Not many people can say they’ve accomplished their life goal of working with animals — one they’ve had since age 5 — and go on to a dream career. But the stress of Seth Vredenburg’s job as a veterinarian was making him a hermit.

Depression from his high-stress position in Portland kept him from simple things like dinner plans. The only social interactions he had, he said, were with other veterinarians, so they could complain. Not a healthy habit, he realizes now. His stress levels led to mounting health problems.

Ultimately, his doctor ordered him to quit his job at the clinic.

Vredenburg is just one of thousands of veterinarians who have suffered from psychological stress on the job. In fact, the Centers for Disease Control and Prevention released a study in January that found suicide rates, when compared to the general population, were 2.1 times as high for male veterinarians and 3.5 times as high for female veterinarians.

The study, which analyzed deaths between 1979 and 2015, came as no surprise to many veterinary specialists in Oregon who have seen this trend play out in real life for years. It did, however, validate their concerns.

Ninety-eight percent of veterinarians with psychological stress report depression, 88% report burnout and 83% report anxiety. Each is a much more significant problem for veterinarians under 45.

In the past several years, Oregon educators, business leaders and activists have initiated programs and conversations to address a previously taboo topic in hopes of saving their colleagues’ lives.

Factors

Most people don’t become veterinarians to get rich.

“Veterinary medicine is a unique industry,” Molly McAllister, a veterinarian, said. “It’s really a calling as a profession, more so than a logical decision.”

It takes a passion for animals and a strong work ethic, she said. That drive helps young vets-to-be to ignore long hours that can affect a healthy work-life balance and student debt that can reach that of a mortgage. The average student loan debt of veterinarians was $167,000 in 2016, according to the American Veterinary Medical Association. Average starting salaries are between $70,000 and $80,000 annually. Some vets can even carry student loans of $250,000 – debt they’ll be paying back well into retirement.

McAllister is the chief medical officer of Banfield Pet Hospital, the Vancouver-headquartered pet care company with 18,000 employees across the country and Puerto Rico, including more than 1,000 in the Portland area. She remembers being questioned about debt when applying to veterinary schools.

.

“The interview board saying to me, ‘You’re going to accumulate a lot of debt. Do you realize what that is?’” McAllister said. “As a bright-eyed student, smiling and nodding and saying, ‘Yeah, I realize I’m going to pay off loans for the next 30 years,’ I could never have understood how that would actually feel like.”

Student loan debt, exacerbated by a high debt-to-income ratio in the profession, is one of several key factors playing into the suicide epidemic, the CDC found.

For a profession filled with high-achievers and perfectionists, it’s easy to see how burnout, anxiety and depression can all play out, said Alex Rowell, a psychologist in the Oregon State University Carlson College of Veterinary Medicine.

“They think, ‘I have to pass this class so I can graduate and earn some income to pay that debt,’" Rowell said. “’Can I pay my bills? Am I going to find a partner and be able to buy a house?’”

There are factors beyond money. Experts have identified compassion fatigue as another top reason contributing to vets’ psychological distress. Treating animals that are often unhealthy can be particularly tough psychologically — or as Rowell put it, “it can drain your tank.”

Then, there’s the exposure to death. Veterinarians are often tasked with end-of-life care for a family’s furry loved one. Vets often become a pet undertaker.

“Sometimes you might have to do five (euthanasia procedures) in a day,” McAllister said. “It can be incredibly emotionally draining. It’s a very unique aspect to health care, that other health care providers don’t necessarily have to deal with death on that level.”

The social media age presents a new stressor, too. Grieving clients sometimes take to the internet to blame a clinic or veterinarian for their pet’s death. A New York vet died by suicide in 2014 after harassment over a cat custody battle made her an online target.

Her death was highly discussed in the veterinary community, exemplifying the seriousness of cyberbullying. The American Veterinary Medical Association created a cyberbullying-specific hotline two years after the incident.

Treatments

Suicide in the profession went largely unexplored until U.S. studies began to surface in 2015. But many vets saw the problem for decades.

The data spurred groups to begin health and wellness campaigns. Banfield Pet Hospital took its first major steps toward a wellness plan in 2017 by creating a team dedicated to the problem, McAllister said. The team started with events like open mic sessions with leadership and mental health presentations at national conferences.

The company will launch suicide prevention training through e-learning sessions in September — during National Suicide Prevention Month. The program will be optional and offered annually to start but may be integrated into the hiring process in the future.

Banfield also began addressing a key factor in the epidemic: debt. The company created student loan debt relief programs for its veterinarians in 2017. Plans range from refinancing options to summer jobs and clinical rotations with loan-addressing incentives to return for full-time work.

In its most direct plan, Banfield pays $150 monthly to every vet’s loan organization. The contributions reached $4 million in one year, according to the company.

But smaller clinics may not have the time or resources for a comprehensive health or debt-fighting plan. At annual conferences, Portland Veterinary Medical Association leaders increasingly heard from their 600 members how much they valued curriculum on health and well-being, president Carla Lerum said. Now, two annual programs center on mental health improvement: from self-care and work-life balance to identifying signs of psychological stress in colleagues.

The association’s resources are especially beneficial for smaller clinics, Lerum said. It is working on direct resources as well — things like health care plans and a la carte additions through the association. The goal, she said, is distributing costs and options throughout the community so more is available.

“It takes a village,” Lerum said. “A lot of that burden can’t just be put on that employer.”

Conversations

Ultimately, though, the most important action can be simply encouraging open dialogue, said McAllister. In the past, the field was filled with people who wanted to solve their problems themselves. Health care professionals are fixers — they’re trained to not ask for help, McAllister said. Turning the culture around could save lives.

Rowell, the Oregon State psychologist, agreed. In 2016, he became the first counselor embedded in the vet school. Last semester, he launched the first elective focused solely on “self-compassion,” leadership and diversity in the profession. He said the class is just one example of how to educate soon-to-be vets on preventing a culture of stress.

Rowell’s role puts a face to the solution. He even walks the halls to get students comfortable with therapists. If students see him as an asset early in their education, then maybe they’ll be more open to conversations or counseling when they are stressed on the job in 20 years.

Already, Rowell sees an increased caseload. The class of 2023, he said, will be more comfortable with an on-site counselor. His clinical caseload increases each year in part because word-of-mouth recommendations from peers make students and faculty more comfortable.

“I think we’ve brought it out of the darkness,” Rowell said. “We’ve had conversations about stress, anxiety and suicide. They used to be very taboo. We used to look at it as some moral flaw. But now we say it’s OK to talk about it with someone.

"Once they get over that initial potential stigma and process their concerns, it’s been a very cathartic experience for them.”

For Vredenburg, the Portland veterinarian, opening the dialogue helped. He left clinical work and focused on “self-therapy,” mindfulness and understanding compassion fatigue so he could identify stressors.

He learned to take two minutes after a euthanasia to give himself to feel the pain of the task and the family, then collect himself again, while still practicing. Vredenburg now works at MARS Pet care, where he develops training for other veterinarians.

There’s no one solution, no “simple pill,” to address each person’s mental health, he said. But for now?

“Right now, it’s all about having conversations.”

Portland is home to Lines for Life, a nonprofit devoted to suicide prevention throughout the Pacific Northwest. It operates a suicide prevention line that is answered 24 hours a day, 365 days a year. It can be reached at 800-273-8255 or by texting “273TALK” to 839863.

-- McKenna Ross

mross@oregonian.com

503-221-5776; @mckenna_ross_

Visit subscription.oregonlive.com/newsletters to get Oregonian/OregonLive journalism delivered to your email inbox.