'Hi. I am a general practitioner (GP) and I have a recurring mental illness. I’m not alone. Despite a paucity of research addressing mental ill health in health care professionals we know that Doctors are more likely than the general population to suffer burnout, anxiety, depression and addictions. As a group we are shockingly poor at self care. Many Doctors are not registered with a GP and when help is required we are stuck and uncertain where to go next. We are naturally born strivers. We hate to fail. We perceive being mentally ill as somehow not coping with the demands and rigours of the job and as a result we avoid seeking help. The cycle of negativity begins and continues. Meanwhile we turn to maladaptive coping strategies; alcohol, drugs, self medicating.
My story
My own story is of a recurrent psychotic depression which first occurred twenty years ago during the psychiatric phase of my GP training in Scotland. It recurred eight years ago during my first year as a GP Partner in Norfolk and again fifteen months ago when I was actually off sick with a milder depressive illness and burnout following a particularly difficult year at work. I feel I have been particularly lucky. My first hand experience of treatment in the NHS has been on the whole fantastic. The most recent episode of psychosis was diagnosed by an excellent private therapist I was seeing who made a direct referral to the Crisis team in my local area who in turn visited me at home that day. The team consultant visited me at home the next morning and I was given intensive support for the next six weeks. I am now under the care of the Community Mental Health Team and my key worker is an insightful and incredibly helpful Consultant Psychologist. Medication seems to be key for me to get well and remain so but I’ve also been able to access psychological treatment reasonably easily.
Stigma
Successful outcome? Currently for me it is. That’s not to say that over the years I haven’t experienced stigma either from colleagues or self perpetuated. Prior to my last episode I have seen my return to work as “the goal”, my proof that I was better. Once achieved I could put that depression behind me and forget about it. The illness was my failure, my inability to cope. As another episode started to creep in I did my very best to push it away and keep going. I’ve sought solace in a bottle at the end of the day. I’ve experienced shocking behaviour from colleagues which reinforced my internal struggle with failure and acknowledging my illness. I know of colleagues who have experienced similarly harmful behaviour including lapses in confidentiality, lack of support and loss of jobs. When we find ourselves without hope and with nowhere to turn to we are at risk of the ultimate act of desperation.
The stigma surrounding mental health particularly amongst medical professionals has to change. It underpins the reluctance to seek help when it is most appropriate, hinders recovery and a return to wellbeing. It has only been during my last episode of depression that I have learned the value of reaching out to others who are in a similar position. I read blogs, articles and books; as a recommendation do read psychiatrist Linda Gask's excellent book “The other side of silence-a psychiatrist’s memoir of depression” My research was how I found the Doctors’ Support Network.
Things are gradually improving
Accessing help will be easier too. This year sees the national roll out of the NHS GP Health Service. This service which began in London as the Practitioner Health Programme offers free and confidential support to doctors who are unable to access help through the normal channels.
Stigma can be addressed and challenged but this work needs recognition, involvement and reinforcement. We all have to take part. For my part "My name is Susan, I am a senior GP and I have a history of depression".'
This piece was first published on the website GP View.
