The Hidden Struggle: How Anxiety and Shame Shape Doctors’ Lives
This is a blog post that I wrote for Shame and Medicine, an interdisciplinary research project that is based at the University of Exeter and the University of Birmingham. The overall aim of the project is to research the role of shame in various aspects of health and medicine, including clinical practice, patient experience and medical student education.
The project is engaging a team of researchers in social sciences, cultural studies, medicine and philosophy to investigate the philosophy and cultural representation of shame in medicine, while also doing empirical studies looking at shame experiences in current healthcare practices and professional culture, particularly exploring how race, ethnicity, class, gender and disability impact on the experience of shame.
The Shame and Medicine project will provide evidence that will improve the quality of health services and enrich our understanding of the experience of shame as it relates to health, professional practice and education. Find out more about their work here
It can begin in small, invisible ways.
A flutter in the chest before ward rounds. A tightness in the throat before speaking up in meetings, the waves of nausea preparing to speak to a concerned relative.
The quiet dread of not knowing, not being enough, not having the answer, not being able to hold it all.
For years, anxiety lived in my body like a quiet, constant alarm. I would feel it rise, an inner fluttering, a heat in my chest. I could feel the blush before it came. And I feared it. Not just the sensation, but what it would mean. What others would see. That they would notice and judge me.
And then comes the shame.
Because doctors, we tell ourselves, aren’t meant to feel this way. We’re trained to be steady, competent, unshakable. We learn to allay fear in others, but not in ourselves. And when anxiety shows up, it feels like a betrayal. A crack in the armour we’ve worked so hard to wear.
I know this from the inside.
As a doctor, I carried anxiety as a heavy load, for years. It crept into my sleep, my thoughts, my breathing. I covered it well, most of us do. Perfectionism became my camouflage. Hypervigilance, my coping strategy. And yet, underneath the polished surface was a nervous system constantly on high alert.
The shame wasn’t just about the anxiety itself, it was about the belief that it shouldn’t be there. That somehow, my inner experience made me less qualified, less capable, less competent as a doctor.
Because in medicine, we’re taught both explicitly and implicitly, that calm is competence. That steadiness is safety. That being visibly anxious is somehow unprofessional. Weak. Incompetent.
I remember the moments that etched that belief in me. I remember them vividly, not because they were loud, but because they lodged quietly beneath my skin.
A senior colleague once glanced at me on a ward round and said:
“You seem anxious. Patients can sense that. It might make them uneasy.”
Another time, during an MDT, my consultant saying.
“You blush when you speak. Why are you nervous?”
With each of these words, my heart would race faster. And I would shrink just a little more. For a long time, I believed these were isolated moments, a few misguided comments that I could shrug off. But the more I listened, the more I realised that this subtle, pervasive view was a part of something much bigger.
And just like that, the cycle of shame took root. The shame in knowing that people have noticed something you want to hold invisibly for fear of judgement. A particular kind of silence that anxiety carves out in a doctor’s life.
It’s the silence of holding your breath in meetings, of counting heartbeats in corridors, of rehearsing the right words so your voice won’t tremble. The silence of shame.
And yet, beneath all that fear, I was still a good doctor. Still caring. Still listening. Still holding space for others with grace and warmth. I just didn’t know how to offer that same care to myself.
It wasn’t until much later—when I started to step outside of the healthcare system and into nature that I began to unravel the knots. Coaching helped. So did the trees.
Nature, unlike people, didn’t care if I blushed. Didn’t ask me to “calm down.” It met me as I, in all my fluttering, aching, imperfect humanness. In that quiet space, I could breathe again.
And slowly, I began to speak.
To name the shame. To tell the truth about the anxiety that so many of us carry in silence. To offer compassion to the younger version of me who thought she had to hide it to survive.
And what I’ve learned is this:
Anxiety does not mean you’re failing.
Blushing does not mean you’re weak.
Speaking up, even with fear, is still courage.
In walking alongside hundreds of doctors through my coaching work, I believe that those who feel deeply, who tremble, who care, who worry because they want to do right, are some of the most caring and compassionate of all. The type of doctor you would want to look after your ageing relative, to be the ones who break bad news, or operate on your best friend.
But doctors need spaces where we can show up as our real selves. We need to know that being visibly human is not a flaw, it’s a vital part of our medicine. A place to remind ourselves that anxiety isn’t a weakness but that it is part of being human and it’s that humanity that makes us the caring, complex professionals we are. For the sake of our patients, our colleagues, and ourselves, let’s embrace that vulnerability and authenticity, and value them as strengths.
So if you, like me, have carried the fear of being “too anxious,” if you’ve swallowed words for fear of blushing, or shrunk your voice to hide your nerves, know this:
You are not alone.
You are not broken.
And you do not have to keep quiet.
There is strength in softness. And there is a path toward ease, gentleness, and wholeness, even if your heart beats fast sometimes.
Even if your voice shakes.
Especially then.
If you struggling with your mental health and need specialist help please access
https://www.practitionerhealth.nhs.uk
https://doctors-in-distress.org.uk