How to recognize and treat your own mental illness

Doctors have a high risk of suicide and alcoholism, so we must be prepared for this fact (and try to prevent it) and for other health-risking accidents (or regularities) in the professional and personal life of a doctor. Our ability to observe ourselves is never as good as our ability to observe others. And if a healer himself is wounded, it is understandable that his ability to help others will be diminished. Our own illnesses can be of invaluable service to us doctors in understanding our patients and what makes them go to the doctor (or, on the contrary, why they refuse medical help), and in understanding the barriers that we (the sick) may erect in order not to take advantage of the doctor's advice. But the very idea of a sick doctor remains a paradox for the layman, and so we can ask: Can true spiritual mastery on a large scale ever be defeated by someone who is counted among his slaves? There will come a time when our mental state will seriously impair our ability to work, and we must be able to recognize this and take appropriate steps. Below are signs that may indicate that such a time is approaching.

• The doctor drinks alcohol before he goes on rounds or performs surgery.
• The doctor begins to reduce any contact with patients and reduces it to the utmost minimum.
• The doctor cannot concentrate on the task at hand. At the same time, his thoughts are completely occupied with the work ahead in the coming days.
• Irritability (defined as disagreement with more than one nurse in a 24-hour period).
• Inability to take time off without feeling guilty.
• Feelings of extreme shame and anger when meeting again with coworkers with whom you had conflicts. In order to avoid further mistakes, it seems that all of us doctors should leave medicine.
• Emotional exhaustion (this is a state when a doctor knows that in a certain situation he will be happy or, on the contrary, angry with himself or others, but at the same time, gathering all his mental strength, he still cannot do anything).

Prospective studies have shown that introversion (i.e., self-absorption), masochism, and isolation are important risk factors for medical failure.

The first step in recognizing such an impending condition is to admit it. The next step is to admit it to a person you trust. Then give your brain time to recover. If the steps you have taken do not bring results, try to get rid of individual symptoms. For example, if the tormenting thought keeps coming back to you that you have been treating your patients incorrectly, taking your time, think carefully about this circumstance and try to find positive aspects in your medical activity. This will be the first step that will restore control over yourself. You yourself must begin to think in this way and not allow your thinking to go uncontrolled along the path that destroys you. Then direct your thinking along some neutral channel, since by this time the series of bad thoughts will already be sufficiently muted. After several repetitions of such an experience, the thinking itself will already be neutral. If suddenly thoughts come that disabling you, then the cycle of shameful and unpleasant thoughts for you will, however, be interrupted.

If all this does not bring you relief, it is probably time to consult a specialist, for example your GP. We have a confidential self-help group for drug addiction and other similar problems. It is a group of British doctors and dentists, contactable through the Medical Council on Alcoholism. If, for example, you are such an expert and a doctor comes to you for advice, then for heaven's sake do not delude yourself with some incredible difficulties and treat your doctor-patient as you are accustomed to. The fact is that a particular treatment approach leads to particular errors in treatment, and so it is much better to guide doctor-patients along well-established paths of advice, examination and treatment than to try to blaze deceptively short, special and new paths.

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