Few of us would tell a patient with moderate-to-severe depression to wait it out alone. Many of us do exactly that for ourselves. Physicians develop depression at rates comparable to or higher than the general population, yet we are among the least likely to seek timely care. The reasons are structural, not personal.
A 2025 JAMA strategic review found that fear of stigma was a primary barrier to seeking help for 30 percent of early-year medical students, 53 percent of final-year students, and 58 percent of residents. Among practicing physicians, the desire for confidentiality emerged as a primary barrier for roughly two-thirds. The effect is strongest exactly where it matters most. Physicians with moderate-to-severe depression are two to three times more likely than those with mild symptoms to self-prescribe antidepressants (30 percent vs. 10 percent) or to forgo treatment entirely over confidentiality concerns (51 percent vs. 17 percent).
Qualitative work across health care professions tells the same story. Shame, self-stigma, and the belief that distress should be handled alone are “deeply rooted in the professional culture.” That culture normalizes inadequate self-care and treats a mental health condition as professional weakness.
The fear is grounded in real consequences
What makes this problem so hard to solve is that physicians’ fears are not irrational. Some employers and regulatory bodies have historically, and inappropriately, treated a mental health diagnosis as evidence of incompetence:
- In a study of residency program directors, identical fictitious applications scored 12 to 14 percent lower on interview and acceptance ratings when they disclosed a history of psychotherapy.
- A 2007 survey found that roughly one-third of state medical board directors believed a mental health diagnosis alone could justify sanctioning a physician.
Licensing, credentialing, and malpractice insurance applications that ask about mental health history, rather than current impairment, have real teeth. In states that ask about hypothetical impairment or illness unrelated to function, physicians are 21 percent more reluctant to seek help.
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The 1993 Medical Society of New Jersey v. Jacobs ruling held that such questions violate the Americans with Disabilities Act. Yet reform has been inconsistent for decades, and many physicians are still left weighing their license against their recovery. Add the ordinary but decisive barriers of inflexible schedules and lack of time, which independently suppress help-seeking, and delay becomes the default.
Untreated physician depression is a patient safety issue
The cost of this delay does not fall on physicians alone. A JAMA Network Open meta-analysis of 11 studies and 21,517 physicians found that depressive symptoms were associated with nearly double the risk of medical errors (relative risk 1.95; 95 percent CI, 1.63 to 2.33). The association held in longitudinal studies, where depressive symptoms preceded later errors.
The relationship appears to run both ways. Errors worsen distress, and distress raises error risk. That cycle is why untreated physician depression is a patient safety issue, not only a wellness one.
It is worth stating plainly, against the stigma narrative: Depression is treatable, and physicians respond to treatment like anyone else. Response rates to SSRIs, SNRIs, bupropion, and mirtazapine are broadly equivalent in physicians and other adults. The obstacle is access and disclosure, not efficacy.
What confidential, schedule-compatible care looks like
The model for effective care is increasingly well defined. The gold standard is the U.K.’s NHS Practitioner Health program, established in 2008. It has served more than 30,000 practitioners through free, fully confidential, self-referral care that operates entirely outside regulatory, disciplinary, and workplace monitoring processes.
In the U.S., the picture is changing. Physician health programs have historically been entangled with disciplinary processes and focused on substance use, which discouraged self-referral. Newer models are building structural independence from medical boards and firewalled pathways to care. Examples include the Tennessee Medical Foundation’s confidential interactive screening program and the Wisconsin Medical Society’s 2024 partnership with a confidential telehealth platform that offers rapid therapist matching and flexible scheduling.
Successful programs share the same ingredients:
- Genuine confidentiality, often through external providers or administrative firewalls
- Accessibility, including low or no cost, flexible or after-hours scheduling, and telehealth
- Convenience, so that care fits around a clinical schedule rather than competing with it
Crisis resources such as the 988 Suicide and Crisis Lifeline and the Crisis Text Line (text 741741) offer additional private entry points.
What this means for us
For the individual physician, the practical message is that confidential, external, telehealth-enabled treatment now exists specifically to fit a clinical schedule. If you are struggling, the care you would recommend to a patient is available to you, and it can be structured to protect your privacy.
There is an important caveat. Most of these protections depend on policy and vary by state. Until licensing and credentialing questions are uniformly reformed to ask only about current impairment, physicians should verify the confidentiality structure and board-reporting posture of any program before engaging.
For those of us who lead practices, departments, and training programs, the work is to remove the reasons colleagues wait: advocate for applications that ask only about current impairment, protect time for care, and talk about our own mental health the way we talk about any other condition we treat.
Ravi Singareddy is the founder and medical director of Empower Psychiatry & Sleep in north metro Atlanta, where he leads an interventional psychiatry practice offering transcranial magnetic stimulation (TMS) and Spravato (esketamine) for treatment-resistant depression. Double board-certified in psychiatry and sleep medicine, he brings more than two decades of clinical and academic experience to patients who haven’t found relief with medications alone. He is affiliated with Emory Healthcare.
His interest in neuromodulation dates back to his years as associate professor of psychiatry at Penn State College of Medicine. There, he taught annually on vagus nerve stimulation and novel depression therapies, and he published on long-term combined electroconvulsive therapy and vagus nerve stimulation in the American Journal of Psychiatry. He has authored numerous peer-reviewed papers on sleep disorders, insomnia, anxiety, and depression, with work appearing in Sleep, the Journal of Clinical Sleep Medicine, and Psychiatry Research.
Singareddy is a Fellow of the American Psychiatric Association and the American Academy of Sleep Medicine and practices measurement-based care, tracking outcomes to guide every treatment decision. He shares updates on Instagram.
