Dr. Folashade Afolabi: A doctor’s journey to recognize her own mental health

In February 2020, as COVID-19 began to emerge as a real threat to public health, Dr. Folashade Afolabi, a pediatric pulmonologist in Dallas, had one thought: “This is going to be really, really bad.” Afolabi, 44, had been a resident when the swine flu hit the U.S. in 2009, so she knew she had to start preparing to protect her patients from COVID-19. What she didn’t expect was the effect the pandemic would have on her own mental health.

“I think I underestimated what this was going to be like,” Afolabi told Fortune. “I didn’t think it’d be such a challenge to cope with the anxiety and the unknowns related to work, my daughter, and my family.”

Afolabi was not alone in her struggle with pandemic-related mental health stress. Doctors and other health care professionals around the country have struggled with a growing mental health crisis in the profession owing to burnout, increased stress, overcrowded ICUs, and more. According to a Washington Post–Kaiser Family Foundation poll, almost six in 10 doctors said the pandemic had had a negative effect on their mental health.

While Afolabi was not directly working with patients in the ICU, she was still treating patients whose parents were largely Black and Latino, two groups that would end up bearing the brunt of COVID-19 infections and deaths in Texas. Recent data from the Kaiser Family Foundation shows that while Latinos make up 40% of the population in the state, they represented 52% of COVID-19 cases and 44% of deaths. Black Texans constitute 12% of the population, 15% of cases, and 10% of deaths.

“This was a patient group that was afraid,” Afolabi, who is Black, said. Many of her patients told her they worried about coming into the office for fear they might contract the virus. As the pandemic wore on and more Americans began to die, Afolabi also encountered grief among her patients who had lost grandparents or other family members.

“I felt an overwhelming sadness for families that were losing their matriarchs and their patriarchs,” Afolabi said. “I felt powerless in my ability to help.”

By the spring of 2020, much of the U.S. was under stay-at-home orders, something that made Afolabi’s home life stifling. “The isolation was far more intense than I ever imagined it to be,” said Afolabi, who is the single parent of a 15-year-old. “I got to spend more time bonding with my daughter, but I’m 44, and I need adult interaction. Zoom just doesn’t do it for me.” To avoid unnecessary stress Afolabi said she stopped watching the news and listening to the radio and started bingeing on more escapist fare like travel shows.

“It was just overwhelming. Every place you looked there was something to be sad about. It was so hard to find peace,” she said.

Despite her growing depression, she did as many doctors are trained to do, and she powered through until a random road rage incident pushed her over the edge. She had pulled over to a shoulder on a highway to avoid an erratic driver when suddenly another driver ran toward her car and started punching and hitting it. “It was really scary. I was worried he was gonna break my window.” she recalled. The attack was something Afolabi said she couldn’t shake. Her anxiety peaked, and she was unable to sleep in her bed. Instead, she would lie on her couch with a view of her front door and watch the security camera.

“I realized I just didn’t have the tools anymore to cope,” Afolabi said.

She had already been seeing a therapist, but after the acute anxiety and depression she asked for a reference to a psychiatrist. The move was a bold one for a physician to make given the reluctance and stigma surrounding doctors who seek psychiatric help. An August 2020 survey by the Physicians Foundation found that just 13% of physicians had sought medical intervention for the mental health strain brought on by COVID-19. “There is a fear that when you fill out your paperwork that says whether you’re on any medications, that will affect your job,” said Afolabi. “The answer is no. I’m on medication that enhances my job.”

One lesson Afolabi learned was that medication and psychiatric intervention is not a quick fix. It can take weeks or even months to find the right balance of medication and therapy to begin to feel better. “I think I found something that works for me, but I did have a little bit of the instant gratification expectation that a lot of patients have,” she said.

The combination of therapy and medication has helped Afolabi become more aware of her own emotional ups and downs as well as those of her patients. “I’ve become better at acknowledging their fears and concerns for their child,” she said.

Her colleagues have also been a tremendous support. After the murder of George Floyd prompted a national reckoning about police brutality against Black Americans, Afolabi said her colleagues were key to managing the uncertainty and tension of the moment: “They heard me, they had the same questions, they were a lifeline.” Her openness about her struggles with anxiety, depression, and medication has also opened the door for more transparent conversations about mental health among her colleagues, Afolabi said. “It’s not stigmatized,” she noted. Hospital staff also now have access to therapists and crisis counselors.

But perhaps the biggest lesson for Afolabi was being open with her colleagues about her choice as a Black woman physician to seek help. Many colleagues told her she was brave for her transparency. But Afolabi doesn’t see any other way. “When we are going through heavy emotional times we shouldn’t be hesitant,” she said. “We need to treat ourselves with the same loving kindness we [give to] our patients.”