EduMed expert contributor: Caroline Myers is a Licensed Master Social Worker who specializes in counseling and advocacy, and works with patients to maximize their mental health and wellness. Read Caroline’s full bio and learn more about the EduMed Experts.
Medical and healthcare professionals make a
difference every day. It’s the LPN who checks your pulse at two in the morning,
the paramedic who bandages your forehead after a fender bender, and the hospice
nurse who cracks the window at night before leaving each of her patient’s rooms.
Their impact is extraordinary, but what often goes unnoticed is that our same
LPN has worked the night shift three months straight, that paramedic just came
from a head-on collision across town, and that hospice nurse lost a long-time
patient just two days earlier.
This emotional labor can take its toll on even the best and most steadfast medical professional. Night shifts, traumatic events, and loss of a patient may be part of the job, but they can also lead to sleeplessness, stress, and other challenges to your mental health and wellbeing. The following guide does NOT replace professional help (this can’t be stressed enough), but it does provide information and resources that nurses, paramedics, and others in the field can use to better understand the health & wellness challenges they may be facing.
The 5 Most Common Mental Health Challenges for Medical Professionals
Mental health challenges don’t
discriminate, whether you work in finance, education, retail, or healthcare.
But given the critical function that medical professionals serve, maximizing
health and wellness (both at work and at home) becomes more important than
ever. Here’s a detailed look at five of the most common health and wellness
challenges that medical and health professionals face – and additional
resources if you need them.
Even if a student never really felt stressed out about assignments or finals while completing undergraduate studies, that doesn’t mean that med school will offer smooth sailing. The demands placed on students, residents, and physicians can increase over time, making it imperative to develop coping skills for – and ways of getting out from under – extreme stress. If left untreated, stress can negatively impact concentration, memory, and sleep, which can lead to more serious issues such as anxiety, depression, and/or suicidal thoughts.
Statistic #1: According to a study by the Committee on Physician Health and Wellness, 56% of med students, 60% of residents, and 51% of mid-career physicians experienced burnout from their jobs.
Statistic #2: That same
study found that nearly one in four physicians said they were considering
leaving their practice within one to three years due to stress and burnout.
Most people know stress when they feel it, but sometimes it can take a while for them to fully acknowledge it. Anyone experiencing one or more of these issues should consider how and where to get help.
- Burnout: Mental and/or physical exhaustion from trying to keep up with all of their tasks.
- Gastrointestinal issues: Chronic stress can alter the biome in your gut, leaving you susceptible to diarrhea, constipation, shifts in appetite, and even food intolerance. You may also experience nausea and heartburn.
- Word processing problems: Difficulty recalling a particular word or phrase.
- Increased dependence on substances: While it’s normal to have a few drinks during the week or weekend, an increased intake could signal using these substances to handle mounting stress.
In addition to the major signs above, if you find it difficult to sleep, continuously feel fatigued, or catch yourself withdrawing from others, you may be dealing with stress. While some stress is normal, make sure it doesn’t become chronic. If you start to feel consistently overwhelmed, speak with your program administrator or shift supervisor about potential changes to your schedule and/or workload.
of helpful tips and support mechanisms exist to help those in the medical
community alleviate stress and stay healthy while serving others.
Given potential stressors and the prevalence of chaotic schedules, some medical professionals may struggle with getting a good night’s (or day’s) sleep. According to “Sleep Disturbances among Medical Students: A Global Perspective”, published in the Journal of Clinical Sleep Medicine, a strong connection exists between sleep disorders and mental health issues, including mood and anxiety disorders.
Statistic: The study found that 28.2% of surveyed medical students had insomnia, with females expressing more difficulty in staying asleep and males reporting more trouble falling asleep.
Given the spectrum of sleeping disorders, the signs largely depend on individual experiences. Common ones include:
- Continuation issues: Even if you can get to sleep, you may struggle to stay asleep, waking up several times throughout the night, or waking up earlier than they intended.
- Unavoidable movement: Those with restless leg syndrome experience sensations in their legs such as aching, burning, creeping, or throbbing. To get any sense of relief, they must be moved or massaged. This is also a sign you might have anxiety.
- Unexpected sleep: Falling asleep unexpectedly or experiencing extreme exhaustion causes you to feel like you’re never truly rested.
- Irritability: After getting fragmented or limited sleep for an extended period of times, you may feel angry or easily irritated.
While the signs above may seem more annoying than dangerous, sleeping disorders left untreated can cause significant issues – especially for med students, nurses, doctors, and other healthcare professionals. Warning signs of serious issues may include feelings of anxiety or depression, memory issues, or an uptick in mistakes or accidents. Once these warning signs present themselves, individuals must seek the help of a sleep doctor or other professional who can get them on the road to rest.
Getting consistent and ample sleep makes it possible for medical professionals to adequately care for their patients. If your sleep is lacking, check out these four resources.
Those who experience stress, sleeplessness, and other health and wellness challenges may have a hard time getting professional help. It’s saddening yet not surprising when this leads to substance abuse. Use of stimulants such as Adderall and Xanax are particularly common among those fighting to stay alert, focused, and energetic for long hours. While these may help in the short-term, abusing substances long-term comes with serious implications, including not graduating, losing a job, or losing a medical license.
According to Peter Grinspoon, a primary care physician and Harvard Medical School instructor writing in the L.A. Times, substance abuse rates in the general public range from 8-10%, while it’s estimated that up to 15% of physicians may abuse drugs.
Whether substance-related or not, addiction creates distinct signs that, if left unaddressed, can quickly start to cause negative impacts on school and work.
- Inability to focus: Individuals can feel so wrapped up in their urge that they can’t seem to complete simple tasks.
- Poor spending habits: Even if living the life of a poor med student, those with an addiction may empty their bank account to fuel it. For example, cashing a paycheck to purchase drugs or alcohol.
- Inability to quit: Addicts often say they can quit anytime they want to, yet they fail to do so.
- Withdrawals: Those who rely too heavily on substances may face adverse effects when they try to stop using them, such as headaches, nausea, trouble sleeping, or body aches and pains.
- Hangovers: Continual abuse of substances such as alcohol can leave people feeling slow, unable to focus, and with headaches.
If someone begins showing up late to class/work regularly, exhibits signs of a hangover in the morning, or becomes less reliable over time, an addiction may be present. Addicts and their loved ones can check out a number of resources provided by the Substance Abuse and Mental Health Service Administration.
Getting help for addiction is scary enough, but individuals in the medical field can face significant fears about what it means for their licenses and careers. Use these resources to find help and answers to common questions.
The Anxiety and Depression Association of America reports that major depressive disorder affects 6.7% of Americans each year, but those who work in the medical profession exhibit higher rates. Med students and professionals alike face unique pressures, including helping individuals with injuries, illness, and disease. If their own mental health isn’t strong, facing these issues every day can take a toll. If left untreated, depression can manifest into much more serious issues, including suicide.
Published in “Depression in medical students: insights from a longitudinal study,” one medical school found that depression rates for its students ranged from 12.7% and 21.5%, depending on the academic year.
A study published in the Journal of the American Medical Association reported that nearly 30% of all resident physicians either show signs of depression or have received a diagnosis.
Signs of depression vary by individual, and may come and go with the presence of certain triggers. However, the DSM-5 notes that five of the following eight symptoms need to be present during the same two week period, with one of those five being one of the first two below:
- Sad or melancholy mood for a majority of the day and nearly every day.
- Lack of interest, especially in activities or subjects that once brought great joy and happiness.
- Weight loss or decrease in appetite, especially when not dieting or trying to lose weight.
- Loss of energy or overall fatigue on a daily basis.
- Slowed physical movement observable by others.
- Reduced ability to think, concentrate, or remember things.
- People with depression often look down on themselves and feel worthless, or like they are needlessly taking up space and burdening those around them.
- Regular thoughts of death or suicide, with or without a plan.
Depression can be deceptive where individuals don’t even recognize shifts in their own behavior. It’s important to stay vigilant and consider the message your brain sends. If you start feeling worthless or questioning your value, it’s time to seek help. Psychology Today offers a free depression test to help ascertain whether you might be at risk.
Dealing with depression can feel overwhelming on top of other responsibilities, but getting help sooner rather than later can help medical students and professionals learn to cope.
In 2018, suicide rates reached their highest in half a century. Suicidal thoughts often stem from other mental health issues, meaning it can be addressed early if recognized. Doctors, nurses, med students, and other healthcare professionals face intense pressure, making it imperative for this community to receive targeted and ongoing support.
According to the American Medical Student Association, rates of suicide are higher within med school than any other higher education degree program.
WebMD reports that one doctor dies by suicide every day, with this profession showing the highest rates of any other career. Between 28 and 40 doctors per 100,000 die by suicide.
While you might think it’s easy to identify symptoms within someone contemplating suicide, in reality, some can go unnoticed rather easily.
- Extreme mood swings: If someone feels extremely happy and emotionally high one day, and then completely depleted the next day.
- Talking about death: Some people fixate on the idea of suicide and say troublesome things like “I wish I hadn’t been born” or “Everyone would be happier if I wasn’t around.”
- Self-destructive behavior: When someone voices their life has little value and then engages in harmful behavior, such as driving drunk or taking part in unsafe activities.
- Thinking about death: If you find yourself constantly thinking about what it would be like to die – or planning how you would end your own life – this is a very serious symptom. If someone has a plan, they are in crisis and need to go to the nearest emergency room or call the suicide hotline immediately.
- Saying goodbyes: Even if indirectly, individuals who say they might be “going away” or who may try to say goodbyes could be having suicidal thoughts.
If any of the symptoms listed above sound even distinctly familiar, seek help for yourself or the person exhibiting these signs. Call the National Suicide Prevention Lifeline 24/7 at 1-800-273-8255. NSPL also provides info on finding therapy and support groups to get help and find community.
Knowing that suicide disproportionately affects those in the medical industry, it’s vitally important for these individuals to have access to quality information and resources.
19 Practical Ways to Take Charge of Your Mental Wellness
When someone in the medical field recognizes that their mental health may be compromised, seeking a doctor, therapist, or psychiatric specialist should be the first thing they do. Professional treatment and potentially taking medication are the most important steps, but there are a few additional things people can do to develop the essential coping skills.
By talking to others in your program that are experiencing the same pressures and challenges, you build a community of people you can lean on and vice versa. Dealing with mental health can feel isolating, but remember that many people experience the same feelings as you, and it’s helpful to talk about them openly.
It’s no secret that doctors, nurses, and med students can work some pretty tough schedules. If you’ve been working the night shift for a long time and feel like you’ve fallen into a rut, speak to a supervisor about your options. They may be able to change you to split shifts, three days on and three days off, or another configuration that allows you to feel less stuck. Even small changes like scheduling can make a big difference.
The break room vending machine and that fast food drive-thru next to the hospital might be extremely tempting after a long shift, but nutrition has been shown to directly impact mental health. Eating lots of fruits and vegetables, alongside healthy grains and small amounts of protein, can provide the energy you need to get through the day. Consider meal planning or finding a service that delivers pre-made meals throughout the week.
It can be tempting to devote yourself fully to a job and let old interests and hobbies fall by the wayside, but we need these outlets to recharge and reset after stressful days. Consider what makes you happy and pursue it. Examples could include hiking in a local park, playing a video game, or participating in a creative activity such as painting or calligraphy. This not only redirects your brain temporarily; it also gives you something to look forward to every week.
In addition to reducing the risks of arthritis, diabetes, and high blood pressure, the Mayo Clinic notes that exercise can also help improve mental health by encouraging our bodies to release endorphins. Exercise also has been cited as a way to protect your brain against depression. While you don’t necessarily need to train for a half-marathon or do HIIT workouts every morning before work, even taking your pet for morning and evening walks or participating in yoga or Pilates classes twice a week can make a significant difference.
Especially while in medical school, the self-imposed pressure to study all the time may feel overwhelming, but both our bodies and minds need breaks to function at their best. Many extracurricular activities exist that pull students away from their textbooks, help them engage in exercise, and allows them to meet others while taking part in a fun activity. Options include joining a local intramural team such as softball, basketball, or soccer. These usually exist at varied levels to suit the needs of beginners to advanced players.
According to Harvard Health, getting a pet can improve our health in myriad ways. For starters, they require us to be more active. Individuals who take their pets out for walks each day have lower blood pressure and often get to connect with other people while out walking. They also help calm nerves by signaling our bodies to release relaxation hormones while simultaneously turning off a stress hormone. For individuals struggling with depression, they create a reason to get up each morning as they need food and water.
A report by Mental Health America shows how meditation helps reduce stress, depression, anxiety, PTSD, and ADHD. One form, transcendental meditation, has been shown to improve mental health by more than 600 research studies. By taking 10-20 minutes out of your day a couple times per week and engaging in breathing/relaxation techniques, you can set yourself up for a calmer and less stressful week.
Even if your schedule feels jam packed with work and school, taking time out to help others can greatly improve mental health. Information provided by the Mayo Clinic Health System states that volunteering can help decrease the risk of depression, give individuals a sense of purpose, reduce stress levels, and potentially make new friends and contacts in the process. If you feel burnt out, consider finding an opportunity completely unrelated to healthcare, such as helping kids with homework or walking shelter animals.
A survey by Glassdoor found that many Americans use only half of their assigned vacation days, while 66% reported that they did work while on vacation. Taking time to unplug, enjoy beautiful scenery, and see parts of the world that are unfamiliar to you can greatly support mental health. By getting away from the demands and stressors of work and committing to taking time for yourself, you feel more refreshed and able to study and care for patients.
While spending time with your medical cohorts allows for commiseration and closeness, it’s also important to spend time with people outside the medical community. Seeing friends who have known you through different seasons of life helps you feel anchored while also providing a social outlet. Examples of activities may include taking part in happy hours, getting a meal together, starting a book club, taking a group fitness class, or hosting a movie night.
According to the University of Rochester Medical Center, journaling offers numerous benefits in terms of mental health. People who write about their days and their challenges on a regular basis may feel more in control of anxiety and stress. Journaling helps by allowing writers to prioritize issues in their lives, track any ongoing symptoms and how to avoid triggers, and use positive self-talk rather than beating themselves up for issues outside their control.
It’s very common for med students to pull all-nighters when studying, and caffeinated beverages seem to be a normal part of working in healthcare. While caffeine can help learners and workers focus, it can actually worsen the effects of some mental health issues. Individuals with anxiety may feel more on edge after drinking caffeine, while those who they drink to many coffees or soft drinks.
We get it. Scrubbing countertops and sweeping floors is the last thing many medical professionals want to do on their days off. That being said, studies show that people who keep their houses clean are healthier than those who don’t, and this includes mental health. Even if you aren’t going for spotless, consider taking half an hour to wipe down surfaces, fold laundry, and make your bed. Play some enjoyable music while cleaning to create a happy environment.
While the obvious link of cooking at home to mental health is ensuring you eat something nutritious, chopping up veggies, making a big pot of soup, or baking cookies can also contribute to good mental health. Cooking requires individuals to slow down and focus, while also providing time to reflect on your day. Culinary therapy is an emerging area that focuses on treating issues such as anxiety, depression, and addiction. If you’re on a budget, cooking at home also costs less than eating out.
If you struggle to carve out time to meditate, do yoga, or engage in another form of exercise, downloading an app made specifically for addressing mental health may do wonders. Many of these apps are free and provide on-the-go options for relaxing and re-centering. The Anxiety and Depression Association of America provides a list of reviewed mental health apps and rates them based on ease of use, effectiveness, personalization, interaction level, and research evidence.
Even if you do not play an instrument, music provides myriad benefits to those dealing with mental health issues. Time Magazine reported that listening to music can reduce cortisol, improve blood flow, and fight of depression when listened to regularly. Music can also help regulate emotions and even improve memory and attention. Used as a calming agent, listening to music while driving to/from school or work can help set you up for a good day and shift your brain to time off.
Taking time to luxuriate in self-care can go a long way in improving mental health, and spa days offer the perfect venue. Getting regular massages helps decrease levels of cortisol and release tension, while essential oils help decrease symptoms associated with anxiety, depression, and sleep issues. If you cannot afford a full spa day, consider finding a massage therapy school offering discounted rates. Taking a warm bath or shower and using essential oil-infused bath salts can also help release tension.
In the midst of studying complex topics and caring for patients, take time to read something mindless. It could be a fun beach read, graphic novel, of a collection of short, humorous stories. By losing yourself in another person’s narrative, med students and practitioners can step away from the pressures of their own lives – even if only for 20 minutes at a time. If you’re on a budget, consider getting a library card so you can check them out for free. Many libraries also offer free subscriptions to audiobooks if you want to listen while on the go.
Confronting the Stigma of Mental Illness in Healthcare
Admitting that you need help with stress, anxiety, or a more serious mental health challenge can be difficult. The unfortunate stigma that surrounds mental health forces too many people to hide their symptoms by any means necessary.
Further complicating the issue, many state licensing boards require physicians to list any current or past mental health challenges they’ve been diagnosed with and/or treated for. While a violation of the Americans with Disabilities Act, many physicians fear they could lose or not be able to renew their license if any mental health concerns appear on their medical records. Fortunately, some individuals are trying to erase stigmas and create more open dialogue around this health crisis. The University of Michigan’s Health Lab shared an inspiring story about how one medical student is working to end the silence and fight against repercussions.
What Institutions Are Doing to Help
With increased awareness surrounding the challenges that students and practitioners face, it’s vital that schools, hospitals, and other organizations step up to support these individuals as they go about their days caring for others. Access to care is increasing, but it’s far from where it should be. These institutions are leading the charge.
Indiana University School of Medicine. IU provides medical service learning opportunities to get students out of the classroom or study center and ensure they have chances to interact with individuals outside the medical community. The program connects them with service learning programs where they can give back and step away from everyday med school stresses.
University of Wisconsin School of Medicine and Public Health. As part of student services, UW Madison provides counseling, psychiatry, and self-help resources to all learners. Counseling services are free to students, as are strategies to help with anxiety and finding balance between academic requirements and self-care.
University of South Carolina’s Keck School of Medicine. As part of ongoing mental health support services, med students at Keck can take part in Keck Checks, a 15-minute weekly check-in with clinical psychologists to ensure they are prioritizing mental wellness and feel on top of all their responsibilities.
Hospitals / Clinics
Vanderbilt University Medical Center. VUMC provides Health Plus, an innovative program for residents and other full-time staff to make use of a fully-equipped exercise facility, healthy lifestyle programs, health incentives, and health risk assessments to ensure all employees feel their best both while at work and on their days off.
Brigham and Women’s Hospital. Based in Boston, this hospital provides resources to help employees manage their work/life balance in healthy ways. The Employee Assistance Program exist to provide preventative and early intervention services for all employees through consultations, problem solving, and referrals.
The Hospital of Central Connecticut. This facility provides a number of measures to ensure employees and their families remain healthy. Specific examples include flexible work schedules, a child development center for children of employees, tax-free dependent care accounts, fitness centers, health and wellness discounts, and a health promotion program.
Non-profits / Advocacy Organizations
American Medical Association. Recognizing the stigma around doctors and other medical professionals talking about their mental health struggles, the AMA created a new policy that encourages state licensing boards to only ask about current mental health challenges rather than past instances that no longer impair their ability to practice.
American Academy of Family Physicians. The AAFP is working with other partners to combat stigmas surrounding mental health in the medical profession – specifically for practitioners – by creating awareness around this growing concern. The organization created the National Physician Suicide Awareness Day to help educate individuals on the seriousness of the problem.
American Foundation for Suicide Prevention. The AFSP offers a comprehensive guide on healthcare professional burnout, depression, and suicide prevention to help bring awareness to these issues and provide tools for supporting medical professionals before more serious concerns present themselves.
Additional Mental Health Resources for Medical Students & Professionals
Individuals looking for additional help and
resources for reclaiming and maintaining their mental health can review the
following websites for actionable and practical tips. Don’t forget to speak
with your school or hospital/clinic about employee wellness programs, as well.