My disclosure

When I finally admitted to myself that I had bipolar disorder and was clinically stable, I made the decision to disclose my diagnosis.  I did so in a very public way at the International Conference of Bipolar Disorders.  After I approached the podium, the first words I said were: “I am a psychiatrist and I am also a psychiatric patient.  I have bipolar disorder.”  It is uncommon for a physician to disclose their mental health diagnosis.

The reaction of my patients

When I did disclose, I was still practicing.  My greatest concern in doing so was not the reactions of family and colleagues.  I was worried about what might happen if my patients were to become aware of my diagnosis. I hoped that I hid my symptoms from patients over the years, but can I be sure this was the case? I believed that for some patients, knowing my diagnosis wouldn’t matter at all. Others might see me as empathic since I was living with a psychiatric disorder. But I had to conclude that my care of some patients would be impacted in a detrimental way.  I was sure that some patients would be angry that I had withheld this information and would terminate their care with me.  This was a sobering realization since I took the Hippocratic oath as a physician to “First, do no harm”.

Why I disclosed

I was unmedicated for most of the years that I practiced, so there might be those who believe that I should have taken medical leave each time I cycled up or down.  Or, perhaps there are those who believe that I should have left the profession entirely. But given the prevalence of mental health conditions within the physician community, I don’t think the best course is to exorcise all of us who have been unwell. I recognize that other clinicians might have made a different choice than the one I did. Despite my certainty that I would negatively impact the treatment of some patients, I made the decision to disclose my diagnosis for two reasons. First, it was an act of self-healing. Perhaps selfish on my part. Second, I thought there might a greater good for my fellow clinicians in the medical community to foster a conversation about physician health. If I had to do it over again, I would make the same choice.

A conversation

Reasonable people may have different views about whether clinicians who have psychiatric disorders should practice.  This is fair to question. I would suggest that these are exactly the kinds of conversations we should be having. We need people of good will to come together and speak about these important issues. Then we can find common ground in our efforts to balance caring for our colleagues in need and, at the same time, placing a premium on delivering excellent care to our patients.

What do you think about my decision to publicly disclose my diagnosis?