Giving up medical school because of mental illness?

[Andy C.]

I am a 4th year med student. Recently diagnosed with Bordeline personality disorder. I am depressed too. At the moment I am using antidepressants and receiving medical attention and believe I can finish medscholl. I am at the top 5%in my class. I am smart..But seriously considering if I can be a good doctor suffering with a personality disorder that makes me very depressed and unstable emotionally.
I would like some advice.
Sorry for the broken English, I'm from latin America
Thanks

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[IMG69]

Path, radiology? Specialties which don't require much patient interaction if you're that worried about it?

 

[TurtleyReady4Med]

One of my classmates has BPD that has been stable for a couple of years and is now persuing medicine. You can definitely do it as long as your symptoms are controlled with counseling and medication.

 

[Goro]

I am a 4th year med student. Recently diagnosed with Bordeline personality disorder. I am depressed too. At the moment I am using antidepressants and receiving medical attention and believe I can finish medscholl. I am at the top 5%in my class. I am smart..But seriously considering if I can be a good doctor suffering with a personality disorder that makes me very depressed and unstable emotionally.
I would like some advice.
Sorry for the broken English, I'm from latin America
Thanks

@Mad Jack

 

[Mass Effect]

DISCLAIMER: Not giving medical advice

So, I don't know the specifics of your case and I am not giving medical advice, but medication won't cure borderline personality disorder, though some meds can help with the symptoms some people with BPD (and many without it) experience. First, you need to learn what BPD truly is. It's a maladaptive way of handling interpersonal relationships/conflicts/stress. This is usually due to defense mechanisms and a way of relating to others that developed starting in childhood. The best treatment is therapy.

There are a great number of doctors, nurses, NPs, PAs, and others in healthcare who have mental health issues, including borderline personality disorders. With therapy, there is no reason you can't be a physician unless you (or others) feel your disorder compromises patient care.

I also have to add this caveat. Be cautious about your diagnosis IF it was made in the context of med school with no symptoms prior. I have seen people in high-stress situations diagnosed with this and I think there is a difference between a primary personality disorder and the symptoms of dysfunctional interactions that only manifest during a specific high-stress/chaotic situation when the person is at their most vulnerable to maladaptive coping. This is also why I question caregivers who diagnose patients with this during a hospital stay when they're very ill.

 

[Dave1980]

You could always go into OB...you'd fit right in (jk).

If you foresee this being an issue then a low-stress field. I saw someone above recommended Radiology. I'm not sure Radiology qualifies as low-stress anymore...the days are pretty hectic, you are expected to perform an a high-level at all time, and there are constant interruptions.

Don't give up though!

Just my 2 cents.

 

[IMGASMD]

There are surgeons who I worked with have bipolar, which is an axis I disorder. (If I remember correctly).
Don’t know where you live or if you can take some time off before you graduate. There are plenty people with mental illness in medical field, we are not immune to illness. Good luck.

 

[Mad Jack]

I am a 4th year med student. Recently diagnosed with Bordeline personality disorder. I am depressed too. At the moment I am using antidepressants and receiving medical attention and believe I can finish medscholl. I am at the top 5%in my class. I am smart..But seriously considering if I can be a good doctor suffering with a personality disorder that makes me very depressed and unstable emotionally.
I would like some advice.
Sorry for the broken English, I'm from latin America
Thanks

You shouldn't live based on a label. Borderline personality disorder is functionally a lack of core life skills and coping mechanisms that can be learned through DBT, which has been shown to have significant positive impacts upon people with a diagnosis of BPD. You aren't hopeless, and people with BPD have widely varying levels of function. I've met several that were well-functioning physicians

Take your meds, go to therapy, and follow the advice of your mental health professionals

 

[Andy C.]

I take antidepressants for depression. I know it won't work for BPD. But they help, not much, but I fell safer taking antidepressants than not taking them. Too scared of suicidal behavior because of BPD.
I am very functional. Very.
It's in my personal life that BPD really affects me. Seriously considering working just part time... low stress medical field.. dermatologist, family medicine.. living by the beach or rural area.
Stress makes everything worse.

 

[IMGASMD]

I take antidepressants for depression. I know it won't work for BPD. But they help, not much, but I fell safer taking antidepressants than not taking them. Too scared of suicidal behavior because of BPD.
I am very functional. Very.
It's in my personal life that BPD really affects me. Seriously considering working just part time... low stress medical field.. dermatologist, family medicine.. living by the beach or rural area.
Stress makes everything worse.

Derm? You mustn’t be in the US then.....

 

[Mass Effect]

I take antidepressants for depression. I know it won't work for BPD. But they help, not much, but I fell safer taking antidepressants than not taking them. Too scared of suicidal behavior because of BPD.
I am very functional. Very.
It's in my personal life that BPD really affects me. Seriously considering working just part time... low stress medical field.. dermatologist, family medicine.. living by the beach or rural area.
Stress makes everything worse.

Are you in therapy? Regardless of what you want to do and how much you want to work, you still have to make it through training and that's the most stressful part. Therapy (dialectical behavioral therapy to be exact) is the best evidence-based treatment for BPD. It teaches you new coping skills and how to deal with that stress that you fear.

 

[sloop]

DISCLAIMER: Not giving medical advice

So, I don't know the specifics of your case and I am not giving medical advice, but medication won't cure borderline personality disorder, though some meds can help with the symptoms some people with BPD (and many without it) experience. First, you need to learn what BPD truly is. It's a maladaptive way of handling interpersonal relationships/conflicts/stress. This is usually due to defense mechanisms and a way of relating to others that developed starting in childhood. The best treatment is therapy.

There are a great number of doctors, nurses, NPs, PAs, and others in healthcare who have mental health issues, including borderline personality disorders. With therapy, there is no reason you can't be a physician unless you (or others) feel your disorder compromises patient care.

I also have to add this caveat. Be cautious about your diagnosis IF it was made in the context of med school with no symptoms prior. I have seen people in high-stress situations diagnosed with this and I think there is a difference between a primary personality disorder and the symptoms of dysfunctional interactions that only manifest during a specific high-stress/chaotic situation when the person is at their most vulnerable to maladaptive coping. This is also why I question caregivers who diagnose patients with this during a hospital stay when they're very ill.

I agree with your last point about diagnosing people with personality disorders in adverse circumstances. This is the classic state vs trait conundrum. However, it is very possible to diagnose people with personality disorders even in the hospital given enough witnessed maladaptive patterns of interaction and robust collateral. Most of the time I just note neurotic personality traits for inpatients but have actually diagnosed a minority of those for whom there is suspicion of a personality disorder.

In any case, yes it is entirely possible to be a physician with borderline personality disorder if adequately treated.

As much as I don’t want to perpetuate stigma, I would also advise not advertising your diagnosis or at least being vague about the particular diagnosis even if you might be open about having a mental health condition generally. Unfortunately, Borderline Personality Disorder is among the most stigmatized mental health conditions among healthcare providers (the general public often isn’t as familiar with it). Like I said, if you want to be brave and be open about it I wholeheartedly support you (in the interest of reducing stigma) but if I was in this position I would probably let almost nobody know what my diagnosis is.

 

[Mass Effect]

I agree with your last point about diagnosing people with personality disorders in adverse circumstances. This is the classic state vs trait conundrum. However, it is very possible to diagnose people with personality disorders even in the hospital given enough witnessed maladaptive patterns of interaction and robust collateral. Most of the time I just note neurotic personality traits for inpatients but have actually diagnosed a minority of those for whom there is suspicion of a personality disorder

Meh, to each his own. I don't do it unless it's a patient who is there for a psych reason, such as OD, and I'm evaluating for why it happened and appropriate dispo. But if a patient is on a medical ward for, say, COPD, I don't tend to make a diagnosis because I'm getting only a glimpse into the patient's personality while the patient is under a great deal of physical and emotional stress. My view is limited and in that setting, it's tough to differentiate between borderline personality or impaired coping (and the two are not the same). The only caveat to that is if I suspect BPD and it is affecting medical care by putting the patient at risk while in the hospital.

By definition, BPD must be present in "a variety of contexts," which is difficult to observe in a hospital setting. Additionally, a key component of the diagnosis is the instability of interpersonal relationships. Sure, you can get collateral, but who's sitting on the phone on an inpatient medical unit trying to figure out how many failed relationships/friendships the patient had, unless it directly affects care/plan as in the patient with the OD? Most non-mental health professionals are notoriously bad at diagnosing BPD, which is why it's so widely diagnosed (in many cases, erroneously, similar to all the kids walking around with diagnoses of bipolar disorder). Once it's diagnosed by anyone, it is carried over in the chart repeatedly and no one seems to bother questioning it. This sucks for the patient because, as I've seen happen, most subjective complaints are then attributed to BPD, despite the fact that medical illness is likely contributing significantly to the emotional/affective dysregulation you see on a medical ward. The psych ward is obviously different.

If I'm on a med/surg floor and suspect borderline traits AND it's affecting medical care, I will do some education with the medical team, but failing that, I often refrain from saying borderline traits because as I've learned there are a number of providers who don't know what that means and think I'm making the diagnosis of BPD. I simply describe the traits instead: "patient tends to become dysregulated when family leaves or is about to leave" or "patient tends to become angry when receiving disappointing news" or "patient shows signs of impulsivity, so would monitor..." They don't need the label to get a clear picture of the patient's tendencies and how it can affect the medical admission. I then offer recommendations to combat these tendencies and may include a referral or option for psych eval upon medical discharge if I think the patient could benefit from it.

 

[sloop]

Meh, to each his own. I don't do it unless it's a patient who is there for a psych reason, such as OD, and I'm evaluating for why it happened and appropriate dispo. But if a patient is on a medical ward for, say, COPD, I don't tend to make a diagnosis because I'm getting only a glimpse into the patient's personality while the patient is under a great deal of physical and emotional stress. My view is limited and in that setting, it's tough to differentiate between borderline personality or impaired coping (and the two are not the same). The only caveat to that is if I suspect BPD and it is affecting medical care by putting the patient at risk while in the hospital.

By definition, BPD must be present in "a variety of contexts," which is difficult to observe in a hospital setting. Additionally, a key component of the diagnosis is the instability of interpersonal relationships. Sure, you can get collateral, but who's sitting on the phone on an inpatient medical unit trying to figure out how many failed relationships/friendships the patient had, unless it directly affects care/plan as in the patient with the OD? Most non-mental health professionals are notoriously bad at diagnosing BPD, which is why it's so widely diagnosed (in many cases, erroneously, similar to all the kids walking around with diagnoses of bipolar disorder). Once it's diagnosed by anyone, it is carried over in the chart repeatedly and no one seems to bother questioning it. This sucks for the patient because, as I've seen happen, most subjective complaints are then attributed to BPD, despite the fact that medical illness is likely contributing significantly to the emotional/affective dysregulation you see on a medical ward. The psych ward is obviously different.

If I'm on a med/surg floor and suspect borderline traits AND it's affecting medical care, I will do some education with the medical team, but failing that, I often refrain from saying borderline traits because as I've learned there are a number of providers who don't know what that means and think I'm making the diagnosis of BPD. I simply describe the traits instead: "patient tends to become dysregulated when family leaves or is about to leave" or "patient tends to become angry when receiving disappointing news" or "patient shows signs of impulsivity, so would monitor..." They don't need the label to get a clear picture of the patient's tendencies and how it can affect the medical admission. I then offer recommendations to combat these tendencies and may include a referral or option for psych eval upon medical discharge if I think the patient could benefit from it.

But ADHD has to be observed in a variety of contexts, too. How do you ever diagnose that other than by collateral?

I agree it's a difficult diagnosis to make but, honestly, the perspective that this is an impossible or almost impossible diagnosis to make as an inpatient (which I've heard multiple psychiatrists claim) is frankly diagnostically nihilistic and makes no sense. Generally as a psychiatrist, even if you see the patient as an outpatient, you only observe the patient in one context, anyway. All assessment of other contexts is by collateral.

 

[Mass Effect]

But ADHD has to be observed in a variety of contexts, too. How do you ever diagnose that other than by collateral?

I wouldn't make a diagnosis of ADHD either when a patient is admitted for medical reasons, like COPD, is the point.

I agree it's a difficult diagnosis to make but, honestly, the perspective that this is an impossible or almost impossible diagnosis to make as an inpatient (which I've heard multiple psychiatrists claim) is frankly diagnostically nihilistic and makes no sense

Of course it makes sense when a key component is personal relationships. Unless this behavior affects care, it doesn't matter in an acute medical admission anyway and if it does affect care, you can pinpoint the problematic behaviors without making a diagnosis based on coping difficulty with medical illness.

Generally as a psychiatrist, even if you see the patient as an outpatient, you only observe the patient in one context, anyway. All assessment of other contexts is by collateral.

That couldn't be further from the truth. An outpatient psychiatrist follows a patient long-term and learns about their relationships, their coping skills, how they handle stress at work, at home, and everything in between, over time. A non-psychiatrist may not grasp the nuances, but psychiatrists absolutely do. And yes, collateral can be helpful (though not required), but that is an outpatient thing, not something you do during a medical admission for COPD.

 

[sloop]

I wouldn't make a diagnosis of ADHD either when a patient is admitted for medical reasons, like COPD, is the point.



Of course it makes sense when a key component is personal relationships. Unless this behavior affects care, it doesn't matter in an acute medical admission anyway and if it does affect care, you can pinpoint the problematic behaviors without making a diagnosis based on coping difficulty with medical illness.



That couldn't be further from the truth. An outpatient psychiatrist follows a patient long-term and learns about their relationships, their coping skills, how they handle stress at work, at home, and everything in between, over time. A non-psychiatrist may not grasp the nuances, but psychiatrists absolutely do. And yes, collateral can be helpful (though not required), but that is an outpatient thing, not something you do during a medical admission for COPD.

I understand this perspective, but I disagree with a blanket prohibition on inpatient diagnosis of personality disorders. It is more difficult, but doable in some cases.

This does matter because it affects, for example, connection of the patient with outpatient DBT resources (which can also be difficult but is possible).

If you are the inpatient psychiatrist or the consultant psychiatrist, you should be getting collateral from someone if possible.

Especially at the end of their hospitalizations, patients are not necessarily less capable of giving self-report of their mental states in other circumstances than as an outpatient. You can say that outpatient evaluation longitudinally at different times counts as different contexts but this is not exactly true. You are still seeing them in the context of a doctor’s visit in an office. The fact that they might have different stuff going on at different visits isn’t truly a different context. Just like for ADHD, different contexts involves different reports in different settings (a psychiatrist noting deficits in the office at different times is not sufficient), collateral is usually the key to diagnosis.

Look, I agree that inpatient diagnosis is rare, but it is not impossible. Many of our diagnoses are technically impossible to diagnose based entirely on what is observed as an inpatient (schizophrenia, Bipolar II, MDD vs SIMD vs adjustment disorder, etc.) Still, we manage to diagnose them with the help of history and collateral. There is reason to try because diagnosis affects treatment and appropriate disposition in many cases.

Mainly my objection is that the practical considerations of personality disorder diagnoses do not really put them in a different class than all of the other stuff we routinely diagnose. Underneath it all, I think people are afraid of diagnosing this as an inpatient because they see the diagnosis as stigmatizing. Stigma is a problem but it should never be a diagnostic consideration. Appropriate diagnosis and subsequent treatment is the main way we express compassion as providers. Ignoring that it is sometimes possible to diagnose an inpatient with a difficult diagnosis to establish only does them a disservice.

 

[Mass Effect]

I understand this perspective, but I disagree with a blanket prohibition on inpatient diagnosis of personality disorders. It is more difficult, but doable in some cases.

You do you.

This does matter because it affects, for example, connection of the patient with outpatient DBT resources (which can also be difficult but is possible).

Unless the BPD is affecting care, it makes no difference. We are not there to diagnose a personality disorder that's of no consequence to the patient's immediate needs. That's like consulting neurology during an admission for COPD just so they can do explore for MS just in case.

If you are the inpatient psychiatrist or the consultant psychiatrist, you should be getting collateral from someone if possible

You can spend your time getting collateral for pointless reasons that don't affect the course of the hospitalization or treatment if you like, but I choose to focus on what the patient and the team needs from me in the acute setting rather than getting collateral for the sake of getting it. Psych evals for suspected issues that don't impact the patient's acute care can and should be done outpatient.

Especially at the end of their hospitalizations, patients are not necessarily less capable of giving self-report of their mental states in other circumstances than as an outpatient. You can say that outpatient evaluation longitudinally at different times counts as different contexts but this is not exactly true. You are still seeing them in the context of a doctor’s visit in an office. The fact that they might have different stuff going on at different visits isn’t truly a different context. Just like for ADHD, different contexts involves different reports in different settings (a psychiatrist noting deficits in the office at different times is not sufficient), collateral is usually the key to diagnosis.

When you get further in your training, we'll talk, because right now, you're missing the point of outpatient psychiatric visits versus inpatient medical hospitalizations where the chief complaint is non-psychiatric.

Look, I agree that inpatient diagnosis is rare, but it is not impossible. Many of our diagnoses are technically impossible to diagnose based entirely on what is observed as an inpatient (schizophrenia, Bipolar II, MDD vs SIMD vs adjustment disorder, etc.) Still, we manage to diagnose them with the help of history and collateral. There is reason to try because diagnosis affects treatment and appropriate disposition in many cases.

And you're also confusing inpatient psychiatric hospitalization with inpatient medical hospitalization.

You do you.

 

[sloop]

You do you.



Unless the BPD is affecting care, it makes no difference. We are not there to diagnose a personality disorder that's of no consequence to the patient's immediate needs. That's like consulting neurology during an admission for COPD just so they can do explore for MS just in case.

I never said anything about a personality disorder that would be inconsequential. My point was only that it can be possible to diagnose in this setting, not that we should go hunting for it as a matter of course. I have no impulse to argue your BS straw man.

You can spend your time getting collateral for pointless reasons that don't affect the course of the hospitalization or treatment if you like, but I choose to focus on what the patient and the team needs from me in the acute setting rather than getting collateral for the sake of getting it. Psych evals for suspected issues that don't impact the patient's acute care can and should be done outpatient.

See above regarding your straw man.

And I disagree about routine collateral being pointless. If a patient has someone who knows them well and is available to talk to, I think it is valuable to get that input. Sometimes one is too busy and the importance is not high enough to justify it in a given moment, but it's still worth doing.

My overall feeling is that my goal is to help the patient and I will provide whatever services I can that will help the patient, which includes documenting information that might be relevant to future care. As long as it's not the middle of the night, I will call for relevant collateral even on call.

When you get further in your training, we'll talk, because right now, you're missing the point of outpatient psychiatric visits versus inpatient medical hospitalizations where the chief complaint is non-psychiatric.

I know what outpatient visits entail. I have outpatients, too. Many of them have personality vulnerabilities. You don't actually know much about me, so your appeal to authority and claim that my opinion is due to some sort of lack of experience is total nonsense.

And you're also confusing inpatient psychiatric hospitalization with inpatient medical hospitalization.
You do you.

I'm not confusing them. You're making all sorts of arguments against things I never said. My only claim was that it is possible to diagnose a personality disorder given observation of an inpatient (of any sort) and sufficient collateral from the right informants. I believe it is rare for these criteria to be met but it is possible. There is nothing about being an inpatient that makes this diagnosis logically impossible. People act like this is the case but the arguments for this point of view do not pass muster for the reasons I've expressed. Perhaps you don't believe it is necessarily impossible either but feel it is less likely than I do that the necessary information for the diagnosis can be had. In which case, fine, but quit acting like this is an issue of my inexperience rather than a topic about which even attending psychiatrists sometimes disagree.

 

[Mass Effect]

I never said anything about a personality disorder that would be inconsequential. My point was only that it can be possible to diagnose in this setting, not that we should go hunting for it as a matter of course. I have no impulse to argue your BS straw man.

See above regarding your straw man.

Speaking of straw man, your entire argument is straw man. No one said it was impossible to diagnose a personality disorder on an inpatient medical floor. What I said was that I question people who do it because most people are not going to get collateral and most of the time, there is no need to even diagnose it as it has nothing to do with what's going on medically.

And I disagree about routine collateral being pointless. If a patient has someone who knows them well and is available to talk to, I think it is valuable to get that input. Sometimes one is too busy and the importance is not high enough to justify it in a given moment, but it's still worth doing.

If I need collateral to diagnose GAD when the patient just relayed their history to me through a one-hour psych eval, then I'm doing something wrong. Unless there are safety concerns OR the collateral is relevant to the reason for admission, reason for co-morbid illness/behavior (someone with a psychotic disorder requiring med rec, etc), or interferes with medical care, collateral is a luxury, but not necessary.

I know what outpatient visits entail. I have outpatients, too. Many of them have personality vulnerabilities. You don't actually know much about me, so your appeal to authority and claim that my opinion is due to some sort of lack of experience is total nonsense.

My opinion is that your view is likely due to some component of lack of experience because of the analogies you're making and the things you're posting. That's my opinion.

I'm not confusing them. You're making all sorts of arguments against things I never said. My only claim was that it is possible to diagnose a personality disorder given observation of an inpatient (of any sort) and sufficient collateral from the right informants

When did I say it's not possible under those conditions? Please quote me.

I believe it is rare for these criteria to be met but it is possible

Again, when did I say it's not possible?

There is nothing about being an inpatient that makes this diagnosis logically impossible

I actually think you're the one arguing the straw man because no one said it's logically impossible with collateral. What I said was that most people are not going to get collateral for this diagnosis unless it affects the patient's acute needs and in many cases, it doesn't. Regardless, you don't need the diagnosis to identify the behaviors. Labels are not necessary, especially if you don't have collateral.

Perhaps you don't believe it is necessarily impossible either but feel it is less likely than I do that the necessary information for the diagnosis can be had. In which case, fine, but quit acting like this is an issue of my inexperience rather than a topic about which even attending psychiatrists sometimes disagree

Fine, I won't mention your experience. What I will say is that when you're on CL and doing 6 consults a day on very ill and complicated patients, stop and reflect every time you don't get collateral for an incidental finding of a personality disorder. That will make my point for me.

 

[sloop]

Speaking of straw man, your entire argument is straw man. No one said it was impossible to diagnose a personality disorder on an inpatient medical floor. What I said was that I question people who do it because most people are not going to get collateral and most of the time, there is no need to even diagnose it as it has nothing to do with what's going on medically.



If I need collateral to diagnose GAD when the patient just relayed their history to me through a one-hour psych eval, then I'm doing something wrong. Unless there are safety concerns OR the collateral is relevant to the reason for admission, reason for co-morbid illness/behavior (someone with a psychotic disorder requiring med rec, etc), or interferes with medical care, collateral is a luxury, but not necessary.



My opinion is that your view is likely due to some component of lack of experience because of the analogies you're making and the things you're posting. That's my opinion.



When did I say it's not possible under those conditions? Please quote me.



Again, when did I say it's not possible?



I actually think you're the one arguing the straw man because no one said it's logically impossible with collateral. What I said was that most people are not going to get collateral for this diagnosis unless it affects the patient's acute needs and in many cases, it doesn't. Regardless, you don't need the diagnosis to identify the behaviors. Labels are not necessary, especially if you don't have collateral.



Fine, I won't mention your experience. What I will say is that when you're on CL and doing 6 consults a day on very ill and complicated patients, stop and reflect every time you don't get collateral for an incidental finding of a personality disorder. That will make my point for me.

First of all, I was not creating a straw man. I inItially agreed with you but qualified. Also, to be honest, I initially thought your reference to "a hospital stay during which they are very ill" was describing a psychiatric admission. It later became clear that you were mostly referring to medical hospitalization. I felt my qualifying remark was still valid there but I agree the diagnosis is even more difficult in that circumstance.

In any case, it seems we agree that it is not impossible but difficult and not often pursued.

I do believe that a standard part of psychiatric care is collateral information if available. Then again, a personality assessment is part of the standard evaluation notes at my program both inpatient and on consults. If we're going to fill out that section, it's useless to do based on self report. This disagreement probably has more to do with a specific program difference with regard to how we formulate patients more than anything else. Happy to talk more about it by PM if you desire.

In any case, I'll stop with this argument here as I'm realizing I'm derailing the thread.

 

[Splenda88]

Move to the US so you won't feel out of place among us (physicians) since most of us here suffer from some kind of mental illness.

 

[Andy C.]

Derm? You mustn’t be in the US then.....

I am not. But here derm is
REALLY DIFFICULT to get in the residency.. but the daily life is not stressful at all.. it's a 9 to 5 job, paying really really well..

 

[Andy C.]

Are you in therapy? Regardless of what you want to do and how much you want to work, you still have to make it through training and that's the most stressful part. Therapy (dialectical behavioral therapy to be exact) is the best evidence-based treatment for BPD. It teaches you new coping skills and how to deal with that stress that you fear.

Yes,I am in therapy. Not DBT, but in therapy. I don't have access to DBT right now,but I do have constant help. And my therapist it's learning with me about BPD and helping too.
I do go to psychiatry once every 2 WEEKS. And therapy once a week. I do get free access to them in my med school.

 

[Andy C.]

I agree with your last point about diagnosing people with personality disorders in adverse circumstances. This is the classic state vs trait conundrum. However, it is very possible to diagnose people with personality disorders even in the hospital given enough witnessed maladaptive patterns of interaction and robust collateral. Most of the time I just note neurotic personality traits for inpatients but have actually diagnosed a minority of those for whom there is suspicion of a personality disorder.

In any case, yes it is entirely possible to be a physician with borderline personality disorder if adequately treated.

As much as I don’t want to perpetuate stigma, I would also advise not advertising your diagnosis or at least being vague about the particular diagnosis even if you might be open about having a mental health condition generally. Unfortunately, Borderline Personality Disorder is among the most stigmatized mental health conditions among healthcare providers (the general public often isn’t as familiar with it). Like I said, if you want to be brave and be open about it I wholeheartedly support you (in the interest of reducing stigma) but if I was in this position I would probably let almost nobody know what my diagnosis is.

My partner knows. My doctor. And my therapist.
That's it.
And I will keep that way. For sure.