Acupuncture May Help Depression



A new study finds acupuncture to be highly effective in treating depression.


 

ACUPUNCTURE MAY HELP DEPRESSION

At least 1 in 10 Americans have been afflicted with major depression at some point in their lives, and some studies suggest that as many as 1 in 5 Americans have experienced significant depression before.  At any given time, an estimated 7 percent of adults in the United States are suffering from major depression.  (For reasons that are not entirely clear, women are twice as likely as men to be diagnosed with major depression.)  In view its very high incidence, it is not surprising that major depression is the leading cause of disability in the U.S. for people between the ages of 15 and 44.

There are a variety of potentially effective therapies available for depression including, primarily, cognitive therapy (i.e., meeting with a therapist for counseling) and antidepressant medications.  However, in view of the limited coverage made available for cognitive therapy by health insurers, there has been an increasing reliance upon antidepressant medications in the U.S. for many years.  While many of these medications can significantly reduce the signs and symptoms of major depression, they are often associated with significant side effects, and as many as half of all patients with severe chronic depression will fail to respond to most such medications.

A newly published prospective randomized controlled study from England suggests that acupuncture may be as effective as cognitive therapy and antidepressant medications as a treatment for depression.  This study appears in the online journal PLOS Medicine.

In this study, 755 patients with documented chronic major depression were randomized to one of three different treatment groups: acupuncture, cognitive therapy (counseling), and “usual care alone.”  (The latter group, which also included the use of antidepressant medications, served as the “control group” for this clinical study.)  All patient volunteers were subsequently reassessed with validated diagnostic tests throughout the 12-month course of this clinical study.

On average, the patient volunteers who participated in this clinical trial underwent 10 acupuncture sessions and 9 counseling sessions.  Compared to “usual care,” there was a statistically significant decrease in depression-associated symptoms in both the acupuncture and the counseling groups at 3 months and at 6 months after the start of this clinical study (by 12 months, however, the patients in the “usual care” group had improved to a level comparable to the acupuncture and counseling groups).  To summarize, acupuncture and counseling were each found to be highly effective in reducing the severity of depression-associated symptoms in patients with moderate-to-severe depression, and both were actually found to be more effective than the “usual care” (including antidepressant medications) received by the control group of patient volunteers at 3 months and at 6 months. 

This small study suggests a potential role for acupuncture in the treatment of major depression, and should stimulate additional research in this, and other, non-pharmacologic therapies for depression, particularly given the minimal risks associated with acupuncture in otherwise healthy patients.  However, if you are already taking antidepressant medications, and you are interested in trying acupuncture as a treatment for depression, please do not stop taking your medications without your doctor’s approval, as doing so could result in a worsening of your depression!

 

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According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  Over the past 12 months, more than 3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious readers.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 


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Impact of Gun Control Legislation on Gun Deaths



A new study links gun control laws with a significant decrease in deaths caused by firearms.


 

IMPACT OF GUN CONTROL LEGISLATION ON GUN DEATHS

Each year, more than 30,000 people are killed by firearms in the United States. In 2010 alone, 68 percent of the more than 16,000 murders recorded in the United States were carried out using firearms, while 51 percent of the more than 38,000 suicides were associated with the use of firearms. Recent mass shootings, including those in Colorado, Wisconsin and Connecticut, have further aggravated the ongoing debate by people on both sides of this issue, as new gun control legislation is being considered by Congress.

Amidst the vigorous and ongoing debate regarding gun control legislation, passionate claims are being made by those for and against such legislation. For example, one argument put forth by advocates of minimal (or no) gun control is that placing limitations, of any kind, on gun ownership is not an effective means of reducing deaths caused by firearms. Yet, there is fairly abundant research data available linking the presence of guns in the home with a significant increase in the risk of gun-associated death (compared to homes in which there are no firearms), including both homicides and suicides associated with the use of firearms.

The effectiveness of existing gun control laws has also been heavily debated by opposing camps, with little consensus being arrived at in this area. Now, a newly published public health study adds compelling data linking tighter gun ownership regulations with a lower overall risk of gun-associated deaths, including homicide and suicide. This new study appears in the current issue of the journal JAMA Internal Medicine.

The authors of this study combined a review of firearms-related deaths in each state (using data from the Centers for Disease Control) with a review of existing gun control laws in each state. Following an analysis of this extensive data, the impact of gun control legislation on gun-associated deaths was then assessed for each state. The researchers also attempted to control for other socioeconomic and demographic factors known to be associated with gun-associated deaths, including age, gender, race/ethnicity, poverty, unemployment, level of education, population density, violence-related deaths not associated with firearms, and household firearm ownership.

Over the 4-year duration of this public health study, there were 121,084 gun-associated deaths in the United States. The average incidence of firearm-associated deaths varied significantly between individual states, ranging from a low of 2.9 per 100,000 people in Hawaii to a high of 17.9 per 100,000 people in Louisiana. Strikingly, states with the most stringent gun control laws had a 42 percent lower overall incidence of deaths associated with guns when compared with those states having the least stringent (or no) laws. More specifically, firearm-associated suicides were 37 percent less common in states with more stringent gun control laws, when compared to states with minimal or no gun control laws. Similarly, the incidence of firearm-associated murders was 40 percent lower in states with higher level gun control laws, compared to states with minimal or no firearms laws.

Taken together, the data presented in this landmark public health study significantly linked the presence of gun control laws with a marked decrease in firearms-associated deaths (including both suicides and murders), and the absence of such legislation was associated with a significant increase in gun-associated deaths.

I do not aim to take a “political side” in the ongoing debate regarding gun control legislation in this article. However, the findings of this study, as with prior public health studies, strongly link the presence of gun control legislation, at the individual state level, with a significant decrease in the incidence of gun-associated deaths, including both suicides and murders. Sadly, however, I do not think that studies such as this one, no matter how scientifically valid, will do much to change the tenor of the ongoing debate regarding gun control legislation, particularly since recent mass shootings in the United States, including the shocking murder of 26 elementary school children and their teachers on December 14, 2012 in Connecticut, appear to have done little to bridge the enormous gap between those favoring more rigorous gun control legislation and those who remain opposed to such legislation. That being said, I hope that those responsible for considering and enacting such legislation will pay attention to public health studies such as this one when it comes time for them to cast their votes….

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.com Top 100 New Book Releases in Cancer” list.

 

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At this time, more than 8 percent of Americans are unemployed.  According to the Bureau of Labor Statistics, however, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is now more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  Over the past 12 months, more than 2.7 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious readers.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 


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Chronic Anxiety and Depression Significantly Increase the Risk of Early Death




 

A large new study suggests that chronic anxiety and depression are associated with a higher risk of premature death than was previously appreciated.


 

 

CHRONIC ANXIETY AND DEPRESSION SIGNIFICANTLY INCREASE THE RISK OF EARLY DEATH

As I discuss in my bestselling book, A Cancer Prevention Guide for the Human Race, most previous research studies have suggested only rather weak links between chronic stress and cancer risk, although there is some data linking chronic depression with breast cancer risk.  However, in view of the increasing number of people around the world who are currently experiencing chronic anxiety and depression during these economically and geopolitically troubled times, the findings of a new public health study that psychological distress significantly increases the risk of premature death from serious illnesses, including cancer, is concerning.  This new study appears in the current issue of the British Medical Journal.

Altogether, 68,222 adults in Great Britain were followed for an average of more than 8 years within the prospectively conducted Health Survey for England study.  All of these study participants were clinically free of serious physical illness when they first joined this very large public health study.  All of the participants in this study were assessed for psychological stress using a validated assessment questionnaire, which was administered in their homes by research staff.  Subsequently, the incidence of serious physical illnesses during the course of this study was then correlated with the degree of measured psychological distress.  The rather dramatic findings of this large prospective public health study illustrate the magnitude of the impact of chronic, severe stress on our bodies, including the risk of premature death due to stress-associated physical illnesses.

After adjusting for preexisting serious physical illnesses, lifestyle-associated risk factors for serious illnesses, and socioeconomic factors known to be linked to chronic, serious illnesses, this study still identified a highly significant increase in the risk of premature death associated with the extent of psychological distress among volunteers in this very large study.  When the “psychological distress score” was compared with death rates, having a score of 1 to 3 (compared to a score of “0,” which reflects no evidence of psychological distress) was associated with a 20 percent increase in the risk of premature death.  A psychological stress score of 4 to 6 was associated with a 43 percent increase in the risk of early death, while a distress score of 7 to 12 was associated with a whopping 94 percent increase in the risk of premature death when compared to study volunteers who were without evidence of any significant psychological distress!

Upon further analysis, death due to cardiovascular disease and other non-cancer causes increased significantly, and proportionally, with each increase in the psychological distress score.  Cancer-associated deaths also increased with rising psychological distress scores, although this association was only observed among volunteers with significantly elevated distress scores.  However, for non-cancer causes of death, the risk of premature death was significantly elevated with evenmild increases in psychological distress.

The potential impact of this study’s findings are highly significant, as they not only reveal a “dose-dependent” relationship between stress levels and the risk of premature death from serious physical illnesses, but the sheer magnitude of the impact of high levels of chronic anxiety and depression on the risk of premature death is much higher, potentially, than has been observed in previous and much smaller studies.

Although this study was not designed to identify the biological mechanisms whereby prolonged periods of increased psychological distress lead to early death, numerous prior studies have shown that chronic depression and anxiety can directly activate an inflammatory response in humans which, in turn, is known to increase the risk of cardiovascular disease, infection, and cancer, as well as other chronic, serious illnesses.  It is also well known that chronic anxiety and chronic depression increase the likelihood of unhealthy behaviors that have also been linked to serious, chronic illnesses, including smoking, excess alcohol or other drug intake, unhealthy diets, and lack of exercise, in addition to other unhealthy behaviors.  What is especially unique about this new study (other than its sheer size), however, is that the researchers were able to identify and adjust for preexisting unhealthy behaviors among the study’s volunteers when they analyzed the study’s data, which increases the likelihood that the adverse effects of chronic anxiety and depression on the risk of premature death observed in this research study are actually a direct result of psychological distress rather than unhealthy lifestyle choices.

If you are experiencing high levels of chronic stress, and if you are frequently anxious or depressed, then please seek help from your personal physician or a mental health professional.  If you are thinking of harming yourself, or someone else, then please seek immediate help.  These are very trying times for many people, and the ongoing worldwide challenges that have provoked such high levels of stress do not appear likely to disappear any time soon.  Knowing that so many other people around the world are also feeling worried and chronically stressed can make each of us feel less alone in our distress.  However, sometimes the awareness that others are experiencing similar levels of distress is, by itself, not enough to ease our anxiety or depression.  So, if you are struggling with anxiety or depression, and especially if you are feeling alone and isolated at the same time, then please seek the help and support of others.  In the vast majority of cases, feelings of hopelessness or helplessness will eventually pass when you get help and support during dark times in your life.


 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.




Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


 

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 




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Deep Brain Stimulation May Help Severe, Refractory Depression

Welcome to Weekly Health Update




DEEP BRAIN STIMULATION MAY HELP SEVERE, REFRACTORY DEPRESSION

Depression is both a common and a potentially very serious mental health disorder.  According to the Centers for Disease Control (CDC), nearly 10 percent of the adult population in the United States can currently be classified as having active depression, and approximately 4 percent of the population currently meets criteria for severe, major depression.

The incidence of depression varies considerably between different groups of people.  For example, women are 70 percent more likely than men to experience depression.  Although depressed women are more likely than men to attempt suicide, men are far more likely to be successful in their suicide attempts.  Other high risk groups include people between the ages of 45 and 64 years, people from ethnic minority groups, people with less than a high school education, people who are divorced and who have not remarried, the unemployed, and those without health insurance.  (Clearly, in view of the still ongoing recession in the United States, the number of people in several of these high-risk categories has increased significantly over the past four years.)

There are multiple effective therapies available or depression, including antidepressant medications, psychotherapy, and electroconvulsive therapy (ECT).  More recently, transcranial magnetic stimulation, vagus nerve stimulation, and other experimental treatments have been evaluated in patients with depression that fails to respond to conventional therapies.  Another recently developed experimental therapy for severe, refractory depression is deep brain stimulation (DBS).  In small pilot studies, small numbers of patients with severe depression, and who have failed every other form of depression treatment (including ECT), have had surgically implanted electrodes placed into their brains, followed by electrical stimulation of their brains through these deep brain electrodes.  While it is too soon to conclude that DBS is both safe and effective in the management of severe, refractory depression, a new prospective clinical research study suggests that DBS may, indeed, produce significant remissions in refractory major depression.  This newly published study appears in the current issue of theArchives of General Psychiatry.

In this small but innovative clinical trial, 10 patients with major depression and 7 patients with bipolar disorder underwent surgical implantation of deep brain stimulation electrodes into both hemispheres of the brain.  Initially, all patients underwent simulated (“sham”) DBS, without the patients’ knowledge.  (This sham stimulation was done to test whether or not the patients’ expectation of benefit, or a true potential benefit simply from having the electrodes surgically placed, might have influenced their depression independent of actually stimulating their brains.)  Following 4 weeks of sham stimulation, all patients then initially received 24 weeks of actual DBS.  Following this period of actual DBS, active stimulation of the deep brain electrodes was then temporarily stopped.  (Once again, this discontinuation of active DBS was not revealed to the patients.)  These patient volunteers were then treated with DBS and monitored for up to 2 years.

In this group of patients who had previously failed, literally, all other forms of conventional therapy for their severe depression, DBS was associated with complete remission of depression in 18 percent (3) of the patients, and a significant improvement in depressive symptoms was observed in 41 percent (7) of the patients after 24 weeks of active DBS.  After 2 years of active DBS, 12 patients remained in the study, and 92 percent (11) of these patients experienced significant improvement in their depressive symptoms, including 58 percent (7) who experienced a complete remission of their depression!

The findings of this small prospective, controlled clinical research study are both dramatic and important, and for several reasons.  First of all, the clinically significant improvement seen in almost all of these patients is extraordinary in view of the severity of their depression and the completely refractory nature of their depressive symptoms.  Secondly this study included several patients with bipolar disorder, a disease which is characterized by alternating episodes of mania (a state of extreme mental and physical hyperactivity) and depression.  (Earlier studies of DBS had suggested that this treatment might not be as effective in patients with bipolar disorder, and might also lead to an increased risk of episodes of mania.  However, in this small pilot study, DBS was as effective in treating the symptoms of depression in patients with bipolar disorder as it was in patients with depression alone.  Moreover, DBS did not appear to increase the likelihood of episodes of mania in patients with bipolar disorder.)

 

Depression is a common mental health disorder, and severe cases of depression can leave patients feeling miserable and hopeless.  In especially severe cases, depressed patients may be unable to function in their daily personal or professional lives.  For some unfortunate patients with depression, suicide or accidental causes of death may also end their lives prematurely.  Based upon the findings of this small, preliminary clinical study, DBS may be a safe and effective treatment option for patients with chronic, severe, and refractory depression.

 

If you are depressed, and you are having thoughts about harming yourself (or harming someone else), please immediately contact your mental health provider, a suicide hotline, your personal physician, a close and trusted friend or relative, or your clergy person.  Even during times when you feel like there is no hope that life will get better for you, it almost always will get better if you get some help.

 


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link:

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I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 




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Physicians and Mental Illness

Welcome to Weekly Health Update




New research confirms that physicians frequently suffer from mental illness, and are more reluctant than non-physicians to seek help.



PHYSICIANS AND MENTAL ILLNESS

While physicians are less likely than the general population to die from heart disease or cancer, we doctors are significantly more likely to die from suicide than our lay brothers and sisters.  Indeed, a very troubling statistic is that suicide is the second most common cause of death among medical students (accidents are the number one cause of death).

Multiple studies have shown that physicians are at greater risk of developing significant mental health problems when compared to the general population, including depression and bipolar disorder.  Physicians also have higher rates of alcoholism, and other forms of substance abuse, when compared to the general public.  Although the potential reasons behind this higher incidence of mental illness among physicians continue to be debated, most experts agree that doctors with mental health problems are notoriously reluctant to seek help.  They often do not recognize that they are ill, in the first place; and when they do become aware that they are not well, they are less likely than non-physicians to seek professional help.  Moreover, there are still tremendous stigmas associated with mental illness among health care professionals, causing many impaired physicians to avoid reaching out for help.  As if these adverse factors that discourage physicians from seeking help are not already bad enough, most state medical boards require physicians to disclose whether or not they have ever been diagnosed or treated for a mental illness (or substance abuse) as a precondition for initial licensure or renewal of an existing medical license.  (In many cases, disclosing a prior or current history of mental illness, even if the physician is receiving appropriate treatment, can result in very negative professional and financial consequences for physicians who disclose their history of depression or other mental health problems.)

 

 

In view of these disturbing statistics regarding physicians and mental illness, I find the results of a newly published clinical research study to be quite revealing (and disturbing).  In this study, 108 physicians were asked to confidentially complete a 56-item questionnaire that assessed their distress levels and their willingness to accept various forms of assistance for their feelings of severe distress.  This study appears in the current issue of the Archives of Surgery.

Within the preceding year, fully 79 percent of the surveyed physicians had experienced either a serious adverse patient event or a traumatic personal event that left them feeling very distressed.

When asked about their willingness to seek support or assistance regarding stressful issues in their lives, 72 percent of the doctors indicated that they would be willing to seek help for legal problems, while 67 percent would do so after being involved in a serious medical error.  Another 67 percent of the physicians were willing to seek help for substance abuse issues, while 62 percent were open to seeking medical help for physical illness.  Tellingly, only half (50 percent) of the physicians indicated that they would seek help for mental illness, and an equally small number also indicated that they would be open to assistance regarding serious interpersonal conflicts at work.

When asked about barriers to seeking help, 89 percent of the doctors indicated that they did not have time to get help with the causes of their distress, while 69 percent also responded that they were either uncertain about how to get help or that they had experienced difficulty in obtaining assistance.  A total of 68 percent of the physicians also cited lack of confidentiality, a potentially negative impact on their career, and the stigma associated with seeking help as barriers.

Regarding the most likely sources of support that they would be willing to seek, 88 percent expressed a preference for their physician colleagues, while only 48 percent were willing to be seen by mental health professionals, and only 29 percent were open to participating in employee assistance programs.

 

 

The findings of this study are hardly surprising.   The prevalence of major distress and mental health issues among physicians continues to be very high, relative to the general population.  At the same time, only half of the physicians participating in this study indicated a willingness to seek help for mental health problems.  Similarly, only half of these doctors would be willing to seek help for serious interpersonal difficulties (a common marker for certain psychological and personality disorders) in the workplace.  Among the most often cited reasons for not seeking help were “lack of time” and uncertainty about how to obtain help.  Additionally, the physicians who participated in this confidential study expressed serious concerns regarding confidentiality, the potential for negative career impact, and the perceived stigma associated with asking for help for mental health issues.

 

 

From my own experience as a physician over the past 23 years, I can honestly say that these disturbing statistics and findings regarding physician stress, distress, and mental health problems are, if anything, most likely understated.  Within the medical profession, it is no secret that the true incidence of depression, bipolar disorder, personality disorders, interpersonal strife, marital duress, domestic abuse, and divorce is very high among physicians, in comparison to the general population.  Ironically, and unfortunately, however, as bad as the stigma associated with mental illness is in the general public, it is even more severe within the medical profession.

Over the years, I have known numerous physicians with various forms of mental illness and personality disorders, and I cannot recall a single one of them ever voluntarily reaching out to mental health professionals for help.  Sadly, in view of the strong aversion on the part of physicians with mental illness towards seeking help from mental health professionals,  proactive and progressive steps to eliminate the perceived stigma of mental health problems within the medical profession, as well as removing the potentially punitive sanctions that many physicians would otherwise be subjected to if they sought professional help, will be necessary before troubled or impaired physicians can begin to feel free to seek help and support for the problems that torment them.


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Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


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