Being a vet is challenging and can be tough. There is even a book about how tough it is (Compassion Fatigue in the Animal Care Community). Many of us have to work long hours – often without practical or emotional backup. We need to assess and understand complex and often incomplete clinical information and at the same time exercise considerable physical skills. On top of this we have to maintain a compassionate and professional attitude towards patients, clients and colleagues. We also need to do this at a level of efficiency which ensures an adequate income for ourselves and the practices we work in.

This group of pages is written to give you an overview of stress, anxiety, depression and other consequences. It suggests some ways of thinking about and taking control of stress, depression and the suicidal thoughts which can sometimes occur.

What is Stress?

Stress is the name we give to our physical, mental and emotional response to pressure. Negative stress happens when the pressures seem to be beyond our ability to cope. Like many other responses, stress has evolved to protect us. No one needs to explain the fight or flight response to a vet. The problem in our complex and sophisticated culture is that in most situations, neither fight nor flight offer a solution.

So we respond with a whole range of sensations (feeling sick, sweating), negative thoughts ("I'm a bad vet" "it must be my fault that client is angry…") and feelings (anxiety, confusion, irritability etc).

What is stress for?

In the 90% of our evolution that we spent on the East African veldt, the increased tension, vigilance, all-or-nothing thinking and increased blood supply to muscles, were literally lifesavers. Now they can make us feel bad without necessarily contributing to a solution.

Stress is not always bad

When you are challenged at a level you can just handle, stress increases your sense of being alive, focused and full of energy. People deliberately put themselves in stressful situations in the course of playing sport, climbing, public speaking and so on. It's when we feel that we have no control, no choices and we judge that the circumstances are beyond our capacity to handle that stress is experienced as negative and ultimately damaging.

See also:-
Sickness and Disability Rights and Support
Relationships
Bereavement
Addiction & Eating Disorders
Employment Issues
Vets & Debt
Legal Issues
Complaints & the RCVS

What Factors Cause Stress in the Veterinary Profession? 

• We often work in difficult circumstances:
  
  
  • long hours
  • fast pace
  • volume of work
  • complexity of work
• We sometimes work in poorly managed organisations – many veterinary practices are small businesses where the expertise is clinically focused with few management skills and with little understanding of the needs of the people on the veterinary team.
• We deal on a frequent basis with the physical and emotional distress of both patients and clients often without emotional support for ourselves.
• We are often physically and psychologically isolated (my experience of the profession is that it is highly competitive).
• In our UK culture, clients and often colleagues are very willing to complain but this is often not balanced by positive feedback and compliments.
• Bureaucracy and changes in the rules can place us at risk unless we are both up-to-date and vigilant.
• We are an independent lot and it's often difficult to ask for help or even see what help might be useful.
• Working long and unsocial hours means that other vital support systems such as family, friends and activities outside work tend to suffer.
• The Emotional Paradox - To be a good vet we need an emotional involvement with our patients but at the same time we need the ability to detach in order to survive emotionally.
• The Critical Paradox - As scientists, in order to learn from our mistakes, we need to be self-critical. On the other hand, high levels of self-criticism can lead to depression.

What About Stress at University - And Immediately After Qualifying?

Leaving home, establishing new relationships, taking responsibility for daily living, exams and social life can all be new and potentially stressful. Go to the Students and New Graduates section to find specific advice and information on these early parts of your career.

What Happens if I Fail to Cope with Stress?

Stress can lead to physical problems such as vulnerability to infection and conditions such as psoriasis.

Stress can lead to emotional problems such as depression and even suicide.

Stress can alter our behaviour – we respond to others (anger, irritability, isolation, self harm) in ways which will diminish the personal and professional relationships which enhance our lives.

And so on…

Key point - It's not your fault
Causes of depression are different in different people. They can include current events, such as debt, client complaints, bullying - past events such as abusive or unskilful parenting and even genetic susceptibility.
This is not something you have chosen. So don't waste energy beating yourself up.
Take action instead - there is plenty of help out there and plenty you can do...

What Is Depression?

Depression is characterised by a whole range of thoughts, feelings and physical sensations which are collectively designed to respond to threat. In cognitive behavioural psychology (CBT), three systems are described:

• a threat response system (i.e. stress, anxiety and depression)
• an excitatory system (e.g. when we feel passion about our work or about projects in our lives)
• a calming system (e.g. when we feel relaxed and at one with the universe)

These systems need to be in flexible balance depending on the demands of the moment. Depression happens when the threat response system takes over and the other two are diminished. Clinical depression is when this happens to such an extent that our ability to enjoy life or even cope with the problems of daily living is diminished or disabled.

What Does Depression Look Like – How Do I Know I'm Depressed?

How depression actually manifests is understandably variable – we respond to threat in many different ways. As with the signs of stress, depression can show up as:

• changes in thinking (black and white thinking, inability to remember the good times, running of disaster scenarios, "it always has been like this and it always will be like this")
• changes in feeling (emotional shut down, anger, anxiety, panic attacks)
• changes in behaviour (loss of confidence, irritability, social withdrawal etc)

If you want to know whether you are suffering from depression, go to Understanding Depression on the Mind website. There are many more useful links on this website -- Find out More.

What Causes Depression?

Just as anxiety has an evolutionary purpose, so does depression. When faced with powerful predators and other situations totally outside our control, it made sense in the past to play dead, go into the back of our cave, shut down. Most depression is triggered by negative and overwhelming stress (look at the specifically veterinary stressors above). A tendency to depression is also influenced by genetic factors and childhood programming.

Burnout and Compassion Fatigue

Burnout is generally recognised as a previously meaningful relationship with a job or project which has now become stressful and damaging. It can be associated with symptoms of stress, anxiety, depression and physical ill-health. Compassion fatigue is a more specific form of burnout in which the stressors revolve around patient and client distress.

The point being that if your problem is with the job in general, changing your job might be an answer. If your problem is with animal and human distress, you might need to consider changing your career.

This is nothing to be ashamed of - jobs change and so do people.

We are hoping to build a careers section for this website to give you some idea of the options that might be open to you.

The Romans got depressed as well...
People have been thinking about depression a long time - this insight is just as important today It's how we react that counts.If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at the moment." Marcus Aurelius 180 AD

What About Suicidal Thoughts or Feelings?

Many people reach a point of difficulty in our lives when killing themselves seems to be the only option. An extra risk factor for us vets is the fact that we are professionally trained to see death as a potential solution to poor quality of life in animals. This makes it easier for us to fall into the trap of seeing killing ourselves as a potential solution.

You are not alone. There is an enormous amount of potential help out there – so seek help as soon as possible – don't sit around with these thoughts or feelings. As a first option, click on the In a Crisis link on this page and make contact with the sources of help detailed there.