Burnout and Depression in Healthcare Professionals

This discussion is an important one, and one we believe is not mentioned enough. Healthcare professionals are in a unique position: seen as helpers,yet are in need of help themselves. One doctor in the United States completes suicide each day, the highest of any profession (American Foundation for Suicide Prevention, 2018). Healthcare professionals have high stress jobs, with high demands on performance, and limited time to invest in self-care.

The symptoms of depression must be ongoing for more than 2 weeks, and include low mood or sadness, irritability, difficulty concentrating, low energy or fatigue, disturbances in sleep (insomnia or hypersomnia are common), changes in appetite, feelings of worthlessness or guilt, suicidal ideation, and lack of interest or pleasure in activities that an individual used to enjoy (APA, 2013). The cause of depression is both nature and nurture: our biology and our environment. Things that could trigger or contribute to depression are loss of a loved one (depression is different than grief), life changes, abuse, social isolation, stress, personal conflicts, as well as one’s genetics may put them at higher risk.

Burnout is a type of job stress that affects physical, emotional and mental well-being, when there is a mismatch in one’s reality and desired state. The three main components of burnout are emotional exhaustion, cynicism, and sense of ineffectiveness at work. Signs of burnout may include increased criticism of self and performance, irritability, difficulty focusing, feeling a lack of control at work, limited job satisfaction, feeling overwhelmed, using food alcohol or drugs to cope with the stress of job, changes in appetite in speech, physical symptoms such as headaches or digestive issues. When there is high pressure at work, especially when we take work home with us (literally or figuratively), it becomes difficult to relax and invest in our life outside of work, which contributes to burnout.

Vicarious trauma can also happen in the healthcare profession, when we hear and see traumas that happen to people. A traumatic event is something that overwhelms your ability to cope, makes you feel powerless and makes it difficult to regulate yourself back to homeostasis. Examples could include witnessing a death or near death, telling family about difficult health diagnosis or watching people suffer through these, hearing about abuse (sexual, verbal or physical) or witnessing the after effects of someone who has experienced abuse. These vicarious traumas can be a trigger for past traumas someone has experienced in their own lives. Trauma responses can include feeling hopeless or helpless, hypervigilance, feeling like you can never do enough, inability to empathize or numbing, anger, chronic exhaustion, feeling powerless, guilt, sense of persecution, addictions or minimizing one’s own emotional reaction (Van Dernoot Lipsky & Burke, 2009).

So, what is self-care then? Self-care is an intentional effort to care for ourselves before we care for others. Think of the airplane analogy that you put your own air mask on before putting on the air mask for others. This is preventative medicine, it improves mood and reduces anxiety, can boost self-confidence, and prevents burnout. However, barriers to self-care include time, not believing you’re “worth it,” and feelings of guilt. Self-care includes nurturing ourselves physically, psychologically, emotionally, spiritually, personally, and professionally. This includes getting enough sleep, eating well, doing things we enjoy, exercise, and nurturing personal relationships.

While we all know the impact working in the healthcare setting can have one people, but we still struggle to seek mental health services when we need it. Barriers to seeking mental health care can include the stigma (from co-workers or supervisors, or hearing other professionals judge patients with mental health disorders), amount of time, feeling like you “should be able to handle it,” not wanting to appear weak, not wanting family members to know, fear of impact at work (licensing boards, having to take time off), pessimism about therapeutic process, or not noticing the impact work is having on you.

So, what do we do?

• Talk to your friends! Asking someone if they are thinking about suicide will not make someone attempt, but not asking about it is a problem. Notice if your friends or loved ones are possibly self-medicating, isolating, becoming more angry or irritable, or if you notice changes in mood or behavior.

• Call 911, Psychiatric Emergency Services (734-936-5900) or the suicide hotline (1-800- 273-8255)

• Create spaces within our programs and workplaces for people to debrief and cope with the difficult things we see and hear about

For further reading:

• https://themighty.com/2016/09/self-care-how-to-take-care-of-yourself-when-you-have-depression/

• https://socialwork.simmons.edu/blog/self-care-for-social-service-professionals/

• https://jamanetwork.com/journals/jama/article-abstract/2672635

• http://www.olgaphoenix.com/wp-content/uploads/2015/05/SelfCare-Wheel-Final.pdf

References

• American Foundation for Suicide Prevention. (2018). Healthcare Professional Burnout, Depression and Suicide Prevention. American Foundation for Suicide Prevention.

• American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mentaldisorders (5th edition). Arlington, VA: American Psychiatric Publishing.

• Van Dernoot Lipsky, L. & Burk, C. (2009). Trauma Stewardship.San Francisco, CA: Barrett-Koehler Publishing.

Written by: Jenna Weintraub

Reviewed by: Tiwaloluwa Ajibewa & Cooley, Charmayne