I'm a therapist who's been hospitalized for a manic episode. I worried about the stigma at work — then, another patient recognized me.

In this excerpt from "The Bipolar Therapist," Marcia Naomi Berger describes seeing another patient at her job and worrying about exposure and stigma.

• Marcia Naomi Berger is a psychotherapist in San Rafael, California.
• This is an adapted excerpt from her memoir, "The Bipolar Therapist: A Journey from Madness to Love and Meaning."
• In the book, she discusses shame, stigma, and her experience with inpatient treatment. 

A year after my first psychiatric hospitalization in Queens, New York, I returned to my job at an alcoholism treatment center in San Francisco. A year later, in 1975, I had a second manic episode, which landed me in Langley Porter Hospital.

The ward's common area looked like a large, L-shaped living room with couches, chairs, coffee tables, a ping-pong table, and a large bin with arts and crafts supplies. Inside it, I saw yarn and knitting needles, among other supplies. The room's walls were in pale, pastel tones; the furnishings were clean and in good condition.

Patients wore their own clothes and seemed mentally clear. All this felt good, yet I was shocked to be there. I wanted to work, see friends, and get my life back.

I first met Henry when I was a patient myself

I played ping-pong with Henry, a stocky, lively patient around my age. He cracked jokes as he slammed back my shots. The score was close to even.

"Hey, where'd you learn to play so well?" he asked.

"My father taught me when I was a kid." I pictured how Dad's eyes would light up when I surprised him with a good slam or shot back one of his.

Henry sent a high one my way, and I smashed it back. His mouth dropped open when the ball grazed the table's edge and landed at his feet.

"Hey, I could learn some tricks from you," he said.

"Just lucky." I was having so much fun I almost forgot where I was.

"This your first time here?"

"Yeah, but I was at another place last year. It was awful. Langley Porter's a palace compared with that snake pit." My stomach tightened at the thought of Elmhurst; then I relaxed

again in the game's rhythm.

He nodded. "I've been in worse too. This place is one of the better ones. It's like — smaller, more personal. Nicer atmosphere, if you know what I mean."

"Hey, you could write a tourist guidebook for the mentally ill and compare the facilities." We both laughed. I continued, "You could rate them, give them a different number of

stars or diamonds for service, appearance, etcetera."

"Yeah, I could compare the doctors, the food, the furniture, the buildings — "

"The patients, visiting policies, bathrooms," I added.

He laughed louder. "Ha, ha! Hey, you crack me up. What did you say your name was?"

"Marcia." I surprised him with a slam, but he lobbed it back. He caught me off guard; I missed, and he won the game.

Later, I took yarn from the bin and knitted a pillow cover in earth tones, like the pillow I'd given Doreen during my recent manic spree at work. The wool against my skin and the repetitive clicking of the knitting needles soothed me. I looked forward to finishing the pillow and sleeping with it at home soon.

Conversation flowed easily between patients. No one seemed too heavily medicated. It felt like a comfortable dormitory. Whatever happened to me that got me there seemed over.

Six months later, I had another manic episode and started taking medication that stabilized me. Yet, it was too late for me to regain the respect of some coworkers, which made for a toxic work environment.

None of my coworkers knew I'd been a psychiatric inpatient

Ironically, I was recruited to my next job as a senior psychiatric social worker in San Francisco General Hospital's psychiatric ward, where my colleagues respected me.

Not wanting to be stigmatized, I told no one there that I'd been a psychiatric inpatient elsewhere. But something happened that almost blew my cover.

A new patient caught my attention one day as I went to the ward's conference room. He looked vaguely familiar.

"Hey!" he called out. "Don't I know you from somewhere?"

I looked at him and felt a sinking feeling in my gut. "Langley Porter, that's it," he called out and laughed. "Langley Porter. Hey, how 'bout that?"

It was Henry!

No one was in earshot. Wishing I could disappear, I looked at him blankly, like he was mistaken.

I worried my cover would be blown

"Yeah! I remember you. Don't you remember me?" he smiled. Was he accusing or just being friendly? Too off-balance to know, I stood frozen in place.

"Ping-pong! I remember," he said loudly. "Don't you?"

"No," I lied, shrugging my shoulders and avoiding his eyes. I sensed he saw through me, and I rushed off.

I was relieved when they didn't assign Henry to my team. But I felt uneasy, like a potential blackmail victim, until his discharge.

Studiously, I avoided him, quivering inside, wondering, Did he tell anyone?

In time, I forgot about Henry — until he was readmitted.

"Hi there," he said at that time. I heard, "I can ruin you."

I wanted to say, please don't tell, but I was still pretending I'd never seen him before. Then I saw his name on my list of patients on the large whiteboard that paired patients with their primary therapists. No, no, no!

I'd become friendly with Barbara, a psychology intern in her forties on a different team. I considered her mature and trustworthy.

Hoping she wouldn't ask why, and with knots in my stomach, I told Barbara privately that I wasn't comfortable being Henry's therapist.

"I'll take him," she said, like it was no big deal.

"Thank you," I gasped, touched by her easy generosity.

I still wondered if Henry had revealed my secret. Could someone in a psychotic state exercise discretion? Had he relished saying: She's as crazy as the rest of us?

Did Barbara know? Did everyone?

After his discharge, I waited for the proverbial other shoe to drop, for the next time he'd show up on the ward. But I never saw him again.

Excerpted from The Bipolar Therapist: A Journey from Madness to Love and Meaning by Marcia Naomi Berger. Copyright 2024, Marcia Naomi Berger. Published by Bitachon Press.