Globally, the death rates due to suicide reduced from 2000 to 2016 by 16% in men and 20% in women. Men in the WHO European region committed suicide the most while women committed suicide the most in the South East Asian region. In both women and men, suicide rates increase by age. However, in women particularly, suicide rates increase by age from 30 years onward but peak among those aged 15-29.
Worldwide, in 2016, two men had completed suicide for every woman who had done so. The suicide mortality rates were 13.5 and 7.7 deaths per 100,000 population in men and women, respectively. Despite the revelations, studies show that doctors commit suicide at an alarmingly higher rate when compared with the general population. Female doctors are likely to die from suicide than the male counterparts.
Female doctors are 250 to 400% more likely to commit suicide – and yet, the male counterparts are only 70% more likely to do so when compared to the general population. In our essay today, we entrench ourselves into the fascinatingly disturbing revelations about why we (doctors) commit suicide.
Because suicide is a retrospective and relatively uncommon event, we cannot (with certainty) ascertain the prevailing reasons why we commit suicide. However, there are multiple factors we can expound on, which are instrumental in the orchestration of suicide by doctors. They range from mental ailments to the personality styles that many doctors exhibit.
Before their deaths, very few doctors have documents that indicate they received any mental health care. Many doctors, especially women, suffer from mood disorders. Most doctors suffer from burnout and depression. Others abuse either alcohol, illicit substances or both. 20 to 40% of doctors who commit suicide either drink alcohol or are substance abusers. Depression is a known risk factor for suicide – yet, very few doctors seek medical help for treatment – because they fear the stigma that encompasses mental disorders in various health care settings. Others fear that once they open up, they may lose their jobs.
Before we became doctors, we were humans – we still are. We differently process the various materials which affect our behaviour. In Duberstein et al. study, 61% of the doctors interviewed had a belief that committing suicide was a rational endeavour in a few situations. By convention (I may be wrong), the world considers doctors to be the ‘cream de la cream in society. We hold such high esteem that relates poorly with reality. Even the strong ones fall – they do so without anyone’s notice.
Suicide committers are never satisfied with life!
The work that doctors accomplish is astounding. We often forget about the creator – thy Lord – He, who gave us all these incredible skills to treat His people. It’s a wrong attribute to call doctors healers. We have never healed anyone. We only treat. Healing is divine, and the Lord extends this attribute to the ailing man through the treatments we (doctors) provide. Some people have healed without any doctors’ interventions. Because doctors forget that we don’t heal, we become obsessively compulsive, achievement-oriented, conscientious, introverted, anxious, self-blaming, and sensitive. Personal characteristics like these don’t do well with the well-being of any human being. Due to the high standards set, we fear embarrassment due to failure – often avoiding crying out for help. We become overly self-reliant (no man is so), lack self-integration, and deny personal distress. Self-reliance and overt achievement-oriented lead to dissatisfaction – features that propel one to want more and feeling empty all the time. Suicide committers are never satisfied with life.
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Several doctors have excessive occupational demands – often stemming from moonlighting to make ends meet. They, especially women, lack the personal support and have extremely competing life responsibilities. Many (female) doctors, on top of their professional workloads, must tend to their household chores, including the children’s welfare. Such workloads exert extreme amounts of strain on the already stretched minds of such doctors. Divorce, physical disability, and domestic violence envelope many other doctors but, they fear talking about such issues. After reaching the walls, such doctors often do not see a way out. All they see is ending their lives to escape the entrapment they entered.
Especially at the postgraduate level for many students in Uganda and all levels in many high-income countries, doctors struggle between educational debt, unrealistic patient expectations, high patient load, performance appraisals, medical malpractice, demands for continuing education, and loss of social status. About two-thirds of the doctors interviewed considered leaving medicine at some point in one study. All these conflicts require addressing – unfortunately, they aren’t. Doctors manoeuvre through the crevices to balance all of them – and when we fail – we become depressed – a prominent precursor for suicidal ideations – that, if we address it not, will lead us to commit suicide.
In a nutshell, we realise that we commit more suicide when compared to the general population and that this revelation isn’t good news. The earlier we embrace the humanity in us, the less we shall feel embarrassed about seeking help about mental health, the earlier we shall tackle this startling fact. We should embrace the Lord – He is good all the time. We aren’t limitless. The Lord has limited us by the skills He conveyed upon us. We aren’t immortals. We shouldn’t behave like we are. Shout out for help in case of burnout. Let’s have a life outside the medical confinements. We cannot treat everyone by ourselves. Important, male doctors should interact and handle female doctors with compassion. They carry a lot on their minds.
Physician suicide. A Fleeting Moment of Despair article by Randy A. Sansone, MD and Lori A. Sansone, MD, inspired our essay. The WHO health statistics 2019 report provided some data about the global trends of suicide.