Depression is quite common among veterinarians in developed countries, with 70 percent of veterinarians experiencing it at some point in their lives, and a large percentage of veterinarians take their own lives when they are unable to cope with the “compassion fatigue” associated with the profession.
I hadn't paid attention to this heartbreaking statistic until I came across a social media post by a veterinarian friend who lives in the US. Her 30-year-old colleague had committed suicide because he couldn't stand seeing sick and homeless animals any more. My friend's timeline was flooded with condolence messages as she tried to express her own guilt for not realising how sad her friend was inside.
I then found several studies and at least three books on the issue: Dealing with Stress and Burnout as a Veterinarian By Nadine Hamilton, Achieving victory: One veterinarian's story of success in a profession plagued by depression Written and most recently by Heidi Pulito Mental wellness and positive psychology for veterinary professionals: a preventive, proactive, and solution-based approach By Laura Woodward. Woodward is well known for helping set up the VSPCA to sterilize and vaccinate stray dogs in Visakhapatnam, India.
All three authors highlight the dark and dangerous side of the veterinary profession and discuss compassion fatigue in detail. Compassion fatigue is a type of stress that results from repeated exposure to traumatic situations and can lead to a variety of negative emotions, including anger, annoyance, intolerance, irritability, suspicion, and cynicism.
According to Hamilton, “veterinarian suicide rates in the U.K., Australia, the U.S., New Zealand and Canada are approximately four times higher than the general population.” She cites long working hours, frequent killing of animals, and financial problems as the main causes.
“Failure to cope with such stress impairs mental health and can lead to serious emotional, physical and behavioural problems. For some people it leads to death,” Hamilton concludes.
On the other hand, Pulito, in addition to getting to the root of the problem, also suggests ways to deal with this stress. She writes that suicide by veterinarians is one of the highest suicide rates among all professions in the world. Her book speaks to “frustrated veterinarians” and she tells them how to cope with their daily work challenges and overcome depression.
A 2023 study by pet food brand Royal Canin confirmed Hamilton and Pulito's fears. The study shows that nearly 70 percent of veterinarians have had a colleague or coworker die by suicide, and nearly 60 percent have experienced work-related stress, anxiety or depression severe enough to require professional help. The same study also points to veterinarians leaving their profession due to poor work-life balance: “60.3% of professionals list this as the main reason why they want to leave, reflecting a growing sense of disengagement (or, in fact, resentment) in the profession.”
How did we get here?
Woodward offers valuable insight into how it got so bad for veterinarians. She blames the stigma around mental health conversations in veterinary circles and the profession's never-say-no attitude to clients. She identifies the main stressors as the work environment, complications that arise during treatment of patients, and the inability to communicate well with clients.
Woodward emphasizes the importance of soft skills for getting ahead in life. “As parents, it's our duty to make our children's self-worth more important than just good grades or a medal in soccer. Kindness is an accomplishment in children. So is empathy, self-regulation, resilience, and the ability to be self-aware of one's own strengths and weaknesses,” she writes.
“…They get into veterinary school and the applause continues. They are seen as whole, complete people because of their accomplishments, and they believe that themselves. But at no stage has anyone stopped to ask, do they have good social skills? Do they have empathy? Do they know how to fail or deal with failure?”
He said this fear of failure leads to cheating tendencies, which in turn leads to severe depression and, in the worst case, death by suicide.
“Learning social skills and empathy on the job is very tiring and they suffer from depersonalisation and compassion fatigue. I wish they were taught these soft skills in childhood or as a student,” she says.
Veterinary Care in India
When our beloved cat Biryani was diagnosed with chronic renal failure a few years ago we knew his time was up. We tried to make his visits to the vet as comfortable as possible over the next few months. And when we noticed him struggling to breathe one morning we rushed him to the nearest private clinic and requested the vet on duty to put him on oxygen – our last ditch effort to save him. Reluctantly, he did so, but to our utter horror, switched off the oxygen supply within 15 minutes. His work was over and he needed to go home. He did not listen to our pleas to save Biryani. We paid the bill, which was a hefty amount as Biryani was considered an emergency patient, and went home. On the drive back, Biryani turned away from us.
If this were a government facility or a cash-strapped animal shelter where dozens of animals are admitted every day and dozens more go to the other world without any identification, I would probably apply the same attitude to the poor doctor-patient ratio in our country and forgive the veterinarian on duty for violating his medical oath.
Recently, when we took our 13-year-old elderly cat Mr. Bush to a private clinic, his blood test did not come out well. We asked the vet to let him die peacefully (not euthanize him) since he was an elderly cat, but the vet was not willing to do that. He took an aggressive course of treatment. One day, after a few injections and some more medicines stuffed down his throat, Mr. Bush came back home dead.
The way the drugs were injected was hard to understand, often not by the vet, but by his assistant, an unqualified “para-vet.” Several times when the paravet had trouble finding Mr. Bush's vein, the vet had to step in at our insistence. The way Mr. Bush, who was the most docile of cats, went is tragic, and I'm not even including the bills that came to several thousand bucks.
In light of Hamilton and Pulito's theory and Woodward's suggestion, I can't help but wonder if these veterinarians are suffering from compassion fatigue. Indifference, heartlessness, and operating on auto pilot mode are symptoms of compassion fatigue.
They appear aloof from their patients and their approach is impersonal and mechanical. To make matters worse, these clinics – which have sprung up in every nook and corner of the city in recent times – are usually understaffed and in the absence of veterinarians, employing unqualified assistants in their place.
Most seem to be driven by the forces of commerce and force pets to undergo repeated checkups, even when these are not needed because the pet's condition is deteriorating. Pet parents are sometimes sent to the farthest corners of town for x-rays and scans because these unsecured vets cannot allow a colleague who offers these services nearby to steal their client.
One might argue that these tests are mandatory for diagnosis, but the staggering bills that make human medical bills seem modest by comparison can be avoided if there are sufficient clinical signs showing that the pet is dying. This is where a veterinarian's judgment – and, most importantly, his medical oath to “use his scientific knowledge and skill to protect animal health, to alleviate animal suffering and to perform his profession with honor” – comes into play.
Veterinarian in trouble
Of course, this is not a general statement for all vets in India. I know many who are kind, safe and dedicated professionals. To be fair, pet parents are also guilty of not seeking treatment promptly or not heeding the vet's advice. And when matters get out of hand they call these professionals “thieves” behind their backs or if not to their face. Social media posts about a vet “killing” someone's pet are also not uncommon. It is unfair to cyberbully them or write undeservedly negative reviews.
Financial factors, long hours on the job, expectations of pet owners and dealing with trauma and deaths take a toll on veterinarians and pet parents should take this into account. Pet parents should also understand that veterinarians have bills to pay too and it is okay to turn down frequent requests for discounts or fee waivers.
Depression and Compassion Fatigue
Though, thankfully, it is unheard of for a veterinarian to commit suicide in India, they are probably facing the same symptoms as their colleagues across the world.
Woodward points out that in Western countries, discussions on mental health have been taboo and this may be true for India as well. Perhaps these vets are not aware of their mental health because of our low level of awareness about mental health, lack of infrastructure to address it and the stigma associated with mental health issues.
Woodward's book is a practical guide for these professionals. It is divided into six sections and provides valuable tools, including meditation, mindfulness, and positive psychology, to help deal with mental challenges.
He has included in the book his experiences while counselling patients struggling with anxiety, compassion fatigue, fear of failure, imposter syndrome and grief. His advice to veterinarians is that they should be prepared in advance about the obstacles they may face in their career so that they can cope better.
We need support groups where veterinarians and pet owners can discuss controversial issues. This will lighten the burden on veterinarians and make it easier for pet owners too. However, veterinarians must do their best to avoid turning this noble profession – as many have done – into a business.
Lamat R Hasan is a freelance journalist based in New Delhi.