Can anxiety be severe enough to cause a physician to leave medicine? Absolutely. I know a number of physicians who have left for this reason. In my coaching practice I am increasingly aware of the toll anxiety takes on many doctors and am making it my mission to bring more attention to this problem and to find solutions. The physicians I have talked to are just the tip of the iceberg in terms of those “suffering in silence” from anxiety.
For this blog, I interviewed one of my clients who agreed to discuss her difficulties with anxiety. Identifying details, including her name, have been changed to protect her privacy.
Background: “Dr. Susan” had done very well in her training and had practiced a number of years as a well-respected surgeon when she developed a problem with anxiety. When she first contacted me she had stopped working because of the anxiety and was inquiring about non-clinical options.
Q: When did anxiety become a problem for you as a surgeon?
Dr. Susan: After about 10 years in practice, I had a panic attack and I worried that this would happen again. It probably wasn’t a true panic attack, but I was doing a long surgical case and I had a fever and I was afraid I would pass out. I got dizzy and had to step away and this was truly a first for me. My partner finished the case for me. The next time I was doing a surgery and the patient was awake, which made it worse, and I got dizzy again. I didn’t sit down but somehow managed to get through the procedure. After that I was really anxious about it happening again. I started to worry about what I would do if it happened again, what would I say if the patient was awake. The fear permeated everything. I would worry about it at home. I would think I didn’t want to go to work for fear of it happening again. I began imagining all sorts of different things that could go wrong.
After this I was plagued by the “What if’s?”
“What if I have Ménière’s disease or Multiple Sclerosis?”
“What if this happens again?”
“What if my hand jerks and the patient notices?”
“What if I am not able to do my job as well as I should?”
Q: Did you talk to anyone about your anxiety or seek help?
Dr. Susan: I talked to my husband, but I didn’t want to consult a psychiatrist. There were several reasons. I thought it would go away or I would be able to handle it. Sum it up to pride. I felt like I should figure it out. I didn’t have time. I didn’t know if anyone could help. I also worried that seeking help might present a stigma against me, or that they would just want to put me on medication, and I didn’t want to do that. I didn’t want this to be in my (medical) history.
Q: How did you try and cope with your situation on your own?
Dr. Susan: Every day I would have to talk myself through work – “It will be fine, nothing bad will happen, you’re fine, you’ll get through the day.” I’d have these conversations with myself. I tried to exercise in the morning, but it didn’t help. I went to a Vitamin Cottage and looked at some herbal remedies like Valerian. I thought about St. John’s Wort, but I was afraid these might have some bad side effect and I didn’t take them.
Q: What was the state you were in when you contacted me for coaching?
Dr. Susan: I had stopped working and had decided I was not going to work clinically anymore. I was happy as I didn’t have the stress anymore, but I didn’t want to leave on a down point. Really, I didn’t feel very good about this. I wanted to be able to work this out. If I was going to leave medicine, I wanted to do it on my terms, not because the anxiety was forcing me to quit.
Q: When you quit work, did anyone know your reasons for leaving?
Dr. Susan: Only my husband. No one knew what was really going on. It was an internal battle.
Q: How was the anxiety affecting your home life?
Dr. Susan: Even at home I was preoccupied with anxiety – at least 50% of the time. It was hard for me to be present with the kids. We’d be doing fun activities but it was hard for me to enjoy myself.
Q: How was your stress level during residency?
Dr. Susan: I liked learning new things and the challenges of complicated surgeries. The stress felt normal; it was a part of learning and I thrived on it. But once I learned to do my cases, it seemed like I was adding to my own stress with the worry – like I needed a certain amount of adrenalin.
Q: Had you considered a nonclinical career as a way out?
Dr. Susan: I did consider some other type of work, but I would only be briefly interested in it. I didn’t see anything where it would be much more than getting paycheck.
Q: How were you able to turn your anxiety around and start working again?
Dr. Susan: I took some time off. This helped me to have a break and figure out what is important to me. I was lucky to be able to take a break. You talked to me. It was really helpful to know that I was not the only person dealing with this kind of thing; that I was not abnormal and I was not alone. That took a big weight off. It was also helpful to know about my personality type and that this type tends to have more trouble with anxiety. I read a lot on the power of positive thinking and books dealing with anxiety. It helped me to see that there were all these books dealing with anxiety – I realized there must be a lot of people who have this problem.
Q: You were able to make a change in your situation rather quickly. What else did you do to lessen the anxiety?
Dr. Susan: I also went through in my head several questions— “Are you going to try your best? Of course. Is your best good enough? Of course. Even when you felt anxious on the inside, did the surgery still go well or were there any problems? Everything was fine.” Then I would usually tell myself to quit making a big deal out of nothing and move on and learned to ignore it. I would repeat the saying, ‘”Keep Calm and Carry On,” a lot. I am still working on the ignoring part but it is better not to dwell on it and just simply think of something else.
I would tell myself that all I can do is do my best and I had to get over expecting myself to perfect and know that if something came up I would figure out how to handle it. I needed to give myself some credit for the person who got through all that training and know there’s a reason you go through all the training. It becomes part of who you are and it is OK to rely on it.
Q: How are things for you now that you are working as a surgeon again?
Dr. Susan: I am doing less elective and more urgent or emergent surgery, the patients are more acutely sick and have more medical problems in general. I feel much better. When I am driving to work I am always a bit nervous, but when I leave I am feeling – “Oh that was rewarding.” I can actually do this and enjoy it. I tell myself I am going to try my best and my best has always been good enough. Every time I get a little better. I sleep at night. Before I wouldn’t sleep well at all.
Q: On a scale of 0 -10 what level was the anxiety level at before and what is it now?
Dr. Susan: Before the anxiety was an 8/10. Now it is a 3/10.
Q: What advice would you give to other doctors who are struggling with anxiety?
Dr. Susan: I would tell them that this is a common problem and not to let it get to the point where it becomes a run-away train. Some amount of nervousness is normal. Give up some of your control and perfectionism. Every day is different; you can’t control everything and be perfect all the time. You can only do your best and let that be good enough.
Please feel free to comment on this interview as I will be posting replies from “Dr. Susan.” In an upcoming blog I will be offering some different resources for dealing with anxiety.
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Many congrats for taming the anxiety beast!!! I also suffer from an anxiety disorder, so I know it can be absolutely debilitating! What an amazing comeback- Well done!
Thank you very much for your enthusiastic support Danielle. It is so helpful for anyone facing a challenge to know that they are not alone. Good luck to you with your own anxiety critter, may it shrink in the light of truth.
Thanks for your blog, and the work you do! Very nice interview, and I’m glad you helped this physician move through her difficulties. But I’m sad that she didn’t feel comfortable also working with a psychiatrist or psychotherapist. Pharmaceuticals are not the only ways to deal with anxiety . . . . and there are excellent psychotherapies that help also.
Thank you very much for your kind comment Pam. You are absolutely right that there are different ways besides or in addition to medications that are helpful in anxiety. I know of a good number of physicians who have benefited from seeing a psychiatrist or therapist. It is true though, that there is still a fair amount of fear related to potential difficulties with licensure if a physician is known to have sought psychiatric help. It would be great if there were a way for doctors to know that they can seek the help they need without having to worry about possible adverse repercussions, whether from the board or others. And this is said with the understanding that there are circumstances where it is appropriate for boards to take action, but I am not referring to that here. Another element that would be useful as well is for hospitals and physician groups to have a wellness program where physicians could obtain confidential referrals for psychiatrist or counselor, as a major roadblock to getting help is often just not knowing whom to call and being reluctant to ask a friend or colleague for a recommendation.
Great work! What I particularly love, Susan, about what you expressed, was the courage & permission to stop and take a look at what was going on for you. Thank you for sharing! Many people, especially Healthcare Professionals, suffer in silence. As we know from our science background, undesirable things grow in dark places. Putting them in the light is the first and most pivotal step to create change and regaining resonant, effective control. I also like how you redirected your focus to what does matter to you and to what is rewarding for you. Your courage and vulnerability is an inspiration to others! Thank you again!
Thank you Kristen for your heartfelt response for Susan. It really is true that there is a lot of “suffering in silence” – way more than anyone knows. Anytime someone speaks out though, it helps others to not feel alone and see that there is a way out. Thanks again for your support.
I am a doctor from Brazil and I am having this problem right now. I am thinking about quiting medicine everyday. I am struggling with the idea of seeking help. I now feel overwhelmed.
Natalia, I am really sorry to hear you are struggling with anxiety in your practice of medicine and are reluctant to seek help. What you are experiencing is not uncommon. It often happens to excellent physicians who no one would suspect are having problems. It is very important to find help for yourself. Often even one conversation with someone who understands this problem can start turning things around for you. I hope you will take some steps ASAP to talk to someone you can trust and find your way through this. Please me know if there is anything I can do for you. Heather
Thank you so much for this post. I am also a surgeon who struggles with anxiety. Like “Susan” I developed anxiety later in life. What helped me become successful (being self-critical and a perfectionist with high expectations) later became the source of my problems. I also had an opportunity to take time off and used a physician coach to help me manage my anxiety. (I’d like to add that I did see a psychotherapist and a psychiatrist but did not receive the help I was looking for/needed until I met my physician coach.) Though I’d like to say I’m doing great (probably 200x better than before), I still deal with a 2/10 baseline level of anxiety. I tell myself that if I was a patient, I would certainly want a physician who is a perfectionist. But I would want her to be able to sleep at night too!
Unlike Susan, I did discuss my situation with my boss who was not the most supportive, and there were ramifications from my disclosure. It is awful not being able to openly seek help, but given the culture of our profession, I would use caution when disclosing your situation.
Marina, your story is very helpful to hear. Thank you very much for sharing your experience. I know there are a good number of other physicians/surgeons out there who are struggling with anxiety and feeling like they are the only ones. Good for you for seeking help and finding a physician coach who was a good fit and who made a positive difference. It is unfortunate your boss was not very supportive. It takes courage to discuss these kinds of things with our collegues and it would be nice to think we could be helpful to each other. Thank you again for responding to this post with your encouraging story. I wish continued success and peace of mind. Heather
Thank you for this very insightful post. This is my situation – I have struggled with anxiety/depression since my fourth year of medical school. I’ve intermittently taken time off to try and get a hold of it. It only ever seems to diminish when I’m away from medicine. Every medical professional that I’ve ever had the courage to confide in has recounted me with situations where they experienced stressful situations but overcame them. I can’t seem to get it across that my stress is constantly 1000% of what I feel able to manage and it absolutely rules my life; I don’t go out, I don’t socialise and I feel on the verge of a mental breakdown constantly. I can’t even watch medical themed programmes on TV because I find them stressful! It’s ridiculous and makes me feel pathetic and weak because I know I’m capable of more and this just isn’t me. Every single moment of my life (I even dream about it) is spent obsessing about work. I’ve tried counselling and 4 different SSRI medications but none of them helped, and now I’ve been referred to psychotherapy but have to wait 6 months for the appointment. I really cannot see a future for myself in clinical medicine. Whenever I attempt to discuss this with family there’s a lot of expectation, shame (my father “doesn’t believe in mental health problems”) and disappointment (I was the first family member to go to university, let alone medical school and it cost a lot of money) and the ultimate question is “yes, but what else would you do?” or “yes, but nobody actually enjoys their job.” I’m curious, in your article you said that Dr Susan initially sought your expertise to discuss possible non-clinical career options. Are there any? I’m 3 years post-graduation and UK based. I’ve done a lot of research and I can’t seem to find an obvious transition career for somebody so early in their career. Thanks for any help. BD x
Hello BD, I am very sorry to hear how much you have been struggling and how unsupported you feel. You are suffering very much and I agree that help is of the utmost importance. From what you wrote, it seems like medicine may not be a good direction for you and it is unfortunate that your family is not able to listen to you without judgement and try to understand what you are going through. It is not unusual for medical students to do OK with taking care of patients at first, but when the responsibility becomes more of their own, in residency and in private practice or academia, the anxiety can become a huge problem. In a significant number of cases, doctors can work through this problem, but for some, and perhaps for you, medicine is just not a good fit. The uncertainty and what if’s are too much. There is a website in the UK for assistance with non-clinical careers. The last conference they posted was 2014, so I am not sure how active the organization is, but it is based in London and may be of help to you. Here is the link: http://medicalsuccess.net/. Please do take care of yourself and do what is right for you. Keep in touch and let us know how you are doing.
[…] This post was originally published at DoctorsCrossing.com. […]
Heather,
I too am struggling and don’t know where to start. I am in my first year of Urology residency so general surgery and having no history of any type of anxiety what so ever. In fact my friends have always commented on how cool calm and collected I am. However over the past months anxiety has taken over most of my thoughts. I have become more reclusive having been very social in the past and I fear for my future career. My biggest problem seems to be performance. I am very comfortable taking care of patients but having to get up in front of crowds for presentations and even sometimes during surgery I find myself dizzy, naisseus and the verge of vomiting. It is becoming too much me for me to handle, and unfortunately I have attempted to seek help but discovered my concerns will not be so well understood by my superiors. I have a wife and 2 young kids at home and my every worry is to take care of them and I just don’t see myself being able to take time off or pay for therapy as are already struggling to make ends meat on a resident salary. I would accept any advice and appreciate the help. I also really enjoyed how you helped “Susan” above and found it inspiring. Unfortunately I have tried many of the things that she did and they don’t seem to be getting a hold of my anxiety. And I am starting to fear my thoughts of failure.
Hello Braedon,
I am so sorry to hear about your struggles with anxiety. It sounds very challenging. You are right to reach out for help. Once anxiety gets a hold of you it can make it hard to even think straight, but often it can be helped so don’t give up hope. Please contact me at heatherfork@gmail.com and I’ll see what I can do for you. Heather
I am so happy to have found this post. As a future MD (I hope), I will be faced with so many stresses. I’m currently doing a Post-Bacc, taking all medical school classes. This program will essentially make or break my application depending on how well I do so there is a ton of weight on my shoulders here. I have done far better than expected but at a cost. I had so much stress build up throughout my first semester, thinking about how I might do so poorly and that would be the end of the line for me in pursuing medicine. I experienced my first episode of anxiety within the first 2 weeks and it was the most morbid feeling. I had never felt the way I did, a rapid heart rate, cloudy feeling, flushed feeling in my chest, uneasiness, some difficult breathing–This was all at its worst. It lasted for a week each time but somehow managed to get through the struggle. Anyhow, It has been almost 2 months since my last episode and this time I think I know what went wrong. It has become a nuisance, the anxiety, and no method has helped but only to let it pass and relax as much as possible. Anyhow, I am glad to see that I am not alone, especially in a forum such as this one because I plan on becoming a physician and I don’t quite know what I will be facing but I know it wont be easy. I hope that I can develop good coping skills from here on out.
Thanks for this insightful article/interview. As a family member of a doctor it has been very hard to get through to her as a non-physician. Pleased to see a physician-physican type of resource. My sister is an Emerg doctor and many of these stories sound like her. But then she had a child. After a series of highs and lows and the quick return to work, her anxiety has gotten the best of her. She has had to leave work now due to her GP and husband’s request. Her anxiety is no longer about work but about her child’s development. She is living in guilt surrounding unreasonable/impossible ways she has affected her child’s development but has rationalized them through medical theory and our family and her husband can’t say anything to convince her her child is just fine. She has agreed to see someone but doesn’t seem to think it will do anything. Her mind isn’t open and she lives convinced it’s her child not her that is the main issue. Has anyone heard of parent doctors going through something like this? It’s likely a mix of post partum on top of everything else but it’s been a real challenge to find the right kind of resources for her. Thanks for any advice.
Hello Chelsea, thank you very much for reading on my site and taking the time to share about the situation with your sister and her anxiety. I really feel for what all of you are going through. It is not uncommon for anxiety to transfer from work to one’s children. And it can be difficult when we are the one feeling the anxiety to have an accurate sense of where it is coming from and how it is affecting those around us. While I have not spoken with someone who is going through exactly what you describe in your sister, the overall picture is familiar. I’ve seen a lot of good results when physicians do get help for anxiety. This can be from a counselor/psychologist, psychiatrist, or other professional accustomed to working in this area. I know you are dealing with her not being highly motivated to see someone, but the fact that she is willing, is a start. If you have not found someone yet, I might first consider a counselor who specialized in anxiety and has a fair amount of experience with physicians. It would be good if your sister can perhaps be presented with some options and have the mindset that it would good to interview a few different counselors/therapists so she can find the best fit. I’m wishing you and your sister and family all the best. Please feel free to update as and let us know what else we can do for you. Take good care of yourself too. Heather
Speaking as someone who is not a med professional but another professional who has suffered long term with mdd and anxiety and wasn’t diagnosed until the middle of my first full time job coupled with a family history of depression and my family member not recognising and not wanting to do anything about their diagnosed depression. I have decided my profession isn’t good for me as I also suffer from social anxiety disorder and my family don’t understand and even mock me for it and it’s not recognised as a condition in my family and it’s off limits for talking to some members about it, the other one I get is oh you don’t look like someone who suffers from it. I’m a chalky/teacher by profession. I’ve gone back to teaching full time under duress from my family, I still can’t handle the thought of a class full of children I do however have small classes, a very supportive understanding boss, the school nurse is a legend and very suiportive. I’ve decided that I will only work part time and complete my studies in psychology, I had doubts about teaching when I was at university but was told I had to complete uni and get a job, this after having worked as much as I could at uni I was also the first member of my family to got to uni and the first to complete a tafe course as well as Uni. The other comments I get is geez you hide it well! The reality is we now know I was probably like this from a young age and it’s hereditary! It explains a lot of my behaviours when I was younger and a secondary school and uni. It also proves I’m a good actress! Many people believe it will never happen to them or indeed anyone they know, they see someone who is looking like they’ve got life sorted and are starting to get themselves together the reality is VERY DIFFERENT! People only see what they want to see, I was in denial I had. A problem and didn’t know I had a problem as it was normal for me I knew no different, no one even thought about my problems or me being different. Having said that my mum made me go and seek help as it was way out of control. I was also on my own 300kilometres away from family or friends, the upshot is after not going to a dr for about 10yrs I have a fabulous GP and gained valuable work friends and now know I can cope with anything on my own! The medications weren’t the first thing I wanted indeed I refused until mum yet again intervened and made me get them other wise we’d both be in a psych ward, fortunantly that didn’t happen and the tablets are great and life is much much better, whilst my family still don’t understand I do have fantastic friends and GP and psychiatrist and psychologist who help. It does get better it’s a case of knowing when not to flog a dead horse! I know teaching isn’t for me it’s a means to an ends, I’m doing things such as extra study to get into a career I hope I’ll enjoy and if not I still have a back up career while I decide my next move relief/supply teachers are often needed and it’s flexible too, the hardest part is saying no to work I was brought up to work hard all the time, I’ve learnt to say no more though especially if I’m not feeling mentally or physically well. Yes there’s a lot of stigma in Australia and in teaching too so be careful who you tell, I only tell people I know I can trust, because I can be struck off the teaching register if I admit i have a mental illness and then I wouldn’t have a job at all, however I am able to do my job and it doesn’t influence my job or my abilities.Good luck to those struggling it doesn’t get better or easier but you can learn to manage it and have a life too.
Hello Australian Girl! Thank you so much for taking the time to share your heartfelt and inspirational story of coping with anxiety and depression. I like your persevering spirit and candor. You are correct that from the outside, others may have no idea what we are feeling inside or how anxious we might be. Being up in front of a group of kids as a teacher (or chalky – a great term I’d never heard before) sounds pretty challenging to me for someone with social anxiety. You are strong and courageous and seem to be making your way well in the world. I wish you all the best in your studies and goal to find a better fit for your career.
Please feel free to update us on your life! Thank you again.
Thank you for your kind words. I’m fortunate I have 7 pets to confide in the dog, bird and 5 sheep will keep their traps shut but they’re very good listeners without judging! I love studying at uni so am looking forward to starting studies for another year.
Keep up the good work. Have a fabulous weekend.
Take care
I am a surgeon. I have started private practice. During training I thrived. I was confident and used to getting great technical results. Now I’m ultimately responsible for my patients. I recognize the one degree of freedom you have as a trainee masks the responsibility you have as a consultant. I have already had one difficult case and another with persistent symptoms post op despite my best attempts. This is destroying me. I don’t sleep, eat, and constantly thinking I am useless. Throughout training my bosses told me I was the best they had seen. This was good at the time but it is ruining me now as I don’t feel psychologically prepared for the realities of surgery. I work with my most revered mentor, a technical wizard but somewhat of a lone wolf. He expects the best. These last two cases I feel like he’s judging me. He may or may not I don’t know. When I started I swore I would not have a major issue in my first year. I saw those that did and I promised myself it wouldn’t happen. It has. On my second day. On a case I would normally smash. My error or unexpected conditions I’m still not sure. Bit of both probably. My biggest problem is wondering what impression I’ve left on my mentor. He was my inspiration in my surgical field. And supported me immensely during training. But what was a tuboboost getting started is now a yoke around my neck as I seem so pinned to what I think he is thinking. I hate disappointing. I feel very unwell and doubting if I actually have the mental fortitude to continue being an independent surgeon. During training people including bosses would come watch me operate to learn, this is the confidence level I was running at. I’m confused and disoriented with my head space. I feel hit by a train I did not see coming. My titanic is sinking. 3 months ago this seemed impossible as I competed a difficult case in training easily. I’m getting very low. Constant anxiety. No idea what to do.
Hello Rotti, my impression from your comment is that you are a very good surgeon but you are having a crisis in confidence. This is not uncommon during the transition from training to being an attending. It can also happen even when a surgeon has been in practice for years, without any specific complication or incident. I have worked with physicians who struggled with this problem and most can overcome it and regain their confidence. I’d be honored to see how I can help you. Don’t lose heart! Improvement is possible!
My husband left his practice after 20 years. He is 60 and dreamed of going into other non clinical careers. He is severely depressed and and anxious due to the suddenness of his of not having a career. He left his practice for many reasons but now looking back with the knowledge of what is available to him wishes he had stayed. He is seeing a psychiatrist but has not been able to tolerate any of the medications for depression. He currently is taking Ativan for the anxiety. The greatest decision we face right now is whether he should take the only job he has been offered which would require more time than his previous job for less money and also performing procedures that he either hasn’t done or based on data that the procedure will not improve the outcome. He is extremely scared of taking this job and not being able to learn and do things that he never had to do. He can barely concentrate enough to read a portion of the paper, this is a man who read 3 papers a day! I’m concerned that his work performance could be a liability. There are many more details to this story but this is the essential part. He needs to make a decision about this job in the next few days. Thank you! TM
Hello Thea, I am so sorry to hear how your husband is struggling. It doesn’t sound like he is in the best frame of mind to make a decision about a job he is afraid to take, and it seems like it is not a great fit for him, since as you said he is scared to death to take the job, it is longer hours for less pay, he is not comfortable performing the procedures and is concentration is very poor. I hope that whoever is treating his anxiety and depression can help him get to a place where he feels better and can re-evaluate his situation and options with more comfort and peace. I imagine this is very stressful for you too. Let us know if we can do anything for you or him. Heather
He also is very afraid of the stigma associated with depression as a physician. Thanks again.
Many thanks for writing this post Heather. You have described one of the issues I face. Although worked for more than 6 years, gaining experience every posting, my anxiety grew faster. Silent suffering is also true. Only my wife knew what I go through before going to work. End of the day is good most of the time. No one else knew. Days were getting more and more harder.
I had seen a psychiatrist (at this point I didn’t care about what medical boards thought) – helped to make sure decisions I was making were rational. It was good to know it wasn’t depression. Unfortunately meds are no help to me – have been discharged by my psychiatrist after my second visit. Came to a point where I could not work another day – I had taken leave and resign. It was my third hospital excluding internship.
I am unable to pinpoint a cause and “fix it” as there are many possible reasons for this anxiety.
On a break now, and going back home. It’s very scary – I can easily get a job as a physician at home – but I did work there before and I should be able to do better. It’s a 45-55; for a career change and against medicine – but leaving medicine is so hard and other careers don’t exist or are unfeasible. There is so much good I can potentially do if not for this major issue.
You are most welcome Asher. I wrote this blog early on in my coaching work with physicians, and since that time I have worked with hundreds of physicians, some with significant issues with anxiety. I had no idea before I started The Doctor’s Crossing that so many physicians struggle with anxiety. In my experience, it is common for doctors who do very well clinically and have very high standards, to suffer from anxiety. There doesn’t have to be any history of poor patient outcomes, mistakes, or malpractice for one to experience anxiety. I appreciate your taking the time to share your story and feel for all that you have been going through. I am not sure where you are living right now or what your specific options are. But I have definitely worked with doctors who were plagued by anxiety who were able to overcome this problem and find the inner confidence to work and trust in their abilities. I would not give up hope. You sound like a very caring doctor and person. I have seen good results in terms of improving anxiety. Not everyone ends up staying in medicine, but for those who do, overcoming anxiety is often very possible.
Thank you so much for your post Heather. I understand many posts here are by already practicing physicians, However, I am a first year medical student. I have testing anxiety that inhibits me to receive the high scores I need. I also constantly worry about my future even in social gatherings and it prohibits me from relaxing. I have tightening in my chest and even away from studying I start panicking on the inside. I experience a fast heart rate and feel shortness of breath. My appetite has declined. I am afraid to speak to a psychiatrist and have this on my record but I feel if I do not resolve this issue soon I won’t be able to make it through medical school. I have great potential but I feel my mind is creating a block for me to excel.
I read this story because i have my own battle with anxiety as a surgeon. And i realize that i m not the only one in this world facing this problem.
Thank you for this nice article, i think it will support everybody with similar situation.
You are most welcome. Yes, you are absolutely not alone in experiencing anxiety. I speak with excellent physicians on a weekly basis who have varying degrees of anxiety. It turns out that a common personality type which makes someone a great doctor, is also rather prone to anxiety. Anxiety can arise when a physician makes the transition from a resident to an attending, but it can also happen later on, even when everything has been going well. The good news is that in a vast majority of cases, the anxiety can be significantly improved without medication and in a relatively short period of time.
I am a fourth year ob resident and they are just now talking about holding me back from graduation because of my surgical skills. I definitely have performance anxiety in the OR but not in other situations. I am fine getting up and talking, and tend to be a very academic person. I am also very introverted, not the best personality for the OR…. i am just stuggling with what to do to get better at my surgical skills, it is a vicous cycle of anxiety making me perform worse than i know I could do, and then not performing as well the next time bc i didnt do well the last time. I have had a few bad outcomes in surgery(2 cystotomies getting in anteriorly on vag hyss, 1 ureteral injury), but i know we will all have bd outcomes and try to overcome that. The bad outcomes i did have were with an attending who herself was new and slightly nervous, and that made me more nervous. I have tried meds but zoloft and escitalopram have both made my migraines worse. Also trying talk therapy which really helps, but in residency and as a new mom i barely have time for those appointments as regularly as i would like.
Thanks for the blog. I have always wanted to become a surgeon. But since I frequently have panic attacks, I wasn’t sure I was capable enough to pursue surgery. I used to be really scared and I thought that I should give up my dream. But after reading about Dr. Susan, I believe that I will be able to cope with the stress and that I shouldn’t give up my dream.
I am so happy Ruth, that Dr. Susan’s story has helped you feel more confident about pursuing your dream of becoming a surgeon! This makes my day. I do talk with a good number of doctors who face challenges with anxiety, both surgeons and non-surgeons, and there is a lot that can be done in working with the mind to lessen the anxiety and be able to do the work that brings you joy and meaning! Thank you very much for your message. Please feel free to keep us posted and all the best to you!
Hello and thank you for this blog. I am reading this at a time when my anxiety has been triggered yet again and I needed to feel less alone. I’m a medical oncologist and unlike most surgeons here, watching patients die is a daily occurance for me. I’m only in my second of year of practice and the first year was absolutely terrible, where I was crippled with anxiety all day, constantly tachycardic and nauseated, mostly because of what I guess is considered imposter syndrome. As I got more comfortable with practice, things got better but it still hits me on days like today, usually when my patients are younger and I somehow identify with them more than my older patients. I’m 36 so the young ones my age feel like me or my brother and the ones in their 50-60s feel like my parents and I just get devastated when something goes wrong with them. The feeling of respoaibility becomes crushingly overwhelming. I love all my patients but perhaps a bit too much and I carry their stresses with me and to have 300 patients at any given time with cancer and 50 who are actively dying, is just too much. I love my job sooo much, I could never do anything else but I can’t be this anxious all the time either. I’m thinking of seeing a psychologist but I live in a small town with a small medical community and I don’t want it to get out that the fancy new oncologist everyone was excited about can’t handle stress and cries every day in her office.
Hello Doctor! Thank you so very much for reaching out and taking the time to let me know what is going on. You sound like a lovely person and an excellent physician. I can tell you really do love your patients! But you should not have to suffer like this to care for them and do this work you have trained so long and hard for. Please know that anxiety is very common for doctors, especially those first few years out of residency or fellowship. I speak with physicians routinely who are experiencing anxiety and the good news is in most cases it can be turned around! You don’t need to be suffering. I’m happy to see how I can be of help.
I just tried to email you but your email address bounced back. Please feel free to directly email me at heatherfork@gmail.com
Heather
I am asurgeon .I feel constant regret in going into it . I have constant performance anxiety and suffer from insomnia, panic attacks . My mind is constantly on my work and I went through a bad couple of years with depression and i couldn’t go through with my fellowship. Medications made my anxiety worse so i stopped them . Unfortunately in my country i can’t just switch onto another specialty. Im looking into pure teaching positions as that was the only thing i liked doing. But the shame,guilt and pressure to do further training is stilll there…
Hi Jaina, thanks so much for reaching out. I really feel for this situation you’re in. It is incredibly hard to be a surgeon and have all of this anxiety. I am really hoping you are able to make some changes and secure a teaching position or something else where you can have peace and enjoy what you are doing. In case they might be helpful for you, I am linking to two podcasts related to physician anxiety. Please keep us posted on how you are doing. I will be thinking of you!! Take good care of yourself. You do not need to be suffering like this. Do what you need to do to enjoy your work. It’s not your fault you are feeling this way. This can happen to anyone. Heather
https://doctorscrossing.com/63/
https://doctorscrossing.com/61/
Hi Jaina, thanks so much for reaching out. I really feel for this situation you’re in. It is incredibly hard to be a surgeon and have all of this anxiety. I am really hoping you are able to make some changes and secure a teaching position or something else where you can have peace and enjoy what you are doing. In case they might be helpful for you, I am linking to two podcasts related to physician anxiety. Please keep us posted on how you are doing. I will be thinking of you!! Take good care of yourself. You do not need to be suffering like this. Do what you need to do to enjoy your work. It’s not your fault you are feeling this way. This can happen to anyone. Heather
https://doctorscrossing.com/63/
https://doctorscrossing.com/61/
Thanks for the post. Im a surgeon .I feel constant regret in going into it . I have constant performance anxiety and suffer from insomnia, panic attacks . My mind is constantly on my work and I went through a bad couple of years with depression and i couldn’t go through with my fellowship. Medications made my anxiety worse so i stopped them . Unfortunately in my country i can’t just switch onto another specialty. Im looking into pure teaching positions as that was the only thing i liked doing. But the shame,guilt and pressure to do further training is stilll there…