Self-Care Crucial for Physicians During Ongoing Pandemic - Physician Burnout on the Rise

When flying, it’s common to hear a flight attendant tell you that, in the event of an emergency, you must put your own oxygen mask on first before you help someone else put on their mask.

Health care professionals should have the same mentality – especially during a global pandemic, according to Penelope P. Ziegler, MD, DFASAM, chair of ASAM’s Physician Health Committee.

“Take care of yourself so you can breathe and then you can offer assistance to someone else,” said Dr. Ziegler, also Medical Director Emerita of Florida Professionals Resource Network.

Prior to 2020, burnout, anxiety and depression were on the rise in the medical profession. Of course, since the coronavirus pandemic started, physicians, nurses, and others in the medical community have endured a new level of physical and mental exhaustion and stress.

As a result, a movement to better protect and care for physicians has emerged. However, Dr. Ziegler suggests that physicians themselves are ultimately responsible for their mental and physical health during these trying times.

“You have to understand that your well-being and your ability to flourish in your own life, professionally and personally, is up to you,” she said. “Nobody in the health care field is going to make that any easier for you. In fact, they’re probably going to make it harder.”

Signs of Burnout

It’s imperative to take action once you experience prolonged periods of burnout, anxiety, or depression as a result of your work, Dr. Ziegler said. Otherwise, its effects could be lasting.

“I have a friend who’s an advanced practice nurse who went to New York and was in the middle of all that stuff in the early part of the pandemic,” she said. “She’s still trying to cope with what amounts to post-traumatic stress disorder (PTSD). It’s almost as if she was in a combat zone. It’s just incredible.”

Dr. Ziegler said there are signs physicians can look for to determine if they, or someone else in the medical field, is experiencing burnout.

In addition to feelings of chronic exhaustion, one sign is a general feeling that what you’re doing isn’t beneficial to anyone. This could include a level of detachment from your work, and a mix of negativism and cynicism.

A second sign of burnout is uncharacteristic angry outbursts.

“You start treating people in a way that goes against your own value system,” she said. “You want to be supportive to the support staff but somehow you’re not doing it. You’re not able to offer the same level of support, compassion, and understanding because you’re having trouble relating to others.”

Another sign of burnout is decreased efficiency and feeling like you could never catch up.

“Things you used to accomplish efficiently now take longer because you’re distracted by feelings of anger, anxiety, and irritation,” she said.

Increased anxiety and depression are red flags too. Anxiety and depression can manifest themselves in various physical symptoms, Dr. Ziegler said, such as headaches, shortness of breath, lightheadedness, and chest pains.

Feelings of hopelessness and passive suicidal thoughts that include wanting to go to sleep and never wake up. And, of course, more explicit suicidal thoughts are the clearest sign that it’s time to talk to someone and get help.

Importantly, another sign is relying on substances to cope. In addition, increasing substance use in the general public, the pandemic has led to an increase in substance use among physicians, she said.

“Nobody knows for sure what the factors are in that increase in substance use disorders, especially opioid disorders during the pandemic, but we do know it's there,” she said.

Take Action

If these signs and symptoms resonate with you, it’s important that you make some changes and take care of yourself.  Dr. Ziegler’s initial advice: Use those vacation days.

“Take more time for yourself,” she said. “Go camping. Get out in nature. Return to enjoyable things that have nothing to do with medicine and try to practice some self-care skills in your day-to-day life. Take up something that helps your mind to tune out all of that stressful stuff.”

These activities could include yoga, meditation, or using your creative side via art, music, etc.

She also encourages physicians and others in the medical community to seek counseling or reach out to someone in their faith community to help them through the stress and burnout that is wearing them down and causing them to feel hopeless.

“We need to sell this idea that doctors are human beings,” Dr. Ziegler said. “They’re just as vulnerable and just as much in need of basic human interaction and support as anybody else.”

Dr. Ziegler recommends physicians struggling with burnout, anxiety, depression, and PTSD contact the Physician Support Line, a free, confidential helpline supported by hundreds of licensed psychiatrists who have volunteered their time. The helpline, which can be reached by calling 1 (888) 409-0141, is open to US-based DO/MD and their international equivalents at the attending, fellow, resident, intern, medical student or research level. You don’t have to currently be practicing medicine to speak with one of their volunteer psychiatrists.

Whatever you may be going through, Dr. Ziegler said she hopes you’ll take a few minutes to invest in yourself, your health, and your emotional well-being. It’s not just indulging in yourself.

“This has to be something that you do for yourself and that you prioritize,” she said. “And you know what? You’re worth it.”

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