Abusing a substance (drugs, alcohol, food) or an activity (gambling, sex, shopping, exercise) as a way of attempting to relieve stress, anxiety, depression, feelings of isolation and loneliness, anger, or any uncomfortable or unwanted psychological/emotional state is self-medicating. For all of our knowledge and understanding of this issue, we, in the healthcare professions, are not immune to this way of coping. In fact, many aspects of our careers foster this unhealthy strategy for those who may be inclined (through genetic predisposition, environmental experiences, or both) towards addictive behaviors.
Healthcare professionals, particularly those of us who choose to work with patients facing life-threatening illnesses, are constantly confronted with the fragility of the body and with mortality. We guide our patients and families through life and death scenarios daily. Our own death anxiety, our histories of illness, injury or loss, our beliefs and values are peaked and challenged again and again. We hold ourselves responsible for the well-being of our patients and we do all of this in settings that are, typically, fast-paced, intellectually and physically demanding, yet emotionally and spiritually underserved.
As human beings, we seek to maintain a sense of equilibrium, of well-being through balance. When we feel or fear that that balance is tipping, we do what we can, what we’ve been taught or know, what is expected or acceptable among our peers to “right the scales."
For healthcare professionals, that equilibrium is consistently challenged; the injustice of illness, the intense emotional responses of our patients, the demands of our work and colleagues, and the realities of medicine’s limitations can leave us feeling empty, drained, sad, angry, frustrated, and overwhelmed. Ideally, our satisfaction in our work, the meaning and purpose that we find through our interventions, and the connections that we make and cherish provide a powerful balance for all of that.
As work and life stressors increase, however, that balance becomes harder and harder to achieve and the scales tip further and further towards feelings of helplessness or hopelessness, impotence, loneliness, grief, and rage. When that happens, we must find ways to rebalance the scales. Sometimes a drink with friends after work is just a drink, a shopping spree is just a spree, a chocolate cake is just a cake. But when our emotional account balancing begins to depend too heavily on one substance or behavior, it may be time to stop and consider our strategies for coping. We might ask ourselves from time to time, “Am I drinking, smoking, shopping, exercising, gambling, etc. too much?”
We all deserve to feel well, to feel loved, successful, and proud of our work and in our lives. We all deserve to find healthy coping strategies that make it possible for us to thrive. No one starts self-medicating with a plan to become addicted to anything; on the contrary, it’s a natural response to the need for a return to stability when multiple stressors over time create an emotional and psychological imbalance.
When behaviors like this become troubling, reclaiming responsibility for our mental health is a powerful choice. Talking with a trusted friend or colleague, a therapist, or a clergy member can be a positive step towards finding ways of coping that help to reduce the need for self-medicating behaviors. We can take our own mental health seriously, and we should -- for the ones that we love, for our colleagues and patients, and, above all, for ourselves.