The connection between the microbiome and mental health
In the award-winning ER drama “The Pitt,” the protagonist Dr. Robby tells a panic-ridden resident doctor to put up “a force field” and keep going. The resident’s panic attack is bottled, unprocessed, and they move on.
While this is a fictional account of life in a chaotic, and often traumatic, medical setting, this is not an inaccurate portrayal of life as a medical provider. “Keep calm and carry on” comes with a price for individuals in the medical field.
Statistics reflect the impact of such stress. One meta-analysis estimates 29% of medical residents meet criteria for depression. Globally, anxiety is more common in healthcare workers than in the general population.
Despite the high prevalence of symptoms, healthcare workers are less likely to seek their own care due to a variety of factors including stigma and time constraints.
Supporting healthcare workers requires more than encouraging resilience—it also means recognizing the unique mental health challenges they face and making care accessible.
How medical professional therapy can help healthcare workers
To support healthcare workers, we must consider both the personality traits (i.e., the nature) that make up the individual, in addition to the external structural issues (i.e., the nurture) at play.
Healthcare workers tend to be high achievers who are accustomed to putting their physical and emotional needs on the back burner in order to accomplish a task. Their ability to do this is reinforced and rewarded as they achieve more, creating a cycle of reinforcement.
It makes sense that mental health struggles for medical professionals are common; they are doing what they know best—pushing through pain in order to achieve.
To support healthcare workers’ mental health, we need to help them foster the ability to practice managing their internal mental and physical resources to support self-preservation. This concept may feel selfish or foreign for individuals who have pulled many all-nighters and worn it as a badge of honor.
What are the impacts of shift work?
Medical work is anything but a 9-to-5 job. The effects of shift work extend beyond disrupted sleep. Irregular schedules can contribute to mood changes, impaired concentration, strained relationships, and an increased risk of burnout over time. In fact, there is even a term for this: “shift work disorder.”
Supporting healthcare workers also requires healthcare organizations to recognize the impact that shift work has on both physical and mental well-being.
Symptoms of shift work disorder affect between 28% and 52% of shift-working healthcare professionals and can include:
Sleep disturbances (circadian rhythm disruption)
Gastrointestinal issues
Decreased alertness leading to fatigue-related errors
Commuting hazards
Mood disorders
Social isolation
How to address compassion fatigue in healthcare workers
Long hours are grueling, but the impact of medical work can go beyond workplace burnout.
Supporting healthcare workers begins with understanding the difference between burnout and compassion fatigue so the right interventions can be provided.
Burnout is a work-related experience that builds over time and is caused by ongoing stressors (i.e., institutional or interpersonal) in the work setting. Emotional exhaustion and a reduced sense of accomplishment are hallmarks of this phenomenon.
Compassion fatigue is defined as the emotional, physical, and often spiritual exhaustion that results from constant empathy and the ongoing caretaking of others. It can result in feeling numb, depressed, fatigued, and overwhelmed. Compassion fatigue can build over time or appear suddenly after the exposure to a trauma.
Burnout may arise when workplace systems are inefficient or there is mounting pressure to complete a pile of paperwork before leaving work for the day. Research shows that primary care physicians often spend more time on paperwork than they do with patients, with some of that work being done at home in their “off” hours.
The most important distinction between burnout and compassion fatigue is that burnout occurs in a range of work settings. Challenging bosses, burdensome workloads, and interoffice politics can happen almost anywhere.
Compassion fatigue, on the other hand, goes deeper. The emotional strain related to caring for people on their worst day can result in feelings that mirror (or can be) a depressive state. It is not something that can be instantly ameliorated by instituting a change to workplace protocol.
As mental health providers, trauma-informed care is essential in helping individuals with compassion fatigue. Treating compassion fatigue means treating trauma.
Addressing compassion fatigue requires more than reducing workloads. Because it is rooted in repeated exposure to others' suffering, recovery often involves trauma-informed therapy, peer support, and intentional emotional processing.
How does trauma affect medical professionals?
Medical professionals are confronted with the high psychological demands of medical trauma as they are exposed to illness, pain, and death on a regular basis. More than half of clinicians report that patient loss has had a profound impact on their emotional health.
In a medical environment, there is rarely time or space to process feelings in the moment. The next patient is waiting for them.
What about medical PTSD?
When trauma isn’t processed, it stays around. Post-traumatic stress disorder (PTSD)—the experience of intrusion, avoidance, negative alteration in mood, and hyperarousal after a traumatic event—is significantly higher for physicians than it is in the general adult population (14.8% vs. 3.9%).
Hypervigilance and sleep disturbances are also common features of PTSD in medical professionals who have experienced trauma.
How to handle colleague loss
Other less obvious trauma can include witnessing violence in the medical space, observing or causing medical errors, and frequent exposure to communicable illness. The loss of colleagues is also extremely challenging for medical workers. Work doesn’t stop when a colleague dies by suicide or other causes.
Alarmingly, in the UK, female healthcare workers have a 24% higher risk of dying by suicide than the female national average—a gap largely driven by elevated suicide risk among nurses. Survivors are left holding onto unprocessed grief, which can lead to mental health struggles.
How to maintain boundaries in a healthcare profession
Supporting healthcare workers includes removing barriers that prevent them from seeking mental health care when they need it. Medical professional therapy can provide healthcare workers with a safe space to process trauma, build resilience, and develop healthy coping strategies—like setting and maintaining healthy boundaries.
Due to structural issues, the medical environment makes it challenging to stop, identify, and experience emotion. Outside of the work setting, individuals in healthcare are less likely to seek care than the general population, which may be due to licensing fears, identity as a "strong" individual, and the very real scheduling difficulties that interfere with attending a session.
Knowing how to maintain boundaries (both internal and external) is a key intervention when working with healthcare providers. External boundary setting refers to creating limits to expectations that are placed on you in the work setting. This may mean identifying a stop time to work and challenging perfectionist thought patterns that have individuals working later than needed.
It can involve heavy emotional work, as many of these boundaries can come up against deep rooted core beliefs that will initially feel destabilizing to challenge (e.g., “If I don’t do my charts better than everyone else, then I have no value”).
As a clinician, providing tools for effective communication (such as DBT’s interpersonal effectiveness tools) can be helpful for individuals working on establishing healthy external boundaries.
Internal boundaries, on the other hand, help maintain an emotional separation between the provider and the patient. Mindfulness exercises, rituals, and routines can all be helpful in creating a mental separation between the self and the work. Integrating clinical peer support in the workplace can also be a protective factor against the perils of trauma.
Ultimately, medical professional therapy can play an important role in helping healthcare workers process trauma, establish healthy boundaries, and sustain long-term emotional well-being.
Conclusion
Supporting healthcare workers is essential to promoting professional longevity and emotional well-being. Professional longevity in the healthcare setting is not the result of a stress free occupation. It is the outcome of a culture of wellness and a deliberate act of self-preservation.
Putting up a “force field” and powering through the day works until it doesn’t. Identifying and honoring one’s emotional experience and implementing both internal and external boundaries are key features in maintaining emotional balance.
Sources
DBT Tools. (n.d.). Interpersonal effectiveness skills.
d'Ettorre, G., & Pellicani, V. (2020). Preventing shift work disorder in shift healthcare workers. Safety and health at work. Short Communication.
Figley, C. R. (1995). Compassion fatigue: coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner/Mazel.
Johnson, K. M., Slavin, S. J., & Takahashi, T. A. (2023). Excellent vs excessive: Helping trainees balance performance and perfectionism. Journal of Graduate Medical Education.
Lin, J. C., Gao, C., Zhong, A., Aysola, J., & Long, J. A. (2026). Prevalence and treatment of anxiety and depression among US healthcare workers, 2021-2024. Journal of General Internal Medicine.
Lipsa, J. M., Rajkumar, E., Gopi, A., & Romate, J. (2024). Effectiveness of psychological interventions for compassion fatigue: a systematic review and meta-analysis. Journal of Occupational Health.
Mata, D.A., Ramos, M.A., Bansal, N., et al. (2015). Prevalence of depression and depressive symptoms among resident physicians: A systematic review and meta-analysis. JAMA.
Nguyen, H. P., Nguyen, T. T. P., Nguyen, N. Q., Van Bui, T., Le, H. A., et al. (2026). Prevalence of depression, anxiety and stress and associated workplace stressors among healthcare workers in a tertiary hospital in Vietnam: A cross-sectional study. PloS one.
NHS England. (2023). Working together to prevent suicide in the NHS workforce: A national suicide prevention toolkit for England.
Petrino, R., Riesgo, L. G., & Yilmaz, B. (2022). Burnout in emergency medicine professionals after 2 years of the COVID-19 pandemic: a threat to the healthcare system?. European Journal of Emergency Medicine.
Reinhardt, J., Linde, K., & Kersting, A. (2025). Prevalence of posttraumatic stress symptoms among physicians - A meta-analysis. European Psychiatry.
Rhodes-Kropf, J., Carmody, S. S., Seltzer, D., Redinbaugh, E., Gadmer, N., et al. (2005). "This is just too awful; I just can't believe I experienced that...": Medical students' reactions to their "most memorable" patient death. Academic Medicine.
Rotenstein, L.S., Holmgren, A.J., Horn, D.M., et al. (2023). System-level factors and time spent on electronic health records by primary care physicians. JAMA Netw Open.
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