious. Rates of mental disorder and substance abuse is definitely lower in doctors. We are just more vulnerable to criticism due to having higher responsibilities.

Don't believe everything you hear! Or in this case what you read.

Mind citing your source? Eagerly waiting.

 

[DermViser]

Naw that's all just puffery to make the life of a physician seem more mysterious. Rates of mental disorder and substance abuse is definitely lower in doctors. We are just more vulnerable to criticism due to having higher responsibilities.

Don't believe everything you hear! Or in this case what you read.

:troll:

 

[zeppelinpage4]

Everyone said it very well already, med students, residents, and physicians are all human and can have mental illness or anything else. As long as there's proper management, they can do just as well as any other physicians.

I know myself, and a few other classmates have either dealt with, or still deal with some level of mental illness such as anxiety or depression. Each of them, including myself has successfully made it through first year and seem to be doing just fine now. Is it easy? Not always, but we get the help we need and have found ways to learn and move forward despite it. 🙂

 

[pre med 2014]

Mind citing your source? Eagerly waiting.

No source needed for the real world. That's just how it works, when you have people's lives in your hands (airline pilots, doctors, etc...) people will call you mentally ill on the basis of behavior that would otherwise not be deemed offensive enough to justify the Dx if you were a tradesman, businessman, etc...

It is part of the whole thing of being held on a pedestal

 

[Chipster.]

No source needed for the real world. That's just how it works, when you have people's lives in your hands (airline pilots, doctors, etc...) people will call you mentally ill on the basis of behavior that would otherwise not be deemed offensive enough to justify the Dx if you were a tradesman, businessman, etc...

It is part of the whole thing of being held on a pedestal

Stay in Australia.

Edit: The study posted was also based on self reported data. You're a f*cking idiot.

 

[DermViser]

Stay in Australia.

Edit: The study posted was also based on self reported data. You're a f*cking idiot.

He's an Australian med student? Good grief.

 

[pre med 2014]

Stay in Australia.

Edit: The study posted was also based on self reported data. You're a f*cking idiot.

I would not have known that since I didn't read the study

 

[DermViser]

Psychiatrists deal with mental issues all the time!

 

[Mass Effect]

No source needed for the real world. That's just how it works, when you have people's lives in your hands (airline pilots, doctors, etc...) people will call you mentally ill on the basis of behavior that would otherwise not be deemed offensive enough to justify the Dx if you were a tradesman, businessman, etc...

It is part of the whole thing of being held on a pedestal

When you make statements such as, "Rates of mental disorder and substance abuse is definitely lower in doctors," then expect to back it up with a source or be called out on it.

 

[The new guy]

I've personally been dealing with anxiety that came up at the end of MS3. I'm fortunate in that I've gotten on a regimen of therapy that has been pretty effective, and I have no concerns about my ability to practice going forward. However, the impact on your career will depend on the disease you develop and its response to treatment. For example, I can't imagine practicing with severe, treatment-refractory schizophrenia, but less severe mood disorders (depression, anxiety, and to some extent even bipolar disorder) wouldn't preclude you from practicing assuming you get treatment and are aggressive about managing your stress levels as much as possible. This might include recognizing that, as an example, doing an extremely rigorous, time-intensive, and stressful residency (e.g., general surgery) may not be the best idea. But ultimately only the individual can make that call.

Did you seek therapy thru your school health services, or did you go outside to avoid anyone possibly finding out about this?

 

[pre med 2014]

When you make statements such as, "Rates of mental disorder and substance abuse is definitely lower in doctors," then expect to back it up with a source or be called out on it.

Well I'm saying its on a spectrum. I'm on my phone so I cannot link the study. However those studies that indicate doctors have higher rates of depression/anxiety also indicate doctors tend to tolerate psychological stress better, combined with the fact that the burden of coming out is greater than the suffering itself is the reason we are less likely to talk to anyone. (Though ironically the fact that you can't get help out of fear of your future can make a problem worse because it adds to the sense of powerlessness... If you could just get help it would get better but instead you have to white fist it or potentially allow it to get worse just because the system is overwhelming)

Now I don't want to downplay anyone's personal anguish, but in the grand scheme of things if you can remain functional on the wards and the burden of being drowned in paperwork is worse than the problem itself then it's not that bad.

Remember that people in the general population have no such barriers, they are free to get help unlike doctors. So you can't just blindly follow a statistic from an anonymous survey, the big picture is a bit more complex.

I agree with you perhaps rates are higher based on surveys, but answers can be exaggerated, imagine if it was given right before exams? How many students would jokingly exaggerate to what extent they've felt hopeless!

 

[alpinism]

Goebert et al. Academic Medicine, 2009: http://www.ncbi.nlm.nih.gov/pubmed/19174678

Scary stuff.

6% of med students reported suicidal ideation = about 1 out of every 17 medical students.

 

[pre med 2014]

Scary stuff.

6% of med students reported suicidal ideation = about 1 out of every 17 medical students.

That's not bad compared to the study I read that claimed 5% attempted suicide. That's right attempted, I find it hard to believe 5 out of a 100 of my classmates have made a solid attempt at suicide.

 

[redpanda]

That's not bad compared to the study I read that claimed 5% attempted suicide. That's right attempted, I find it hard to believe 5 out of a 100 of my classmates have made a solid attempt at suicide.

I'm sure it all depends on what one defines as a suicide attempt (aka attempt v. gesture), etc. As well all know, medical students are secretive about mental health issues, so it's hard to judge from an individual's experience, but I can tell you that I've gotten that "good bye" message from a colleague in medical school before and it was real. It happens and it's not uncommon even though you think everyone seems to be functioning ok.

 

[NickNaylor]

Did you seek therapy thru your school health services, or did you go outside to avoid anyone possibly finding out about this?

I went to my school's clinic as the psych records are completely separate from the main hospital system and otherwise inaccessible. Given my relatively non-serious issue I was also less worried about it.

 

[DermViser]

I'm sure it all depends on what one defines as a suicide attempt (aka attempt v. gesture), etc. As well all know, medical students are secretive about mental health issues, so it's hard to judge from an individual's experience, but I can tell you that I've gotten that "good bye" message from a colleague in medical school before and it was real. It happens and it's not uncommon even though you think everyone seems to be functioning ok.

😱😱😱