Psychiatric Drug Use by Medical Students and Residents

Pamela Wible, MD, Founder of the Ideal Medical Care movement; Author of Physician Suicide Letters—Answered; Family medicine practitioner in Oregon;

Q: Medical students and residents are among the most important human resources in the United States. Yet we lose many during training due to suicide. Have you information you can share with our readers about the mental health and psychiatric drug use of medical students?

A: I asked 220 doctors: “Have you ever been depressed as a physician?” Ninety percent stated yes. Yet few seek professional help. Here’s what depressed doctors do (when nobody’s looking). Some drink alcohol, exercise obsessively, even steal psychiatric meds. Still more shocking—I discovered that 75% of med students (and new doctors) are now on psychiatric medications.
“I was told by the psychologist at my med school’s campus assistance program, that 75% of the class of 175 people were on antidepressants,” shares psychiatrist Dr. Jaya V. Nair. “He wasn’t joking. How broken is the system, that doctors have to be pushed into illness in order to be trained to do their job?”
How many docs do we lose per year to suicide? The equivalent of one medical school full of students wiped out annually. In my 2016 TEDMED talk, I explain why doctors kill themselves. Personally, I lost both doctors I dated in med school to suicide and 8 physicians in my small town. In 2012 I decided to run a suicide hotline for doctors. I’ve heard from so many suicidal doctors that I published a book of their suicide letters.
In 1990, even I was severely depressed as a first-year med student. So my mom (a psychiatrist) mailed me a bottle of Trazodone. I thought I was the only one. Turns out occupationally-induced depression is rampant in medical training. Now schools dole out antidepressants like candy. Stimulants are used by med students like steroids in athletes. So where do we go from here? Should med schools distribute samples of Zoloft and Adderall during orientation?
The problem is physicians must answer mental health questions (right next to questions on felonies and DUIs) to secure a medical license, hospital privileges, and participate with insurance plans. Check the YES box and be forced to disclose your “confidential” medical history and defend yourself—again and again–for your entire career. You get treated like a criminal for taking meds to cope with the torment of medical training (and practice).
Maybe that’s why so many future (and current) physicians sneak drugs and go off-the-grid for mental health care.
“I’ve been in practice 20 years and have been on antidepressants and anxiolytics for all of that time,” says Jason. “I drive 300 miles to seek care and always pay in cash. I am forced to lie on my state relicensing every year. There is no way in hell I would ever disclose this to the medical board—they are not our friends.”
What if we stop the mental health witch hunt on our doctors? Why not replace threats and punishment with safe confidential care? What if we address the root of the problem—the great sickness in medical education—rather than shifting blame to 75% of medical students for not having enough serotonin or dopamine or norepinephrine in their brains?
As scientists, we can’t continue to approach medical education reform as a neurotransmitter deficiency in medical students. Can we?

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