An excerpt from Physicians With Lived Experience: How Their Stories Offer Clinical Guidance (APA Publishing, 2025).

What follows is a slightly edited narrative, the story of Kieran Allen, MD. Dr. Allen is from Australia, a psychiatry resident (registrar) at the time of writing. Dr. Allen writes from a different perspective, that of someone with a relapsing and remitting mental illness. He focuses on this for the simple reason that “trumpeted narratives celebrate those who maintain recovery whilst those who relapse are cast aside.” His story captures the juxtaposition of being a patient on a psychiatric unit about to receive electroconvulsive therapy (ECT), as a practitioner who is usually a treating clinician preparing his own patients for this treatment. There is profound isolation, alienation, and objectification. His usual good sense of self has become a distant memory. He describes the cold sensation of the anesthetic rising in his arm before going unconscious, a reprieve from the relentless barrage of his illness, depression, pain, failure, and loneliness.

Dr. Allen tells the reader his long history, of having been in treatment repeatedly over the years, including a suicide attempt in medical school and hospitalization, that he’s tired, feeling done and losing his fight. When well, he is a committed advocate and sought-after speaker on physician wellness. Now, as he lies in the ECT treatment room, he feels fraudulent and undeserving of that recognition, feelings magnified by the recurrent nature of his illness.

Then Dr. Allen raises another point: the ambivalence that he, and perhaps other physicians with lived experience, lives with. How much do you share about the nitty-gritty details of one’s illness and the various treatments, especially ECT? He wonders if he is ashamed or is he trying to protect interested others who may not want to know, it’s too dark, too frightening, too close to home. He adds, “Perhaps, most of us simply cannot bear to face the reality that any of us can become so unwell.”

In a piece written a few years earlier, Dr. Allen focuses on the tyranny of internal stigma, the damaging stigma directed inwardly by those suffering from mental illness, the irrational shame, the self-doubt, the relentless fear of relapse. He also talks about dated and cruel thoughts and attitudes in today’s medical world directed toward doctors who suffer from psychiatric illness. The grief and loss that accompany mental illness are uncovered here: “Each time I educate a patient about their newly diagnosed illness I feel, in some small way, a shared understanding of their grief. This insight has given meaning and allowed me to accept my own illness. My own illness has allowed me to empathize in a way I may never have been otherwise able.” Dr. Allen attacks the painful secrecy so many physicians live with who have received treatment before, exhorting them to speak out, to stop hiding, and calls for peers and colleagues to accept and not judge. He has written other articles that address bullying and teaching by shaming in medical education, contributing to illness in trainees, and in some, one of the factors driving suicide in young physicians.

Here are my thoughts on clinical guidance arising from Dr. Allen’s lived experience:

• Remember that a certain number of physicians will have recurring bouts or exacerbations of their illnesses. Making ourselves available to them when or if they return is key. And if we’re not able to because of a professional pivot in our careers, do what we can to facilitate finding a new psychiatrist who we think will be a good fit. Anecdotal incidents in my own life confirm this as always welcoming and healing in a hurting former patient.
• Empathize with the profound loss and dislocation that occurs when we must hospitalize our physician patients. Be sure to visit even if the care is transferred temporarily to an inpatient team of psychiatric clinicians. Your knowledge of the patient will assist their management. Those few minutes spent with your patient, much like the visit of a family member or friend, will reinforce the therapeutic alliance and give hope.
• Remember what Dr. Allen describes about the fatigue and demoralization that comes with getting sick yet again. This must never be minimized and always validated and listened to. Our hopeful demeanor will fall flat otherwise. And be sure to discuss a second opinion with such patients, or a case conference. This is simply good medicine in other medical disciplines but too often, perhaps because of stigma, underutilized in psychiatry.
• Support your physician patients who decide to speak openly about their illnesses and treatments. And should they have fraudulent and self-chastising sentiments about their worth when ill, be sure to remind them of their illness speaking, the cognitive distortions and dislodgements, and employ helpful cognitive behavioral therapy (CBT) exercises.
• Speak up in the presence of medical students, residents, faculty, or physician colleagues when you hear them refer negatively to physicians diagnosed with a mental illness. Use this as an opportunity to teach and enlighten. Should you have a personal narrative yourself, say so. You might be surprised, not just how quiet everyone becomes, but how much they view you with endearment and integrity.

Michael F. Myers is a professor of clinical psychiatry at SUNY Downstate Health Sciences University in Brooklyn, New York, where he previously served as vice-chair of education and director of training in the Department of Psychiatry and Behavioral Sciences. He is internationally recognized for his work on physician mental health, suicide prevention, ethics, and professional identity across the medical lifespan.

Dr. Myers is the author or co-author of ten books, including Physicians With Lived Experience: How Their Stories Offer Clinical Guidance (APA Publishing, 2025), Becoming a Doctors’ Doctor, Why Physicians Die by Suicide, and The Physician as Patient, Touched by Suicide, and The Handbook of Physician Health, as well as widely cited works on medical relationships, marriage, and divorce. He has published more than 150 articles on topics including suicide, stigma, boundary crossings, ethics in medical education, sexual assault, AIDS, gender issues in training and practice, and the treatment of medical students and physicians.

Dr. Myers has received multiple awards for excellence in teaching and has served on several medical journal editorial boards, including the Bellevue Literary Review, where he has been a board member since 2021. He is a recent past president of the New York City chapter of the American Foundation for Suicide Prevention and lectures widely throughout North America and internationally. More information is available at michaelfmyers.com, as well as on LinkedIn and X @downstatedoctor.