![\"photo](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/05\/ht-250515-darrell-kirch-120x156.jpg\")
Darrell Kirch, MD<\/p>\nBe sure to scroll down after this story to find links to extensive Medscape Medical News coverage addressing mental health and medical professionals.<\/p>\n
The nightmares started in his second quarter of medical school.<\/p>\n
Darrell Kirch, MD<\/p>\n
Darrell Kirch, MD, had struggled with anxiety since early childhood but this was another level. He was feeling burned out while studying anatomy in the cadaver lab. The combination brought jarring anxiety dreams. \u201cIt was brutal,\u201d he said. \u201cI started having nightmares about our cadaver coming alive and chasing me.\u201d<\/p>\n
Kirch made it through the quarter. But during the next break, he experienced a massive panic attack. Not just a few minutes of heart-pounding fear, it persisted for days. Kirch thought he was dying. Finally, he realized he was overmatched by the demands of medical school.<\/p>\n
When classes resumed, Kirch told the dean he needed to drop out. The dean listened but ultimately \u2014 and compassionately \u2014 refused his request.<\/p>\n
\u201cWhy?\u201d Kirch asked.<\/p>\n
\u201cI think we can help you,\u201d he said.<\/p>\n
Is Anxiety in Healthcare \u2018Normal?\u2019<\/strong><\/p>\n Anxiety disorders are the most common mental health disorders in the world. According to the National Alliance on Mental Health<\/a>, 19.1% of adults in the United States have an anxiety disorder. The prevalence among healthcare professionals is even higher. One study using data from 2021 and published in the Journal of Affective Disorders<\/a> found rates as high as 31.0% for physicians and 53.3% for nurses.<\/p>\n Several studies noted a significant increase in physician anxiety symptoms during the COVID-19 pandemic, including a survey published in BMC Psychology<\/a>.<\/p>\n More recently, a 2024 study on post-COVID anxiety published in the Archives of Psychiatry and Mental Health<\/a> found that 21.6% of physician participants had mild anxiety, 10.3% had moderate anxiety, and 12.9% had severe anxiety. There was a higher risk among female physicians, general practitioners, those with a family history of anxiety, and those who worked night shifts.<\/p>\n The study concluded that the rate of anxiety disorders among physicians had returned to \u201cnormal\u201d since the pandemic. But should we consider the status quo normal?<\/p>\n Today, much of the conversation surrounding physicians\u2019 mental health focuses on rising rates of burnout. But burnout and anxiety are often intertwined: Situational anxiety can lead to burnout, while burnout can lead to more severe anxiety. Without recognizing and addressing these relationships, physicians\u2019 anxiety disorders can reach debilitating levels.<\/p>\n \u201cBurnout and anxiety are overlapping circles,\u201d Kirch said. \u201cI had a mental disorder, got into med school, became burned out, and had that massive panic attack.\u201d It was a cycle of triggers that Kirch couldn\u2019t escape.<\/p>\n Trauma and Triggers<\/strong> Cardiologist Jonathan Fisher, MD, is familiar with unavoidable triggers. He described a recent incident at work where he needed to steady himself, notice his breath, and focus on releasing tension from his body caused by a flood of traumatic memories. Why? A 21-year-old patient had come into his emergency room with ventricular tachycardia.<\/p>\n Alarmed by this patient\u2019s young age, Fisher was reminded of a terrible day in residency when he was tasked with helping to resuscitate another young man\u2019s stopped heart. That patient didn\u2019t survive.<\/p>\n \u201cThose memories always live with us, and they change us,\u201d said Fisher, who has learned to manage his anxiety issues. \u201cThat early experience of having the young person die unexpectedly is something that informs my practice to this day, even 25 years later.\u201d<\/p>\n While difficult cases can linger for many physicians, those with anxiety and panic disorders tend to experience these effects as persistent and severe, threatening their confidence.<\/p>\n While working as a junior doctor with the National Health Service in Bristol, England, Karen Wallace, MD, received a disturbing phone call. She was being summoned to a coroner\u2019s court for an inquest into a patient\u2019s death. That night, Wallace woke up, sweating and breathless with a thumping heart and racing thoughts. It was her first panic attack. From then on, like clockwork at 2 AM for 3 years, Wallace would wake up riddled with self-doubt and self-blame.<\/p>\n \u201cI woke up making up patients that I had never seen, thinking that I had prescribed the wrong drug, or I\u2019d missed something when examining a patient,\u201d she said. \u201cI was working 12-hour days and then working all night with my brain, doing fake clinics through my anxiety.\u201d<\/p>\n Following difficult patient cases, many doctors struggle with self-blame. \u201cThere\u2019s this feeling like maybe they should have been able to prevent things, even if realistically and rationally that wasn\u2019t possible,\u201d said Shin Ock, PhD, a Washington, DC\u2013based clinical psychologist who specializes in therapy for physicians and executives.<\/p>\n \u201cOftentimes [in therapy sessions], we\u2019re working on not letting those difficult experiences define physicians\u2019 future experiences or lead to further avoidance, because I think that\u2019s mostly where the anxiety can start getting in the way of practice,\u201d Ock explained.<\/p>\n Hiding the Panic<\/strong><\/p>\n In medical school and residency, no one guessed that Fisher suffered from anxiety. He was very good at hiding it. He leaned into the stereotypical overachiever doctor persona, seeing his struggles as sacrifices in the service of others.<\/p>\n In the early years of his practice, Fisher dealt with sleepless nights, headaches, and stiff muscles. He started feeling a sense of dread before going to work in the morning. Then the dread started on Sundays, knowing he was going back to work the next day. Before long, he was spending the whole weekend in that state.<\/p>\n Meanwhile, Fisher was seeing patients with anxiety-related heart symptoms that he had experienced himself, including palpitations, rising blood pressure, and chest tightness often worsened by emergency situations, a heavy workload, or insufficient sleep.<\/p>\n The dread of going to work mounted until Fisher felt unable to function. He knew he needed help but felt reluctant to seek it. \u201cThat resistance is something that I see in a lot of colleagues today,\u201d he said. \u201cThere\u2019s a fear that if others find out that a physician needs help with their own mental health, then maybe they can no longer be trusted to care for others.\u201d<\/p>\n Wallace\u2019s anxiety also went unnoticed by her colleagues, who thought of her as \u201chappy-go-lucky,\u201d until a receptionist walked in on her having a panic attack after a difficult morning clinic. Wallace was sent home, leaving her colleagues surprised by how severe her anxiety really was.<\/p>\n Also attempting to keep his anxiety and panic hidden, Kirch never told his classmates, colleagues, or family members until his fateful visit to the dean\u2019s office. \u201cWhy? There\u2019s a one-word answer: Stigma,\u201d he said.<\/p>\n Solutions and Strategies<\/strong><\/p>\n When physicians receive treatment for anxiety, the results can be dramatic.<\/p>\n That dean referred Kirch to a psychiatrist and after being treated for generalized anxiety disorder, Kirch graduated near the top of his class and went on to become a psychiatrist and clinical neuroscientist. From 2006 to 2019, he served as the president and CEO of the Association of American Medical Colleges (AAMC). He has received 11 honorary doctoral degrees and the Outstanding Service Medal of the US Public Health Service for his leadership and contributions to the field.<\/p>\n Kirch takes antidepressants for his anxiety, along with short-term benzodiazepine to manage panic attacks as needed. But he has treated many physicians who have been reluctant to take psychiatric medications, which he suspects is due to stigma.<\/p>\n Along with medications, Kirch makes use of cognitive strategies to keep his anxiety and panic at bay. He does meditative breathing exercises. He \u201crides the wave\u201d of his anxiety rather than resisting it. And he uses self-talk to bring himself back to reality. \u201cIf I\u2019m feeling anxious, I remind myself that this is my fight-or-flight syndrome acting up at an inappropriate time,\u201d he said. \u201cThere is no saber-tooth tiger sneaking up behind me, no foe waiting in the wings to kill me. It is simply my evolutionary biology acting up.\u201d<\/p>\n Despite Fisher\u2019s initial resistance to seeking help, he has since built a \u201cpersonal toolbox\u201d of skills to manage his anxiety, including what he calls \u201couter work:\u201d Support from others, and \u201cinner work,\u201d including mindfulness and strategies from cognitive behavioral therapy, which involve observing thoughts and feelings rather than identifying with them.<\/p>\n \u201cI don\u2019t suffer from anxiety anymore,\u201d Fisher said. \u201cThere\u2019s a difference between experiencing something and suffering from it. I now have a healthier relationship to worrying thoughts. I honor them, I listen to them, and I address them, and I put them away.\u201d<\/p>\n Through medication, talk therapy, meditation, lifestyle changes, or a combination, the right treatment can help physicians to feel more in control of their minds and their careers. For some, though, therapeutic measures are not enough.<\/p>\n After many sleepless nights and panic attacks, Wallace\u2019s coroner\u2019s inquest concluded that there was nothing else she could have done to prevent the patient\u2019s death.The patient\u2019s family thanked Wallace for her care.<\/p>\n But a year later, her anxiety was still lingering, leading her to seek help. She tried online cognitive behavioral therapy, counseling, and mindfulness. \u201cNone of it really took away that trigger of the responsibility that I felt and the risk if something went wrong,\u201d she said. \u201cMy anxiety couldn\u2019t handle it.\u201d\u00a0<\/p>\n The only thing that helped Wallace was pivoting in her career. She switched from her work as a general practitioner to focus on disability medicine and occupational health. Wallace still marks that initial phone call about the inquest as the moment she lost the joy in her practice.<\/p>\n \u2018Two Words: Reach Out\u2019<\/strong> When asked for the #1 piece of advice they would give to healthcare professionals suffering from anxiety, Kirch, Fisher, Wallace, and Ock all gave some variation of the same advice: Talk about it, even if your voice shakes.<\/p>\n During the COVID-19 pandemic, Wallace shared her story through her article \u201cA Doctor\u2019s Duty,\u201d published in InnovAiT<\/a>. To this day, people from all over the world reach out to tell her they feel the same way, and often that they are suffering in silence and isolation.<\/p>\n Ock said this is crucial. \u201cIf you can be the brave person to say \u2018me too,\u2019 or if you can reach out to a professional or a colleague or anyone, it\u2019s going to help you feel less powerless, less isolated, and less like you have to live up to some sort of perceived expectation.\u201d<\/p>\n Fisher also prioritizes sharing his experience with healthcare professionals and patients alike. A healthcare executive and keynote speaker, he has written a guide for patients and doctors struggling with anxiety and depression called Just One Heart: A Cardiologist\u2019s Guide to Health, Healing, and Happiness.<\/p>\n It was decades into Kirch\u2019s career before he decided to open up about his struggles. He shared his story with AAMC News<\/a> and wrote an article for Academic Medicine titled \u201cPhysician Mental Health: My Personal Journey and Professional Plea<\/a>.\u201d This past March, he told his story at a national, thousand-person annual meeting of residency directors.<\/p>\n \u201cIf you suffer from anxiety, do what that dean helped me do: Get proper help,\u201d Kirch said. \u201cYou can thrive, and you will be a better doctor for it. The more open we are, the better care we\u2019ll take of ourselves and the better care we\u2019ll take of our colleagues. Two words: Reach out.\u201d<\/p>\n Read more about the mental health challenges and solutions for medical professionals:<\/p>\n How These MDs Conquered Imposter Syndrome<\/a><\/p>\n How Physicians with Addiction Heal and Return to Practice<\/a><\/p>\n How a Mindset Shift Can Transform the Way You Practice<\/a><\/p>\n Med Student Mental Health: Why Future Healers are Hurting<\/a><\/p>\n Why Postpartum Depression Hits Physician Moms at High Rates<\/a><\/p>\n \u2018I Feel Alone\u2019: Why Loneliness is Now Common Among Doctors<\/a><\/p>\n Why Do MDs Have Such a High Rate of Eating Disorders?<\/a><\/p>\n Why \u2018Resilience\u2019 Can Be a Loaded Term for Healthcare Workers<\/a><\/p>\n![\"photo](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/05\/ht-250515-jonathan-fisher-120x156.jpg\")
Jonathan Fisher, MD<\/p>\n![\"photo](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/05\/ht-250515-karen-wallace-120x156.jpg\")
Karen Wallace, MD<\/p>\n![\"photo](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/05\/ht-250515-shin-ock-120x156.jpg\")
Shin Ock, PhD<\/p>\n