An estimated 300 to 400 U.S. doctors kill themselves each year - a suicide rate thought to be higher than in the general population, although exact figures are hard to come by.

Some doctors believe the stigma of mental illness is magnified in a profession that prides itself on stoicism and bravado. Many fear that admitting psychiatric problems could be fatal to their careers, so they suffer in silence.

And when the pain is too much, doctors have easy access to prescription drugs and a precise knowledge of both how the body works and the amount of a drug needed for an overdose to stop breathing and halt the heart.

"All physicians have access to neat, clean ways to commit suicide," said Robert Lehmberg, a Little Rock surgeon who has battled depression and long considered suicide "an exit strategy if absolutely necessary."

The American Medical Association has called physician suicide "an endemic catastrophe" and pledged two years ago to help prevent it.

But suicides have persisted. So the American Foundation for Suicide Prevention has launched an educational campaign to encourage troubled doctors to get help.

The foundation, the American College of Psychiatrists and Wyeth Pharmaceuticals, a maker of antidepressant pills, paid for the program. It includes a documentary, Struggling in Silence, that begins airing on public television stations this week.

The foundation says that 300 to 400 doctors commit suicide each year, based on estimates from research, but that more studies are needed.

Suicide figures in broader society are not fully reliable because suicide is often not given as the cause of death.

The overall U.S. suicide rate among men is four times higher than in women - about 23 per 100,000 vs. about 6 per 100,000 in women, according to the most recent government data.

Among doctors, suicide rates are about equal for men and women.

A 28-state study from 1984-95 found female doctors were more than twice as likely as women in the general population to kill themselves. Men in the medical profession were more than 70 percent more likely to commit suicide than were men in the general population.

Depression is often a cause. Depressed doctors often self-medicate but do not seek psychotherapy that could help them deal with underlying issues, said Dr. Glenn Siegel, who runs a Chicago-area program that treats doctors suffering from drug abuse, depression and other problems.

"If you're admitting something like that," Siegel said, "you're saying maybe you're not fit to do your job."

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