Bipolar disorder Pendulum: stories and information Women and bipolar Medication and self-management keep me well Gen Webster was diagnosed with bipolar in 2000. Here she explains how a combination of medication and self-management help her stay well Diagnosed with depression in May 2000 following a suicide attempt, I was then diagnosed with bipolar type I in September 2000 and my life changed forever. That four-month climb to the heights of mania, when I was sectioned, irreparably damaged relationships, left me broke and when the diagnosis came, left me feeling fearful that I would never lead a ‘normal’ life again or have a family. How wrong I was. In this blog, I share a little of my story and explain how my focus is on what I can do, not what I can’t. Using self-management techniques alongside medication have let me live a full, happy and fulfilling life with bipolar as my critical friend. Difficult early days Following diagnosis in 2000 and a poorly managed hospital discharge, I had another serious suicidal crashing bipolar low, but then I began to receive the support and medication I needed. I gradually restarted working and rebuilding my life over the next four years until, with support, I was able to stop medication to become pregnant. Recovering after a post-partum relapse My pregnancy was straightforward and after the birth in 2006, I wanted to breastfeed for as long as possible. I became adept at hiding signs from professionals and got through maternity leave in a haze of hypomania and low-level depression. Unfortunately, after restarting work caring for a baby whilst juggling work had a real impact on my mood and I was again sectioned for mania. For eight years I had resisted lithium but now for the sake of my family, I started it. I am one of the fortunate ones. Lithium works well for me and, other than the regular blood tests and weight gain, I haven’t looked back. Today I have been well (on lithium), using self-management strategies, for over 13 years. I use the mood scale to assess my mood when I need to and have been discharged completely from psychiatric services for nine years. I work full-time in a responsible and often stressful career. Challenging times Over those 13 years living well with bipolar has been “tested”. I found a cancerous lump and lost my brother to suicide in the same week. Going through surgery and radiotherapy, whilst grieving my brother was hard. I have been peri-menopausal for the last couple of years and I notice my moods are more finely attuned. The stress of Covid-19 and the decision to change jobs earlier this year was also not an easy one – should I stay in a role I knew well but where I was bored or take the risk of a new but stimulating challenge? Having almost died once, by my own hand, to me life is short and precious, so I embarked on the change, knowing it could be detrimental to my health. After 21 years, bipolar is so much a part of who I am I cannot imagine life without it. I can cope with the infrequent lows, and love and equally fear the hypomanic episodes when I feel creative, amusing and fun. I know how hard it can be to prevent it developing into a full-blown manic episode and potentially destroy everything. Top tips for staying well As I am more prone to high moods, my top strategy to stay well is that if my sleep is disturbed for more than 2 nights, I take a sleeping tablet (my GP has given me a small supply for this) and, if necessary, take a half-day off work and avoid alcohol. If I feel my mood rising (I am spending more than usual, talking lots on the phone or having lots of ideas), cutting back on social engagements and getting rest and alone time are vital. If I’m feeling low, things to look forward to in the diary (holidays or a spa day or catch-up lunch with friends) are essential to stay on an even keel. Meditation and mindfulness work for many, but for me a mindful walk, especially by the sea, or relaxing with a word puzzle or a game of solitaire on my phone whilst listening to gentle music works best. The Pause app has been useful when I’ve needed a moment when I’m at work to calm my racing thoughts. Working with my doctor to manage my medication Over the last five or six years I have been very gradually reducing my lithium dose, under medical supervision, and am now on a third less dosage than when I started. However, I know that if my three-monthly lithium blood levels change I may have to increase the dose again, and that’s ok. Medication and self-management are what keep me well. They’re what allow me to do my job well and to keep my family together. They make me hope that whatever life throws at me in the future I will be able to deal with it, whilst knowing that unexpected life events may continue to test me living well with my critical friend.