Many doctors suffer silently with physician PTSD—occupationally-induced or exacerbated by work.
As doctors, we often minimize our trauma exposure by labeling it with less-stigmatized conditions like OCD, stress, or burnout.
While doctors who are compulsively obsessive and attentive to details are celebrated for being comprehensive and thorough, doctors with PTSD may be considered impaired by hospitals or licensing boards.
Physicians often hide their PTSD—even from themselves.
As doctors we are supposed to fix problems—so it’s challenging to admit a problem we can’t seem to fix. Plus employers and medical boards may punish us for a diagnosis of physician PTSD.
I’m Dr. Pamela Wible and I’ve been running a free doctor suicide helpline since 2012. I’ve also compiled a registry of doctor suicides (1,710 suicides as of 9/2022).
Anesthesiology, surgery, and emergency medicine are the highest-risk specialties for suicide—and PTSD. No surprise that medical professionals develop PTSD given their high exposure to trauma in training and practice.
Vicarious trauma is the emotional impact of exposure to traumatized people. As physicians, we hear trauma histories and witness the pain, fear, and terror our patients have endured.
Most medical trainees and physicians are accustomed to extreme overwork with traumatized patients. When doctors work 60 – 100 hours per week, they compartmentalize trauma so they can keep moving in chronic fight or flight—until they freeze and can’t function any longer.
And it’s not just doctors. Nurse practitioner PTSD and physician assistant PTSD is real—especially for those in emergency departments and operating rooms.
Nurse practitioners and physician assistants have less autonomy and liability (and certainly less toxic and lengthy training) when compared to doctors, yet they have similar trauma exposure in high-risk specialties, leading to PTSD. So to all my NP, PA, EMT peers out there—this is for you too.
Physician PTSD—5 tips to disrupt the cycle
1) Share your secret with someone.
Find someone you trust—a pastor, friend, or therapist. Tell them you think you may be suffering from PTSD. Ask that they keep your conversation confidential. Here’s how to get confidential mental health help for physicians. If you have nobody to tell, you can always contact me.
2) Slow down your breathing.
When traumatized, you may dissociate from your body. As overworked physicians immersed in trauma scenes, we have dysregulated sleep, eating, and bathroom habits. Chronically disconnected from our bodies, we may feel disoriented. Take a break. Go to the bathroom or to a safe space. Notice your shallow breaths. See if you can slow down your respiratory rate while deepening each breath. Count for 3 seconds for each inhale and another 3 on exhale. How slow can you go?
3) Get grounded in your body.
While taking deep breaths, imagine yourself connecting to Mother Earth. Go outside and feel the ground. Find a rock. Hold it in your hand. Learn to meditate. Inhale a relaxing aromatherapy oil like lavender. You can carry a tiny bottle with you to work and use as needed. Recite a short prayer or chant. Google “PTSD grounding techniques” and discover what’s right for you. Experiment.
4) Keep a curiosity journal.
Befriend your trauma by getting curious. Study yourself like a scientist. Write down each time you feel traumatized. Keep a list of inciting events, sounds, words, people. Notice subtle body sensations when you feel triggered. Like helping a patient notice sensations of a migraine prodrome—visual auras, food cravings, neck stiffness, pins and needles on their face or body. What do you feel? What do you think? Keep a list of intrusive thoughts. When you stop running away and start getting curious, your fear will subside. Writing your feelings releases them from your body like draining an emotional abscess. Search for your hidden loculated pockets and open them to avoid ending up in emotional sepsis.
5) Get help decoding your PTSD patterns.
Sometimes we are too embedded in our own patterns to see them objectively. Bring your journal to a professional who can give you feedback and notice themes you may not be able to discern. William Osler said, “A physician who treats himself has a fool for a patient.” So find a wise “puzzle-solver” who can help you see your hidden or shadow self. I’m happy to help or direct you to others with expertise in specific issues underlying your PTSD. If you’d like to join a confidential physicians trauma recovery group, we meet every Sunday on Zoom.
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Wondering if you might have developed residency-induced PTSD? Meet a courageous physician who shares her PTSD story. View full interview here.