Bipolar disorder: ‘There is still such stigma and ignorance’

Vincent van Gogh was born on March 30th and in honour of the great artist’s battle with bipolar disorder, each year the date is given over to World Bipolar Day with the aim of raising awareness of the condition and reducing any stigma associated with it.

According to Aware, approximately one in 50 people in Ireland experience a “lifetime prevalence of bipolar disorder” and although every person’s experience is unique, the national organisation that supports people impacted by depression, bipolar disorder and other mood-related conditions, says it is important the conversation around this and other mental health issues remains open.

Stephanie Nolan can attest to this as she experienced “15 years of chaos” during her 20s and 30s as a result of bipolar. “I was working in New York when I had a total breakdown and had to be flown home after just six weeks of being there,” she says. “Someone had to come with me as I was severely ill and couldn’t fly on my own. I wasn’t sleeping, was completely manic and also delusional. Then after the mania, I had the all-encompassing fog and depression which follows and leads to a crash.

“I ended up in a psychiatric hospital and had six sessions of ECT (Electroconvulsive Therapy) – but there was no label put on what was wrong with me. So, over the years, each time this happened, I would fight and get better and try and manage it myself.”

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The 45-year-old says she endured many “ups and downs” over the years and in 2004, had another serious breakdown, which saw her admitted to hospital once again. She was put on medication, but as, “no one said exactly what was wrong”, she didn’t realise the importance of sticking to her prescription. So, after discharge, it wasn’t long before the same patterns began to emerge once again – “feeling very high and manic before coming down to earth with a crash and feeling depressed”.

In 2010, things came to a head, when she and her husband Chris decided they would like to start a family. Due to her medical history, she was referred to a psychiatrist for advice on how to deal with a potential pregnancy. It was only at this point, after years of “doctors believing the symptoms were due to stress or overwork”, she discovered she had bipolar disorder.

“Over the years, there was no consistency to my care and because I was in the public system, I would see someone different every time,” she says. “So, it wasn’t until my case notes were transferred to the maternity hospital, that I was diagnosed. I told the specialist that I had come for pregnancy advice, and he said that I was a clear case of someone with bipolar disorder. He advised me, in a nice way, to go home and think long and hard about whether or not I really wanted children.

[ Bipolar disorder: ‘If you can come out the right side of the illness nothing in life will faze you ]

“He told me he had an aunt with bipolar and the family had a chaotic existence with her, so I took his advice well. But, at that stage, I wasn’t taking my medication regularly so began to take as prescribed. Chris and I decided we did want a family and it wasn’t long before I got pregnant with Oisín.

“Looking back, I was a bit manic, particularly in the operating theatre when they were doing an emergency C section and for the first few months after he was born. Then I crashed completely and actually became suicidal, so I checked myself into St John of God’s Hospital as I felt I was a danger to myself. It took a long time to get better from that whole episode.”

The mother of two – Oisín (11) and Diarmuid (9) – says that, following her diagnosis, she was told she had an overactive thyroid and the “bipolar gene may have been lying dormant until the overactive thyroid triggered it”.

So, as a result of her experience following the birth of her first child, when she decided she wanted a sibling for him, she sought advice from a consultant psychiatrist, who monitored her throughout her pregnancy and crucially, after the birth of her second son.

This, she says, was transformative and once prescribed the correct medication, she has been able to live life to the full. “The psychiatrist told me that during my pregnancy my hormones would be all over the place, so I was placed under his care,” she says. “On the day that Diarmuid was born, he was at my bedside with my prescription and I haven’t looked back since.

“For the past eight years, I have been stable and feel wonderful today. I remain incredibly lucky to be well, but continue to do all of the right things. I get out of bed before 5.30am most mornings to journal and then to walk or do yoga. On the mornings I find it hard to get out of bed, I have to remind myself that that’s okay – we can all have those days.

“But, generally, I just feel so much happier in my life and my husband, who never seeks the limelight, is my rock. He allows me to flourish and gives me so much space when I need it. He knows how important my sleep and exercise routines are and sacrifices his time to enable me to have mine. I am so grateful to him for that.”

The Wicklow woman, who lives in Dublin, believes there are probably many others who are waiting to be diagnosed and she would encourage anyone who has concerns, either about themselves or a loved one, to seek help as it is vital to open up about mental illness. “There is still such stigma and ignorance, so the more people normalise conversations about mental health the better. I haven’t put much on my LinkedIn profile about my mental health journey because that’s my professional network and I’m still afraid of being judged, even today with all the hype about mental health.

“But I am so proud of what I have overcome and it has been the biggest influence on my personality and outlook in life. I am more empathetic and grounded as a result of my battle with mental ill health. Although I’m not perfect, I’m a better wife, mother, sister, friend and colleague because of what I have been through. I used to fret that when my friends were going into graduate programmes after our university degree, that I was either stacking shelves or battling to overcome serious ill health.

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“But now I know that what I lost out on in those early years post-college, I made up for in gaining emotional intelligence, resilience and determination which all stand to me in my career today.”

Ahead of World Bipolar Day, Nolan, who is head of fundraising and communications with ARC Cancer Support Centres, advises people to be aware of the signs and seek help if any concerns. “When you are high it is so hard to notice it yourself and you think you’re invincible,” she says. “So try and take in what other people are saying. Listen to and respect trusted others when they are gently trying to tell you they think you are sick. And to loved ones of manic people, try and get them to a doctor. Looking back I’m not sure I know how I stayed alive during my manic episodes.

“If you are feeling low, be good to yourself, but also try and push yourself. I remember that my mother once persuaded me to ring the Aware helpline when I couldn’t get out of bed. It took every ounce of motivation to make that call and the support worker encouraged me to go to the nearest chemist and buy some vitamin D tablets. Now, I know it wasn’t really about the tablets, but about getting out of bed and having a purpose – because if you don’t have a purpose you will not want to be alive, so help your loved one find a purpose.

“Also, many doctors say that people only present to them when they’re feeling depressed as during the high stage, they feel elated and on top of the world, so I would say to loved ones to look out for signs of this and don’t be afraid to say something.

“It’s really important to speak out about having bipolar disorder – there is nothing to be ashamed of. If you had survived cancer, you would shout about it, so we should be the same about mental health as it affects everyone. I happen to have a mental illness, but mental ill health can happen to anyone.”

About Bipolar

• 1-2 per cent (up to one in 50 people) in Ireland experience a lifetime prevalence of bipolar disorder.
• Bipolar disorder is characterised by periods of low (depressed), high (elated) or mixed mood separated by periods of normal mood.
• Although it can be difficult to diagnose, the first signs are often seen in late teens or early adulthood.
• During a depressive phase people can feel sad, anxious, tired and have poor sleep, low self-esteem and physical aches and pains.
• During a manic or high phase, people may feel elated, excited, angry, have increased energy, racing thoughts, increased interest in life and high self-esteem.
• If mania or depression is severe – psychotic symptoms such as delusions and hallucinations can appear, reflecting the extreme mood state.
• Symptoms can be severe but it is possible to live a healthy and productive life once the illness is effectively treated.
• Correct diagnosis of both bipolar disorder and the type of bipolar disorder a person is experiencing is essential for successful treatment.
• For more information and advice, visit aware.ie