Depression/ Suicide

Residents and faculty are human and sometimes need help. Depression is as common in the medical profession as in the general population, affecting an estimated 12% of males and up to 19.5% of females.According to data and conclusions drawn from 31 cross-sectional studies comprising 9447 medical residents and 23 longitudinal studies (8113 residents), the overall depression prevalence was found to be 28.8% (4969/17,560 residents) in residents.

Each year in the U.S., roughly 300 – 400 physicians die by suicide. Physicians are not at greater risk for suicide than the general population because they are “weaker” or less resilient; rather, the opposite is true. Despite their high levels of personal resilience, physicians are often placed in situations of recurrent stress. Recurrent stress can lead to physiological and physical exhaustion, otherwise known as burnout (Romani).

Stethoscope on a background X-ray images

Factors associated with suicide among physicians include (AMA):

Depression
Emotional exhaustion
Substance-use disorder
Impaired relationships
Self-destructive tendency

Factors Associated with Increased Depressive Symptoms

Burnout
Social isolation
Long work hours
Poor sleep schedule and fatigue
Lack of control (e.g. schedule, hours, workload)
History of depression, anxiety, SI, or trauma
Substance use
Inadequate feedback
Experiencing patient deaths
Poor inpatient learning experiences
Feeling mistreated at work
In the process of or history of being sued
Restrictions on license
High institutional research rankings
Stressors outside work (e.g. finances, relationships, health)

When to be Concerned

Changes in Work Performance

Change in punctuality
Delayed response to pages/phone calls
Failure to complete required tasks
Poor participation in work activities
Change in “professionalism”
Poor eye contact
Poor patient care
Work-family conflict
Increased frequency of medical errors
Sudden change in patient satisfaction scores

Changes in Mood

Sad or depressed mood
Hopelessness
Irritability
Humiliation
Guilt
Anxiety
Rage

Changes in Behaviors

Recklessness
Withdrawing from others and activities
Decreased engagement
Isolating self from family and friends
Change in sleep habits
Aggression
Increased drug or alcohol use

Beware: Performance at work for physicians is often the last thing to go. Professionals often function relatively well until the depression is severe!

What to do if you suspect there might be a problem

If you suspect a person is in crisis, escort the individual to the Emergency Department.
- Do not leave them alone!
- Get help and notify Program Director, DIO, Program Coordinator, or supervisor
If not in crisis and not sure what is going on, escort the individual to employee health.
Get help and notify Program Director, DIO, Program Coordinator or supervisor