Depression: When medical professionals are affected

Every fourth doctor in Switzerland feels burnt out. But where is there help for those who usually help? Prof. Edith Holsboer-Trachsler, Extraordinaria for Clinical Stress and Trauma Research, UPK Basel, and President of the Swiss Society for Anxiety and Depression gave an assessment of this problem in conversation.

Ms. Holsboer-Trachsler, the 1st SGAD Public Congress will be held under the motto “Giving a voice to those affected”. How often are medical professionals in Switzerland themselves among those affected?
Edith Holsboer-Trachsler: For most doctors, stress is part of everyday life. Along with teaching, the medical profession is one of the areas of activity with the highest stress levels. However, it is known that chronic exposure to stress can have not only cardiovascular but also psychological consequences. In this occupational field in particular, many stress-associated secondary diseases occur, such as sleep disorders, psychophysical exhaustion, as well as anxiety and depressive disorders. We know from the literature that about one third of physicians suffer from burnout – up to 60 percent have corresponding symptoms. And according to a Geneva study covering the years 2002 to 2007, one in four doctors in Switzerland feels burned out. In addition, a 2005 study by Buddeberg-Fischer showed that depression and anxiety were more common in residents than in the general population.

When medical professionals themselves are affected, how should they ideally act? Where can they turn?
For affected physicians, of course, the same approaches apply as for all other patients: Prevention and specific diagnostics and therapy as early as possible. Prevention in particular is enormously important in this area, where the risk of stress-associated secondary diseases is high. In this context, we can mention mindfulness, self-knowledge or sports. But seeking help and advice at the first signs is also essential for early diagnosis and treatment. Physicians, however, often have a rather particular behavior toward their own health: They are reluctant to seek help, diagnose and treat themselves. In 2004, 35 percent of physicians surveyed in a Bovier study said they had difficulty seeking medical help. Ninety percent of physicians who took a medication in the past week did so by self-medication.

How big is the taboo regarding anxiety and depression in clinics?
Clinics are not significantly different from other work organizations. Again, the same reservations about mental illness often prevail. However, the tendency to diagnose and treat on their own tends to reinforce taboo and stigma. In addition, burnout understandably meets with resistance in a professional circle that is always in the helper role. Many clinics therefore run targeted training programs on stress management and dealing with mental illness, which does much to break down taboos and stigmas.

The interview was conducted by Elke Koch for MedInside.