Another Axis II d/o and residency

[Shakyground]

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I felt I should post my situation, in light of the responses to Matthew33 in this forum and the support they provided...

Last fall I experienced my first bout with BP-1 (i.e. manic episode). Unfortunately, this was amidst a fourth year rotation in my field of choice (very competitive). Ultimately I took the rest of the semester off to stabilize and I'm back in rotations now (will grad/match next year). I could go into the details of who saw me when I was ill (residents, attendings, friends, etc.) but I don't want to type too much and give the impression I am off my meds/relapsing. My mind/confidence/energy level are not completely back to baseline (meds vs. recovery phase) but nothing like what Matthew33 described.

In short, I am very concerned about how the stress of residency will affect me, as well as the impact the illness may have had on my ability to match into a competitive field. Not only this but whether or not I will be able to function as highly as I had prior to my affliction. I would appreciate any comments (+/-), advice etc.

 

[Winged Scapula]

I think it would help knowing the type of residency you are considering. A competitive residency in say, Derm, would perhaps be less stressful than a surgical subspecialty.

 

[sunlioness]

Well, the psychiatrist in me feels compelled to say that you're actually talking about an axis one disorder.

*whew* Feel better now. (sorry)

Otherwise I agree with Winged Scapula. Especially since lack of sleep is such a huge trigger for manic episodes in bipolar illness. Nevertheless, I would imagine that a sympathetic program director would work with you on that and I know that there are bipolar physicians out there in many specialties.

 

[Tired]

First of all, this will probably be the minority opinion. And second, I have no personal experience with mental illness. But that being said:

I would just go for it. If you feel like you've got your disease under control, and you are with it enough to continue to monitor your disease and take your meds, I see no reason to shy away from your goals simply because of this new diagnosis. There are highly-successful physicians and surgeons out there with your same illness, who went through the same situation. You have invested so much of yourself into this path, that I don't think you should radically alter your plans on the basis of a fear of what could happen, but hasn't yet.

Just my 0.02

Good luck.

 

[buckley]

This is from an essay "From the Brink" by an anonymous General Practitioner who has had several episodes of depression in the book "Wounded Healers" (this is the book I've talked about in another thread):


"You may wonder why I persist in trying to pursue a career for which I seem unfit. My contention is that my depression is neither caused nor exacerbated by my choice of profession, but due to some innane abnormality in my physical and/or mental constitution which would be present regardless of where I worked at...I have wanted to be a doctor since the age of 10, and this determination has never altered since then during sickness or health. I gain enormous personal satisfaction from the practice of my profession...I am certain that it is more fulfilling to do a job one likes, and that a repugnant, though less demanding, job would be more likely to precipitate than prevent mental illness...At the time of this writing I am on the brink of another breakdown. At work I am saying little, doing less, and panicking inside at the effect this behaviour is having on my patients and colleagues. In consultations, I am tense, irritable and rejecting...At best, my patients must feel I have lost interest in them; at worst, my conduct may seriously affect their health....My worry now is whether I ought to take sick leave. My mind is confused by conflicting emotions: guilt at letting my partners down; doubt that it may be a delusion that my clinical judgment is impaired; anger that self pity suggests the coward's way out; fear of the damage I may do to my patients, my colleagues, and hence, my career. The whole is complicated by the pervasive indecisiveness that goes with depression..."

I don't know if that would help you but I think it gives a perspective on how it is to live with depression as a doctor. Of course, I must point out that the writer points out that he/she is on the verge of a breakdown. Still, I admire the honesty with which he presents his story.

My personal thoughts would be to listen to what it is you truly want, and to always ask for help when you need it. If anything I hope that above piece of literature just lets you know that you are not alone. Good luck