‘The NHS wears you down. It depends on people going the extra mile and staying late, but you can’t do that when you just want to curl up and cry.’ Photograph: Carl Court/Getty Images
On his way to work one day as a first-year junior doctor, Craig felt so desperate that he considered jumping in front of a bus.
He had never experienced suicidal thoughts before. He felt helpless, as though there was too much to do and not enough time to do it. He was, it transpired, suffering from depression, partly triggered by the huge pressure he was under at work. It had become routine to put in an extra two or three hours after a 12-hour shift, because it was just too busy for him to leave.
“The NHS wears you down,” he says. “It depends on people going the extra mile and staying late, but you can’t do that when you just want to curl up and cry.”
This incident took place five years ago, but today Craig is struggling once more. “This last year the atmosphere at work has become toxic. My wife, another junior doctor, and I are both now back on antidepressants.”
The number of doctors struggling with their mental health in the UK is a major concern. According to a survey by Cardiff University, which consulted almost 2,000 British doctors at various stages of their careers, 60% had experienced mental illness (the figure is 82% among doctors working in England). What’s more, most of those struggling had not sought help.
The Guardian asked doctors to share their experiences of mental health problems, and many of those who submitted stories talked about feeling burnt out, overworked and completely adrift.
Many feel that there can be a lack of sympathy for doctors experiencing mental health problems. When Craig talked to his supervisor, for example, he was told: “You cannot tell people you feel that way. They’ll judge you – just keep your head down.”
Harriet, 28, from West Yorkshire, says that when she developed an anxiety disorder – which manifested itself as a crippling fear of contracting a disease or illness at work – she was terrified to talk to her colleagues.
“I felt that admitting my problems would suggest an inability to cope with being a doctor, that it would make me bad at my job and that I would be forced to quit,” she says. “It took nearly six months of hell for me to finally confess to my partner, and several more to tell my parents. After nearly a year of struggling, I spoke to my educational supervisor and she helped me talk to occupational health professionals, who convinced me to receive counselling. These problems aren’t gone but they are manageable.”
This prejudice also extends to patients. Mary, 46, from Birmingham, says: “My experience of the perception of mental health problems in the NHS has been very mixed. Most people that I have opened up to have been very understanding and supportive, but there are a significant number who clearly have a poor understanding of mental health issues.
“I experienced bullying from one consultant whom I had told about my depression. And when patients who have self-harmed come in, there has been a general lack of sympathy and understanding.”
But being able to talk openly is incredibly beneficial. Mhairi, 34, from Scotland, says: “I frequently talk to my colleagues (including managers) about having bipolar disorder and most of them have been very kind and understanding.
“Many have had their own mental health problems. Several others have said that their perspective on their patients has changed as I have made them realise that even doctors like them can get ill, so they can identify with them more.”
Em, 29, from London, also found that an open environment helped her to recover from anxiety: “I was able to openly talk with management and my supervisors about my condition but I guess I was just lucky.
“I have met doctors before who don’t believe in mental illness and so that would have been difficult. But I have only had two clinical supervisors, and they were both very understanding.”
Stigma is just one problem, however. Work also needs to be done to address the bigger issues affecting wellbeing in the first place.
Brye, 37 from the south-west says: “The underlying problem cannot be resolved. That is that the NHS is under-resourced and that staff who have been working with a blitz-mentality for years are told that they must do more and are frequently criticised in the media. Politicians promise more and more for less and less, all of which rubs off on patients’ attitudes to staff.”
Sam, 30, is a trainee paediatrician from Manchester who suffers from anxiety and depression, and says that a huge proportion of the workforce is at breaking point. “We are asked to work longer and harder for less – and so what? So are many people. But our days involve things like telling a family that their baby will die in their arms, or fighting to save a septic toddler, or being covered in vomit or blood … sometimes you don’t sleep because you might have made a mistake. We are all at breaking point.”
This pressure can mean colleagues are less sympathetic than they might have been. Kyle, 60, from London, says that when he suffered with mental health problems, the people he worked with were initially supportive – until they became exhausted from having to pick up his workload as well as their own.
However, the consequences of not addressing this issue now are great. Ade, 26, from Northern Ireland, talks about the impact of her poor mental health on her ability to work.
“At times I was unable to concentrate due to the overwhelming depression I was experiencing,” she recalls. “I found myself wandering around the wards almost in a daze at times because my concentration was so poor. I went from the top decile in my medical school to the bottom decile due to my illness. I almost dropped out of medical school at times and have even applied for other jobs outside medicine due to the fact that I was struggling.”
Harriet has a similar story. She says: “I felt preoccupied and unable to concentrate. At times I had to leave the unit to try to control my anxiety. I kept a log of every time I undertook an ‘at risk’ procedure, like taking bloods, and whether or not I had cut myself, as I no longer trusted my own memory of events.
“I was exhausted from nights, laying awake in bed convincing myself to just make it through one more day. Every day I imagined calling in sick, or resigning. It was only a feeling of loyalty to junior colleagues also struggling with the same workload that kept me returning.”
Some of the doctors’ names have been changed.