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Medicine’s unspoken epidemic

The good news: The medical literature- and more casual medical publications- is replete with discussions of burnout and “well-being”. Somehow over the last decade an epiphany has occurred that physicians aren’t actually the superheroes that we’ve always been assumed to be.

The not so good news: By many accounts, mental health within our profession is still a taboo subject and we’re simply not doing enough. Prior to COVID, plenty of our colleagues were experiencing everything from stress responses to major depression, with or without anxiety, and with a mismanaged pandemic on top of that…well, it’s hard for even the most resilient to be in a good place.

Before I go on, I want to be clear: I am grateful that we’re talking about burnout and wellness, and I am grateful for those who generously and bravely share their stories on those topics. Because of the nature of our work, we tend to bury and minimize and we just push on through because we were trained to “suck it up, buttercup.” And I hear you those of you loud and clear who speak in derisive tones about your employer organizing a yoga class to check with wellness box (note: I personally LOVE yoga and find it helpful, but I also understand it is not everyone’s jam, and if you say the words “hot yoga” to me, I get downright twitchy).

And yet, I’ve become acutely aware that we’re doing ourselves and one another a disservice when we euphemistically talk about wellness and burnout. We need to stop the sugar-coating around mental health and call it what it is.

Wait, what?

We need to call mental health exactly that, and we need to treat the components of it with the same relevance and priority that we do physical health. Think about the things that you do to maintain your physical health…brushing your teeth, wearing sunscreen, taking medication for a chronic health condition, washing your hands. Those things are all “normal” in day-to-day life, and the last time I checked we had no stigma attached to any of those things- quite the opposite, in fact, since I will definitely judge you for NOT washing your hands!

In contrast, how routinely do we incorporate things that support our mental health into our day-to-day lives? And how often do we feel guilty when we do? We convince ourselves that it’s a luxury and a form of privilege to rest, to say no, to check in with ourselves (or someone we care about) to see if we are REALLY okay.

Then, of course, within medicine there’s the issue of licensing and credentialing and how much more complicated they can become in many places if you’ve had formal treatment for a mental health disorder. We don’t challenge someone’s medical competence for a history hypertension or asthma, but institutions and organizations can make it hard(er) if you’ve got depression or anxiety. When untreated mental health issues have been shown to impact how clinicians are able to function, it only seems logical to me that we would WANT to have people ask for help when they need it. Lives, and not just their own, may depend upon it.

We need to check on each other. We need to check on ourselves. We need to advocate for not just wellness, but for mental health and all that comes with that.

And remember…it’s okay to not be okay. It’s okay to ask for help. It’s not okay to do nothing about it.