The Sad Doctor - Depression

I’m a psychiatrist with a history of depression.

After a number of stressful life events, including residency training itself, I developed symptoms of major depression. This progressed to having a well thought out and lethal plan of suicide, which I am thankful to have recognized as a sign that something was very, very wrong. A brief and surreal admission to a psychiatric unit resulted in medication adjustments and more hope. 

We have come a long way in reducing the public’s perception of mental illness and stigma, and while there are miles to go, we don’t seem to extend that same compassion to our peers in medicine. Thankfully, the current generation of medical students is far more apt to engage in open dialogue about this issue and ensure self-care is a priority, but change is slow.

Medicine tends to attract people who are driven, perfectionistic, independent, and proud. These qualities are extremely helpful, and arguably necessary, but they are the very same qualities that result in us getting in our own way if we find ourselves unwell and in need of treatment. 

Identifying what “fills your cup” is important, as is maintaining healthy coping strategies. I love binging a good Netflix show, spending time with my family, online shopping, listening to podcasts, and playing zombie apocalypse video games. Beyond individual coping strategies, however, is the sometimes toxic and dysfunctional system we train and practice in. It should not get off scot-free.  

Dr. Pamela Wible is an American physician who devotes herself to the prevention physician suicide. She has said one of my favourite things about the issue of physician illness and the driving systemic factors: “Nobody says to them, “You’re working inhumane hours” or “This sleep deprivation you’ve been dealing with for seven years is dangerous.” Nobody says that. It’s not going to be meditation or yoga that solves this. If you’re in the coal mine and your canary dies, you don’t take deep breaths and do resiliency modules online. You get out of the coal mine.”

We need to look after each other. We need to speak up. We need to address what maintains illness and what may prevent our peers from seeking help. 

-Michelle Marlborough, MD, FRCPC