A remarkable article titled “Why ‘Happy’ Doctors Die by Suicide” was published in August in the blog Ideal Medical Care. The blog’s author, Dr. Pamela Wible, a family medicine practitioner in Eugene, Oregon, writes that…
A remarkable article titled “Why ‘Happy’ Doctors Die by Suicide” was published in August in the blog Ideal Medical Care. The blog’s author, Dr. Pamela Wible, a family medicine practitioner in Eugene, Oregon, writes that physicians have the highest suicide rate of any profession. Wible calls this a “global public health crisis” and attributes this problem to several factors: the trauma doctors deal with daily, exhaustion from long work hours, little sleep and guilt about their errors.
“She also points out that there’s often a big disconnect between how they appear or are expected to appear — happy, confident, well-adjusted — and how they really feel inside, which causes them great anguish and ultimately great despair,” says Alison Ross, a practicing psychologist and adjunct associate professor at City College of New York.
What’s most scary is that many of the reasons for this despair, even among outwardly happy doctors, stem not just from the work they do but from the demands placed on them in modern work environments. Doctoring today is nothing like the Marcus Welby days of the 1970s — more bureaucracy, greater demands on their time, less autonomy. And the same can be said for just about any job you can name. “I know this is just one particular profession, but maybe some aspects of this issue apply to other professions as well,” Ross says.
Modern work life is far more stressful for nearly everyone. “I think people entering the workforce today and those already in it feel much less secure about the jobs they have,” Ross says. “There is no longer the expectation of longevity or loyalty from the higher-ups, even if one is good at their job. With frequent downsizings, mergers and acquisitions, people feel a chronic sense of unsettledness, anxiety and worry about their job.”
According to the American Psychological Association’s 2017 Work and Well-Being Survey, more than a third of working Americans say they experience chronic work stress. This increases the risk of becoming depressed, Ross says, “because there is an underlying sense of helplessness and lack of control about their professional lives. Many people long for a professional home, a place where they feel they belong and have close relationships with the people they work for and with, but often that’s not their experience because their workplace doesn’t engender a sense of safety, fairness, continuity or true collaboration.”
Longer Hours, Loneliness, Lack of Security
People are also working longer hours. A 2014 Gallup Report said that 4 out of 10 Americans work more than 50 hours a week. (In 2003, employed persons worked 7.6 hours on average on the days that they worked, according to the U.S. Bureau of Labor Statistics.) That doesn’t include commuting time and the expectations to continue working after they’ve left the office,in the evenings and on the weekends. This puts work-life balance way out of whack. “One patient recently told me in a session that she was thrilled she was able to see a Broadway play — she was between jobs so had two weeks off — because typically she didn’t feel that she could not respond to her phone for the two hours that a show lasted,” Ross says.
This is especially true for those working at global companies. “They wake up and find [an email or text] from a colleague in another part of the world. It creates a 24/7 workload,” says Dr. Michelle Riba, professor of psychology at the University of Michigan and associate director of the University of Michigan Comprehensive Depression Center. “They feel like they have to keep their phones by their bed and have to respond, or feel anxious if they don’t. Sleep gets compromised.” Insufficient sleep is a risk factor for both depression and anxiety.
The gig economy has left more and more people working from home. While there are many advantages to telecommuting, there are also dangers. “The drawback for some people is the feelings of isolation and loneliness these work situations may cause because the person is working alone, separate and apart from other co-workers,” Ross says. Depending on the company and job, it can also leaves many people without benefits like health insurance. “They have to work more than one job to make ends meet or put things together in a patchwork fashion,” Riba says.
Of course, one person’s stress may be another’s dream job. “There are all kinds of jobs and all kinds of people for whom their jobs are a good fit,” Ross says. But jobs that are more likely to lead to depression, she says, are those that leave workers feeling lonely, isolated or highly stressed. Also, “jobs where workers feel like they are being treated more like widgets than real people might cause them to feel depressed, as opposed to jobs where the person has a supportive professional network and feels appreciated for the work they do,” she says.
Likewise, personalities need to match the work they do. “Some people like being surrounded by others, and others prefer being more on their own. It’s important for people to know themselves and know the kind of work environment that’s most suited for them,” Ross says. It’s also critical to choose the right career path. “In law, many people realize they don’t like that field,” Riba says. “Some kids go to college instead of trade school, where they might be much happier. Many are pushed into something that is not right.”
Work is inevitably stressful, but depression isn’t. If you are feeling overly burdened by work, there are steps you can take to fight back. “I think mental health care is the first step,” Riba says. That includes talk therapy and, if warranted, medication. Talking about it with friends and significant others can also be valuable, she says, as can working with a certified career or life coach. “You can talk about challenges in work and how you can be happier,” Riba says, “It may not be changing jobs but finding a fit better within the company.”
Some people may find comfort in building deeper bonds with co-workers. “I think one of the most important things a person can do is to form close relationships with at least one or two people in the place where they work,” Ross says. “It can make a big difference being able to go to lunch with someone and having a person at work to confide in.” For those who work at home, create boundaries that separate your two lives. “Set up a specific workspace at home, with specific hours, and try not to mix work and home life, so there is a barrier between the two,” Riba says. She also suggests everyone turn off the phone and close email after a certain time of day. “Let everyone know you are doing that. Look to company leadership for support, and hope they understand that,” she says.
And be sure to do all the other things that help fight depression: Eat a balanced diet, be physically active, avoid alcohol and drugs and get adequate sleep.