A psychiatirist who specialises in treating doctors outlines a typical case.
Dr McManus (not his real name) is a consultant psychiatrist who specialises in looking after doctors with mental health problems. He describes a typical doctor-patient as either a single-handed rural GP or a highly pressurised but competitive hospital consultant.
"Typically the person I see is someone who finds it difficult to say no. Everyone, apart from his family, likes him. He has become a difficult person to live with."
A doctor-patient identifies himself in terms of his work and takes his health for granted. When he starts to feel the pressure of work, rather than easing off, he tends to go into overdrive. He may begin to drink excessively or else he will self-medicate, Dr McManus said. Some doctors with easy access to intravenous drugs may abuse narcotic medication.
The doctor's spouse or partner is often the person who decides enough is enough. They will have noticed that the doctor has become highly irritable, controlling, argumentative and difficult to reason with. "Often his mood will oscillate from absolute nihilism and hopelessness about the future to a sense of 'I'm fine', where he tries to work even harder," Dr McManus told The Irish Times.
The spouse will often approach a medical colleague to see if he has noticed anything amiss. But sometimes the colleague has not noticed, perhaps because he, too, is busy trying to be a "super-doctor".
However, the colleague may agree with the spouse and will approach the unwell doctor. If this interaction goes well, the doctor will agree to seek medical help.
Dr McManus has found that doctors who seek help rather than being forced by disciplinary proceedings into getting treatment have a more positive outcome.