It is crucial that we address a significant, yet frequently ignored, element contributing to physician burnout: attention-deficit/hyperactivity disorder (ADHD), especially among those with high IQs and a track record of academic and career achievements.
Numerous physicians, who are typically ambitious and intellectually adept, cultivate elaborate coping strategies that disguise their ADHD symptoms for many years, even extending to decades. Their elevated IQ can, interestingly, balance out executive function weaknesses, enabling them to thrive in challenging settings such as medical school and residency. Although they may seem organized, concentrated, and successful externally, this often incurs a hefty internal toll.
**The masking effect and misdiagnosis:**
For physicians dealing with ADHD, masking transcends merely diverting the conversation to obscure a digression; it is an intricate, frequently subconscious, method of overcompensation. This can reveal itself in various forms:
– Sophisticated organizational methods: A neurotypical individual might use a planner. A physician managing ADHD might possess several color-coded calendars, an abundance of alarms, and an almost compulsive dependence on to-do lists merely to maintain control of their time and prevent the disorder their mind inherently generates.
– Hyperfocus: Although their capacity for hyperfocus can serve as a tremendous advantage during intricate surgeries, it also constitutes a type of masking. They might become so immersed in one particular task that they disregard others, only to catch up later with a burst of adrenaline-driven effort. This intense concentration may appear as commitment, but internally, it represents a frantic endeavor to complete the task.
– The “perfectionist” guise: To combat a fear of making unintentional errors—a typical ADHD trait—a physician might cultivate perfectionistic behaviors. They could meticulously double-check every order and scrutinize each chart, laboring late into the night to assure everything is impeccable. This may seem indicative of an exceptional physician, but for the individual with ADHD, it is a taxing mental strain.
Peer-reviewed studies indicate that those with both ADHD and a high IQ are more inclined to mask their symptoms, thus postponing diagnosis or resulting in misdiagnosis. Rather than ADHD, their challenges with organization, time management, and emotional control may be misattributed to anxiety or depression, leading to inadequate treatment.
**The path to burnout:**
This ongoing masking and overcompensation generate an unmanageable degree of mental and emotional strain. Physicians with ADHD often exert twice the effort to attain what their neurotypical counterparts accomplish with comparatively less strain. This unyielding battle to keep pace, combined with the intrinsic pressures of the medical field, culminates in profound and often crippling burnout.
Research shows that individuals with ADHD exhibit a greater vulnerability to burnout due to the continuous toll of symptom management and the associated physical, mental, and emotional fatigue it necessitates. For physicians, the consequences are even more severe, as unrecognized ADHD can hinder their capacity to manage stress, prioritize tasks, and sustain focus in a high-pressure environment, ultimately impacting their well-being and potentially the quality of patient care. More frequently than not, without appropriate accommodations, physicians often compromise their physical health and overlook their relationships. Over time, many married physicians with ADHD, lacking sufficient support, confront divorce due to insufficient contributions to relationship and household responsibilities.
**The call to action:**
There is a need to cultivate a more sophisticated comprehension of ADHD, acknowledging that it manifests uniquely in high-achieving adults. It is vital for healthcare systems and individual clinicians to:
– Enhance awareness: Educate themselves about the varied manifestations of adult ADHD, particularly in individuals with high IQs.
– Advocate for thorough assessment: Look beyond superficial success and consider ADHD as a possible core issue in physician burnout, anxiety, and depression.
– Ensure accessible support: Establish environments where physicians feel secure in pursuing evaluation and obtaining suitable, neurodiversity-affirming support and treatment.
By supporting physicians with ADHD, we can not only enhance the well-being of our committed physicians but also strengthen the healthcare system as a whole.