Tuesday, July 18, 2017

How Should Doctors Recognize and Treat their Own Metal Illness



Introduction
Doctors have a higher than average incidence of suicide and alcoholism, and so all doctors must be prepared to face (and try to prevent) these and other health risks in their professional and private lives. A doctor's  skill at looking after himself/herself has never been as good as their skill at looking after others, but when the healer is wounded, is it clear that his ability to help others will be correspondingly reduced.

Indicators of Affected Mental State
If the time comes when a doctor's mental state seriously reduces the ability to work, the doctor must be able to recognize this and take appropriate action. The following may indicate that this point is approaching:
• Drinking alcohol before ward rounds or surgeries.
• The minimizing of every contact with patients, so that the doctor does the bare minimum which will suffice.
• Inability to concentrate on the matter in hand. The thoughts are entirely taken up with the workload ahead.
• Irritability (defined as disagreeing with >1 nurse in 24 hours time period).
• Inability to take time off without feeling guilty.
• Feelings of excessive shame or anger when reviewing past mistakes.
• Emotional exhaustion—for example knowing that you should be feeling pleased or cross with yourself or others, but on consulting your heart you draw a blank.
• Prospective studies suggest that introversion, masochism, and isolation are important risk factors for doctors’ impairment.


Management

  • The first step in countering these unfavourable states of mind is to recognize that one is present.
  • The next step is to confide in someone you trust.
  • Give your mind time to refresh itself.
  • If these steps fail, various psychotherapeutic approaches may be relevant, like cognitive behavioral
  • therapy.
  • In addition…learn from the experience! If symptoms persist, the time has come to consult an expert, such as your general practitioner.
  • Diagnose and treat any depression if present.
  • Allow time for the person to recognize that there is a problem.
  • More hobbies, and more nice holidays.
  • Strategies such as career counselling are also said to be effective

Burnout: it is defined as a state of mind characterized by falling performance and personal accomplishments, emotional exhaustion, negative affect, poor leadership, and depersonalization
brought on by months or years of overexposure to emotionally demanding situations at
work, on the battlefield, or at home.

Risk factors For doctors:
  • Lack of hobbies,
  • lack of physical activity, and lack of enough time for vacations and religious activities are all important.
  • Pressure of work, 
  • conflict with colleagues, 
  • less personal relationships with patients, 
  • suboptimal income 
  • lack of time to provide needed care, 
  • work being so demanding that it influences one’s home life, and not being able to live up to others’ expectations.

Risk factors For Medical students: 
  • Impulsivity, depression & money worries are predictive

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