There’s a Twitter thing right now where a lot of attending physicians are talking about how they benefit from therapy and/or antidepressants; so, my version is:

I've benefitted greatly from therapy at various times in my life, including currently. In a trauma-filled environment, with more and more people working under my supervision, I realized my team needs to hear that, more than I need to keep it private.

And, many of us who are drawn to respond to the suffering of others are also wrestling with some s**t of our own, and sometimes trying to unconsciously work part of it out through our work with patients. It is our obligation to our patients to be mindful of what we carry.

We can heal with our patients, but it's not fair to our patients (and it doesn't work) to try to heal through our patients, or to use our patients to heal. When we start looking at that for ourselves, it often goes deep and there are good odds that we need help with it.

There are plenty of doctors who are actually seem to be just content and balanced people; but many of the rest of us are more complicated. Some of us need to "fix"; or to "be perfect"; even tho the world can't be fixed, and is imperfect. Me? my thing is to go towards trauma.

That impulse to go towards the pain, to respond to suffering, can be legitimately framed as a moral choice; but it can also come from our own pain. The difference between moral bravery, v. just working out our s**t through other people, can be surprisingly hard to distinguish.

Plus, depression is literally an occupational hazard. The intern health study (https://srijan-sen-lab.com/intern-health-study…) looks at specific circumstances of interns--by annually re-creating new cohorts of people who have reliably high incidence of depression.

I'll never forget reading a study thinking it was about interns and realizing, no, it's using interns as a model to ask questions about susceptibility, because it's a high-incidence population where you can get statistical power to ask that question. I mean, we have a profession where we create depression year after year after year, so reliably that you can create statistical power for subtle questions about susceptibility. And then, then!… we also stigmatize real solutions to depression and other mental health challenges.

The profession's solution to this tradition of creating mental health challenges and then stigmatizing them should be clear: stop seeing mental health challenges as a hindrance to professionalism, and start seeing treating them as a key component of professionalism.

This is distinct from how we should contemplate this personally--which can just be personal, and not for our patients. But professionally, part of the reason we need to talk about this differently is b/c doctors who don't deal with their s**t aren't good for patients.