Mental Health Issues In Medicine
As viewers from the outside, we are unable to see what medical school students and graduated M.Ds often have to go through and are restricted to the somewhat-often Instagram posts a student may make. This practice, however, leads many pre-med high schoolers to miss the truth behind the social media posts. One of the biggest hidden truths high schoolers miss is the mental health issues many in medicine face.
A literature review by Thomas and Bigatti found that perfectionism has been prevalent in medical students, interns, residents, and physicians - a trait that is shown in all stages of the journey. Perfectionism, unlike common belief, is not the tendency to try to make everything as accurate as possible, but in reality, is a “‘multidimensional personality construct with adaptive and maladaptive subtypes.” Furthermore, a core belief in perfectionism is the thought that the world is not a safe place and is untrustworthy. Another common syndrome in medical students worldwide is imposter phenomenon (IP). IP is loosely defined as doubting your abilities and feeling like a fraud. According to Pinto-Powell in 2016, “a quarter of male medical students and nearly half of female students experience imposter syndrome and report burnout components of exhaustion, cynicism, emotional exhaustion, and depersonalization.”
Unfortunately, these mental health issues are not the most common, with depression and anxiety being prevalent in a considerable percentage of the medical industry as a whole. Depression and anxiety have always been an occupational hazard to doctors as a systematic review of 31 studies published in the Journal of the American Medical Association found that “29 percent of practicing physicians reported depression, a rate twice that of US adults.” The number is increasing of medical students, as recent data shows that “rates of depression and anxiety have increased among medical trainees since March 2020, with nearly half of this group now having depression or anxiety.” This anxiety brings doctors to breaking points, with many being unable to eat and sleep. Thankfully, you would think that these people are getting help, right? Unfortunately, that is not the case. Doctors are incredibly hesitant in sharing their problems to seek counseling or medication since their medical license may be revoked, even though the practice is illegal under the Americans with Disabilities Act.
The question arises, however, why do these doctors and students face so many mental health issues? For residents and physicians, depression specifically results from the job’s stress, as doctors are exposed to more work-related stressors than any other professional group. Outhoff writes that these stressors include “long hours, extensive workloads, the growing intensity and complexity of the job, relentless contact with patient ill health and emergencies, high levels of responsibility, rapid change within healthcare, institutional constraints such as discrimination and intimidation, lack of autonomy, low levels of support, loss of job satisfaction, low morale and the inability to attend to their personal lives.” Because stress level changes along the way, the answer for medical school students shifts based on the year a student may begin. A study done in 2018 creates a baseline however, writing that stressors include academics [15,18], lack of balance [23], relationships [18], poor student guidance/support [23], volume of information [18,23], finances [23], uncertainty of the future [15], lack of time to oneself [18], time and responsibility [23], and the need to succeed.”
Thankfully, support and awareness for these conditions among doctors and students are increasing. Due to COVID-19, the experiences of healthcare workers in totality were shown, and as a result, organizations such as the CDC started to help. Specific hotlines, such as the National Awareness for Mental Health (NAMI) hotline and SAMHSA hotline were directed toward many healthcare professionals dealing with mental health.
Behind the screens of our technology, we are unable to see the many mental health issues medical school students and doctors have to deal with. These people are living the lives that many dream of living, however many of them suffer daily. Thankfully, support for these people is increasing and more of them are getting the help they need.
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Thomas, Mary, and Silvia Bigatti. “Perfectionism, Impostor Phenomenon, and Mental Health in Medicine: A Literature Review.” International Journal of Medical Education, vol. 11, 28 Sept. 2020, pp. 201–213, www.ncbi.nlm.nih.gov/pmc/articles/PMC7882132/#:~:text=Perfectionism%20and%20IP%20have%20been,with%20adaptive%20and%20maladaptive%20subtypes.&text=Three%20recognized%20dimensions%20are%20self,%2C%20and%20socially%2Dprescribed%20perfectionism., 10.5116/ijme.5f54.c8f8. Accessed 29 June 2022.
“Imposter Syndrome.” AAMC, 2016, students-residents.aamc.org/medical-student-well-being/imposter-syndrome#:~:text=A%202016%20article%20Imposter%20syndrome,%2C%20emotional%20exhaustion%2C%20and%20depersonalization.. Accessed 29 June 2022.
“Stop Telling Women They Have Imposter Syndrome.” Harvard Business Review, 11 Feb. 2021, hbr.org/2021/02/stop-telling-women-they-have-imposter-syndrome#:~:text=Imposter%20syndrome%20is%20loosely%20defined,they’re%20deserving%20of%20accolades.. Accessed 29 June 2022.
“Many Doctors Suffer from Anxiety and Depression. States Aren’t Helping. - the Boston Globe.” BostonGlobe.com, 2022, www.bostonglobe.com/2022/01/27/opinion/many-doctors-suffer-anxiety-depression-states-arent-helping/. Accessed 29 June 2022.
“Depression in Doctors: A Bitter Pill to Swallow.” South African Family Practice, 2019, www.tandfonline.com/doi/full/10.1080/20786190.2019.1610232. Accessed 29 June 2022.
Hill, Monica R., et al. “In Their Own Words: Stressors Facing Medical Students in the Millennial Generation.” Medical Education Online, vol. 23, no. 1, Jan. 2018, p. 1530558, www.ncbi.nlm.nih.gov/pmc/articles/PMC6179084/, 10.1080/10872981.2018.1530558. Accessed 29 June 2022.
