Psychic toll of coronavirus

While physicians are conditioned to manage pressure from their earliest training, the added stress of COVID-19 is creating a burden that is pushing many past their ability to cope. So much so that AAO CEO David W Parke II MD regularly hears from colleagues who are burned out or depressed, including one who was suicidal, he reported at AAO 2020 Virtual. It’s part of a broader problem in medicine, said Saul Levin MD, CEO and medical director of the American Psychiatric Association. “Our health system was broken before but now it is severely broken.” The pandemic is taking an even greater toll on Black and Latinx minorities who have less access to care in the best of times, Dr Levin added. In addition, people with existing mental illness and substance use disorders tend to do worse in health crises, and the pandemic has been no exception. Dr Levin pointed out that care providers need to look after themselves as well as others – and reach out when they are feeling burned out or depressed. Even taking part in social hour calls at meetings such as the AAO Virtual can help, Dr Levin said. “I was a little bit sceptical but I’ve got to tell you when I do [participate in virtual social gatherings] I leave feeling a lot more uplifted that I am not alone.” WARNING SIGNS Dr Levin recommended that everyone stop and consider who they can reach out to when they are feeling stressed, and pointed out some warning signs to watch for. Consider whether you are just tired or if, when you get up in the morning or get home at night, that you just want to be left alone, or your appetite is gone or unusually strong. “If you hear a colleague – or yourself – say ‘I feel like I can’t go on’, take it as a sign of impending burnout or even depression, which often overlap in symptoms, Dr Levin said. “If you hear even more concerning statements, such as ‘I want to die,’ do not dismiss it as just a sign of exhaustion. This could be an important outreach for help. Make sure he or she knows where to turn for help such as a national suicide hotline. Ensure that other people in the colleague’s home, such as a spouse or family member, know of his or her distress.” Physician suicide is not talked about enough within the medical community and it contributes to stigma and physicians being afraid of seeking help. The COVID pandemic has only made the challenging work of being a physician more stressful. “It takes great courage to ensure your colleague gets help, regardless of commitments made,” but it does help in the end, Dr Levin said.