A little over a year ago I wrote a post called “Scary Stats.”  In it I talked about the high rate of suicide among physicians.  This week those stats hit close to home, as I learned about a fellow student from my school, a fourth year, who committed suicide.

I didn’t know him personally.  Yet, I can’t seem to get him out of my mind.  I keep thinking, What would drive a person who is less than one month away from graduating medical school to kill himself?  He was so close to what we are all working towards – to be doctors.  How could he just give up like that?

The truth is, his death hits close to home, not just because he was a student from my school, but because I can relate to his struggle.  As someone with a personal history of depression, his death breaks my heart.

Suicide is always a tragedy.  But in a young physician, it cuts deep.  Not only did we lose his life – but the lives of all of the patients he could have saved.  So many lives he could have touched.  It’s a big loss for all of us.  And it could have been prevented.

What I’ve learned in the past year of rotations is that mental illness, even in the medical community, has negative connotations.  I’ve had numerous preceptors who have made comments like, “I hate dealing with psych problems,” and I’ve had others who will roll their eyes and sigh every time they read “Depression” or “Bipolar Disorder” among their patient’s problem list.

Physicians – who have trained for years in biochemistry and physiology – who have learned the pathophysiology of depression and other mental illnesses – should be more understanding.  Such a high rate of suicide among fellow physicians should be a wake up call to our profession.  It’s ignorant to think that mental disorders are any different than other health issues.  Depression, just like diabetes and hypertension, has a physiologic explanation, and it kills just like every other disease if left untreated.

Physicians are at least as susceptible to suffering from depression as the general population.  When you couple that with the fact that physicians have longer/more stressful training, work more hours on average, have higher rates of divorce, and have access to lethal drugs – it’s just a recipe for disaster.

Sir William Osler is quoted as saying, “A physician who treats himself has a fool for a physician.”  So to whom does the physician go when he gets sick?  Other physicians.

We have to help each other.  We need to create an environment that is more understanding and accepting of mental illness, especially amongst our own.  If we don’t, mental illness is going to continue to be a major cause of mortality for physicians.

A few months ago I attended a lecture about Depression, specifically for physicians.  After the lecture, a young intern raised his hand and shared his story.  He talked about his own struggle with depression that got really bad after he lost his brother in a car accident.  He recalls riding the elevator one day with a fellow intern who asked how he was – just making small talk – and he broke down crying.  But when his fellow intern supported him and listened to him, he was encouraged.  He got help.  And now he’s doing a lot better.

Who knows what would have happened without that interaction.  If his colleague hadn’t been understanding and supportive, we could’ve lost another young physician.  His story was so inspiring for me, and I think it’s important that people who struggle with mental illness to share their stories.  The biggest problem with depression is that it is often kept secret.  And for physicians, many don’t want to be perceived as being “weak” or “unable to handle things.”

I have read from several sources that rates of depression also appear to be higher during medical training – maybe even as high as 30% – which makes sense because of the long hours, high stress, pressure to perform well on boards, and residency match.

I urge anyone who thinks they might be suffering from depression or suicidal ideation to seek help.  “Suicide is a permanent solution to a temporary problem,” or so the saying goes.  I know that I have classmates who are struggling, and I hope that they know I’m always here if they need me.

Medical school is probably a thousand times harder than I anticipated it would be, and my classmates are really the only ones who know exactly what I’m going through.  I hope we stay in touch.  I hope we can always rely on each other to listen and to understand what we are experiencing.  And I pray that I never lose another colleague to suicide again.