Mental Health: Shattering the Stigma

Photo by Ryan Athearn


Justin Bullock, MD, MPH

By Stephanie Watson

Every year many thousands of people walk, jog, or cycle across the Golden Gate Bridge. But for years, Justin Bullock avoided crossing the San Francisco landmark alone, despite being an avid runner and cyclist. He didn't consider it safe: The bridge brought on thoughts of self harm.

When Bullock was depressed while a medical student in the Bay Area, he saw suicide as a means to end his suffering. He even planned how he would do it. "I would bike to the Golden Gate Bridge and put a 'free' sign on my bike. The jump would have to be quick; I would not want anyone to talk me down," he wrote in a 2020 perspective for The New England Journal of Medicine.

Bullock's story in the prestigious medical journal was deeply personal. He wrote candidly about his struggles with bipolar disorder and the suicidal thoughts that shadowed him during his medical training. By sharing his story, he hoped to inspire other struggling medical students and doctors to come forward and ask for help.

At the time, Bullock was doing his medical internship at the University of California San Francisco—a pressure-cooker environment, even for someone without mental health issues. For Bullock, who'd already survived two suicide attempts—one after coming out as gay to his family in high school, the other during his second year of medical school—it was a powder keg situation.

A Hard Truth

It had been a long road to Bullock's bipolar diagnosis. His father, who has the same condition, wasn't diagnosed until late in life. "I think that there was a lot of mental illness in my family, but just not openly spoken about," he says.

Initially, Bullock only showed symptoms of depression. His doctors put him on SSRI antidepressants, medications that can worsen mood episodes in individuals with bipolar disorder. Things came to a head during medical school. He was sleeping only 90 minutes at a time while studying and working out at a frenzied pace. "One day, I did an angry 22-mile run," he recalls. "I was basically running to the point where I could no longer walk."

Photo by Tom Burr

Eventually the situation exploded, and he attempted suicide. Only then was he diagnosed with bipolar disorder.

Coming Forward

Bullock felt the need to come forward about his struggles because no one was talking about suicide and the intense pressure that drives so many doctors to it. In a 2014 Archives of General Psychiatry study, the rate of depression among interns jumped from less than 4% at the beginning of the year to more than 40%."You don't take all these healthy people and break them without there being a problem," he says.

Bullock has been writing and speaking out about the need for more mental health support for doctors. Publishing his story in a medical journal was a way to get the industry's attention.

He's been encouraged by the positive response he's received. "Literally hundreds of people have reached out to me and shared their personal stories," he says. "So many people share in this experience, either themselves or a family member, friend, classmate, etcetera. I feel like people have connected."

                                      Photo by Tom Burr
On June 24, Justin Bullock, MD, MPH, spoke to a group of doctors in the Department of Pediatrics at the University of Texas at San Antonio via Zoom. "I talked about why the experience of just one individual still matters for equity in medical education," he says.
Bullock is now doing a fellowship at the University of Washington School of Medicine in Seattle. He's planning a series of projects aimed at improving the environment in medicine for people of all identities, including those with mental illness. "A lot of my work involves trying to change the narrative of how we separate patients and providers in our minds; how health care workers think of people with illness as 'them' and not a part of 'us,'" he says.

Justin Bullock, MD, MPH, shares additional details about his mental health journey and why being an advocate means so much to him today.

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