My supervisor is questioning me - help!

Hi,

I'm at work and my supervisor, who is a psychiatrist, started asking me about my flat affect. He was asking me generally how i'm doing, and i didn't know what to say.Flat affect is an ongoing problem for me, which i'm not sure if it's bipolar or a med side effect causing it. Plus i have been depressed for the last 2 months. This questioning was over coffee at my supervision meeting, where we review my patient cases and he gives me input into my treatment plans etc.

So he doesn't know i'm bipolar, and i didn't know how to answer the questions. I said i'm feeling kind of sick today, so that must be what he is seeing. Part of me wanted to tell him the truth, because he should know my mental state i guess if he is supervising me clinically. But part of me is terrified that he will find out, because i don't know how he would react and if it would change how he views me, or make him question my judgment. I didn't self disclose. I had the perfect time to do it, but i don't know if i should. I could send him an email about it, or i could keep making excuses when things come up.

I really don't know what to do. Thoughts?

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That is a tough situation...

If you don't feel comfortable disclosing it, it is your right. My thoughts is he will probably figure it out eventually being a psychiatrist and all. The thing is, he is not your personal doctor so I don't think he has the right to pry. A good general answer would be your not feeling up to par and end it with that. If he continues to ask questions, you have the right to tell him it is personal. Idk, it is going to come down to what you want and feel comfortable with. Sorry if I didn't help.

Thanks, right now i'm outside the hospital, walking to see some patients for outreach, i'm a nurse practitioner. I feel really anxious and nauseous just thinking about it. I emailed my pdoc to get her opinion of what to do. I don't like it that be asked me a direct question and i lied. He seemed to accept the answer, so i could do nothing, but this will probably come up again. I get questioned every time there is a work social event, because the doctors always buy drinks for everyone, and i turn them down because i can't drink. Telling him would maybe make him stop doing that.

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There are many reasons for ppl not to drink . . . meds, alcoholism, etc. or some ppl just don't care to drink. Maybe tell him you don't like to drink or you can't cause of medical reasons.

The drinking thing is ongoing, but i'm not sure what to say about problems with affect. I feel like he might figure it out eventually, so maybe it's better the telling him about bipolar comes directly from me. But i don't know if that's over disclosure. A couple of the social workers on the team that i work closely with know, but i'm afraid of how my actual supervisor will react. I don't want him to think i'm fragile, or to question me clinically. The team is recovery focused, so if he believes in how he practices he shouldn't judge me. But i don't know if it's crossing a boundary to self disclose like that. Ugh! I hate lying

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To me it sounds like you want to tell him. It would be very unprofessional of him to treat you any different if you tell him. It may be beneficial in the future, if you have to take time off. It just comes down to if YOU want to tell him. Personally, I have told most of my employers just in casual conversation. Not ever had a bad experience from it, but when I was going through a real bad depression, it helped to save my job and I think it was because I was up front about it.

This is only tangentially related, but some migraineurs (luckily, not me) get triggered by alcohol in general and red wine in particular. So if you want to weave a tale. ... but it sounds like you don't.

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Thanks, i think i will tell him in an email, but i'm going to wait until later to give it more thought and to hopefully get input from my pdoc. I want to feel sure before i send the email. I have a habit of sending emails when i am emotional, and regretting it later. I really appreciate your input vhdragonfly, it helps

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Thanks Hamster,
I'm sick of lying, but i'm scared to tell the truth. I feel like a hypocrite hiding my MI, and telling patients that recovery is possible for them. I don't want to show any weakness, especially as an NP, because i already get questioned by some doctors because of my role. This doc is really supportive of NPs, but i still try to look perfect

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your welcome Curiosity, glad it helped

Greetings - may I throw my two cents in please?

I was in graduate school at the University of Colorado doing frontier research in organometallic compound synthesis - when a super bad depression hit me. I tried to hide my illness (BP 1), but I was absent for nearly two whole months within giving my research team a word. I was paralyzed with overwhelming fear and hopelessness. When I was partially well enough to return to school for a mandatory meeting with my graduate advisor, I felt that I didn't have any choice but disclose the truth.

The meeting started our poorly, he was yelling at me for disappearing and stopping my research without permission. He was threatening termination from the program if I didn't "clean up (my) act immediately!" I let him vent all his frustration and anger until he was through, and then I replied "Dr. *****, I'm very sorry about all this, but I have bipolar disorder, and . . . "

He interjected with "Oh My God, I wish you'd told me this before, because I have a niece with that and it's very tragic."

Anyway - I completed my graduate studies with flying colors, and since that experience, I let everyone who might be affected by my illness that I'm bipolar and proud to be a survivor.

Also - the 1992 ADA federal law protects us from employment discrimination.

Incidentally, I totally agree with everything vjdragonfly says.

I ended up telling my employer thru a note from my Dr but I'm on ssd and can only work pt so I had to tell her so she wouldn't schedule me for more than 3.days a week. It went fabulous. Very accepting of me. Now I know my job is secure and its much more pleasant to go to work cause I know I'm supported. Sounds like you have a great career that means alot to you. I understand you wanting to protect it. I think he sees thru you too but it is still not his business. I'm not saying don't.tell him cause you might be surprised and having his support could be very helpful for you. I.hope I've helped. You are a good writer so im sure an email would be a good way to go. You can do it If that's what you decide. Good luck

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I wish my experience with disclosure had been as positive. Initially my supervisors did try to work with me, but when push came to shove the Americans with Disabilities Act didn't protect me when they decided they couldn't make the 'reasonable accommodations' I needed to stay in my job.

My current bosses know nothing about my bipolar, and God willing they never will. I too hold a very responsible position, and I don't want anyone questioning my judgment every time I turn around because the existence of mental illness colors people's perspective of everything one does. That stigma is so ingrained, even among us so-called healthcare professionals, that I'd just rather not deal with it if I can help it.

Of course, I know my odds of "getting away with it" over the long term aren't good, simply because I don't seem to be able to stay on an even keel for more than a few months. Your odds may not be all that great either simply because you work with people who sniff out mental illness for a living, but in your place I would think very long and very hard before sharing your diagnosis with anyone. Just my two pence worth.

Ok, I decided to tell him, so I just sent him an email a minute ago. The email said:

Hi Steve,

You asked me a direct question today about my affect looking flat, and I feel now that I should explain more than I did. I have bipolar disorder, which I am well treated for, but as a result of this my affect tends to look really flat. I am self-conscious about it, but I don't think there is anything that can be done. It is something I am still looking into.

I wanted to be completely truthful with you since you asked directly. I think my own experiences sometimes give me insight into what some of the youth may going through. I definitely practice from a Recovery model and believe recovery is possible and expected. I hope that explains things a little better. Please hold this in confidence.

Thanks,

So, now it's done. Hopefully this was not a mistake. Thanks for input everyone.

I hope it works. I have and am using mid-level (master's degree) healthcare professionals myself (CNM's and NP's) and feel that without them, it is impossible to get out of the healthcare crisis, but not all MD's agree for self-protection reasons, so your need to prove your qualifications to him is an unfortunate result of that.

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I got an email back from my supervisor, saying he was just checking in because last week was quite difficult with the patients. He apologized, and said he didn't mean to pry. Then he said he has suffered with anxiety and depression, so he will hold what I told him in confidence. I feel a lot better now, and I think telling him was the right thing. It's amazing how crazy I can make myself with obsessing about things! I do have a secondary Dx of GAD, so there you have it.

thanks again everyone, you really helped!