Depression is a complex mood disorder caused by various factors, including genetic predisposition, personality, stress and brain chemistry, as well as cultural and systemic factors. Stressors unique to the medical profession place physicians at particular risk for depression, with the 2017 CMA National Physician Health Survey finding that more than 1 in 3 physicians have screened positive for depression.
Stigma prevents many physicians from seeking help
The culture of medicine perpetuates the stigma associated with mental illness, including depression. Physicians are not encouraged to prioritize their own health — and shame or a perception of weakness can cause them to not disclose feelings of distress and to “work through it” on their own. The 2017 National Physician Health Survey found the most common reasons for not seeking help were:
- Believing the situation was not severe enough
- Being ashamed to seek help
- Not being aware of available services
A physician’s work environment also plays a significant role. A lack of collegiality, dissatisfaction with work-life integration, career dissatisfaction and presenteeism (i.e., going to work when physically ill or distressed) are all significant occupational predictors of depression. Left unmanaged, depression can negatively affect both physician health and patient outcomes.
To cultivate a healthy and vibrant profession, there is a clear need to shift the medical culture from one of stigma to one that promotes self-care.
Taking steps to normalize help-seeking behaviours and create psychologically safe work environments is a shared responsibility.
Physicians are subject to many stressors that reinforce symptoms of depression
In addition to the risk factors related to medical culture as a whole, physicians are subject to many other stressors that put them at higher risk of depression, including:
- Heavy workloads and unrealistic expectations
- Limited resources and workplace inefficiencies
- High administrative burden
- Social expectations such as:
- Not talking about their feelings
- Showing no “weakness”
- Pushing through problems rather than seeking help
- Focusing solely on “not letting patients down”
- Loss of a patient
- Personality traits, with physicians often:
- Desiring high achievement
- Being overly self-critical
- Exhibiting perfectionist tendencies
- Having a strong sense of obligation
- Over-committing to their work
While individually targeted initiatives (e.g., resilience training) are important, a greater emphasis is needed on reducing stressors within the practice environment. This includes the creation or refinement of physician wellness programs.
Strategies for coping with depression
If you or a colleague are experiencing significant stress or depressive symptoms, here are some coping strategies that may help:
- Set limits and know when to say “no” if too much is asked of you or you’re tempted to stray from important priorities
- Ask for help from colleagues and staff
- Seek formal or informal peer support
- Nurture personal relationships and stay connected with family and friends
- Prioritize time for yourself and check in on your health regularly using self-assessments
- Eat a balanced diet, stay physically active and get adequate sleep
- Have a formal primary care physician
Contact your provincial physician health program for additional support
Need help now?
Get support from your provincial physician health program.
In crisis? Get immediate help by:
- Calling 911 or visiting the nearest hospital.
Results from the latest 2021 National Physician Health Survey and more recent physician health and wellness data are available here.
Are you in distress? Get help now.