Suicidal behavior in a medical professional with comorbid depression and substance use disorder: an educational case...

Here, we publish a report of a previously practicing nurse practitioner who presented to a community hospital with severely depressed mood and neurovegetative symptoms in the context of recent relapse to alcohol and cocaine abuse. This patient had a long history of depression and polysubstance abuse. Additionally, the patient had a history of multiple previous suicide attempts with a high possibility for lethality. All of his attempts occurred in the setting of depression, escalating substance use, and interpersonal difficulties. Due to his chronic struggles with mental health and substance abuse issues, the patient lost his marriage, many close friends, and, eventually, his license to practice medicine. In this report, we highlight the increased risk of suicidal behavior or completed suicide in patients with co-occurring depressive and substance abuse disorders. We also look to highlight the often unmet need of mental health and substance abuse treatment for healthcare professionals. Studies suggest that healthcare providers experience increasing rates of burnout, mood and anxiety disorders, and substance use disorders, but available treatment resources remain scarce. This is a serious public health issue that will require increased vigilance by the community at large to ensure the safety and wellbeing of both patients and their providers.