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295: Ignoring Advice, He Disclosed His Bipolar Disorder in Apps

By Ryan Gray, MD of Meded Media

Session 295 If you're struggling with mental illness and you're debating whether or not to put that in your application, today's interview is something you must listen to. Logan is currently a rising second-year medical student at Pacific Northwest. He decided to reach out to me after gaining an acceptance and after originally being discouraged way back in Episode 194, where I interviewed Jeff who is legally blind and decided not to disclose his disability in his second application because he didn't get in the first time. So Logan decided to ignore my advice of leaving off any huge red flags from the application. He was very open about his bipolar disorder. [02:00] From YouTube to Podcast Logan was originally a YouTuber, and his first taste of disclosing his bipolar disorder publicly was through this platform. But not being a tech guy and hating filming, he just felt he was putting a facade. And it was through a podcast that he realized he was being his natural self. Logan likes to be a psychiatrist in the future and so he likes his future patients to be at ease with him in telling him their embarrassing, dark secrets. [04:03] Interest in Becoming a Physician Logan only realized he wanted to be a physician some five years ago. He got diagnosed with bipolar disorder at 22, right when he graduated undergrad. Then he worked in insurance and finance after it and hated it. He found it so depressing, even more so than he was diagnosed with the disorder. So he knew he needed a change. He then started working as a public speaker in the mental health sphere and was giving his story to different institutions and he loved what he was doing. He also worked various roles within mental health but he wasn't sure what he wanted to do initially. However, having talked with a lot of people, he saw the frustration they had with the medications they were taking as well as the diagnosis. So he wanted to take out a lot of subjectivity around mental health. And rather, find some objective means of understanding these mental illnesses and how to better correct them. "What really led him to medical school is being able to take out a lot of subjectivity around mental health." [05:40] The Motivation to Tell His Story Logan was initially warned by the doctors and social workers about the stigma around mental illness. There could be discrimination and it could jeopardize his career and relationships. So they told him it's not a good idea to tell people outside of your most immediate circle. He was frustrated by this and listened to their advice. He was ashamed of his disorder and didn't tell anybody. "I lived almost with this cloak of shame and I was really embarrassed about my bipolar disorder. I didn't really tell anybody. It was a horrible way to live." He continued to live this way for about 18 months until The Sandy Hook Shooting. He grew up in Connecticut, about an hour north of Sandy Hook. So how after that incident gave a perception that people with mental illness were violent, and that they were ticking time bombs, he just found it to be so absurd. He knew it wasn't him. He's not a violent person, never been arrested and never been in a fight. He knew he was a good person and so he wanted to share his story. He wanted to prove everybody wrong. He then joined the Speaker's Bureau and started posting on YouTube about his experiences. "I want to share my story and show that people with mental illness are not like this. They can be normal people that contribute to society." [07:30] What Bipolar Disorder Looks Like Logan describes his disorder as experiencing depression at first. He studied in Scotland and when he got there he was struggling with insomnia that actually lasted for months. He started to have really bad anxiety. He thought all his friends hated him and that his family was disowning him. He was having all these negative thoughts that weren't true and these kept him up late at night. This was what led him to alcohol abuse. He as self-medicating with alcohol to sleep, every night for a year and a half, still getting 2-3 hours of sleep every night. He describes his moods being all over the place. Then when he graduated from undergrad, it was the same time he broke up with his college girlfriend, resulting in his first manic episode. He describes it being too weird, not sleeping the first night. And by the second night, his words and speech were all over the place. He was rambling. People would come up to him asking him if he was on coke or meth. Not having slept for so many days in a row, he started having auditory hallucinations. He thought the FBI was following him around and hacking his computer. Thankfully, his circle of family and friends was able to intervene and had him check into the psych ward. He also knew that gene existed in his family. His uncle had bipolar disorder who eventually committed suicide. So growing up, he always knew he was susceptible to something like that. It wasn't until that manic episode that he realized something was going on. He thought it would have come out no matter what but at that time he was experiencing insomnia, he knew he needed sleep. He knew he wanted to sleep but he was still so ashamed of talking to a therapist, much less telling anyone. He didn't tell his parents or his friends about what was going on. But then had he told anyone sooner, it wouldn't have gone so acute. It could have been a little bit friendlier means of diagnosis. "I wish I just would have talked about it sooner. And I think having that social support and network was really what helped me manage this disorder better." [12:40] Going to Medical School with Bipolar Disorder At first, Logan really didn't think he was going to be smart enough for medical school. He was initially looking into nursing programs thinking medical school was just far outside of his capabilities. Then he met a friend in Sacramento who took all the premed requirements at University of Michigan but wasn't sure if it was something he wanted. Dan also knew about Logan's disorder and his interest in improving medicine around bipolar disorder, that he encouraged Logan to try to be a doctor. He gave him some ideas about how to do it, especially that he wasn't a science major. So he began reading articles online. And this was how he eventually found this podcast. Logan's favorite episodes were those featuring the nontrads who had a similar path to him, going back to school and applying. I fact, his friend told him that he was going to stick out being a nontrad because he might just have a great story to tell. "You might not be the smartest kid in your class, but you'll be able to stick out in an application, so why not go for it?" Not coming from a family of doctors, when he told his parents he wanted to abandon his career in insurance and go to medical school, they thought he was out of his mind. It was really that friend who never cast any shadow of doubt. He was super encouraging, telling him he could really do it. And he also realized this was also what he really wanted. Now, he's a year ahead of him Logan in medical schoo. [15:45] Bringing Up Red Flags in an Application Jeff, back in Episode 194, was diagnosed as legally blind and he applied to medical school the first time around. He wrote his essays and everything was around being blind and how it affected him that led him down this journey. Unfortunately, he didn't get in anywhere. So his logical conclusion was they must be scared of his disability so he decided not to talk about it when he had to apply again. He was able to see during the day that he really didn't need a walking stick so he was able to go through the entire application process and was accepted. It wasn't until the letters came asking if he needed accommodations that he revealed his condition. And I've talked about this several times since, about bringing up red flags. I have always recommended trying t not disclose things that are going to be an easy out for the admissions committees. So when you look at a disability or mental illness, DUIs, alcohol abuse, arrest, etc. they'd be thinking that there are 10,000 other applications here that don't have this so why should they even bother wasting a second with this application. But Logan decided to tell his story instead. Logan was a voracious listener of this podcast. He describes listening to it every Wednesday when it gets first released. He was just always looking forward to it. And when that podcast 194 came on and he listened, he was just heartbroken. He didn't have any premed advisors but he considered just me and Dan as the closest things to it. In fact, Dan had the same similar stance that it wasn't a good idea to bring it up in the application. This discouraged Logan that he stopped listening to the podcast for a while. But he bought The Premed Playbook: Guide to the Medical School Interview and he has already been listening a lot to this podcast about developing a personal statement. What he took away from this was that he needed to tell a story. "Why do you want to go to medical school? That's really the key that every medical school wants to know." So he sat down trying to figure out any way he can tell his story of why he wanted to go to medical school without disclosing his disability of his mental illness. But he couldn't find any. He knew he would be lying. Unlike Jeff who has always wanted to become a doctor even before his disability, really for Logan, the only reason he wanted to go to medical school was because of his own personal experience. So he thought there was no way he can do this without saying it. He knew it was a big gamble. But he also knew he wanted to be physician no matter what and he didn't care if no US medical school would accept him as he'd go to Canada or Mexico or wherever. [21:15] Telling His Story and Dealing with Physician Burnout Logan thought it would have been much harder to tell his story if he didn't disclose otherwise and put on the big face of being the perfect applicant. So during interview days, he would sit there with the other applicants, telling himself that they're not going to say what he was going to say. So he knew he'd be memorable, be it for better or worse. "I just try to always put it in the perspective of patients. How am I going to be able to help patients feel better because of my experiences?" His dream is to be able to sit down with patients and just say he's been in their shoes and they can do this. Speaking of the future, where you're being treated for depression and you need to get license by the state, this could be a red flag and there could be potential issues. As to how he would be dealing with this possibility, Logan just thinks of it from another perspective of physician shortage, and especially, psychiatrist shortage. He's aware he could be shutting his doors to certain opportunities. This could be frustrating but he also thinks that people like him are going to be ones leading the future who will be ending this physician burnout or medical student burnout epidemic right now. In fact, he was so open about his experiences during the interview that he was making other students around him feel more comfortable to seek their own mental healthcare. [24:40] From the Admissions Committee Standpoint Logan says one of the things he got asked at almost each school was how he was going to be able to handle this, considering this is probably the most stressful thing he was going to go through. So he knew he had to convince them by telling them that he's not going to tell them that his disorder is perfectly managed. There are going to be days he'd feel depressed and days he'd feel manic. But by being open and allowing people around him, they could help him identify what's going on. He also credits his wife for being the biggest supporter and his family. He recognizes how it's so important to still have a relationship with his therapist and psychiatrist. He had to convince them he'd still be able to do all this. "I'm not going to sit here and say I'm perfectly recovered because that's just not how mental illness works. But I really had to be strong and challenging when they would ask those difficult questions." Out of around 28 schools he applied to, he got five interviews, all from osteopathic schools. He thinks this is because maybe they think he's trying to present a holistic recovery to his own recovery of mental illness. It's not just because of the pill that he got better. But he's seeing a therapist, he's actively participating in daily meditation and exercise, and just this holistic philosophy he wants to bring to psychiatry. "So many patients show up at a psychiatrist's office and they think that they can get a medication that's going to make them feel better tomorrow." Historically, osteopathic schools are more lenient towards nontrad students and students who have had issues. They like those stories and they think they make better physicians. And I would agree. And for some reason, the MD world still doesn't value that experience as much, just based on anecdotal stories like Logan's. But I just came from a conference with premed advisors and admissions committee members. I had a conversation with a Director of Admissions for a medical school and we talked about mental illness. She said when something comes across their desk, it's prior drug use, alcohol use, mental illness, they have to think about "what if" or it's irresponsible not to. First thing is safety. Second thing is whether other students are going to be safe. So they think about safety for everybody, especially the students. Then they also think that if they'd give the seat, is this student going to be able to finish school? Otherwise if you had to delay the school for a year for some reason, that's going to be a black mark on the school since the student couldn't finish in four years. And schools are very risk-averse to this kind of stuff. So it's very easy for them to just pass on that sort of application. [30:35] Being Aware of the Risks At the end of the day, if this is your story then you have to tell it. I never tell the student not to talk ever talk about the mental illness or whatever. But only that if you talk about it, here are the risks. "Is there stigma around mental illness? Of course. Should there be? No! We just need to be aware. There are risks." Logan adds that identifying the risks in your application makes you become a stronger candidate because you're ready. Then you can practice those types of questions that you're going to get in the interview which you know they're going to ask. He recommends really taking an honest look at yourself and just be able to think of yourself as an admissions committee and asking why shouldn't they accept you. Then you yourself becomes a better interviewer. [32:10] Framing the Story and the Interview Process Logan admits having a hard time doing it himself, saying there's a lot of bias. So what he did was send his personal statement to as many people as he could. He asked them for the most honest feedback and told them whatever they say won't hurt his feelings. In fact, he did my webinar on interviewing and he got his butt kicked but this really humbled him. "I got my butt kicked but it really humbled me. And it made me really develop how I want to tell my story in the best light." For anyone struggling with mental illness or disability, if you're telling your story and you're going to write about it and you get an interview, I think you can relax since they're seeing you as a person and not as someone with a disorder. Sure, they're going to ask you about your disorder. They would want to find out if you're ready for this. During his first interview, he didn't think he was going to be asked about his weaknesses. He was just too brutally honest saying he wasn't that good in Biology. So he redeveloped this response for the subsequent interviews. Ultimately, Logan got in at Pacific Northwest. He actually got into a waitlist here as well as another waitlist at another school. But as soon as he got off the waitlist, he was just ready to go and got accepted right away. Logan suspects the reason for being waitlisted at the school he's at now is that they're very regional focused. So they want students to be from the pacific northwest because of the huge shortage. And Logan is from Connecticut so he definitely didn't fill this aspect. As for the other school, he just really never got the call so he didn't have to go through any decision process in terms of selecting schools. That being said, he was happy with where he ended up. [36:44] Disclosing His Disorder to His Classmates In his YouTube channel where he talked about his bipolar disorder, he just posted this on their school's Facebook page. He was terrified aware that people might not like him after that thinking all his classmates around him were just perfect. But he found that there were also people around him dealing with mental illness but they just didn't disclose it to the admissions committee. "I found there's so many other people around me also dealing with mental illness." Then they started talking to him a lot more. This was what motivated him to start his podcast. His first nine episodes have all been his medical school classmates talking about various mental health challenges they've gone through. He has interviewed people with OCD, depression, PTSD, ADHD, as well as women who have dealt with sexual assault. "One of the best things he has ever done is making other people feel that it's okay to not be perfect and not be this little square on an application." [39:30] The Impact of Medical School on HIs Mental Health Logan describes going to medical school as extremely challenging, especially they had to take Biochemistry early on. It was something he didn't do great it prior to medical school. Nevertheless, all the techniques he used to benefit mental health (meditation, exercise, family time, traveling, etc), he would sacrifice all of those things thinking he had to study and pass the course. "I was sacrificing really everything that was proper to my mental health. I was sacrificing sleep. I was consuming way too much caffeine." So he could see himself going down a bad road that even during the Spring semester, he injured his back that he couldn't exercise at all. Then he started to really feel depressed and so he knew he needed to go back to a therapist. He knew he had to get back to committing to exercising everyday. He had to schedule date time with his wife every week. He won't have to study as much but his mental health is going to be better because of this. Aware that medical school is a marathon, not a sprint, he just continues on with this mentality that he just has to start preparing for stuff early. He also understands why medical students get burned out. Additionally, having prior experience using the mental health system, he was no longer ashamed. He already knew what he wanted to get back to his healthy state of mind. If you're starting to go this path of not sleeping and too much caffeine and not exercising, and eating poorly, Logan recommends really looking at who in your life can you call up no matter what. People oftentimes go to their therapist when they start feeling depressed. But just start small. So just disclose and open up to someone you feel comfortable with and they're going to be able to reconcile with you and connect with you. Hopefully, you do get motivated to seek out therapy and a physician if necessary. But with that said, start small. Don't be intimidated by opening up to a best friend. "I don't think people with mental health illness are the only people dealing with mental health challenges. Every single person has some sort of mental health challenge throughout their entire life." Ultimately, Logan ends this interview with an advice to always dream big and to never give up even if you fail the first time. Links: PMY Session 194: Overcoming Disability and Biases The Sandy Hook Shooting The Premed Playbook: Guide to the Medical School Interview Logan Noone’s YouTube Channel Logan Noone’s Podcast: Talk Mental Health with Logan Noone Follow him on Instagram @logannoone

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