Stressors, suicide, and other surprises

June 13, 2011

By Dr. Bob Kroeger

It’s common knowledge that dentists are at high risk for suicide. True or false? I attended a lecture given at our dental society’s monthly meeting several years ago and raised my hand immediately, challenging the speaker to document her claim about the high incidence of dentists’ suicide. She could not quote the study but made some vague references. Hogwash!

I’ll bet most of you don’t personally know a dentist who committed suicide. That’s because we work in dentistry, a fairly happy and safe occupation. This rumor started with two surveys, both small samples, in California and Oregon in the 1970s. And, yes, in those surveys dentists had a higher than average incidence of suicide. But these two states are hardly representative of the entire nation.

Once the media (don’t they enjoy poking fun at dentists?) heard about these surveys, they spread the news to every household in the world. Instantly it became common knowledge. But in a JADA article published in 1976, researchers evaluated death certificates of dentists in all states and found that dentists died mostly of heart disease and had only an average incidence of suicide. But, guess what, reporters did not find this news interesting and they let it die on the vine.

In 1982 Dr. Art Bedeian of Auburn University published data on incidence of suicide in many occupations that showed that psychiatrists and chemists were at risk (more females than males). Dentists again were merely average. In 2001 Dr. Alexander did a review for JADA with the same findings: dentists are not at risk for suicide. But the popular notion persists.

Back in the early 1950s an uncle of mine committed suicide. I never found out why. Not that anyone knew. A young single physician, he took his life in his early 30s. Why, why, why? Did he feel isolated? Romance problems? Was he depressed? I never met him and so I can’t comment on his personality. But, if depression was the culprit, he wasn’t the first depressed person to commit suicide.

Depression is serious and it’s more than feeling sad. It earns a specific clinical diagnosis and requires immediate medical attention, follow up, and medication. Depressed people can feel isolated. And, since most dentists are introverts (including myself), we do need quiet time, which sometimes can lead to isolation. Being depressed while isolated spells trouble. Period. So, if just one of you feels depressed and decides to get help, my writing this column will be worth it. You are not alone.

Professor Robert Sapolsky in Why Zebras Don’t Get Ulcers devoted a fascinating chapter to depression, which he describes as a “genetic-neurochemical disorder requiring a strong environmental trigger.” He points out the connection between serious life events (stressors) and depression and details how the stress-released hormones can trigger major depression. But, even though we all go through down times, I believe that knowledge and hope can help us emerge from this sad condition.

When my wife of 33 years died, I had grief, which was worsened by witnessing her daily pain and suffering during brutal medical treatment for over a year. Her death would have been much easier for our family to accept if she had died quickly in a car accident. Grief and sadness are not fun though there’s nothing wrong with them … as long as they don’t last for a long time. I asked myself if I were feeling sorry for myself – or for my wife. How could I feel sorry for someone who’s in heaven? So one day I wrote a note to myself and taped it to my bathroom mirror. The phrase comes from a movie, "The Shawshank Redemption," when Andy says to Red, “It comes down to a simple choice, Red. Get busy living or get busy dying.” That was my theme song and it helped me to move on with my life. I decided to get busy living.

Yes, we all have stressors. You know what they are. Deadbeat patients, staff conflicts, more government regulations, and on and on. But at least you know that you aren’t at risk for suicide. So when you have dinner tonight, celebrate this morsel of good news!

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Dr. Bob Kroeger retired after practicing general dentistry for 33 years. A stress management consultant, he presents seminars to the dental profession as well as to general industry. In addition to lecturing and writing, he runs seven to nine marathons a year and is a certified personal trainer. Contact him at [email protected].