Depression is manifested differently in men than in women, and differently in all high achieving and high level professionals than in the general population. It can be hard to recognize in these groups and therefore more difficult to diagnose and treat. Not only family members, but even physicians may not consider the possibility of depression in fellow physicians or in leaders. Often depressed people with power and influence will exhibit irritability instead of sadness. In very high achievers, in some instances, such behavior is tolerated; in others, it will be labeled. Physicians who are labeled "disruptive" because their behavior might adversely impact patient care may in fact be suffering from depression.
It is rare for high achievers in medicine to be forthcoming about their experience with mental illness. This is not by coincidence. In order to persist (remain licensed), let alone achieve in medicine, it is often necessary to pretend to be all but invulnerable to conditions that affect normal humans. (see what happened to Steven Levin, below, who was mercilessly hounded by his medical board until the DOJ went to bat for him, and to Leon Rosenberg). To admit to even the most common types of mental illness is almost tantamount to betrayal of the mutual myth of invulnerability that physicians share, and more frightening, invites invasive, intrusive and ADA impermissible examinations foisted by employers, medical boards and physician health programs (see Word Is Out.)
There are exceptions. An important one appeared today in Academic Medicine. Darryl Kirch, twice a dean and past president of AAMC (the American Association of Medical Colleges) published an OpEd regarding his own lifelong battle with anxiety and depression, and shared how the supportive intervention of a dean made all the difference to his persistence in medicine. There is also an accompanying article by Stelling et al, showing the overwhelming importance of faculty disclosure, in empowering trainees to acknowledge and deal with common human conditions that may actually disproportionately affect those who choose a career in medicine. THis is a welcome development.
An excellent 2015 article by James TR Jones in the Duke Forum for Law & Social Change collects cases of very high achievers in Law and Medicine, and makes the case that individuals with various types of mental illness are far more prevalent in society (and particularly in the higher achieving echelons) than is generally imagined. He discusses persistence of stigma, and the attendant discrimination, which can of course contribute to job loss, licensure challenges, and suicide.
A forthcoming book previewed on Medscape by Naseer Ghaemi, will discuss the bipolar disease suffered by Martin Luther King. Smiley has also referenced the illness in his 2014 book, Death of a King.
An article in the Denver Business Journal March 24 2015 describes the high incidence of depressive disorders and suicide in high achieving entrepreneurs. This was part of a series called Depression, Entrepreneurs and Startups
Robin Williams, one of America's best loved actors completed suicide after a long battle with depression and substance abuse. Almost certainly he was bipolar. A Forbes article by Walton details some of the known associations between creativity (especially comedy), mood disorders and substance abuse. A Medscape article illustrates that Williams fit the profile of persons most at risk for suicide (registration may be required).
See Healy, Depressed Men, Atypical Symptoms, LA Times
Dr. Leon Rosenberg is former dean of Yale University School of Medicine. His little publicized but stirring account of his lifelong battle with bipolar disease and very serious suicide attempt, "Brainsick: A Physician's Journey to the Brink" can be found at Dana Foundation's Cerebrum V4 No 4 Fall 2002. More of his story can be found at All About Psychotherapy, including the fact that even he did not reveal his diagnosis or seek treatment due to well founded concerns about stigmatization. Another article about Dr. Rosenberg's suicide survival is here.
Steven Miles is an acclaimed medical ethicist and physician, an academician who has faced medical licensure challenge based on treatment for Bipolar Illness in MN. His story is here. More about mental health and licensure challenges here.
Dale Carrisen MD headed Nevada's Homeland Security Commission. His story can be found here.
Arthur Zankel was not a physician (financier and close friend of Citibank chair Sanford Weill), but his suicide illustrates many of the problems inherent in addressing depression and suicide prevention in high achieving persons.
Mike Wallace, Art Buchwald, and William Styron discuss their experiences with depression in Gray Matters: Depression and the Brain, a 1996 panel discussion by the Dana Alliance in conjunction with Public Radio International.
Mike Wallace admitted on the occasion of his "retirement" from CBS Sixty Minutes in 2006 that he once attempted suicide by overdose during a depressive episode. Wallace's first depression was triggered by litigation stress.
Abraham Lincoln clearly suffered from depression, a fact which has been obscured by some historians. An excellent biographical account can be found in Lincoln's Melancholy , a book by Joshua W Schenk which is reviewed in JAMA here.
NAMI maintains a long but by no means inclusive list of famous people who have suffered from mental illness. Dr. Kay Jamison has published many books about extraordinarily gifted persons throughout history who have suffered from mood disoorders.
See also Inspirational Stories section of this website for more on successful survivors.