Doctor suicide: 5 ways to tell if you, someone you love, or a colleague may need more support

January 22, 2018

A POST I WISH I DIDN’T HAVE TO WRITE

This piece is weighing so heavily on me today.

It’s called “What I’ve learned from my tally of 757 doctor suicides” and it ran in The Washington Post on 1/13. A colleague of mine sent it to me last night. (This issue has actually been on my mind for the past few months — ever since I myself heard about a local doctor suicide and the circumstances surrounding it.)

The author of the piece was inspired to dig into the issue of doctor suicides about five years ago, when she attended a memorial service for a doctor who had died by suicide — the third doctor suicide in 18 months in her local community.

Since then, she has been on a crusade to understand this phenomenon better. Distressed medical students and doctors at all phases of practice began to contact her to share their experiences of stress, exhaustion, shame and guilt in the wake of errors, and a culture that often prizes “gutting it out” and being strong and stoic.

As it turns out, first-year medical students start out at LOWER risk of suicide than the general population, but this risk spikes during medical school and residency, and never returns to the lower baseline (Privitera et al 2017). There’s some variation in risk depending on specialization, but the fact that doctors are at greater risk for suicide is something most people don’t want to talk about.

 

From the article:
+ One million Americans lose their doctor to suicide each year.
+ Male anesthesiologists are at greatest risk.
+ Doctors who kill themselves often appear “happy” and well-adjusted on the outside.
+ Malpractice suits can be absolutely devastating and can set some physicians on the path to suicide.
+ “Assembly line” working conditions that focus on productivity and force physicians to see very complex patients in short slots can create a pressure-cooker situation, pushing some doctors to their limit.
+ Many doctors fear that their mental health treatment will not remain confidential, preventing them from accessing needed support.
Does any of this resonate, even a little bit? You may not be able to imagine getting to the point of taking your own life, but it’s so important to see the signs of chronic stress, overwork, posttraumatic stress and depression long before it reaches that point.

 

5 ways to tell if you, someone you love, or a colleague may need more support:

  1. You feel disconnected from your practice, lack patience and empathy, and have trouble accessing the passion and satisfaction you used to have for being a physician. These are signs of burnout and can spiral into depression and even suicidal impulses when left untreated, especially when accompanied by passive thoughts of death (e.g. “I wish I’d fall asleep and never wake up” or “My family would be better off without me.”)
  2. You’ve experienced a trauma at work. Maybe you made a mistake and a patient died, or you lost a patient and can’t stop thinking about what you could have done differently (even if others around you aren’t blaming you). Maybe you’re up at night, or you can’t shake feelings of dread, guilt or shame. Let someone help you with this. Time alone will not necessarily heal what you’ve experienced.
  3. You are facing financial or legal problems. If there’s an active malpractice suit against you, you may feel hopeless, scared, and/or unable to talk about this with friends or colleagues. You may fear the loss of your ability to provide for your family. You are human and humans make mistakes, but this essential truth can get lost when there’s a legal proceeding going on.
  4. You are abusing substances. This could take many forms ranging from mild to severe. It could be occasional alcohol binges that create conflict in your marriage, or a flat-out addiction that you’re hiding from the people you work with and the people you love. Secrets are destructive. Substance abuse is a common way that people manage overwhelming emotions, but there are so many other ways. Since abusing substances lowers inhibition, it can create a scenario in which a person acts impulsively to take their own life in a moment of despair or fear.
  5. You know that you want or need therapy, but you’re afraid your care will not be confidential, so you’re putting it off. Therapists are bound by HIPAA. If you are worried about your records being confidential within the system in which you work, find a therapist in private practice whose records are not connected in the same EMR. Pay cash for utmost privacy. Don’t delay needed treatment because of this fear — talk through your doubts or anxieties with your therapist in the first appointment.

This post is not meant to substitute for professional mental health treatment. If you are suicidal now, reach out for help immediately. The national suicide hotline is 1-800-273-8255, or you can visit https://suicidepreventionlifeline.org/ to access the online chat. If have concerns about someone you know or love, talk to them directly or involve someone you trust in coming up with a plan.

And if you’re not worried about suicide right now, but you are struggling with chronic stress, burnout or relationship issues, please get in touch with me so we can explore next steps. Don’t let worries about confidentiality or the thought that you “should” be able to power through on your own prevent you from getting the help you need and deserve.

Send me an e-mail at dobbinlmft at gmail dot com or check out the rest of my website for more information about how I work, my rates, and the types of services I offer.

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