Beth Garbitelli and Nora Taranto MD add a new intro and share their own insights on this Curbsiders classic! Physician suicide is a problem. There, we said it. We all have that story; Many of us have experienced the symptoms of depression or suicidal ideation ourselves, or have the colleague, mentor, friend, teacher, sibling, parent, or significant other who has experienced these signs and symptoms. Some of us (probably more than you’d think) have lost someone meaningful to suicide. And yet, we don’t talk about suicide and mental health in medicine, or at least, not enough. So, today, we at the Curbsiders are trying to change that.  The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat). In this episode, we talk with expert Dr. Elisabeth Poorman about the natural history of depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming (read: we think need to be coming) down the line.  N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available via email at doctorpoorman@gmail.com, or you may reach out to any of us on Twitter. We are happy to talk and see that you get the support you need. New episodes return January 20, 2020! Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20 Credits Written and produced by: Nora Taranto MD, Shreya Trivedi MD Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD Edited by: Matthew Watto MD  Guest: Elisabeth Poorman, MD  Time Stamps  00:00 Sponsor - ACP’s Internal Medicine Meeting 2020 in LA 00:45 Fresh intro by Beth Garbitelli and Nora Taranto MD 10:15 Sponsor - ACP’s Internal Medicine Meeting 2020 in LA 11:08 Guest one-liner 12:18 Wellness Recommendations: Find a Therapist  15:05 How to find a therapist in training; Licensing and Mental Health  21:07 Disclaimer and Trigger Warning: Stories are Sensitive. National suicide hotline info  Next, Dr Poorman and each of The Curbsiders share their personal experiences with mental health (see below). 22:25 Shreya story 30:30 Stuart’s story 40:12 Elisabeth’s story 45:10 Watto’s story 55:27 Passive suicidal ideaiton, a definition; Suicide and Depression: Do they always coexist? (No); Life Cycle of Depression and Suicide in the Medical Profession  56:07 Depression and Suicide in Primary Care  56:44 Mini-Cases  62:39 Noticing signs in a colleague: how to help  66:40 Specific programs doing things well  71:55 Questions from Social Media: Burnout vs. Depression; Will getting treatment affect your board applications  75:03 Take home points 76:49 Outro Goal Listeners will learn about the risk factors for depression and suicide in medical training, and be empowered to advocate for themselves and their colleagues to be safe. Learning objectives  After listening to this episode listeners will Learn about the life cycle of depression in training and its prevalence at different stages in our careers. Analyze the risk factors that lead to depression and why depression is becoming more prevalent in doctors over time. Evaluate barriers to effective care for physicians and the impact of stigma on those experiencing depression or suicidal thoughts. Assess effective strategies for supporting physicians an