Physician mothers are experiencing significant rates of moderate to severe anxiety during the COVID-19 crisis, with frontline workers and informal caregivers reporting the highest rates of anxiety.
Of the more than 1,800 respondents surveyed from the Physician Moms Group on Facebook, 41% had scores that put them above the Generalized Anxiety Disorder 7-item scale (GAD-7) cutoff point for moderate to severe anxiety; 18% reported suffering from severe anxiety, reported Elizabeth Linos, PhD, of the University of California Berkeley, and colleagues.
Anxiety levels were even higher for those who identified as frontline workers and informal caregivers, with 46% scoring on the higher end of the GAD-7 (β=0.80, P=0.01; β=0.873, P=0.02, respectively), they noted in a letter to the editor in the American Journal of Psychiatry.
To put these numbers in perspective, CDC data from September 2020 found that 3.4% of adults experienced moderate anxiety, and 2.7% experienced severe anxiety.
The findings of this study might indicate significant problems for the future of women in medicine, Linos told MedPage Today.
“Physician mothers are such a large part of the workforce, and women are almost the majority of medical students,” she said. “So understanding what predicts their mental health is really critical in thinking about how we’re going to have a workforce that doesn’t quit, that stays, and is able to provide these critical frontline services.”
Linos and team surveyed 1,809 participants at the height of the first wave of COVID-19, from April 18-29, 2020, using standard scoring for the GAD-7. Respondents were asked if they identified as frontline workers, defined as “those who had cared in person for a patient with presumed or confirmed SARS-CoV-2 infection within the last 14 days.” They were also asked if they worked as an informal caregiver, defined as “having provided regular care or assistance to a friend or family member who had a health problem or disability in the past 30 days.”
Respondents were also asked about demographic variables, including race, ethnicity, age, having a child younger than age 6, age of youngest child, and medical specialty.
In a study published in JAMA in 2019, Veronica Yank, MD, of the University of California San Francisco, and colleagues examined the rates of burnout and mood disorders among physician mothers from the same Facebook group. She told MedPage Today that the results of the more recent study — which took a snapshot of physician mothers’ anxiety during a pivotal moment in the pandemic — didn’t surprise her; still, she emphasized the seriousness of these numbers.
“To reach clinically defined anxiety, it doesn’t mean that you’re just walking around stressed,” Yank said. “It means that you are impaired by the level of stress.”
Linos also studies burnout rates and mental health issues among 911 dispatchers and other frontline workers. A potential solution, she said, may be strengthening a sense of the population’s group identity and peer-support system.
Tamara Goldberg, MD, is a primary care doctor at Mount Sinai Morningside West in New York City and a mother of two young children. In April 2020, she wrote about the challenges of being a physician mother during the first COVID-19 outbreak in New York.
Goldberg reflected on the ways that the pandemic has heightened the often unrealistic expectations women have for themselves, causing them to feel like they’re failing at both their work and being a mother.
“But as a physician mother, you learn to adapt and I think that’s a good thing,” she told MedPage Today. “But I think to rely on individual resiliency is a mistake.”
Goldberg said that now is the time for institutions to be more flexible to female workers’ needs and to start rethinking promotion metrics, childcare options, and how to account for the time female physicians spend mentoring residents who are also struggling with their mental health.
She also believes that support from male co-workers and supervisors can be a key factor in changing the way physician moms mitigate their anxieties.
“I think male allyship in leadership is critical and it starts by listening and asking questions,” Goldberg said. “Women need to be heard and feel valued and recognized.”