We catch up with Naomi as she shares her story of dealing with anxiety and depression whilst working as a doctor, and thoughts on mental health for doctors.

WHEN DID YOU FIRST REALISE YOU HAD MENTAL HEALTH PROBLEMS AND WHAT DID YOU INITIALLY DO?

I knew I had been experiencing anxiety for many years. Whilst at medical school I did seek help from my GP, but this was really a sticking plaster. I was offered antidepressants to ‘get me through’ but due to the initial side effects I could not sustain them through studying and clinical placements. I soldiered on and this continued in my foundation training.

In my F2 year it started to affect me a great deal more and I began to explore the option of CBT but again did not have time (or so I told myself!) I just about coped in my A&E placement and told myself if things were not better when starting GP training (which I was keen to persue) I would need to re-evaluate things.

HOW LONG HAD THIS BEEN A PROBLEM AND DID THIS HAVE ANY IMPACT ON YOUR WORK?

Although I had been having unhealthy anxiety for many years, it was only in the last 2 years that I had severe symptoms, and only when I began therapy that it became evident that there was also an underlying severe depression.

I first noticed this impacting on my work in my GP placement in GPST1. I was feeling extremely stressed, pressured and if I am honest slightly unsupported. I was very teary all the time and particularly struggled with confidence. I had comments from supervisors that I was not good at coping with stress but the reason(s) for this were not addressed. I needed to develop stronger resilience and manage uncertainty better. I knew I wanted to be a GP and the way I was feeling was something I needed to fix, but not at the expense of my vocation/career.

I then started another A&E placement and it was following some difficulties with getting annual leave and the general work pressures that;

I started to be in tears much more frequently, on edge, hypervigilent, seeking reassurance inappropriately as well as the physical symptoms of anxiety. I felt embarrassed about how weak I must have seemed.

My main concern was making a mistake – initially I told myself this was quite unlikely but it was when the anxiety and stress was affecting me so much that I felt I actually was going to make a mistake and cause harm that I felt I needed help ASAP.

I also noticed a developing apathy towards others, which was when I started to think – wow things are really not right. It is not right that I’ve started not to care. This is not me.

WHERE DID YOU GET HELP AND HOW WERE YOUR EXPERIENCES OF THIS?

My GP programme director had directed me to self refer myself to the Professional Health Programme (PHP) and they assessed me over the phone, and I was awaiting my first appointment. However, as crisis point hit I called them and spoke to someone who saw me straight away. All I can say is that my therapist saved my life. It had got to that point, and I will be eternally grateful for the absolutely professional but personal care I received.

I then got in contact with the Professional Support Unit (PSU) and saw a careers coach. She was absolutely brilliant and this was therapeutic in itself. We went right back to my early life, the highs and lows, where I have thrived in the past and slowly began to re-evaluate my career choice. I was not pressured either way to stay or to leave the NHS but what was clear was that I needed a break.

YOU’VE NOW CHANGED CAREER. WHAT ARE YOU DOING AND WHAT’S LED YOU DOWN THIS AVENUE? HOW DOES IT COMPARE TO YOUR PREVIOUS ROLE?

After making a full recovery, I started to look for and apply for jobs with the guidance of my careers coach. The main area I had identified was Health promotion/advocacy/support and was quite keen to work for a charity.

I now work for a charity as a Health and Wellbeing Practitioner. I work in a fantastic team of practitioners who have a variety of clinical backgrounds including psychology. My role is to work with clients who have health barriers to getting into or staying in work whether that be a physical disability, a learning difficulty, mental health problem or physical illness. We then work one to one with them, support them in accessing services available (e.g. counselling or pain management services) and run group sessions.

I love my new job. I still get to work with people in a caring capacity but I am able to maintain a work life balance. I don’t have to work nights or weekends which really affected my mood. Yes I get paid less, but this really doesn’t matter to me. It is a small price to pay to be living a happier life and spending time with my friends and family.

It is still early days, and as with any job, there are pressures and always more I can do, but the important thing is that I am extremely supported by my colleagues. Simple things such as receiving my contract and knowing my salary well in advance of my start date! I am able to choose my annual leave mostly – as long as I organise my diary in order to get the work done either side and ensure clients are getting appropriate timely support. The autonomy is great. I have a good relationship with my manager, who is professional but also supportive. Most of all I feel valued as a professional and as a person. Simple things have made such a difference.

WHY DO YOU THINK DOCTORS ARE SO RELUCTANT TO ACT QUICKLY ON THEIR HEALTH PROBLEMS?

I can’t speak for others, but I personally feel it’s the nature of the beast. Doctors are well-educated, conscientious individuals. We always want to do things right. Being anxious or worrying is seen as a weakness – it is something you need to just get over and learn to live with. We feel the most important thing is our patients, our medical colleagues and our training – getting to that end goal of GP/Consultant is what drives us forward constantly. Doctors are also so busy that there is barely time to reflect on feelings and how these may be impacting us.

For me, I had to hit rock bottom and physically not be able to walk through those hospital doors in order to accept I wasn’t well and couldn’t work.

I needed to be told by someone else that I wasn’t fit to work, and that it was okay. It was okay that I had become overwhelmed; it was okay that maybe this career wasn’t quite right. I would have never accepted that by myself.

There is also an element of the environment doctors work in – it is patient focused, and so there is an element of guilt (conscious or unconscious) if we were to get sick and not be at work. Everyone is overworked, tired, stressed and this does mean that seniors may not be as empathetic and supportive as they might otherwise be. This is not to blame them, but is a symptom of a system that is under increasing pressure.

WHAT ADVICE WOULD YOU GIVE TO DOCTORS EXPERIENCING PROBLEMS WITH THEIR MENTAL HEALTH?

Be kind to yourself.

It is okay to feel this way. It’s not nice, fair or desirable but accept that this has happened to you, and that does not mean you are a failure, it does not mean you will always feel this way and does not mean you need to just soldier on. You don’t. The most helpful thing my PHP therapist said was “It is what it is”. Accept it, and this will allow you to get help. People say this all the time, but it doesn’t mean it isn’t true.

What is most important is YOU and your health. Yes “patient safety should be our first concern” but remember that may well mean that doctors need to be the patient for a bit.

You are not alone, and it does not also mean the end of your career in medicine. That is something you can think about later. Get well, get better and then that difficult decision will be much easier.

Are you a medic who has experienced mental health problems in the workplace? Please help us continue the discussion and raise awareness by sharing your story anonymously or otherwise by contacting us.

Check out our support page including mental health support services for doctors. 

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Sara Sabin

With a solid corporate background, Sara specialises in advising doctors in how to prepare a non-medical CV and how to prepare for a non-medical interview. She is also the Co-Founder of Medic Footprints.

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