By Dr EK Wills
I had an interview yesterday and that morning I couldn’t eat breakfast and I had to run to the bathroom.
The interview was for a job that I am already working in where I lead two mental health teams and am covering for another consultant for a couple of months. Logically, there is not much to be concerned about, but I was. I even surprised myself. In fact, every time I do an interview, I go through the same thing so have taken measures to counter the symptoms.
I get a nervous stomach or ‘butterflies’, sweat more and my voices has been known to shake when trying to give a confident response. So I don’t eat breakfast, I wear extra deodorant plus clothes that won’t show wetness and consciously lower my voice to steady it. Did I also mention a handy trick is a beta blocker medication (prescribed by a doctor) to keep the heart rate down?
I’m not alone in this anxiety space. It’s called performance anxiety and can be worse for people with A type characteristics, perfectionistic beliefs, creative ability and … female gender. It seems to go hand in hand with imposter syndrome (I talk about this here) In fact a recent study of NSW junior doctors found 14% had moderate to severe levels of general anxiety. Luckily, it seems to improve with agency as more senior doctors did not suffer to such a high degree.
But people with early trait anxiety, that is, onset in childhood, can have an increased risk for PTSD stress reactions which further limits optimal performance.
Performance anxiety is a specific type of anxiety, diagnosed as part of social anxiety disorder and is specific to social situations such as giving a speech. Treatment involves psychological skills to manage the cognitions (thoughts about the anxious situation) and exposure is the main approach in therapy. The idea is that the more you do it, the more you become desensitised to it. But many people find the treatment intolerable and medication taken at the same time (such as antidepressants) can help to be able to deal with the therapy as well as dampen the symptoms.
Doctors are just beginning to talk about their own experiences and a new book has been written by a very experienced and well-known psychiatrist, Dr Mark Cross.
In an interview, he comments on the stigma associated with anxiety amongst professionals because doctors are supposed to be the ones curing others and not experience problems themselves. However, it is good to know that doctors are also human and they too can face their fears by owning up to their needs and seeking help. Some people even write about it…
Changing Minds by Dr Mark Cross, Dr Catherine Hanrahan (booktopia) The Go-to Guide to Mental Health for You, Family and Friends
