Winter is here. It’s colder. Sometimes we don’t see the sun for days. Let’s take a moment to think about some mental health issues.

Published in Annals of Emergency Medicine in December 2017 was a piece by some of our very own (Lara Vanyo, Randy Sorge, Angela Chen, and Daniel Lakoff) on posttraumatic stress disorder (PTSD) in EM residents. PTSD is characterized by intrusive thoughts, avoidance, and negative changes in cognition/mood as well as in arousal and reactivity. Physicians are already at higher risk of PTSD, especially ED physicians given the regular witnessing of patient illness, trauma, and death. The new DSM-5 exposure types applies to workers as part of their professional responsibilities.

While burnout and depression are more recognized diagnoses, it is important to be aware of PTSD and apply both preventive and treatment strategies to address this. Prevention of this still requires more research, but recognition of PTSD as an overlapping issue with burnout and depression may be a first step in stopping the downward spiral to anxiety, worsening depression, negative coping strategies, and suicidality. Residents especially should recognize the signs and interventions should be started early in careers. A 2009 review found that trauma-focused cognitive behavioral therapy (CBT) improved PTSD symptoms, which is also supported and used with veterans. EMS initiatives include stress debriefing after traumatic events.

Take care of yourselves. Seek help when you need it.


Posttraumatic Stress Disorder in Emergency Medicine Residents. Vanyo, L., Sorge, R., Chen, A., and Lakoff, D. Annals of Emergency Medicine, Volume 70, Issue 6, 898 – 903.

June 2024