If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day. If someone is in immediate danger, call 911 or go to the nearest emergency room.
Ask a senior leader why they have not sought help for depression, and the answer is often not about time or cost. It is about exposure. What if the board finds out? What if investors lose confidence? What if a licensing form asks about it someday?
For physicians and attorneys who run practices or firms, the worry can be sharper still. Their professional identity is bound up with judgment and reliability, and they may fear that any record of treatment could be held against them.
Those concerns are understandable. They can also keep someone in danger from reaching out at all, especially when depression has started to include thoughts of suicide.
Naming the fear honestly
Fear of disclosure tends to grow in silence. A leader runs the worst case over and over, late at night, and it begins to feel like certainty. Meanwhile the depression itself goes untreated and may deepen.
It can help to separate two questions. The first is whether you need care. The second is what, if anything, you would ever need to share with anyone. The first question is urgent. The second can be worked through calmly, with accurate information, once you are safer.
Rules about what employers, boards or licensing bodies may ask vary by field and by state. This article cannot tell anyone what applies to them. A clinician can explain how medical privacy generally works, and a trusted advisor in your own profession can help you understand what your field actually requires, rather than what you imagine it does.
Signs that it is time to reach out anyway
- Thoughts that you would be better off dead or that others would be better off without you
- Feeling trapped, with no acceptable way out of a situation
- Withdrawing from colleagues, friends and family
- Changes in sleep, appetite or drinking
- Unusual recklessness, or a sudden settled calm after a long dark period, which can be a warning sign
- Making arrangements as though preparing to leave
If any of these sound familiar, your health comes first. Questions about disclosure can wait for daylight.
For colleagues who notice
If you are concerned about a partner or fellow executive, talk with them privately and promise discretion within the limits of keeping them safe. Ask plainly whether they are thinking about suicide. A calm question signals that you can handle the answer.
If they say yes, stay with them and help them contact 988 or a clinician, or call 911 if danger is immediate. Encouraging them to keep medications and firearms stored securely, or held by someone outside the home for a while, is a reasonable step during a crisis.
A treatment option given in a clinic setting
Leaders who want to know what care might look like before deciding anything may come across Spravato. Spravato (esketamine) is a nasal spray the FDA has approved, taken along with an oral antidepressant, to treat depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behavior. It is also approved for treatment-resistant depression. It is not a crisis treatment: it does not replace emergency care or a hospital stay when one is needed, and it has not been shown to prevent suicide or to reduce suicidal thoughts or behavior. It is given only in a certified clinic under a safety program called the Spravato REMS. The patient takes it there under supervision, stays at least two hours to be monitored, and does not drive until the next day after a full night of sleep. It is never dispensed for home use. Whether it fits is a clinician's decision after an evaluation.
Care and confidence can coexist
Depression is a treatable condition, and recovery is possible. Seeking care can be an act of responsibility toward the people and organizations that depend on you.
Privacy questions are welcome from the first minute. Some clinics offering this treatment hold a free 30-minute consultation where you can ask how records are handled, describe what you are facing, and decide whether to go further. Someone you trust can be in the room with you.
If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day. If someone is in immediate danger, call 911 or go to the nearest emergency room.