I am a physician who recently had to resign from Residency due to a breakdown which resulted in a Bipolar II diagnosis. I'm on the right meds and taking care of myself and haven't felt this healthy in over a decade. There is so much stigma, especially in the medical community, about mental illness. My question is: Can a bipolar doc be effective and safe to treat patients?

The answer is: Yes, absolutely!  But we should think more about how to address that stigma and how to keep things on a good path.

First, I can’t help wanting to say that you’re a doctor living with bipolar disorder rather than a “bipolar doc.” Living with bipolar disorder can make things complicated, but it doesn’t define you. In decades past, many state medical boards asked whether doctors applying for a medical license had ever had any mental health treatment. They were assuming that ever having mental health treatment meant that a doctor could not practice safely or effectively. Fortunately, that has changed. Medical boards now ask whether applicants have any health condition that would interfere with practicing medicine safely. That’s the right question to ask.

That stigma is not limited to the medical profession. The Federal Aviation Administration (FAA) used to “ground” any pilot taking antidepressant medication. So many pilots decided not to seek treatment for depression. If I were choosing between a pilot with untreated depression and a pilot with treated depression, I’d certainly choose the latter. The FAA no longer automatically disqualifies pilots because of depression treatment, but stigma about other diagnoses or treatments is not much changed.

Your own story is a similar to the airline pilot example. You are feeling and functioning much better after learning about bipolar disorder and getting effective treatment. Having a correct diagnosis helps you to be a safer and more effective doctor. One issue is especially relevant to residents or doctors in training: a stable sleep schedule. For many people living with mood disorders, changes in sleep can increase risk of mood swings or hypomania. This can be an issue for people with jobs that involve big swings in work hours (like hospital nurses or emergency medical technicians).  You’ll want to do your best to maintain a stable sleep pattern, and you might need to ask for accommodation to do that. Big changes in sleep schedule are actually not healthy for anyone, but they can have worse consequences for people who live with mood disorders.

When you create your personal wellness plan, you’ll want to include some “doctor specific” warning signs to look out for. For example, you might think about changes in your mood could affect your personal interactions with patients (like being more irritable) or the way you make decisions (like being more impulsive or overly pessimistic). All doctors could use more self-awareness in those areas. But someone who is prone to depression or hypomania should develop a more specific list of warning signs and actions you’ll take if you notice them.

About the Doc

About the Doc

Greg Simon, MD, MPH, is a psychiatrist and researcher at  Kaiser Permanente Washington Health Research Institute in Seattle. His research focuses on improving the quality and availability of mental health services for people living with mood disorders, and he has a specific interest in activating consumers to expect and demand more effective mental health care.