The impact of depression
on healthcare
practitioners (HCPs)

If you’re a healthcare practitioner struggling with your mental health, you
are not alone. The Canadian Medical Association’s 2021 National Physician Health Survey revealed that 6 in 10 respondents reported having worsened mental health since before the COVID-19 pandemic. Nearly half of respondents screened positive for depression.

Stressors in the medical profession include physical isolation, a surge in care demands, scarcity of critical resources
like personal protective equipment (PPE), ongoing risk of infection and financial hardship or worry.

In the Survey on Health Care Workers’ Experiences During the Pandemic, the three most commonly reported job impacts were:

Feeling more stressed at work (86.5%)
Increased workload (74.6%)
Having to do work that they do not normally do (55.5%)

From burnout to exhaustion to moral distress, healthcare practitioners are facing deteriorating mental health, with the COVID-19 pandemic worsening existing pain points in the healthcare system.

If you think you might be experiencing depression, the information, tips and tools below may help.

Look out for these depression symptoms

Depression can lead to a variety of emotional and physical problems and
can decrease your ability to function at work and at home. As a healthcare practitioner, you might be accustomed to assessing symptoms in others – it may be more of a challenge to spot your own. Here are some depression symptoms to look out for, which can range from mild
to severe:

Feeling sad or having
a depressed mood

Loss of interest or pleasure
in activities once enjoyed

Changes in appetite – weight loss
or gain unrelated to dieting

Trouble sleeping or
sleeping too much

Loss of energy or
increased fatigue

Increase in purposeless
physical activity (e.g.,
hand-wringing or pacing)
or slowed movements and
speech (actions observable
by others)

Feeling worthless
or guilty

Difficulty thinking, concentrating
or making decisions

Thoughts of death
or suicide

If you’ve been experiencing these symptoms for at least
two weeks, you may be experiencing depression.

Recognizing anxiety symptoms associated with MDD

Depression is often accompanied by
anxiety symptoms, such as:

Feeling keyed up
or tense

Being unusually
restless

Having difficulty concentrating because of worry

Fear that something awful may happen

Being afraid of
losing control

Mild
anxiety

2 symptoms

Moderate
anxiety

3 symptoms

Moderate-severe
anxiety

4-5 symptoms

Severe anxiety

4-5 symptoms
with
motor agitation

Up to 90% of depressed patients
experience anxiety symptoms

Dealing with compassion fatigue and moral distress

Compassion fatigue

If you’re a healthcare practitioner, you likely have a desire to help relieve other people’s suffering. But there can be a
cost to caring for others and supporting them through their emotional pain.
This is called compassion fatigue.
The COVID-19 pandemic may have increased your risk of experiencing compassion fatigue due to the influx
of very sick patients, bed and staff shortages, lack of resources like ventilators and PPE and added
personal risk.

The symptoms of compassion fatigue can make it more challenging for you to provide patient care and perform your work duties.

Look out for the following warning signs:

Feelings of helplessness and powerlessness in the face of patient suffering
Reduced feelings of empathy and sensitivity
Feeling overwhelmed and exhausted by work demands
Feeling detached, numb and emotionally disconnected
Loss of interest in activities you used to enjoy
Increased anxiety, sadness, anger and irritability
Difficulty concentrating and making decisions
Difficulty sleeping and sleep disturbances like nightmares
Physical symptoms like headaches, nausea, upset stomach and dizziness
Increased conflict in personal relationships
Neglect of your own self-care
Withdrawal and self-isolation
An increase in substance use as a form of self-medication

Moral distress

Do you feel unable to do the right thing? Like your values are being compromised? Do you feel like you’re unable to be the professional you know you should be?

As a healthcare practitioner, you may be forced to make ethical decisions, like choosing who receives which level of
care, depending on the resources available. Being faced with a situation
you can’t change or one that’s at odds with your personal or professional value system can lead to moral distress.

To manage moral distress, try asking for support from colleagues, mentors and peer support groups, meeting with your department to share decision-making
and debriefing with your team when morally charged situations occur. You can also try reaching out to an ethicist to
work through the situation.

Tips to help you cope

Communicate openly. Talk to your coworkers, supervisors and employees about how you’re feeling and work on identifying stressors and solutions.
Stick to a routine. Try to get adequate sleep, make time for healthy meals and take breaks when you
need them.
Avoid misusing drugs or alcohol. If
you feel you may need it, ask for help.
Get outside. When you’re away from work, try to spend some time outdoors being active.
Take breaks from the news cycle.

It can get overwhelming and mentally

exhausting watching, reading and

listening to news stories and

social media.
Be mindful. Engaging in
mindfulness techniques such
as breathing exercises and
meditation can help.
Recognize how amazing
you are. You are performing
a crucial role and doing
the best you
can with
the resources you’ve
been given.

Reflect on your feelings at transition points during your day

On your way to work: Get ahead of any anxious thoughts by asking yourself how you feel and how you want to feel. Is there anything you can do with your feelings right now?
Between tasks at work: As you move from one task to the next, ask yourself whether you’re feeling anxious or distracted. Do you need a mental break?
On your way home from work: Process the day during your commute home, and be ready to ask your loved ones for help transitioning mentally and emotionally. Do you want to vent about your day? Or do you need to be left alone for a bit?

Look out for number one (that’s you!)

By putting yourself first and focusing on managing your depression, you will be better equipping yourself to care for your patients.
It’s easy to let yourself get distracted, but so important to take care of yourself first, before taking care of others.

Don’t be afraid to ask for help from coworkers, family or friends to help balance things while you focus on yourself.

Goal setting

Working toward specific goals can help you live the life you want while managing depression. You may start with setting one small goal to accomplish each day (e.g., writing down 3-5 things you’re grateful for in a journal or going to sleep an hour earlier than usual). Ask yourself, "What's one thing I can do today that helps me get closer to where I want to be?" Once you become more confident, you can work on accomplishing larger, more long-term goals. Think of the short-term goals you set as stepping-stones to your larger recovery goal.

To help you figure out what goals to set, think about:

What’s important to you?
What are your hopes and dreams?
What would you like to do more of?
What does being happy mean to you?
What is an area of life you would like to improve (e.g., relationships)?

Short-term goal ideas

Be out of bed by a certain time
Finish a household task
Call a support group
Spend some time with family
or friends
Go for a walk in nature
Stick to a daily schedule

Long-term goal ideas

Improve or build a relationship with
a friend or family member
Get involved in the community
Plan a trip
Find a hobby you love

Download this form to help keep track of your short- and long-term goals.

Download goal setting form

My symptom journal

Download this helpful journal to help keep track of your symptoms.

Download symptom journal

Online resources

Here are some helpful online resources for managing depression in healthcare practitioners.

Canadian Medical Association. Sound Mind podcast.

cma.ca/physician-wellness-hub/sound-mind-podcast

Canadian Medical Association. Virtual peer support.

cma.ca/physician-wellness-hub/wellness-connection

Canadian Medical Association. Powering your wellness.

cma.ca/physician-wellness-hub/physicians

Canadian Medical Association. Pandemic wellness toolkit.

cma.ca/physician-wellness-hub/pandemic-wellness-toolkit

CAMH. Resources for health care workers during
COVID-19.

camh.ca/en/health-info/mental-health-and-covid-19/information-for-professionals

Ontario Shores Centre for Mental Health Sciences. Depression resources and support.

ontarioshores.ca/resources-support/self-help-resources/depression-resources-and-support

Dr. Mélanie Joanisse. Psychological first aid for frontline health care providers during COVID-19.

drive.google.com/file/d/1Du1uWFE6v7DsO5k0PiKV5j2cZF_MiVnu/view

Waypoint Centre for Mental Health Care. Frontline Wellness.

waypointcentre.ca/programs_and_services/frontline_wellness_program

Please note that Lundbeck is not responsible for the content and management of the websites mentioned above.

Looking for more information?

For more information about depression and its treatment, or to find help and resources, you can refer to the following websites:

MOOD DISORDERS SOCIETY OF CANADA

mdsc.ca/

CENTRE FOR ADDICTION AND MENTAL HEALTH

camh.ca/en/hospital/Pages/home.aspx

CANADIAN MENTAL HEALTH ASSOCIATION

cmha.ca/document-category/mental-health

http://www.heretohelp.bc.ca/factsheet/depression

MENTAL HEALTH COMMISSION OF CANADA

mentalhealthcommission.ca/English/

GOVERNMENT OF QUEBEC

https://www.quebec.ca/en/health/health-issues/mental-health-mental-illness/depression

Please note that Lundbeck is not responsible for the content and management of the websites mentioned above.

Learn to support loved ones who are struggling with their mental health

The Be There Certificate is a learning experience aimed at providing you with the knowledge, skills and confidence to safely support anyone who may be struggling with their mental health.

Be There Certificate

betherecertificate.org

Please note that Lundbeck is not responsible for the content and management of the website mentioned above.

We hope you find this information helpful. Don’t hesitate to discuss any questions or concerns that you have about MDD and depression.

The impact of depression on healthcare practitioners (HCPs)