Article Archive
July/August 2020

The Last Word: Get Rid of the Boxes
By Lynette D. Charity, MD
Today’s Geriatric Medicine
Vol. 13 No. 4 P. 34

The time has come to erase the stigma associated with mental illness among physicians.

On a dark, dreary night in the fall of 1998, my chronic depression almost got the best of me. At that point in my life, I’d been battling my demon voices for more than 25 years. That night, the demon voices said, “You’re not a good mother. You’re not a good doctor. You should just die!”

I aimlessly walked around town until I happened upon an old wooden bridge. I climbed to the top railing, closed my eyes, leaned forward, and prepared to jump. At that moment in my life—at age 46—I couldn’t find a good reason to live. And honestly, I was tired; I was tired of the battle. I don’t think I wanted to kill myself, but I know I wanted the voices to stop.

A systematic review of physician suicide gathered from various sources and published by the American Psychiatric Association noted that almost 400 physicians die by suicide annually—the highest suicide rate of any profession. It was also noted that the physician suicide rate is 28 to 40 per 100,000, which is more than twice the general population of 12.3 per 100,000. Physicians who take their own lives often suffer from untreated or undertreated depression or other mental illness. I believe this failure to adequately treat these individuals is the major reason for their suicides.

How Tragedies Can Happen
There’s a sense that physicians should not have depression or anxiety or bipolar disorder. This stigma makes physicians fearful; this becomes an obstacle to seeking medical treatment. In addition, physicians have little time for mental health self-care, and when they do consider such care, there’s a potential lack of confidentiality. Long hours on the job, being inundated with so many bureaucratic tasks, and heavy patient caseloads contribute to the lack of time for self-care. So many physicians suffer in silence, and some eventually die by suicide.

Medical licensing boards add undue stress. There’s an assumption that a physician with a mental illness is impaired. Many people with mental illness function quite well with proper therapy and/or medication. Physicians are people too. Yet these medical licensing boards force physicians to disclose their mental health histories when applying for a license to practice. They’re asked whether they have or have ever been diagnosed with or treated for a mental illness and are asked to check off boxes indicating the illnesses. If they check any box, they must attach a detailed explanation. It’s then at the board’s discretion whether a license is issued. And once their information is out there, physicians may have difficulty obtaining health, disability, or medical malpractice insurance.

I suffered in silence with my untreated depression for most of my career as a physician because of this stigma. And when I almost succumbed to the voices in my head telling me to end my life, my mother’s voice intervened. With her southern accent, the voice said, “Call yo’ mama.”

My mother saved my life. I left that bridge and sought care immediately. And I called my mother.

My treatment—a combination of psychotherapy and an antidepressant—worked. The voices were gone and I felt great. However, when it was time for me to be recredentialed, I stopped all treatment. So it was true I was not at that time being treated for a mental illness, but I had been. I decided that was none of their business. What’s important here is that physicians should be allowed to seek mental health care without repercussions. A physician being treated is better than one who is not. And the right to be treated for mental illness should be available to everyone. Help stop the stigma. Get rid of those boxes. The life you save may be your physician or colleague.

— Lynette D. Charity, MD, is a board-certified anesthesiologist with more than 40 years of expertise. She’s also a CME-accredited keynote speaker, author, and humorist. Her focus is on physician mental health care. Contact her at