Because of the high suicide rate, most medical schools and hospitals now have mental health programs. This may include counseling services and support groups. The ACGME for many states has made learning about mental illness a part of continuing medical education. 

While these self-help services are a nice thought, the crux of the problem lies within the toxic, self-sacrificing work culture. 

So how can you succeed as a doctor, land your dream job, but preserve your mental health? From the very beginning, connect yourself with a counselor who has experience with healthcare providers. Establish care with a primary care provider, perhaps even a psychiatrist if you have a known history of anxiety or depression. Preemptively schedule weekly appointments. Despite your grueling schedule, these must become part of your routine. Pay cash and hide it if you must.

As soon as you start to experience symptoms of depression or anxiety, alert your providers and take action. Treating these things during a crisis is like trying to abruptly stop a spinning merry-go-round. Once set in motion, the inertia is much more difficult to reverse.

Many turn to drugs and alcohol to curb the anxiety or help them sleep. Rely on healthy methods from your healthcare team. You may need to change your friend circle to ensure you do not fall into these habits. If you currently struggle with addiction, it’s even more important to recruit the help of a psychiatrist. 

Doctors are taught to be independent and solve their own problems. This mindset only leads to feelings of shame, guilt, and depression when you cannot overcome the addiction on your own. 

In your professional life, set firm boundaries. In Andy Stanley’s book Choosing to Cheat, he describes how many cheat on their families with their jobs, but when they ask for time off, their boss accuses them of ditching the team. No matter which you choose to prioritize, you will cheat in some area of your life. Determine when and how you will invest your time and stick to it.

For example, set a work or study schedule. Others will push you to work more but stand firm. You may lose patients, opportunities, or miss some things, but keep in mind, for every decision there is an opportunity cost.

For every additional hour you work above your limit, this takes a toll on your family, relationships, physical, and mental health. Is it worth it?

As a student, it can be incredibly difficult to choose a specialty. You may enjoy the rush and grueling hours, but in twenty years, will you realistically want to keep working at the same pace?

Have these conversations openly with your family and partner. They know you oftentimes better than you know yourself. If you’ve been in practice for some time, consider going part time or changing specialties. This can feel overwhelming at first, but nothing is worth your mental health.

Being a doctor includes defending yourself – learn how to stand up for yourself professionally. 

Every day, someone somewhere will challenge your boundaries. Dr. Henry Cloud describes in his book Boundaries how to effectively, powerfully, and professionally communicate and maintain healthy boundaries at work. 

I hope these tips will help you steal your time back; you deserve it.
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**Editors Note: For more resources on mental health for physicians, consider reading our other articles on the topic**