Attitude/Behavior Changes:

• Rapidly turns from compassionate and caring to abrupt, caustic
• Withdraws from friends and activities
• Becomes mistrusting, anxious, depressed, irritable

Physical Changes:

• Loss of appetite or reduced level of exercise
• Looks tired; admits to insomnia
• Personal hygiene deteriorates
• Physical problems are self-treated

Performance Changes:

• Misses appointments
• Makes rounds at unusual hours
• Can’t be reached when on call
• Sloppy charting
• Smell of alcohol on breath during the day