Ep 45: Talking about Physician Mental Health with Dr. Jeannie Lawrence

Both physicians and the lay public often feel puzzled when they read an article highlighting a physician who dies by suicide.  But she seemed to have it all: a high-power job, a fancy house, a caring spouse, beautiful children, and so much going for her.  How come it ended this way?

As physicians, we excel at keeping it together at work.  We do this at all costs until we have nothing left.  This expectation is part of our training and socialization.  How do we change the culture?  We do so by starting the conversation:

❤️ Physicians are experiencing record-high rates of burnout and high rates of suicide.
❤️ Physicians have historically looked down on the field of psychiatry, to the point of discouraging bright medical students from pursuing it.
❤️ Physicians may not be underprivileged but are underserved in the area of mental health due to cultural and licensing barriers.
❤️ Most physicians lack insight into their mood disorders but may notice they feel overwhelmed or distant from their loved ones, or turn to food and alcohol to cope.
❤️ Physicians normalize struggle and overwhelm in their personal lives, but normalization doesn't equate to lack of a problem.

I loved part 1 of this important conversation with Dr. Jeannie Lawrence, a psychiatrist, psychotherapist, and coach, who founded the program on Emotional Mastery for Women Physicians.

Tune in to this week's Dare to Dream Physician Podcast episode, and stay tuned for part 2!

Dare to Dream Physician Resources:

Dare to Dream Physician, Life Planning for Physicians

 https://daretodreamphysician.com

Dare to Dream Physician on Facebook

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DreamPhysician on Instagram

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Resources for Dr. Jeannie Lawrence:

Jeannie Lawrence, MD Website at https://www.jeannielawrencemd.com/

@dr.jeannielawrence on Instagram
https://www.instagram.com/dr.jeannielawrencemd/

Transcript

Dr. Gray, Host 0:00

welcome back to another episode of the dare to dream physician podcast. I'm so excited for our guest today and the conversation that we're going to have. this is just a topic. Near and dear to my heart. and I think all of you are going to get so much out of our conversation today. My guest, her name is Dr. Jeannie Lawrence. She's a psychiatrist, a psychotherapist and coach for women physicians. She's the owner of a new. Private practice in North Carolina and also the creator of emotional mastery for women physicians, a program that's designed to help women in medicine create lives that are not only successful in the outside, but feel amazing on the inside. And more importantly, I can just vouch for Dr. Genie, as a person, because I've actually had the pleasure of meeting her in real life, at a retreat last year. And, she's just such a. kind soul and just a really, really amazing human beings. So thank you so much for coming on the podcast, Dr. Gini. Welcome.

Dr. Lawrence, Guest 1:03

Thank you, Wally. I'm so excited to be here and have this conversation with you. Thanks for having me on.

Dr. Gray, Host 1:08

So I I've been really looking forward to our discussion, because mental health is I think so. Important in general. And our, I feel like our culture and our society is now on. the brink of, making that shift to finally de-stigmatizing mental health. but also, in professionals, in physicians, I think this is still maybe more stigmatized and it needs to be for various reasons. but it really. Uh, it, it just lately, when, when I look at the news and I look at stories of physicians that have committed suicide, for example, you know, that I know that's a more extreme version, but to me, when I see that it's just so painful to watch, to, to learn about these stories of physicians that felt like their best way out, because of the pain that they're in is to actually. And their life. because this podcast is about life planning and about helping physicians dare to dream their most fulfilling and meaningful life. I just thought that, your expertise and the conversation that we have is, is gonna help our listeners really think about, what is it about their mental health that they could start making a change in today, that can help them get to their dream line.

Dr. Lawrence, Guest 2:27

I'm really glad that, you were open to having this conversation on your platform. I think that, mental health and physician mental health. like you said something that carries a lot of stigma and it's not talked about as much as, as it should be. And there's a lot of silence and shame around, topics like depression and suicide. And I think the only way, to really reverse, what we're seeing, which is. Record high rates of burnout and, physicians having the highest suicide rate of any profession. The only way that we're going to make a dent in that is starting by having open conversations about it and shedding light on a, on a place that's been really hidden and dark. So I'm really glad that that you've been willing to have this conversation on your platform.

Dr. Gray, Host 3:11

Um, tell us a little bit more about yourself, Dr. Jeanie. I mean, how, how did you end up being a psychiatrist and a psychologist?

Dr. Lawrence, Guest 3:19

Yeah. Hmm. Let's see. So, going down memory lane a little bit, I, didn't when I, when I decided to be a physician, first of all, I didn't know that, psychiatry was a medical specialty and I'll share a quick story. I, I remember as a pre-med student taking a tour of the medical school that I eventually went to, and I was walking with one of the, head deans of the college and she is a psychiatrist. And, I said something to her. I put my foot in my mouth and I said, And when I found out that she used to see a psychiatrist, I was like, I didn't know, psychiatrists were medical doctors. And she was really gracious and didn't shamed me for making that statement. But in retrospect, that was probably, you know, a full pot to say the least to say that to, to my Dean. but she was gracious and explained to me that, yeah, psychiatrists are medical doctors and you can choose this as a medical specialty too. how I landed on it. I definitely, like I said, I didn't know that it was a specialty. I had no thought to go into psychiatry when I started med school. I thought about a lot of different things. Maybe that I might be an OB GYN. I had had a rotation. I spent a whole year actually, interning with an ophthalmologist. I really liked that. but. I went through all of my rotations. And I think psychiatry was like my last or second to last rotation, third year, when we're checking out all the medical specialties and it just felt different when I got there. I liked all my other rotations, but I just loved it. I was like, I agree. I think there's something about, being able to, spend time with folks and hear their stories that really resonated with me. I think my whole life I've been someone who imagine myself working with an underserved population and, psychiatry really allows me to do that because unfortunately mental health is so stigmatized and, so that, that group of people as a whole is generally underserved. And so I think that's, it just kind of clicked for me. And, I went for it. I, I was, another story definitely met with some opposition when I decided to go into psychiatry. this was many years ago, but it wasn't a popular choice. I had, uh, I remember, uh, very clearly in my internal medicine attending, pulling me aside and saying like, Hey, don't, don't go into psychiatry. Uh, whatever you do. And I even had some family and friends who, express. surprise that, that I would choose that out of all the specialties that I could go into. But, I definitely had to follow my gut and my heart in that. And, I'm really, really, really glad that I did. Cause it feels like the right fit for me. So.

Dr. Gray, Host 5:52

Wow. I love, I love that. And I can relate to So. much of what you said there. actually psychiatry was one of, I did not expect this at all, but it was one of my favorite rotations as a third year medical student. And I. highly considered going into psychiatry, as well. And sometimes I, I think back what would have happened if I had picked psychiatry? I think I would really, really enjoy it now. And I still do some of that. because I, I have patients in sleep medicine and, there's a lot of, a lot of mental health where we cover there, but. I just think back to, cause I graduated medical school in 2009 and just even the, the, the culture shift that's happened then, I think in the last, 10, 15 years since I've been in medical school. there's also just been a lot more interest. One is, neuroscience, has really, taken off, made leaps and bounds and discoveries, and it's now in our popular culture and also just that, that starting to de-stigmatize some of these, mental health conditions that, in medical school, maybe we saw extreme cases of. and that was actually the question I wanted to ask you too, which is you started wanting to help the underserved, right. And, and that sort of, kind of what drew you to psychiatry. and now, I'm sure you still have a heart to serve the underserved, but the sense I'm getting is that you're also, wanting to serve a different population. you mentioned like women physicians, women, physicians is not, you were certainly not underprivileged, cause there there's, you, you can argue like with our education. financial, means that, w we're more privileged than a lot of patients that, are, kind of the patients that we think about who we took care of as medical students in psychiatry. but you know, what, what kind of made you interested in, in this population?

Dr. Lawrence, Guest 7:35

Yeah. I liked the distinction that you started to make. between underprivileged and underserved. So I agree with you that women physicians from like a socioeconomic standpoint and education, all of that, is not a, a traditionally underprivileged population, but I do think we're underserved, that when you think about how difficult it is for a physician in general, who's struggling with their mental health, to get any kind of help and support, The, I think that's where the under, under service is. And I think that is, why, uh, physicians have the highest suicide rate of any profession and why women physicians, die by suicide rates that are 130% higher than the population. I think we are underserved because the barriers to care are so high. when you think about, Yeah, a lot of physicians don't seek help because, there are questions like on, on our medical licensing, applications that ask about, uh, mental health history. And there are certainly stories of people being, denied their ability to practice and thereby their ability to. To care for their families because of a diagnosis or something like that. Or when you think about like you mentioned at the very beginning, even though there's been some push in kind of general culture to reduce stigma around mental health, it's still pretty strong in the. The whole community. It's not, it's still not something that we can talk about, openly and honestly, and, again, there's that stigma and that shame that keeps people in silence. The fact that, women in physicians in general, oftentimes opt to, suffer alone. Silence because there isn't that access and support and then end up dying alone, really tragically. Sometimes I think it does point to the fact that, that this group of people is really underserved and just not seen. And, I could go on about that, but I think, what I do now still in a, it still really aligns with, what's always been my, my passion, uh, helping people who, Aren't being helped, and not receiving the kind of care that they deserve. So,

Dr. Gray, Host 9:36

Hm. So, I would just love to hear, as, as a psychiatrist and psychotherapist, you talk to women, physicians, who suffer and maybe oftentimes before they meet you and talk to you, maybe they're suffering sort of alone. I would love to try to just better understand, like, get, get in side the stories and the heads of, these women physicians who, who are, who are suffering, who are, dealing with either depression or anxiety or, multiple mental health conditions. do you have any, of course, keeping everything anonymous, but do you have any sort of stories or examples that, that you could share with us? I have a better understanding of, what it's like to live live with this firsthand.

Dr. Lawrence, Guest 10:20

Yeah. kind of generally sharing and generally speaking, I'll say that, the folks who come to me for help, usually aren't saying that I have depression, they're coming from. I'm really overwhelmed. they're saying, I'm starting to feel burned out at work. I am burned out at work I'm super stressed or, I, I'm not sure how much longer I can, keep doing this. These are like the kind of, chief concerns that, that I hear. and I think when I, I'm glad you asked that question, because I think, people don't often, self-select for depression, right? They don't, they don't come in thinking that they have depression, almost never. they, they just know that, the things I just mentioned that they're stressed or overwhelmed or their relationships maybe with their husband or their kids that they're snapping or, that's that end of things, isn't going to. they know it's like really hard to, to get up and get going in the mornings. and th and they're going to work in there showing up in there, making it, so nobody's noticing that anything is off, but at home, things are falling behind and, Like I said, close family members are noticing that, they don't want to be bothered or they're turning to food or alcohol or something to kind of deal. So I guess what I'm trying to say is that, the presentation that I see is not like that obvious, stereotypical, uh, depression that people might, imagine in get from TV and programming, right? These folks are not. Losing their jobs or not, able to pay their bills or take care of their families are doing all of those things. but behind the scenes and in a much more subtle way, they're, they're, they're struggling and having a hard time and, really pointing to the external things that they're dealing with, like relationship problems and overwhelm and all this stuff. And then when we dig deeper, we see that, sometimes, depression is what's going on underneath all of that.

Dr. Gray, Host 12:07

Wow. As you're describing that, I, this, this, the. Uh, image kind of flashed in my mind, which is, I think exactly why we are always so disturbed when we read an article about physician suicide. Right. Because when you see these articles, you read about the physician who committed suicide. Yeah, Usually their life sounds amazing on the outside right there. They could be, a successful dermatologist with, a, a husband and, multiple kids. And it's like, you, you look at that and. Probably the first reaction is, well, they have so much going for them, why did they end their life? What, what, what, what drive them to end their life. And this is exactly what you were just describing from, from, patients and clients that come meet with you, which is. It doesn't look like there's anything wrong on the outside. And I think that is the silent epidemic of, physician mental health, that it doesn't look like anything's wrong, but there are suffering so much on the inside. It's almost like they can't even acknowledge it themselves because there isn't any, they haven't lost their jobs. They haven't, they're still, they still have their homes. They still have their family. They're not, divorced or, it's. Things don't even look like they're, falling apart, but they feel that way. And they may have been feeling that way for years.

Dr. Lawrence, Guest 13:30

Yeah, I think there's a normalization of struggle in medicine, right? Like we know it's hard. it's, it's difficult to become a doctor is difficult. and so that struggle like B kind of becomes normal. And when you look when all of your colleagues and all of your friends, by the way, are physicians too, who are probably struggling as much as you are, then it just starts to seem like it's again, normal, right? Like everybody, everybody's kind of in a bad mood, right. Everybody's kind of like dreading coming to work. Everybody's kind of, Eating too much or drinking too much or whatever to try to cope, behind the scenes. and so, I think by association, and then also just by, uh, the rigors of the profession, struggle becomes kind of normal. And so that's why people don't really see what they're dealing with as anything that's, that requires any, help or support. I think.

Dr. Gray, Host 14:24

That is such a good point because as you were naming, the one thing that flashed in my mind was yes, this rings exactly true of these physician suicide articles that I read. but then the other part that came to my mind when you were telling me about how these women usually come to you, is, oh, isn't that, that's what every woman physician. You're just looking struggle with, they feel overwhelmed. They're snappy, they're, that's really, that's really more the norm than the exception. and then there's maybe a few unicorns that are not experience in that. And, I, I look up to those people, but in general, it's, it's that's, that is pretty much what we encounter, on a regular basis.

Dr. Lawrence, Guest 15:07

Yeah. Yeah. I think a lot of physicians are kind of. a lot of times you just don't know that there's more out there. Like maybe you have a sense that there's some happy people out there are satisfied people out there. but again, you don't see it. And then there's something about the rigors of medicine. And like when you're working 40 50, 60 hours a week. You're, you're kind of in survival mode. So you don't really have the time or the bandwidth to, really exist at a, at a higher level. If, if that makes sense, you don't have time for personal development and you don't have time for self care or even rest and like, you know, normal bodily human needs that we all have. And so, yeah. All of these are reasons that, the struggle that women physicians go through physicians in general go through, gets unnoticed by folks from the outside. And then also, by the folks, uh, struggling themselves.

Dr. Gray, Host 16:04

I'm so grateful for an opportunity to start the discussion on physician mental health with Dr. Jeannie Lawrence. This is just a teaser of what's going to come next week. When we have part two of our conversation, that is going to be a phenomenal episode. Make sure you're subscribed to the podcast. So you don't miss that episode. In the meantime. I'll be sharing the show notes, ways that you can connect with Dr. Janie Lawrence. I really believe in the work that she's doing. And then I also hope that this will stimulate conversation with you and your colleagues, with you and your family members on physician mental health. Until next time.