Thoughts on psychotic illness & bipolar One of our service users shares his experience of bipolar and psychosis and gives some tips for how to keep well. I suffered my first psychotic episode at 18, requiring two separate hospital admissions. I was treated with Stelazine, Lorazepam, Procycledine, and later on, antipsychotics like Sulpiride and Olanzipine. Shortly afterwards I was diagnosed with schizophrenia. The psychotic illness that affects me is towards the schizophrenic end of the spectrum although the pattern of my illness seems to be bipolar. In my youth and naivety, I made the weighty error of identifying with this diagnosis. It hit me harder than anything ever had; I felt my life had ended and things would never improve. My psychiatrist advised me that I could recover and go on to lead a relatively normal life whilst managing the illness. I could work and have a family because the medication is effective for me. Fortunately, it suppresses the most disabling symptoms but medication isn't as effective for everyone. Years after the schizophrenia diagnosis, I was diagnosed with schizoaffective disorder with my bipolar 1 diagnosis arriving 9 years later. On average, it takes 10 years to receive a correct diagnosis of bipolar. I've lost years of my life to the illness though with time I've learnt to sometimes catch episodes early and I've got a better understanding of my triggers. Navigating through a recent frightening and traumatic episode, I held onto the knowledge that I've been through this many times and I can get through it again. The quotation usually attributed to Churchill puts it well: "When you're going through hell, keep going." Here are some suggestions I've gained over the last 20 years, the things that have helped me the most: Learn all you can about the condition. You may be affected throughout your life so you owe it to yourself to become an expert on bipolar. Begin with the Bipolar UK website, as well as the Sane and Mind websites. Numerous books on bipolar cover symptoms, coping techniques and stories of managing the illness hold knowledge and inspiration. Your condition is individual, though millions of people have had comparable struggles. Bipolar UK's Support Groups provide assistance for anyone affected by bipolar. Some people have reservations about attending for the first time. There's no pressure upon you. You can say as little or as much as you like. You can meet and learn from sympathetic people with similar experiences and you might make new friends. Look at your options regarding medication. Your NHS GP or psychiatrist has limited time to find an effective treatment for you. It's a process of trial and error, often with side-effects. Therapy and counselling are also useful. A good therapist can change your life, though you must find the right practitioner. Ask your GP or psychiatrist about your options. Identify your triggers and symptoms. You're the only person who can ever know yourself. If you're able to pick up on subtle signs and catch episodes early, they'll probably be milder and your recovery may be easier. Writing. Keep a simple journal and get problems out of your head and onto paper. Although painful, I've written when becoming manic and psychotic. Without these personal notes, I'd never be able to remember my delusions. When depressed, I write a lot and it's a helpful aid in managing my illness. Routine and sleep. Regularity can be a great benefit in managing bipolar. Wake up at the same time each day and you'll have structure for the day. Get outdoors and take your medication at the same time every day. I function better on 9 or 10 hours of sleep but need up to 16 hours of sleep when I'm unwell and on a lot of medication. Therapeutic interests. Activities can prevent you from ruminating on your diagnosis. Pursuing something creative, such as poetry or drawing, is a relaxing way to spend time. Bipolar and creativity is romanticised though plenty of creative historical figures experienced mood disorders or psychosis. Diet and exercise. Regular exercise has profound benefits, like improving your mood. Your mind and body are linked and your brain will become a better friend if you exercise and eat well. I also no longer drink alcohol and I've limited my caffeine intake. Keep a monthly mood diary and use the mood scale. It's important and revealing to record your moods, hours of sleep and medication regime. Looking over the charts gives you an insight into the pattern of your own condition. Remember that bipolar is a part of you but not all of you. Do not be defined by the diagnosis and recognise that you can still achieve outstanding things in your life. Be grateful for what you can do.