People Won't Reach Out If They Need Something...
...unless you do something first. A call to action for National Physician Suicide Awareness Day
Welcome! I’m Dr. Jillian, a physician leader, mom, and coach who is on a mission to help other high achieving professionals and recovering perfectionists reduce overwhelm, recover from burnout, and learn to live the lives they truly want to be living. As someone who experienced depression as a medical trainee, I’m also a huge advocate for healthcare worker mental health. Today’s post is in honor of National Physician Suicide Awareness Day. As a content warning, it does contain discussion about suicide and depression. If you ever find yourself in crisis, the National Suicide and Crisis Line is available in the US by calling or texting 988 or by going to their website. I understand that this content might not be for everyone, so feel free to skip this one and come back next time for our regularly scheduled posts.
When I was a pediatric critical care medicine fellow, I diagnosed myself with depression.
I had been struggling for months, but it took me a long time to sort out what was going on. After I finally realized, I told a few people and went to find help.
It was incredibly challenging to find the energy to get help. At the time, I didn’t really know where to turn, and I felt like I was moving in slow motion. I don’t think we had an employee assistance program, and I know for certain that we didn’t have a Director of Wellness to turn to. Even my program director seemed to be at a loss.
So, I turned to the internet. I googled something like “depression psychiatrist new patient blue cross Chicago,” scanned the results, and picked an office that was reasonably close to my apartment so that I could get there via public transit. I consider myself “lucky” to have had this experience prior to the pandemic and to have had private insurance so that I was able to access therapy and a psychiatrist relatively easily after finding them.
From then on, I never really spoke about my experience with therapy or treatment except to a few select people. And I certainly never spoke about the passive suicidal thoughts I had been experiencing.
It was incredibly difficult to find time or energy to go to my appointments, and I often attended them after working >20-hour shifts.
I think my stubbornness is what got me through.
But it’s also what kept me from sharing my experience with anyone around me. That and the shame I felt about experiencing depression in the first place.
It would be years after my recovery before I started talking about it.
The first people I started talking about it with were the residents at my hospital.
During “debrief” sessions, I gradually shared a bit about my own experience when the residents talked about how they were struggling. I hadn’t really been intending to talk about myself, but it seemed to be helpful to them.
Over time, the residents began to say that I should share my story more publicly. They said that it was important and that “more people needed to know” because “no one talks about this.”
Although I was still navigating the shame of my experience, I knew they were right.
I started with a piece for the Women in Medicine Summit in 2020 and haven’t looked back.
When I first started speaking publicly about my experience with depression and passive suicidal thoughts, people were incredibly supportive.
No one had an unkind word to say about me. Or, if they did, they were decent enough not to say it to me directly.
Most people who had known me during that time in my life said a version of two things:
“I wish I would’ve known so that I could have helped.”
“I wish you would have told me.”
I know that these people were well meaning, but I will now get on my soapbox to say that these are profoundly unhelpful things to say to someone who has experienced (or is currently experiencing) a difficult thing.
Although these types of statements are generally said by well-meaning people, both of them center the person saying them, not the person who had the difficult experience.
It would be far better just to say: “That must have been difficult for you.”
This allows the person to feel seen instead of feeling like they have to comfort the person they are talking to.
These statements are also problematic because people will not ask you for help unless a few criteria are met:
They are convinced that you won’t judge them.
They feel that you won’t require them to “pay back” the help in the future.
They believe you have the resources to help them.
In my case, it was hard to ask for help before I knew that I was struggling.
And, even after I knew that I needed help, I didn’t believe that people wouldn’t judge me.
I now understand that it is incredibly likely that many of the people around me would’ve been non-judgmental and supportive, but the internal stigma and shame that I felt at the time kept me from believing it. I didn’t see many people around me talking about their struggles, so I believed that it was just me.
Now I know that 1 in 3 medical trainees experiences depressive symptoms, and that the rate of depression is higher in attending physicians than it is in the general population.
It wasn’t just me. And, if you’re experiencing them, it’s not just you.
So… how can you truly help someone who is struggling?
Don’t tell them to reach out to you. Reach out to them first.
So many people have told me that they could tell something was wrong with me but weren’t sure how to talk about it.
Don’t let not knowing what to say keep you from trying. Even saying “it seems like something is different with you lately, are you ok?” is a good place to start.
If the person tells you they’re ok or doesn’t want to talk, don’t push them. But this is a perfect time to let them know that you’re always available to talk if they change their mind.
Know the resources in your workplace (and nationally).
Many workplaces (especially in healthcare) have employee assistance programs that provide therapy.
If you are a leader in your workplace, it is your responsibility to know about these resources and how to access them.
Help the struggling person get help.
Depression takes all of your energy, and this can be a barrier to seeking help. You can help people by offering to help make phone calls, send emails, or schedule appointments.
As an example, I sat on a video call with someone as they filled out their intake paperwork for therapy. We didn’t talk as they did it. But I sat there so they knew they weren’t alone. They were so grateful to have someone there.
Talk about your own struggles and how you get help when you need it.
Normalize and model taking care of your own mental health. I know that speaking about my own experience leads to more people reaching out to me when they are having a hard time.
It’s not my responsibility to “fix” them when they come to me. But I do refer them to the resources in our organization.
We have a leader in our hospital who normalizes going to therapy simply by saying that she is unavailable for certain meeting times because she has an appointment with her therapist. You don’t have to share more than this in order to start making an impact.
400 physicians die by suicide each year. That’s more than one per day.
You can make a difference by starting to follow the tips above and reading more on the National Physician Suicide Awareness Day website. This is how we start to change the culture in our workplaces.
And we can make a difference nationally by joining organizations like the Dr. Lorna Breen Heroes Foundation.
How will you make a difference today?
More people do need to hear this, and need to hear that it's ok to ask for help. What I've noticed is that you're never alone, people are so willing to help. Unfortunately still too many people feel they can't share how they feel or they need to "suck it up" or "toughen up".
Thank you for sharing 🫶 knowing how to reach out and start a conversation to show you are there is helpful. Your work is so important, thank you for being a voice and light to these topics!