Physician training now recognizes awareness of depression

By Cynthia Pegram

Published: June 21, 2008

By Cynthia T. Pegram

(434) 385-5541

T oday, more is known about the tough spots in the road where physicians are likely to encounter stresses that can set the stage for depression.
Physician education looks at the issue, and depression is a lot less likely to appear without warning.
Awareness is factored in at a number of points in training, said Dr. John Schorling, a professor of internal medicine and evaluative sciences at the University of Virginia, who works with students as well as the University’s Employee Assistance Program.
Education includes year-long courses in the first and second years of medical school in which groups of six students meet three hours a week with one faculty member and one non-physician. The course includes discussion time with each student about how things are going.
“We get to know them extremely well. We talk about the issues in patients, about those in physicians as well, about alcohol and drug problems, and stresses,” said Schorling.
The cause of stress changes over the educational experience.
For example, during the first two years of training, students can be overwhelmed with the amount of information for which they’re responsible. The stress doesn’t lease in residency — the causes change. The long hours and demands of patient care can create issues that need to be processed. Symptoms of depression can turn up then.
“Some stress is good,” said Schorling. “Too much leads to burnout.”
Most people who go into medicine have a high degree of altruism, Schorling said.  When they have low feelings of accomplishment or feel that the work they do is not worthwhile, then “that’s the formula for defining burnout.”
Schorling also works with older physicians in the UVa Physician Wellness program.
Depression can occur at any time, particularly in times of transition, “when people are moving into new places and have new roles.”
Some physicians are concerned about stigma and mental illness, he said.
“I think there is a growing awareness that it’s not a sign of weakness — mental health issues can be successfully treated.”
In general, he said, physicians who are experiencing despair or who seek help for whatever reason, “those who really work on what the underlying issues are, often wind up feeling much better after they get into the process than they did before — and are very thankful, even if it means taking time off from work.”
“What I hear all the time is that ‘things were bad. I’m so glad that I did something about it. I feel better than I ever did.’ ”