Can I be a doctor with bipolar disorder?

“I have bipolar disorder. Can I be a doctor?”

It’s one of those questions to which there is no real answer. Being a doctor takes a long time, it requires reliability, diligence, and a willingness to learn things you may not want to learn and do things you may not want to do. It requires endurance and passion. You need to be tolerant of many things: arrogant supervisors, irritable colleagues, sick people who may not be charming and who may, in their distress, be down-right nasty. You have to tolerate a militaristic order and be willing to work with a system that may be very difficult, wrong, and demand your obedience in ways that may be uncomfortable. Oh, I am so happy to no longer be a medical student or a resident in training.

So can you do it with bipolar disorder? Can you do it with diabetes? Can you do it with attention deficit problems? Can you do it if you’re disorganized or ugly?

The question assumes there is one bipolar disorder, that for everyone it has the same course and the same prognosis. Some people have an episode a few times in a life, and between episodes, their mood is stable, their emotions gentle. Others cycle from one mood to another, feeling the whole bipolar thing most minutes of most days. Some patients with bipolar disorder are in and out of the hospital, behave in impulsive and criminal ways when ill, and can’t hold any job. Some do fine with medications and therapy, while others have refractory conditions that defy the most creative of cocktails and the best of therapists, even with their total compliance.

And some people become doctors and then get bipolar disorder.

So, the answer to the question is, maybe.

Dinah Miller is a psychiatrist who blogs at Shrink Rap and co-author of Shrink Rap: Three Psychiatrists Explain Their Work.

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  • http://drpullen.com health blog

    Bipolar along with many other psych and chemical dependency issues can be causes of impaired physicians. In our community alcohol and opioid abuse have been the issues over the years. More opioids prior to anesthesia coming under closer scrutiny.

  • Anonymous

    I am a physician with bipolar II disorder. I have been in practice for 25 years. For years I thought I had major depressive disorder but as I gained insight I realized I had periods of hypomania which probably helped in many phases of my career. The depressions are the most debilitating and have been the most frequent. I am well with medications and psychotherapy.

    If the disorder is treated and stable there is no reason why you cannot pursue a career with high responsibility. However the negative environmental stressors in training and practice must be faced realistically. I have risen to positions of high leadership at the local community level, the state specialty and medical society level and on some national commissions. My colleagues were totally shocked when I revealed that I had a psychiatric disorder. It all depends on the severity of the disorder and your underlying personality traits.

  • Anonymous

    I wanted to thank the Anonymous poster above. I’ll be entering medical school in the fall, and currently dealing with a new diagnosis of Bipolar II (though, it’s something I suspect I’ve had for a while…and luckily, I experience more hypomania than minor depression). There are times when I worry whether or not this will hinder me in my education, or in my future career, but your post really inspires confidence. I know with the right type of therapy, treatment, and appropriate coping skills, I can be an excellent physician.

  • http://fertilityfile.com IVF-MD

    I agree that the answer to this question should be individualized.

    There are patients who have psychiatric diagnoses who work as police, physicians, soldiers and teachers. The litmus test is whether they do their job at an acceptable level (in comparison to all their coworkers who don’t have a set diagnosis) rather than arbitrarily denying them a chance to work because of some ICD-9 label. As a medical student, I remember many residents with malignant personalities who were extremely difficult to work with. Now some of these may have had Axis II diagnoses rather than Axis I diagnoses, but I concluded that the regulatory boards can be very forgiving towards physicians whose proclivities make it hard to work with them. Having said that, there were also residents and students who suddenly disappeared from sight amidst rumors that it was due to some sort of psych impairment or substance abuse.

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