BDS – burnout, depression and suicide
Sorabh Patel gives his account of dealing with depression during university and how it helped form The Deciduous Group on Facebook.
In recent years, the stigma of mental health has started to break; but we’ve only just begun to crack through the first few layers.
Many young dentists are facing early signs of burnout and depression, both of which are risk factors and precursors to suicide. Therefore, it is important that we support and talk openly with our colleagues. This way we can remove the stigma behind mental health and make it easier for those in need to come forward with any issues.
Suicide and mental health isn’t a taboo subject in society anymore. We should encourage open dialogue amongst all. It’s 2020 and sadly the rate of suicide in young people has been on the increase, with the highest rate being in that of young men below 25. Dentistry has often ranked near the top, as the profession with the highest rate of suicide. Emotional stress and financial pressures are some of the main factors that contribute to this trend.
Dentistry is a highly competitive field and with the influx of social media, it has led to a surge of mental health issues, especially with young dentists. The pressures of social media have greatly influenced this generation. This leads to increasing feelings of anxiety and issues with confidence and self-worth. However, there has been a shift towards protecting and helping dentists from anxiety, burnout, depression and other mental health concerns. The Confidental helpline and other charities are now helping to shine a light on this once-neglected area of wellbeing.
This isn’t just a topic I pick at random.
This is something I have firsthand experience of. It took some time to express my situation and story. But I want those in similar situations to know that you can overcome it. Help is available and other people still believe in you.
During my final year, I had various projects outside of dentistry and a few within the profession itself. On top of studying, I was working a part-time job throughout university. I was a postgrad with limited funding, so I had to make do where I could.
A few months in my father became ill, he had always suffered from heart conditions, but this time it was more serious. The news he was now borderline risk of having heart failure broke me. I would tell myself that I should have helped him more, I should have acted earlier or that I could have prevented this. I would often count the pills prescribed to him before leaving for campus, just to make sure he was taking them as ordered by his cardiologists. Between clinics I would call and text to remind him and then ask my mum to check.
This all occurred whilst I had to maintain my weekend job, side projects, studying (or trying to at least) and attending clinics to achieve my quota for clinical work. This felt like a lot of pressure and ultimately, my mind would constantly worry over every detail.
I did not ask for help as I felt ashamed in doing so at the time. The shame either came from my apparent sense of pride, the fear of the stigma attached, or from the judgement I may endure from colleagues and friends. I did not want special treatment and believed I could handle it alone.
The above story is an outline of what I had to manage my time between during my final year. And any student will tell you; final year is stressful enough without additional pressures. The inevitable moment came a few weeks before my finals.
I was on clinics, clearing down after a patient and I saw an email from the dental school. Simply put, the email informed me that I had been suspended from finals because I did not reach my quota. The reason being patients cancelling.
I wasn’t a perfect student with the best academic grades, but I had always done what was required and more. The school introduced new rules for sharing quotas and patients, which I adhered to. I went to the extra sessions, did the work and gave up patients to other students with less experience than me. But nonetheless, I was suspended. After eight years of university, I couldn’t sit my final exam. I felt a complete loss of faith in the school and the system. It was emotionally exhausting.
Plunging into depression
My tutor and a good friend knew something was wrong. My mental barrier broke and it all came flooding out. I couldn’t describe how I felt at that moment, but I just remember hating dentistry and losing all hope.
I wish I could say there was some profound advice my tutor gave me to snap out of it or some life-changing paradigm shift, but there wasn’t. It was something to face myself. It was over a year before I regained my self-confidence and achieved a stronger mental state. All before eventually sitting my finals.
It took me some time before I felt comfortable talking about my story. The barriers I put up reinforced my denial over the situation.
‘I am not depressed’, ‘I am not burnt out’, ‘Man up and just deal with it’. Toxic traits and vocabulary strengthening a fall into depression. Even now some of my closest friends will read this and will never understand.
Depression and burnout affect each person differently. I felt that plunging deeper into work I could find my solace and break free. But the more I did, the more I slipped and fell into just giving up altogether.
Eventually, people closest to me started to realise something wasn’t right and after a few deep conversations with a close friend, I realised something was different. I hated how I was feeling; empty and struggling to find some self-worth or my place in the world.
Finally I reached out anonymously. With a confidential adviser, I had someone I could speak to outside of dentistry. It felt cathartic to vent without judgement. With their help, I realised there are other ways to combat these feelings and that it would take time but I could regain and rebuild a stronger mental state. Finally I accepted I had been burnt out and was masking my depression over a thin facade of positivity. I agreed to talk it through and work it out.
Thankfully, with the help of my adviser, I opened up to a few trusted friends outside of dentistry. This did help, they were incredibly supportive, helping me gain perspective on life. I continued with sessions with my adviser for about a year and I could see the progress.
Ask for help
Hindsight is 20-20. Since reflecting on my experience, it has been a blessing and a curse. If I could go back in time to give myself advice, it would have been to ask for help. I understand the struggles and stresses within dentistry that most young dentists might face, especially now with the rise of social media and COVID-19.
My take-home message is that there is help. The stigma is broken and people want to help, I know it is hard to find the courage initially but you are not alone.
This was one of the reasons behind starting The Deciduous Group, a forum for young dentists to learn from a collective experience and to be a platform for growth, learning and support. Since starting the group with other members, we’ve helped hundreds of students. Within the last two months we’ve focused on their anxieties towards COVID-19 and their place within dentistry going forward.
Our experiences shape us into who we are. Looking back, I feel stronger and happier with who I’ve become. And through my experiences I can help others in similar situations.