As a physician, I manage patients’ illnesses while easing their fears. I must be strong—a sounding board—and know how to treat the “bread and butter” of chronic diseases. At the beginning of 2019, after years of debilitating symptoms, I was diagnosed with major depressive disorder, also known as clinical depression.
I didn’t “look depressed” at all. I had a successful career, a loving family, and a happy personal life. I traveled the world regularly, and from the outside, it seemed that I “had it all.” Maybe I did, but I was depressed, and it was affecting every aspect of my life.
I was exhausted, and I had no energy, felt lonely, and could not get out of bed some days. Receiving this chronic diagnosis represented both a positive and a negative: I was relieved I finally had an answer as to why I was feeling so low, but I was nervous about how it would affect my patient care.
The emotional and physical toll of chronic illness
Whether it’s diabetes, kidney disease, depression, bipolar disorder, or asthma, getting diagnosed with a chronic illness can be especially difficult for physicians. Chronic conditions often result in both mental and physical exhaustion; you may constantly question whether you are fit to care for others while struggling to care for yourself.
Although we as physicians are often held to a high standard, we are still human, just like our patients. Sometimes, having a chronic disease can help us relate even more to those we are treating.
So, how can we show up for our patients when we are exhausted or personally struggling with chronic illness?
We must take care of ourselves first
After being diagnosed with clinical depression, I started therapy and was introduced to life coaching, and my world started to shift. My therapist taught me how to manage the symptoms and triggers associated with depression, and my life coach taught me how to take back control, feel my emotions, and make daily choices based on honoring those emotions.
"Being stuck and constantly questioning “Why did this happen to me?” was not a helpful way forward, nor conducive to caring for my patients, so I worked to leave the victim mentality behind. "
— Kristen Fuller, MD
My therapist and life coach helped me create space in my day to think, process my emotions, and make my own decisions—all things we, as physicians, do not typically allow our patients to do. When we feel exhausted and overworked, it can be difficult to hide negative mindsets from our patients. We might ask them to do things without explaining our reasoning, then become frustrated when they are “noncompliant.”
Over time, as I worked through difficult emotions and utter exhaustion, I learned to hold space for myself and reconnect with my patients. The insight I received from therapy and life coaching due to my chronic disease has given me a new perspective when treating patients.
The grace I can show my patients gives them time for mental clarity, enabling them to slow down and process what is happening so they can move forward intentionally.
When I meet a patient struggling with their chronic disease, I often share that I am also struggling and running on low energy. This humanizes the patient-doctor encounter. Sharing my diagnosis with my patients allows me to better connect with them, as I suddenly become someone who knows their suffering firsthand.
Giving a patient a chronic disease diagnosis when you are struggling with your own chronic disease may seem overwhelming, but being honest about what you are going through shows empathy and kindness. Your patients understand what you are dealing with and may be more willing to listen as you now share common ground.
Break your day down into bite-sized chunks
Some days, my depression leaves me with zero energy, even at the start of my work day. As a result, I have learned to break my day down into small bites and tackle three tasks at a time. For example, my first priority is my morning routine, and once I complete this task, I can move on to breaking down my work day into small chunks. This has helped decrease my anxiety about a long workday and, as a result, provides me with enough energy to get through each task.
Starting the day with the mindset that you have a grueling 12-hour day of seeing patients can be exhausting, regardless of whether or not you are struggling with low energy from a chronic illness.
Take time off
Treating patients is mentally and emotionally exhausting, even more so when you have a chronic disorder. Even after therapy, life coaching sessions, and self-care, sometimes we need to take time off from patient care. Whether this means a long weekend away, a three-week holiday, or a sabbatical, taking time to rest, reset, and recharge is necessary to be at your best, so you can eventually get back to giving your best care to patients.
Each week in our "Real Talk" series, mental health advocate Kristen Fuller, MD, shares straight talk about situations that affect the mental and emotional health of today's healthcare providers. Each column offers key insights to help you navigate these challenging experiences. We invite you to submit a topic you'd like to see covered.