I’m bipolar and was finally diagnosed in 2017. Six years later, and my mental illness is all over popular culture. It was the subject of a hit Netflix show and a West End musical. I’m on a constant mission to raise awareness so the focus is welcome, yet portrayals need to be handled with more care.
The Bipolar Commission describes the disorder as “extreme changes in mood and energy, which go far beyond most people’s experiences of feeling a bit down or happy”. The main types are bipolar I and II. Type I suffer periods of mania and depression, whereas type IIs, like me, will have episodes of depression but without the extreme highs. Instead we get hypomanic; super-energised and more prone to risk taking, which can be harder to diagnose but is dangerous if untreated.
There are over one million sufferers in the UK and millions more affected through friends and family. The boxer Tyson Fury is diagnosed bipolar, as well as ADHD, which is documented in Netflix’s At Home With the Furys. Following life with wife Paris and their six children, Fury’s mood changes dominate. A sample: he flies his entourage to Iceland to face-up to an opponent, who is actually in Rome. He breaks his booze ban to commiserate, unwise given he’s previously battled alcohol and cocaine addiction and suicidal thoughts. We see him hungover and depressed but back home, he’s high, telling Paris he’s going to buy another private jet and, improbably, Blackpool airport. “It’s just easier to roll with it,” she says.
It’s recommended that bipolar is treated with medication and talking therapy. Fury previously said in an interview “exercise is my medication”, and we see him training. My worry is that bipolar could be interpreted as an illness that’s manageable by going for a jog. Or a viewer could consider the disorder incompatible with family life. I know first hand that, when diagnosed and managed, the highs and lows can be evened out – but too many sufferers don’t have that luxury.
According to a landmark study by the Commission, it takes an average of 9.5 years to get a diagnosis. I had my first depressive episode at university in 2005, sought professional help in 2013, and was diagnosed four years later. When I first went to my GP, I was given antidepressants, which didn’t help so I was referred to a psychiatrist. There was a six-week wait and I was extremely fortunate that my parents could pay to go private.
Like two-thirds of the study’s respondents, I was initially diagnosed with depression and given more antidepressants, which can make bipolar lows worse. The next three months were a blur of nausea, insomnia and sky-high anxiety. Then, I got a new job at a national newspaper; my brain was firing, I was my usual chatty self. Why take medication when I was ‘normal’ again? Within six months, I was back at the psychiatrist and back on the medication.
Guidelines say that anyone with a low mood should be asked if they’ve had high periods. But if asked (many aren’t), like me, patients can mistake hypomania for normality. During highs, I’d take on extra work, sleep less, decide unsuitable dates were “the one”, and spend £100s on clothes. But what was the problem? I was in a creative industry so a brain fizzing with ideas was ideal, my friends had equally chaotic love lives and I was only buying things I could afford. Excessive spending meant spanking thousands on designer stuff, right? Not a Zara spree.
As for the downs, people with bipolar are 20 times more likely to take their own life. I just wanted the world to pause until I caught up. I remember seeing a homeless man outside my local station, shrinking into his blanket as commuters rushed by. I felt I had more in common with him than anyone around me, while feeling deep shame at my navel-gazing.
In late 2017, something snapped. I changed psychiatrists – terrifying, as I knew it would mean new medication. She asked me about my mood swings and spoke to my mum about my teenage years (often up-and-down and irritable). I was diagnosed and given a mood stabiliser and told to come back every three months and to continue seeing the psychologist.
On the NHS, most only have access to a psychiatrist through their GP when they’re unwell, which can mean bipolar symptoms are missed. Undoubtedly, it’s the continuity of care that has helped me to stay working – 63 percent of the Commission’s survey respondents had lost a job – and cope with a bereavement and the pandemic without relapsing.
I’ve got better with my self care: I try to get eight hours’ sleep, drink less and move more. I see friends (good pals are always a tonic) but spend less on eating out and booze and more on exercise. Nearly half of bipolar sufferers are obese and my weight has crept up since I stabilised. Now, I do pilates in a studio where they play classical music and no phones are allowed – bliss. I also go to a personal training gym, where I’m open about my mental health. And I’ve met someone. I told him about my diagnosis on our third date. He already knew as he’d read an article I’d written but let me tell him in my own time. He’s unfazed. “It’s part of who you are,” he says two years on.
It’s daunting to think about the future. Hormonal changes can affect bipolar symptoms and have to be carefully managed. If I want to try for a baby, for example, I’ll get specialist perinatal mental health treatment on the NHS, but would still be at high risk of relapse. Plus one-in-four women with bipolar suffer postpartum psychosis.
I was intrigued to see Next to Normal, a musical following a mother with bipolar whose illness is complicated by unresolved grief. We see her go through manic phases, hallucinations, ECT therapy and a suicide attempt. Watching her husband feverishly mop up blood from the stage was confronting to say the least.
Sensitive depictions that help to raise awareness are a good thing, but I wish the personal nature of the illness was clearer for all. The mother’s grief added a complex dimension and this was explained thoughtfully in the £8 programme. For future runs, I’d hope theatres would consider giving nuanced information to all attendees, for free.
Tyson’s management of his bipolar is his choice but I think in the reported second series, the production company has a responsibility to highlight the recommended path. The Commission’s goal is for sufferers to get a clinician that knows them and can help them manage their condition over years.
As Fury puts it, evoking The Eagles hit: “It’s like the Hotel California, you can check out any time you want, but you can never leave.” You can’t leave, but the government needs to take note: there are ways to make the stay more comfortable for all.
- Next to Normal is at the Donmar Warehouse until 9 October
- At Home With The Furys is available on Netflix
For more information on bipolar disorder, see bipolaruk.org
