“We masquerade as strong and untroubled professionals even in our darkest and most self-doubting moments. How, then, are we supposed to identify colleagues in trouble - or admit that we may need help ourselves?” -Pranay Sinha, MD
Each year approximately 400 physicians commit suicide. That is more than one per day and roughly the equivalent of two entire classes of graduating medical students.
When screened, approximately 10% of medical students, resident and physicians report current suicidal thoughts.
Suicide accounts for 26% of deaths among physicians aged 25-39. This is more than twice (11%) that of same age group in the general public.
Male physicians have a 40% increased risk of suicide compared to non-physician counterparts.
Female physicians have a 130% increased risk of suicide compared to non-physician counterparts.
Depression is not the Same as Burnout
Burnout is defined in many ways but it generally encompasses emotional exhaustion, depersonalization, and a sense of decreased personal accomplishment. Burnout is more directly related to your professional environment. While burnout is a risk factor for depression and suicide, they are not the same. Depression is a medical condition with specific set of diagnostic criteria.
Potential Reasons Why Physicians Have an Increased Risk of Depression and Suicide
- Physicians are much less likely to seek treatment for mental health conditions. Treatment for depression and other conditions has been shown to be protective against suicide.
- A stigma of mental health persists even with physicians.
- State medical boards and hospital credentialing forms ask about mental health treatment and physicians fear that reporting this could jeopardize careers.
- Physicians have access and knowledge of medications and other lethal techniques.
- Increased rates for female physicians may be due to increased work-family conflicts (more time on domestic tasks, higher rates of divorce, etc) and gender bias in medicine (pay differential, less career advancement).
How do We Help Our Colleagues?
- Take care of each other - reach out to people who are struggling.
- Be a vocal advocate to combat stigma about mental health.
- Do not participate in shaming of people with mental health conditions.
- Advocate for change to medical board licensing criteria.
Tired if reading? watch Dr. Macvane discuss Physician depression and suicide
References & Further Reading/Listening
1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed February 15, 2018. www.cdc.gov/injury/wisqars
2. EMRAP: Suicide Risk in Physicians. August 2017.
3. Guille C et al. Work-Family Conflict and the Sex Difference in Depression Among Training Physicians. JAMA Intern Med. 2017;177(12):1766–1772. [Pubmed]
4. Hill A. Breaking the Stigma- a Physician’s Perspective on Self-Care and Recovery. New England Journal of Medicine 376; 12, 2017.
5. Jolly S et al. (2014). Gender Differences in Time Spent on Parenting and Domestic Responsibilities by High-Achieving Young Physician-Researchers. Annals of Internal Medicine, 160(5), 344–353.[Pubmed]
6. Khullar D. Being a Doctor is Hard. It’s Harder for Women. NY Times, December 7, 2017.
7. Muller D. Kathryn. New England Journal of Medicine 376; 12, 2017.
8. Schernhammer, ES., Dolditwz, GA. “Suicide Rates Among Physicians: A Quantitative and Gender Assessment (Meta-Analysis). American Journal of Psychiatry. 161 (12). December 2004.[Pubmed]
9. Sinha P. Why do Doctors Commit Suicide? The New York Times. September 4, 2014.
10. Sowa McPartland A. Suicide and the Yong Physician. The Atlantic, September 2014.
11. Lindeman S et al. A systematic review on gender-specific suicide mortality in medical doctors. Br J Psychiatry. 1996 Mar;168(3):274-9. [Pubmed]