The growing incidence of burnout among health care providers is well known. The unique and significant stresses of the pandemic, layered on top of the already high level of burnout that preceded the onset of COVID, has produced a degree of burnout throughout the health care sector beyond what we have ever experienced, exceeding an overall incidence of 60% by late 2021 (JAMA Health Forum 2022;3:e224163). Although system-level factors are a major contributor to burnout in the health care sector, that does not replace the need for mental health care for those who need it (Taking Action Against Clinician Burnout A Systems Approach to Professional Well-Being. 2019; N Engl J Med 2022;387). A recent survey of anesthesiologists reported that more than one anesthesiologist in five acknowledged they were depressed, either as a sole diagnosis or in combination with burnout (asamonitor.pub/3VGzTif).
As pervasive as burnout and related mental health issues have become, it is likely there are large numbers of our colleagues who are suffering silently. The same recent survey cited above indicated that among anesthesiologists acknowledging they were depressed or burned out, three out of four had no current plans to seek professional help (asamonitor.pub/3iFv9ei). Clearly, there are significant impediments to seeking mental health care services, for a variety of reasons.
“ASA’s website also has resources that help to identify warning signs, self-screening tools, and resources to help a colleague in need, including information on the new 988 Suicide and Crisis Lifeline.”
If we ever hope to minimize the barriers prohibiting our colleagues from seeking appropriate mental health care, it needs to become something we can discuss as openly as we do any other medical issue any of us experiences. In that spirit, I will share that I was diagnosed with depression a year and a half ago. I recognized that the challenges and stresses that I had faced and conquered in the past were becoming an increasingly greater challenge to overcome. Although I was able to continue performing all my duties, I found that by the end of the day, I had nothing “left in the tank.” The combination of the pandemic and increasing challenges I was facing in maintaining our department’s clinical staffing needs caused me to recognize that I was either burned out, depressed or both, and I had reached a point where I needed professional medical guidance and treatment.
I asked my primary care physician for a referral to a mental health professional. After being evaluated by a psychiatrist, and discussing my symptoms in depth, I was prescribed an antidepressant, accompanied by further counseling sessions. I will admit that, despite my hope that I would see an improvement in my mood, I was somewhat skeptical. However, after a few weeks of treatment and counseling, my mood and energy were noticeably improved and have remained so since then.
I fully realize that on the spectrum of mental health disorders, I have experienced a relatively mild and – hopefully – readily manageable level of disorder. I have no doubt that many who read this have suffered, and continue to suffer, far more significantly than I have. However, I am equally certain that some who read this are in a similar place where I was 18 months ago. If you feel that you are depressed or burned out, please recognize that you are by no means alone in your struggles. ASA’s Committee on Physician Well-Being has assembled an extensive list of resources on well-being on our website that you may find are of benefit (asamonitor.pub/3Bdk2j6). That being said, we physicians all too often try to “heal ourselves,” particularly in the mental health realm. Please consider seeking professional mental health care resources to help you better evaluate and manage your condition. By all means, if you are considering suicide, seek help immediately. ASA’s website also has resources that help to identify warning signs, self-screening tools, and resources to help a colleague in need, including information on the new 988 Suicide and Crisis Lifeline (asamonitor.pub/3Wd5Mz1).
Having the benefit of time to reflect on my diagnosis and treatment, I recognize now that I likely had been experiencing burnout and/or depression for a good while before I finally sought medical attention. Although I eventually recognized that I needed to reach out for professional help, I see now that I delayed seeking help longer than I should have. I have a list of excuses and rationalizations for my delay in seeking the care from which I would have benefitted, but I am fortunate that I eventually acknowledged the need to seek assistance. It’s clear that we have a long way to go before we are at a point at which seeking mental health evaluation and treatment is viewed no differently than treatment for any other medical condition. Depression and burnout are extremely – and increasingly – prevalent among health care providers. None of us are immune to them, and none of us should suffer needlessly for fear of seeking the care we need.
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