California's Surgeon General Had a Bipolar Disorder Diagnosis. She Disclosed It While Still in Office.

In early 2022, Devika Bhushan, MD was sitting in her San Francisco office when she learned that Dr. Nadine Burke Harris — California's first Surgeon General and her mentor — was stepping down, and that she would be stepping up. She had just returned from maternity leave. Her baby was eight months old. The pandemic was still very much active. Her first feeling, she says, was disbelief. Her second was slight panic.

What followed was one of the most consequential tenures in California public health in recent memory — a year of governing through compounding crises, translating science into policy, defending evidence against a rising tide of misinformation, and ultimately making a disclosure that no sitting state Surgeon General had made before. The armor, as she would later describe it, was something medicine had trained her to wear. Taking it off, in public, while holding the state's most visible public health role, was something she chose to do herself.

Part One: The Role She Stepped Into

A Pediatrician Built for Translation

She grew up between India, the Philippines, and the United States — a first-generation Indian American who spent her early years in a country where the effects of vaccine-preventable diseases were not historical abstractions. On railway platforms across India, she could see people whose bodies had been permanently altered by polio. That was the world before vaccines worked at scale. She never forgot what it looked like.

Her academic path was exceptional: a BA in Neuroscience and Behavior from Columbia, summa cum laude; an MD from Harvard Medical School, cum laude; a pediatrics residency at Johns Hopkins. She joined Stanford's faculty as a clinical instructor in general pediatrics, teaching residents at a federally qualified health center. Then, in 2019, she joined the newly created Office of the California Surgeon General as its inaugural Chief Health Officer — the person responsible for the research and clinical foundations of everything the office did.

The role that followed — Acting Surgeon General — was, she says, a natural extension of what she had always done as a physician: translate. Take the science, understand what it means for a real family in a real situation, and help them make sense of it. At scale, that meant press briefings and keynote stages instead of exam rooms. The skill set was the same. The audience was just the entire state of California.

"As a practicing pediatrician, a lot of what you're doing is helping families make sense of what the science says and how it applies to their particular situation. The role of Surgeon General asks the same thing — just at a different scale."

— Devika Bhushan, MD

Governing Through the Storm

The year she stepped into the role, 2022, was not a quiet one. COVID was still reshaping daily life. An infant formula shortage had created a genuine national emergency for the most vulnerable population in medicine. Federal policy was threatening reproductive healthcare. And running underneath all of it was the office's foundational work — the ACEs Aware initiative, a $500 million statewide program she had helped build from the ground up to change how California's clinicians understood and treated the hidden health costs of childhood trauma.

The premise of ACEs Aware was both clinically rigorous and, in the context of American healthcare, quietly radical: that two thirds of adults have experienced something traumatic in childhood, and that those experiences leave a biological residue — on hormones, on the immune system, on metabolic processes — that shapes disease risk across an entire lifetime. That the root cause of a patient's early-onset diabetes or treatment-resistant depression might not be what it appears on the surface. And that clinicians who understood this could treat the actual root cause, not just the downstream condition.

"When we miss the root cause — that the underlying issue is dysregulated stress biology — we miss the opportunity to more specifically treat what's going on. A lot of times what we're missing is a way of re-regulating the stress system."

— Devika Bhushan, MD

Part Two: The Science She Spent Her Career On

What ACEs Actually Are — and Why They Matter

Adverse Childhood Experiences — ACEs — include things most people have some familiarity with in the abstract: growing up in poverty, living with a family member who had untreated mental illness, having a loved one incarcerated, experiencing abuse or neglect. What the research shows, in dose-dependent fashion, is that the more of these experiences a person accumulates, the greater their risk across 80 different health conditions. Not just mental health conditions. Everything — heart disease, cancer, infections, autoimmune disorders.

The mechanism is stress biology. Chronic early stress keeps the body's stress response systems — the hormonal axes, the immune system, the metabolic processes — in a state of persistent activation. They never come back to baseline. And when those systems are running hot indefinitely, they contribute to the development and progression of disease in ways that conventional treatment often fails to address, because conventional treatment is designed for the downstream condition, not the upstream cause.

What the ACEs Aware initiative did was build the infrastructure to actually address this in clinical practice — a training program for providers, a reimbursement mechanism for trauma screening, and a toolkit of specific interventions that physicians could offer patients within the scope of a real clinical relationship: anti-inflammatory nutrition, structured exercise, time in nature, sleep support, meaningful connection. Things that are within the reach of what a physician can recommend and a patient can actually do.

The Misinformation Problem — and How to Talk Through It

The same year she was running the state's public health infrastructure, trust in that infrastructure was actively being eroded — not just by the ambient noise of social media, but by the most powerful messengers in the country pointing in the wrong direction. She is careful about how she discusses this. The problems she identifies are real: the healthcare system genuinely isn't working for everyone, and people who feel failed by it are not wrong to be skeptical. The issue is where that skepticism gets redirected.

"We live in a time where the messenger matters much more than the message. The question isn't whether the system has failed people — it's whether the alternative being offered is actually going to help them."

— Devika Bhushan, MD

Her approach to vaccine-hesitant or misinformation-influenced patients is not to lead with data. It is to start with questions — where did you hear that, how did you feel when you heard it, what do you believe about it? Understanding not just what someone thinks but why they think it, and what values underlie the belief. Then finding common ground — in a pediatric visit, that is almost always the child's wellbeing — and building from there. Facts arrive only after she has established that she has heard the person. Because when someone feels genuinely seen, she says, they become open to reconsidering how they look at truth.

Part Three: Taking Off the Armor

The Diagnosis She Carried Through Medical School

She was diagnosed with bipolar disorder in her early twenties — in medical school, as an insider in the medical system, where such things are not supposed to slow you down and are certainly not supposed to be spoken about. Even with that insider access, it took her three years to get the right diagnosis and the right treatment plan. That is actually faster than average: for bipolar disorder, the gap between first symptoms and correct diagnosis can stretch to a decade.

She carried it quietly for years. Not ashamed, exactly — but navigating the calculation that anyone in medicine with a serious mental illness navigates: the professional risk of disclosure in a culture that rewards the appearance of invulnerability. Medicine's culture of toxic perfectionism, as she describes it, trains physicians to show up to work regardless of what is happening in their bodies or their lives, to project an exterior of complete composure, to never let the armor show cracks.

"We project an exterior of no chinks in the armor — completely buttoned up. And that's part of our training. But I think we need to start unraveling those tendencies and truly honor the humanity and the suffering that we all hold."

— Devika Bhushan, MD

Going Public — While in Office

In 2022, while serving as California's Acting Surgeon General, she decided to speak publicly about her bipolar disorder for the first time. Not because it had become easier — because it had become necessary. The pandemic had made clear that suffering was not rare or hidden; it was everywhere, and pretending otherwise was costing people something real. She wanted to demonstrate that it was possible to live with serious mental illness and still do the work she had done — and that the disclosure itself was a form of leadership.

She has since been featured in the PBS documentary BrainStorm, advocates nationally on mental health destigmatization, and hosts a podcast and newsletter dedicated to the same. She is also writing a children's book series on stress and resilience, co-authored with Dr. Bruce Perry — built on the same ACEs science she spent her career developing, translated into bedtime stories for two-to-ten-year-olds and their parents.

"Having walked through something really difficult shapes the kind of leader you are — the kind of physician, the kind of parent. It builds the empathy and appreciation for the full spectrum of what humans can go through."

— Devika Bhushan, MD

Her message to healthcare providers who are struggling is not complicated. You are not alone. Most people in medicine have struggled in one way or another. The culture just makes it very difficult to say so. The armor is not serving the people inside it, and it is not serving the patients on the other side of it either. The more physicians can normalize authentic connection — inside and outside the profession — the closer medicine gets to what it actually is: a human endeavor, practiced by humans, on humans. All of whom are carrying something.

Devika Bhushan, MD stepped into a role she hadn't expected with an infant at home and a state in crisis. What she brought to it — the science of childhood trauma, the practice of empathic communication, and eventually the willingness to make her own struggle visible — reflects a particular theory of leadership: that authority comes not from the absence of difficulty, but from the willingness to be honest about it. That the armor isn't the point. What's underneath it is.