What to do: recognition, barriers and diagnosis

Recognition that there is a problem

The first step is the recognition that you are struggling, whether you are just fed-up, chronically stressed and exhausted, or suffering from anxiety and depression.

This sounds obvious and simple, but in reality it is not always. I personally did find it hard to recognise that there was a problem that needed a different solution. As for everyone, there are times in your life and career that are more stressful but they pass either with time or with a few simple changes. Dr Dike Drummond, in his work, often refers to this quote below by Albert Einstein:

“We can’t solve problems by using the same kind of thinking we used when we created them”. 

For me, recognising that this time was different, that I would not just be able to ride through it, that it would not turn out well with time or working harder, was one of the problems.

Looking back, what worked for me before, was clearly not going to work. It seems obvious now, but when I was in the thick of it, I could not see anything clearly.

Earlier recognition and action would have certainly made a difference.

I will be discussing warning signs and what I could have done differently in future blogs.

Barriers for doctors seeking help

I delayed seeking help for many months even though I knew that I was struggling.

I was worried about confidentiality. Many of the doctors at the practice I am registered at knew my work colleagues.

I also felt guilty, ashamed and a failure.

I was also worried that anxiety and stress would be on my medical records and that may have implications.

I worried that it would affect future job opportunities.

I think that most of us do realise that we are struggling but often find it hard to know what steps to take next because of similar concerns of confidentiality or because  we are worried what impact this may have on our careers and what colleagues will think of us.

This is confirmed by a Department of Health report in 2008.

Diagnosis: am I stressed, anxious, depressed, or burnt out?

Is it stress, anxiety and / or depression or are you just feeling dissatisfied and unhappy at work or are you burnt out? 

There are many validated questionnaires used to help diagnose anxiety and depression objectively which you might be helpful to complete to help you work this out. The best course of action is to see your GP or a therapist to help you work this out and support you with any treatment and recovery plans. 

Depression:                     PHQ-9 (used commonly in primary care) and Beck inventory

Anxiety:                            GAD-7

Burn out:                           BMA questionnaire. No true consensus on how to diagnose it (no                                                   DSM criteria as yet)

Is there a difference between stress and burnout

YES, according to helpguide.org, a Californian on-line guide for mental health set up by digital mental health pioneers, Jeanne & Rob Segal.

Extreme stress can lead to burnout however and they suggest using what they call the 3 R approach to preventing and treating burnout – Recognise. Reverse. Resilience.

Table on Stress vs. Burnout 

Stress Burnout
Over engagement Disengagement
Emotions are over-reactive Emotions are blunted
Produces urgency and hyperactivity Produces helplessness
Loss of energy Loss of motivation, ideals and hope
Leads to anxiety disorders Leads to detachment and depression
Primary damage is physical Primary damage is emotional
May kill you prematurely May make life seem not worth living

(Source: Stress and Burnout in Ministry)

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