Signs of burnout / anxiety / depression / substance abuse

As junior doctors, our job is to look after others who are unwell. However, it’s also important that we look after our own wellbeing. Sometimes, despite our best efforts, things can get away from us and we need to ask for help.

It’s not always obvious when someone is struggling, and sometimes it’s even hard to recognise it in ourselves. Here are some signs that you or your colleague may not be coping:

  • Don't want to see friends or no longer enjoy spending time with friends and family
  • Stop doing things you used to love or don't seem to be enjoying yourself
  • Can't remember things, concentrate, or pay attention
  • Feel bad about themselves—guilty, worthless or ashamed
  • Have a big change in eating patterns or appetite
  • Have extreme mood swings including increased irritability
  • Feel hopeless or really sad, or cry a lot
  • Feel anxious, stressed, nervous or scared a lot and can't seem to relax
  • Are not happy unless using drugs or alcohol
  • Don't take care of appearance or personal hygiene
  • Have signs of injury or that they are hurting themselves
  • Have panic attacks—rapid heartbeat, unable to breathe, feeling dizzy and extremely scared or anxious all at once.
  • Significant unexplained absences from work
  • Physical symptoms such as constant tiredness, headaches, muscle pains, sleep problems, weight gain/loss
  • Expressing thoughts of harming oneself


Signs of substance abuse:
  • Legal problems, eg, trouble with the police through drinking or other drug use
  • Relationship problems
  • Family / whānau problems, such as family or whānau violence, disruptive relationships, financial difficulties through substance abuse
  • Social problems
  • Work related problems, eg, time off work, poor work performance, job loss.
  • Physical effects—shakes, sweats, injuries, effects on physical health


Signs of anxiety:

  • expect the worst
  • worry excessively about money, health, family or work, when there are no signs of trouble
  • be unable to relax, enjoy quiet time, or be by themselves
  • avoid situations that make them anxious
  • be irritable
  • have constant worries running through their head
  • have difficulty concentrating or focusing on things
  • feel edgy, restless or jumpy
  • suffer from stomach problems, nausea, diarrhea
  • suffer from poor sleep
  • need to know what’s going to happen in the future


Signs of depression:

  • Persistent low, sad or depressed mood. Feeling empty, having no feelings, or feeling physical pains
  • Loss of interest and pleasure in usual activities, including loss of interest in sex
  • Irritable mood
  • Change in sleeping pattern. Wake up feeling unrefreshed by sleep
  • Change in appetite
  • Decreased energy, tiredness and fatigue. These feelings may be so severe that even the smallest task seems too difficult to finish
  • Thoughts of worthlessness or guilt. As a result of feeling bad about themselves, people may withdraw from doing things and from contact with others
  • Thoughts of hopelessness and death. Feeling there is no hope in life, or have thoughts of suicide
  • Difficulty thinking clearly, difficulty concentrating.

Source: Mental Health Foundation