Bipolar in my Wainwrights Shoes 

Doctors Solicitors Police Family Stories. Fight Stigma & Illness  

 

Christopher Wainwright LLB (Hons), Infantry Officer Retd, Shoe Retail Specialist, Ex Solicitor, 

 

6. Getting the Best Treatment for Bipolar 1 

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My GPs let me think I'd had some sort of emotional problem when I had my manic episode. They must have decided for me that I wouldn't be able to cope with the bipolar 1 label. There are jokes about 'breaking bad news gently' but this was not breaking it at all. I only found out the truth when they finally sent me to the Warneford to be diagnosed and that was only after my close shave with a 12 gauge. Years later I happened to ask Dr C why they didn't know my illness from the outset and he told me he had his 'suspicions'. I realised that along with psychiatrist Dr Shribman they'd let me drift, at risk, for 14 years knowing I was at risk. Anyone could've told them I'd have wanted to know the truth immediately. My GPs knew I had bipolar 1 early on. They should have referred me to the experts immediately and saved me and my family considerable distress. 

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I'm not a pyschdoc so it took me years to work out that stigma was the cause of my problem. It wasn't the depressive episodes or the one-off manic spell, but the fear of being shunned by people who knew I had bipolar. I thought of different things that would help. Not being too serious was one of them while overthinking was another. My family and friends at the time weren't worried because they knew I was ok. In fact I never experienced a bipolar episode once I'd been diagnosed by the hospital experts. I'd managed our Wainwrights family shoe shop at Beaconsfield where I was always serving with staff and customers on the shop floor. At that stage I hadn't come out I didnt think it right to involve my coodirectors in the decision which, for the business, I'm sure was the best thing then. I knew that I was working perfectly well so there was no problem hiding the illness other than feeling it wasn't quite right. For years I wondered what I would say to a son or daughter in my shoes!

 

To improve my confidence ... I decided to experiment with some positive coaching methods from the sports world. I made every effort to think myself onto the front foot. Searching the internet for advice about confidence is good if you believe it will work. If you're reasonably well it's easy but if you're struggling with your mood you'll need to be patient. It  makes sense to ditch bad habits and be physically fit. To improve or regain form be patient, don’t force things but want to be better. Get into good habits that work for you. Low moods can be stubborn but doing anything active is good. Reading is relaxing if you enjoy your material and keep focussed on it. If you struggle with concentration find something more interesting. As your mood lifts your concentration will improve. If it doesn't the lowest mood can be treated so consider seeing your doctor. Most things are trial and error. Keep activity and fitness going all the time. Some mornings I'm not a good starter because I think too much instead of just getting on with it! That's a big mistake because it stops me getting on. My answer's simple. I force myself to make a start. Over-thinking is often counter-productive.

There are things about bipolar that your psychiatrist won’t tell you at the outset but with time you can generally work them out. Psychiatrists and websites for example tend to make light of stigma because they don't want to discourage you. They’ll have you believe that stigma is much better nowadays but I'm not sure. Until there's a solution I say fight it by talking about it! Stigma won’t stop by itself! I know folk who can't discuss mental illness because they're frightened of it! The solution is to make the subject palatable just as we do with cancer growths and heart disease. The days of the lunatic asylum are long gone. It's not often necessary but anyone admitted to hospital for a psychiatric assessment will find little difference from their own home!

I never thought I'd find anything funny about bipolar but laughter's good medicine! I wondered if making a joke about my 'shameful' illness would help me come to terms with it make and easier for people tp discuss? Men in particular findit difficult to laugh at themselves male ‘micky-taking’ is good for bonding but not if it's spiteful. Noone jokes about my bipolar but I wish they did. I grew up with older boys teasing me. I learnt to laugh at their remarks which never hurt me. As long as there's no spite humour should be welcome otherwise we miss a trick by trying to be over protective. I was wrong to think that my bipolar 1 was a disaster! Positive well-intentioned humour can work. There were cognitive behavioural principles which I'd overlooked. I decided that I could fight stigma and make bipolar my strength. Instead of hiding and avoiding I could make my bipolar humorous. My pre-bipolar friends will recognise my attitude of old.

The internet has helped us massively. The majority of us with stable bipolar 1 mental illness are as good if not better than any person alive. Although I was knocked off my perch at 22 after an excellent run I still counted myself as very lucky. I had my parents support, my upbringing and my personality. I have my wonderful wife and beautiful daughters who I can't thank enough. They never wavered even during my difficult early years.


John Geddes MD, FRCPsych:-

I was sorry to read that Professor  John Geddes MD, FRC Psych has retired. When an expert goes on public record with his opinions it pays to listen. He recently referred to the mood stabiliser lithium as the ‘gold standard’ treatment for bipolar. Unfortunately he also said that NHS cut-backs have lead to a reduction in its use because of the cost of blood tests. In its place doctors are prescribing cheaper but less effective alternatives. I couldn’t believe what I was reading! Will I be asked to switch? If it wasn’t for lithium I might not have been able to regain my normal health! If you have a medicated illness you'll clearly want the most effective drugs. You might need to trial them firs. Bipolar 1 can be tough enough without doctors being pressed to prescribe inferior meds in order to save money. 

I think that people with bipolar 1 need specialist treatment. I didnt see one for 14 years. I should have been offered access to a Bipolar 1 expert like Professor Geddes. The psychiatrist I was offered was no expert and I paid a heavy price. An expert the equivalent of Professor Geddes is vital for the best advice about Bipolar 1. I'd imagine he is now much in demand as a 'consultant'. My own case demonstrated that local doctors surgeries don't have specialists.  Why doesn't the NHS have a dedicated bipolar 1 'Q&A's service available by email/telephone? I dare say the usual excuses would be made but isn't it worth a trial! 

The medication I take for Bipolar 1 works well and completely eliminates the extreme depressive moods and mania. In my opinion the most harmful enemy of the illness is its stigma therefore I believe that reducing or preventing it will be a huge move forward for everyone affected. In my case dad wanted my bipolar hushed up for that reason but all along I suspected that secrecy was the wrong approach for me for several reasons:- 1) it caused me a lot of stress 2) it was nigh on impossible for me to keep it hidden and 3) it meant I was giving in to the pressure of social stigma. On average a total of over ninety people will be closely involved by each individual case. That comprises family members, friends, relations, acquaintances and work colleagues all being concerned in every case of bipolar.

 

Some patients fare better in recovering from bipolar episodes than others depending on their individual differences in health. Other factors are relevant of course such as income, education, knowledge, guidance, support and so on. I think that the impact of bipolar 1 on a person is considerably understated. Depression can be so profound that it can finish people for good if not properly treated by professionals with experience or able to find people who have. The relatively short period of mania of maybe 7-10 days can lead to the most embarrassing behaviour imaginable. Men in particular are vulnerable where even the most decent often lose restraint of their natural desire for sex then have to come to terms with their unconscious promiscuous behaviour. 

 

Untreated bipolar 1 depressions and manic episodes are so serious that sufferers will often be unable to function properly for lengthy periods. It’s surprising however that once recovered they're back to normal quickly as if there was an on/off switch. Don't forget that all illnesses affect patients differently. I was told mine was about average. My medication has been the same for years. I believe my personality and temperament are much the same as when growing up before bipolar started. It's a great shame that so many people know so little about the illness. Once they are better informed they won't need to worry. Why be frightened needlessly?

 

Once treated with suitable medication (and used as prescribed by a psychiatrist) people can live normally and function to the highest of levels. To be at your best with bipolar 1 do what the experts say. Alcohol and recreational drugs are off the menu - I’m pleased to say I’ve been 99.9% booze free for many years and don't ever miss it. Not easy for starters but I had to do it. If you’re alcohol dependent or addicted to anything else which is likely to interfere with your health you will be able to find a way to stop it. It would have done me a lot of good had the internet been available in my younger years.

 

I can't emphasise this enough but negative beliefs about bipolar continue to cause widespread prejudice. Stigma will turn bipolar 1 into a lifetime problem but there’s absolutely no need. Its effect can be almost impossible to overcome. I don’t believe doctors and psychiatrists fully understand how true that is. It means that people with bipolar 1 and 2 are wide open to abuse by anyone so minded. There will always be situations where someone wants to undermine say, a work colleague who happens to have bipolar. They might be motivated by jealousy! They could use stigma like a weapon. It happened to me and it's difficult to do much about. Many times I’ve seen peoples attitudes towards me change for the worse once they knew I had bipolar. Hiding my illness made a huge difference but once disclosed the damage is done! The answer is to stop stigma as best we can!

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BIPOLAR 1 ANTI DEPRESSANTS SIDE EFFECTS:-
Medication for bipolar 1 illness has much advanced but a lot remains to be done. Side effects need improving and one in particular. Weight gain for example has been an issue for me. I remember following my diagnosis shop customers remarking that I was putting on the pounds. Without owning up to the reason I made light of it. Searching Google I didnt find much but it seems to be based on food craving. I'm working for the umteenth time on this and will report again. Libido is an issue as is perspiration but I'll leave those for now. Bipolar 1 meds need to be ten steps forward in your mood control but negative steps elsewhere won't help

Prof Geddes has highlighted how bipolar 1 is intertwined in our lives. Hardly surprising when it's known as cruel?

I hope I've shown that I live a normal life but how can patients keep improving without access to immediate expert help?

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BIPOLAR 1 & THE LAW:-

I emphasise the '1' in BP type 1 because it alone includes manic episodes with serious depressions. If you're thrown into a period of mania for say a couple of weeks ( times vary) no matter how well you are you'll behave so bizarely and out of character that youll be ashamed when you come round. The psychdocs skate around this embarrassing subject because they don't yet have an answer. During my manic episode I had the excuse that I was ill but it didn't explain to people that I'd lost control and no longer had my usual inhibitions! As a normally perfect gentleman and invariably polite I could have explained my promiscuous behaviour as due to illness. As an experienced marksman how could I also accept playing around with a dummy pistol and pointing it at a group of soldiers in the train carriage? I wouldn't want to  explain it to anyone in the Regiment! On the other hand of all people I know they'd be tops in understanding abberrations of the mind.
I've written before about the case of RvMadjeski and the legal defence known as 'automatism'. A defence in law but you're left with memories you don't really deserve

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