After practicing psychiatry and behavioral health for nearly 25 years, I’m done. I feel sick, and especially sicker from my occupation. Not merely burned out, but ill. Primarily mentally. I’ve always had complex post-traumatic stress disorder. And depression and generalized anxiety, and many other diagnoses from the DSM. But, I’ve covered my illnesses so I could go to work and help so many people. Least of all myself. My mother had chronic psychosis, and my upbringing was highly traumatic. I re-channeled a helplessness, deeply felt toward my mother’s severe illness, into the academic pursuit of becoming a doctor to try hard to help other people. Thousands. But, I can no longer help as a psychiatrist. I can no longer responsibly and compassionately listen with my heart and soul and perform the material duties of my job. I, apathetically, allowed my board certification to lapse several years ago. I am beaten up. I am scarred emotionally and mentally. My job has repeatedly re-traumatized me. I can’t turn off my mind at the end of a day. I am watching myself go deeper into the abyss of unhappiness. I am suicidal nearly every day, and I am a high risk for suicide: Older white male, negative affect, precarious finances, isolation as a solo practitioner, and living alone. I picture my own death. I could easily become another statistic, though I would prefer not to be. I am closing my practice to the disappointment, worry, tears, and understanding of my loyal patients, who see the good in me more than I do in myself. I know I’m a good person, but I do feel terribly ashamed of myself for not properly living my life in a more protective way for me. I am angry at myself. I have been wrongfully targeted at times, causing further trauma. I have no real cushion—no retirement savings, a tenuous support network, few truly deep connections. I have made many mistakes in decision-making and judgment—professionally and personally. I have sacrificed myself primarily for the good of many others; however, self-destructively so. I have a doctor I see, an empathic psychiatrist. I take medications daily. I have been to therapy on and off over many years — supportive, cognitive-behavioral, EMDR for trauma. I am treated for ulcerative colitis, an autoimmune disorder, and tied to infusions. I am not whole — nor will I be by continuing to be a psychiatrist. I really need to be so much less of my perfectionistic self, to find my authentic self and add value back to myself, instead of giving it away. But, I worry that I’m too far gone. How utterly sad and scared I am. I’m reminded of an elderly patient who has anxiety and memory problems, but who is nevertheless optimistic and said to me that she thinks it takes tremendous courage to stop practicing and find a different path. If only I had, or acquire, the belief in myself that I’ve had for so many other people overcoming themselves and the problems in their lives. Michael Dorfman is a psychiatrist. Source
