Warning…System Collapse: Signs of and Coping Strategies for Distress

I recently posted about physician burnout and what role the system plays in our overall satisfaction with our careers.  As professionals, we are trained to handle complicated medical situations, as Ob/Gyns we often deliver news that affects two patients.  Counseling a woman through a stillbirth or fetal demise never gets easier. In discussing one such patient in a meeting a few weeks ago, the office social worker asked, what do we do to cope?  To whom do physicians talk to manage their stress and emotions during difficult times?  I must admit, as a group we do not prioritize this area well.  Too often, we hear of physicians who abuse drugs and alcohol or even commit suicide when the pressure to perform, to strive toward perfection gets too great and the support is not enough.

While doing locums full time, my friend graciously offered to house my belongings in her basement.  She is a psychologist working specifically with undergraduate and graduate students. With any highly regarded university, that produces excellent graduates and professionals, students arrive on campus highly motivated and prepared to succeed.   To say the least, the demands of college curriculum can be daunting. Across the country, medical school admission standards are high and require disciplined study habits.   As physicians, most of us were once these same ambitious college students who kept late hours, ate erratically, exercised infrequently, not placing enough emphasis on our personal well-being.  These habits we create while training are often the habits we continue when practicing.  These habits are not always healthy or easily broken.

Today, we talk with Dr. Leslie Leathers about the mental health conditions she believes are particularly pertinent to young professionals, warning signs and viable coping mechanisms.  As we spend most of our days caring for others, it is just as important to dedicate the appropriate time and attention to ourselves.

1. Tell us a little about yourself.

I am from North Carolina originally, and growing up in my Black American, middle-class, Christian family, certain values were instilled in me. Values most pertinent to our topic today include the pursuit of formal education, collectivist ideals, and helping others. These values were a natural fit with the field of Counseling Psychology with its emphasis on helping people improve their quality of life while acknowledging and respecting multicultural realities. I moved to Baltimore for my job doing psychotherapy with university (undergraduate and graduate) students. This position entails a specific focus on supporting students of color. It’s a privilege to be able to support students as they begin to navigate young adulthood. As a woman of color who benefited from wisdom and guidance of professionals who came before me, it is particularly gratifying to be able to provide support to students of color as they pursue their higher education goals and work to improve their quality of life, both in the short and long-term.

2. In counseling professional students, are there any common themes that you can address?

One theme that leaps to mind is the pressure to succeed and secure employment in academia where job applicants far outnumber available positions. Another theme is learning to manage (what are often) new levels of stress adaptively.

3. For friends and loved ones, are there any warning signs that indicates someone needs professional support?

Significant changes in ones’ behavior may indicate the need for extra support. For example, increased irritability in someone who usually is easy going or social isolation from someone who typically is outgoing and social. Someone could begin shirking responsibilities or, alternatively, one could start taking on more commitments in an attempt to distract oneself from one’s experience of distress. Additionally, one could experience distress somatically and emphasize physical aches and pains. A more complete list of potential signs may be found at

https://www.nami.org/Learn-More/Know-the-Warning-Signs

4. Different cultures intersect with mental health differently and recently, conversations around racism, mental health and self-preservation have been more common in popular media and on college campuses.  How has your work contributed to increased awareness and strengthened relationships across campus?

There does seem to be a groundswell of momentum to acknowledge and redress patterns of inequity. My own direct work with, and indirect work in support of, students who represent diverse backgrounds has benefited from this momentum. One thing we know from research is that students who feel marginalized within a campus environment can benefit immensely from having distinct spaces that are affirming of their marginalized identity/ies. My work contributing to such spaces on my own campus have been among my most valued work experiences to date.

5. What resources do you recommend for someone who is feeling overwhelmed?

Well, being a psychotherapist, who at various times in my life has also been a therapy client, I wholeheartedly recommend therapy. A couple of good resources for assistance identifying a therapist are

http://www.apa.org/helpcenter/index.aspx

and

https://therapists.psychologytoday.com/rms?utm_source=PT_Psych_Today&utm_medium=House_Link&utm_campaign=PT_HomeTopB_find

That said, there are a number of other strategies one might try. For instance, engaging in regular self-care that nourishes the important parts of oneself is often helpful. Prioritizing commitments and determining the limits to one’s control within a specific circumstance may help alleviate excess pressure that can lead to feeling overwhelmed. Although it is often hard to do so, it can be very helpful to remember that we are all human and doing the best we can considering the resources and knowledge available to us at a given time. If we’re feeling overwhelmed, that may just be a signal that we need to improve our existing resources/strategies or try to acquire some new ones. Here is a link to a list of apps that could be useful in bolstering or adding to existing strategies for managing distress:

https://psychcentral.com/blog/archives/2013/01/16/top-10-mental-health-apps/

Finally, social support, whether from one’s best friends, gym buddies, spiritual group or leader, family, etc. can help one feel connected to a community and/or to something(s) greater than oneself. None of the aforementioned resources/strategies are mutually exclusive and there often is a process of trial and error in figuring out what works best for you. So, if you find that one strategy or combination of strategies does not work for you, know that it may take some time to identify your own unique path to good mental health maintenance.