MedConnect

Anxiety—one of your body’s natural ways of responding to sudden changes in your environment. In moderation, it can be a good thing, forcing your reactions to tighten, your attention to hone in over the one thing you need to focus on, and your body to… no, no, no. That’s stress. Anxiety, rather, is a much more insidious form of stress. It’s an anticipatory response to something that’s coming, and it stays with you for longer stretches of time, even in the absence of the perceived threat.

Usually, patients are on the ones on the receiving end. But that doesn’t mean it isn’t something physicians aren’t familiar with either. During the COVID-19 pandemic, the rate of anxiety among doctors was found to be almost 26%⁶. But physicians’ anxiety isn’t only linked to public health calamities. Medical careers are demanding, with hours of dedication required and incessant barrages of applying oceans of knowledge to specialized scenarios. On top of that, all of it is often packaged with grueling high stakes. Doctors have people’s lives in their hands. That’s a huge responsibility, and we should never fault them—or ourselves as we enter the medical field—when it causes anxiety. It isn’t anything to be ashamed of. It’s just a simple part of being human. Yet, that doesn’t mean it can’t cause problems. At a certain point, anxiety can begin to upset the rhythm of a physician’s life. It can work against their ability to give patients the best care possible and makes them more prone to burnout (another frequent consequence of taxing medical professions that further exacerbates the former issue). Again, this doesn’t mean we should get angry at doctors and hunt them down with pitchforks and torches in hand. In contrast, we should work to keep them healthy so patients can also see the best outcomes. Destigmatization of physicians’ anxiety and calling attention to how prevalent it is are two important steps that we, even as pre-meds, can take. Our advocacy goes a long way towards encouraging proper treatment, and helps out both doctors and patients. However, this means resolving anxiety once it already develops in physicians. What about prevention?

One particular angle involves teaching children coping strategies for anxiety that they can use later on in life. This focus comes from the strong connection between untreated childhood anxiety and the development of later mental health conditions in adulthood. Those conditions don’t only include recurring anxiety, but expand to new ones like depression, too³. While anxiety in physicians by itself is already worrying, when other issues get added into the mix, doctors can suffer quite gravely—and their patients alongside them. But even if we narrow our scopes just onto anxiety, it’s inescapable that supporting children against it is beneficial should they pursue medicine. It can prevent the aforementioned barriers that anxiety creates for patient care. Luckily, though, pediatric psychology provides us with various treatments to help such children, like medications and cognitive behavioral therapy.

But all the treatments in the world aren’t worth much if patients aren’t receiving them. Recognizing when a child may be suffering from anxiety is therefore just as important to resolving it. With pediatric patients, this can be a little harder to spot. In school, for instance, it can often manifest itself as what we might consider inappropriate behavior, or even trouble with keeping up in class, paying attention, and making friends. It can also create physical symptoms, like tummy aches or headaches, that we normally wouldn’t think to associate with anxiety in the first place⁴. Parents might think, “Maybe they just caught some kind of virus?” And in most cases, that, or another underlying cause, would probably explain it. Just because we’re bringing attention to how these signs can be related to anxiety doesn’t mean we should jump the diagnostic gun with every show of them. But when other plausible reasons can’t be come up with, then the child’s mental health should become part of the conversation. This can allow them to receive the treatment that they actually need, and connect them with a professional that can teach them valuable skills in managing their anxiety as they grow up. For those kids who lean into the TV a little bit more than their classmates when Doc McStuffins patches up a toy in her backyard clinic, this can mean going into the medical path better prepared to manage all the stressors it can hit them with—and better prepared to give patients the care they need under all circumstances.

References

1. “Anxiety.” American Psychological Association, 19 April 2018, https://dictionary.apa.org/anxiety.
2. “Anxiety and Its Impact on Learning.” Kennedy Krieger Institute, https://www.kennedykrieger.org/stories/making-difference/inspiring-stories/anxiety-and-its-impact-learning#:~:text=Fight%2Dflight%20responses%20can%20inhibit,overall%20flexibility%20in%20one’s%20thinking. Accessed 6 May 2024.
3. “Childhood Stress and Anxiety.” Yale Medicine, https://www.yalemedicine.org/conditions/childhood-stress-and-anxiety#:~:text=Substantial%20research%20links%20untreated%20childhood,age%20of%20onset%20is%2011. Accessed 6 May 2024.
4. Ehmke, Rachel. “How Does Anxiety Affect Kids in School?” Child Mind Institute, 30 October 2023, https://childmind.org/article/classroom-anxiety-in-children/.
5. Hussein, Farah S, et al. “Pharmacologic Treatment of Pediatric Anxiety Disorders.” Child and Adolescent Psychiatry, 22 April 2016, https://doi.org/10.1007%2Fs40501-016-0076-7.
6. Johns, G., et al. “The global prevalence of depression and anxiety among doctors during the covid-19 pandemic: Systematic review and meta-analysis.” Journal of Affective Disorders, 1 February 2022, https://doi.org/10.1016/j.jad.2021.11.026.
7. LeBlanc, Nicole J., and Luana Marques. “Anxiety In College: What We Know and How To Cope.” Harvard Health Publishing, 27 August 2019 https://www.health.harvard.edu/blog/anxiety-in-college-what-we-know-and-how-to-cope-2019052816729.
8. “What are Anxiety Disorders?” American Psychiatric Association, June 2023, https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders.