Picosecond laser predictions; wildfires and atopic dermatitis; and protecting your mental health: Psychiatry-Dermatology crossover

Dermatology Weekly

Physicians face unique challenges with regard to mental health but often are resistant to seeking professional treatment. In this special crossover episode, Guest Host Dr. Candrice Heath (@drcandriceheath) talks with Dr. Lorenzo Norris from the MDedge podcast Psychcast and psychiatrist Dr. Nicole Washington (@drnicolepsych) about common stressors and mental health conditions they encounter when treating the physician population. They discuss how dermatologists can evaluate and protect their mental health, particularly during the coronavirus disease 2019 (COVID-19) pandemic. “We will have to show ourselves some grace and realize that there are going to be some days where we don’t do as well as we think we should do, because we all have very high expectations for ourselves,” Dr. Washington advises.

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We also bring you the latest in dermatology news and research:

• Authors of picosecond laser review predict more widespread use of the technology
• California wildfires caused uptick in clinical visits for atopic dermatitis
• COVID-19 update: distancing works, N95 respirators work better

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Key takeaways from this episode:

• Common mental health disorders in physicians include anxiety spectrum disorder, depression, and substance use. Burnout and demoralization often present as precursors to these syndromes.
• Physicians have a higher suicide rate than do the general population, with an estimated 300-400 physicians dying by suicide each year. “If there are that many who actually complete, how many more are there who walk around with the thoughts daily who don’t complete? How many are there who we don’t include in the numbers that we have as far as the anxiety and depression and substance abuse because that relies on either them admitting to it or seeking treatment for it? The numbers I think are much larger,” Dr. Washington says.
• Economic uncertainty and financial stress brought on by fewer patient visits has created new anxiety for dermatologists that was not there before the COVID-19 pandemic.
• Some physicians feel guilty that they are not on the front lines of the COVID-19 pandemic. “They are feeling as if they’re watching their peers jump in and be in the game ... and they’re kind of just sitting on the bench. I’ve had multiple physicians talk about the guilt that they feel or feeling as if they aren’t doing enough and really being harder on themselves about their lack of action on the front lines, and that is affecting their mental health,” Dr. Washington observes.
• The amount of work physicians have taken on to keep outpatient care afloat during the pandemic can become a source of stress. “Many of my colleagues, even though they’re not necessarily seeing COVID patients, their workloads have increased tremendously ... it’s like the volume has gone down, but the stress of everything -- and meetings and constant information and education -- has gone up. So I kind of like to think sometimes COVID is everywhere and it just kind of depends on in what shape or form you have to deal with it,” Dr. Norris points out.
• The biggest thing dermatologists can do to protect their mental health is to be honest about their feelings and be willing to reach out and get professional assistance.
• Because dermatology often is perceived as the “happiest” specialty among medical professionals, dermatologists may not be pursuing treatment for their mental health because they feel bad about saying they are having a hard time. “Don’t let your circumstances or what you think people see as your circumstances stop you from reaching out,” Dr. Washington advises.

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Hosts: Nick Andrews; Candrice R. Heath, MD (Temple University Hospital, Philadelphia)

Guests: Lorenzo Norris, MD (George Washington University, Washington); Nicole Washington, DO, MPH (Elocin Psychiatric Services)

Disclosures: Dr. Heath reports no conflict of interest. Dr. Norris reports no conflict of interest. Dr. Washington reports no conflict of interest.

Show notes by: Alicia Sonners, Melissa Sears

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You can find more of our podcasts at http://www.mdedge.com/podcasts

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