'Talking about physician health is talking about physician mental health, but we can’t quite bring ourselves to come out with that.  The question is why? 

I am the first to say that our mental health is totally linked to every other aspect of ourselves, that we are whole people – physical, mental & spiritual – by that not meaning religion but our sense of self within the world we live in.  But we still don’t really believe that mental and physical are inextricably linked or that to have a primarily mental condition is on a par with the physical. 

We hide this with our inability to talk about a diagnosed condition that is termed ‘psychiatric’. Of course this is nothing new and, for decades, we have hidden our distress in such ways that are acceptable to others. The term stress is more acceptable than di-stress!  But some of us have braved it and accepted a diagnosis such as depression, anxiety disorder or bipolar……but even amongst psychiatric illness there is a level of acceptability.  Few talk about addiction or personality disorder, let alone schizophrenia. 

But we are also in a vulnerable position because there is an increasing concern that physician health is all about what we can do to prevent ‘burnout’.   We are encouraged to exercise, do mindfulness have a healthy work:life balance etc.  The onus is on the individual to keep themselves healthy.  But if systemic stress and pressure continue unabated it misses the point completely and once again, stigma comes in through the back door.  It is an easy pathway to blame and that is something we need to avoid at all costs. 

I was invited to speak at the Emergency Medicine Continuing Education Forum (EMCEF) in Birmingham on May 8th 2019. I am lucky that I managed to survive severe depression and have been well for over a decade; being able to talk to colleagues in emergency medicine about my experience is a privilege that is not easy to come by.  I want to make this a subject that is interesting and compelling even for those who believe it’s ‘not their thing’ or they ‘don’t get it’.  Stigma is at the heart of it, because let’s face it, if we fail to recognise that there is no such thing as a purely ‘physical’ condition, then we cannot do our jobs well.  ‘So what about a fractured femur?’, some may say.  But our response to any physical insult involves emotion and pain is a brain event as much as sadness or anxiety! 

My talk: ‘what doesn’t kill us makes us stronger’ will, I hope, encourage emergency medicine doctors to seek support, without the worry of being alone or unusual for doing so. (Doctors' Support Network leaflets and information were available at the event. )'

Cathy  tweets about her experiences as doctor and patient, using the handle @cathywield1 and blogs here  She has written two books about her experiences: Life After Darkness: a doctor’s journey through severe depression 2006  and A Thorn In My Mind: mental illness, stigma and the church 2012