What a difference a year makes...

I was a teacher for 12 years and in that time I had several periods of ill health associated with my Bipolar Disorder. By the time I left a year ago I had become very despondent with education and was having significant doubts about my abilities as a teacher. A year on another period of depression, but this time when employed outside teaching, has made me look back as reassess the role that employment and employers can have when someone is unwell. Stress is a known trigger for most mental illnesses including Bipolar disorder. Much of my care and crisis prevention planning is about managing stress and my life so as to minimise excessive stress as much as possible. Teaching is a stressful job and has only become more so in recent years. When I started teaching I was keen and enthusiastic and threw myself into the job, loving the creativity of planning lessons and working with teenagers. I did struggle with the all encompassing nature of the work, but I was young and had no other responsibilities in my life. At the start of my second year a change in school, with a complete lack of support, as well as moving across the country triggered a depressive episode. I never returned to that school and left after a term. Then came two years a private school and my confidence began to build again and I began to enjoy teaching once more. I put this down to the amount of planning and preparation time I was given- over double the amount given in the state sector. Added to this a long lunch break (70mins) and an understanding that I had a life outside of my teaching. As my confidence built I started to look around for a move up and moved to a state school as a head of department. Once again the stress hit. I was building a department from nothing and despite my willing and enthusiasm I began to feel the strain. Towards the end of my teaching career I had dropped to three days a week and relinquished my head of department role. All for the aim of reducing my workload and associated stress. The last year has been eye opening. I was completely up front with my employer regarding my Bipolar Diagnosis. I requested and was granted some reasonable adjustments to enable me to cope better with the working week. Because this involved an outwardly obviously change I shared my diagnosis with colleagues. It was a revelation for an employer to genuinely listen and try to adapt the working situation so that I could do my best. Despite now working full time, I was never brushed off with "its a stressful job" and never was it suggested that I reduce my hours (and therefore pay) unless it was what I wanted. This was very unlike my previous career in teaching. The biggest difference was shown most recently. At the end of August we moved house, a sale and purchase that was anything but straightforward. Moving house is listed as one of the most stressful things a person experiences (divorce and death are the top ones). I made changes, enacted my wellness plan and tried to cope with the stress as well as possible. However it was too much and triggered a depressive episode, which to some extent I am still experiencing. The response of my employer was phenomenal and has meant that I have not been signed off and instead have only taken 4 days sick leave throughout the whole period. This is significant period of depression, equal to the whole term (13 weeks) I took off in my second year of teaching or even the postnatal depression I suffered after the birth of my children. The difference was how it was handled. I spoke to my managers about how I was feeling, but also explaining that although daunting, being at work was actually good for me. It meant I was out of the house, interacting with people. We agreed some small changes to my working- staying off the phone if I needed to, I was offered a change in working hours if needed, and some time off to allow my increase in medication to take effect. At the same time I felt able to tell friends and colleagues how I was feeling and they were supportive and sympathetic. All this has made a huge difference to me getting better and as not resulted in a long period off sick, as I believe would have happened were I still in teaching. On reflection I wonder whether I should just accept that teaching wasn't for me because of my inability to cope with stress and teachings inability to be flexible in the way of other jobs. But then I also consider if that would be acceptable with other conditions. Should we simply tell people with certain conditions and disabilities that some careers are closed to them? The Equalities Act attempts to resolve this, allowing people to request reasonable adjustments to enable disabled people to continue working, to adjust their working so that they can compete at the same level as their peers. At the moment teaching is way behind other careers in dealing appropriately with mental illness and in fact any kind of change from the standard. Everyone is held to the same standards, and the attitude is often keep up or get out. But it may have to change, teachers are leaving the profession in droves. Mental illness in teachers in on the rise year after year. I now work with teachers as an Adviser, and speak to far too many in tears, depressed and unable to cope who think their only choice is to leave. Looking back there were certainly other things my teaching employers could have done to enable me to stay in work and feel useful and productive- so important to someone suffering from depression. Rather than guilt laden conversations around letting children down, and useless reminders that everyone is stressed, there could be real conversations on how this job could be made more mental health friendly- for all teachers, not just those with underlying mental illness. My mood is lifting, slowly. I have increased my medication and I am employing lots of self help tools. I am getting there!

Discharge- the good kind!

Unlike in many other areas of medicine, discharge is a good sign in psychiatry. Yesterday I was discharged from the care of the psychiatrist and community mental health team (CMHT), back to GP care. It was such a low key conversation, some admin to be sent to my GP surgery, but for me in real terms it was a momentous moment. Because the reason for the psychiatrist suggesting it, the reason I could confidently agree, is because I am well. I have been reasonably well for a period of time and there is no indication that I will not continue to be well in the future. I have been under the care of a psychiatrist and CMHT since 2009, so this is a big step for me, like taking the stabilisers off a bike for the first time. In reality this has been coming for a while. I haven't had a regular community psychiatric nurse for about a year, after it was agreed that I didn't need that aspect of care and my psychiatrist appointments have gradually got further apart, like a parent gradually releasing the hold on the bike seat. And to continue the cycling analogy, I feel equally excited and anxious, worried that I might wobble and fall at any moment. I can always contact the service, and re-refer myself if I need to. One of the most telling parts of the discharge conversation with my psychiatrist, was her observation on how much better I was since leaving teaching. She's not the first person to comment on this, I've even been told that I look younger by a few people! I've been out of teaching for seven months now and the difference to my mental and physical health is amazing. I sleep better, my relationships are better, I feel like a totally different person. There are wistful moments where I wish I could have made teaching work, at the core it was a job I loved and I was passionate about. I never imagined I wouldn't be doing it until retirement. However, I couldn't make it work with my bipolar, and considering the number of teachers leaving the profession at the moment, it isn't just people with mental health issues struggling to cope. I will probably always wonder if I had to sacrifice my teaching career because of my mental health or whether even without bipolar it would have become untenable as a job. In the meantime I will keep on practising without my stabilisers, trying not to get to anxious about the wobbles, knowing that if I do fall off there are people able to lift me back up and start again with me I need them.

One day at a time

Today (30th March) is Bipolar awareness day. There is an abundance of awareness days and months, for all sorts of conditions and diseases. In mental health I think it can only be a good thing, to raise awareness, get people talking, reduce stigma.  In an effort to move away from simple social media sharing as awareness, this year mental health charities have asked people with Bipolar (and hopefully other mental illnesses on those relevant days) to share what it is actually like living with the illness. So here is my account of life with Bipolar.

Definitions and descriptions of Bipolar focus firstly and mainly on the mood changes, the highs and lows and how these can be characterised. In reality that is such a small part of the illness in actual terms. What I mean is that those events over shadow everything in a kind of 'what if' way. I live day to day doing my upmost to avoid those extremes, even though the actual amount of time I have lived with those types of extreme are short when compared to 'inbetweens'. That's not to reduce the impact of those periods, they are terrifying and life changing, but it is the fear of them, rather than them themselves that overshadows daily life.

Bipolar Disorder is with me everyday, every decision I make- big and small. In the mundane it is the importance of me keeping routine in my life, regular sleeping and eating patterns. Spontaneity and wellness do not go together with this mental illness. Sometimes it drives me crazy, I've never been one for schedules, other times I accept it as a mild annoyance as a price for staying well.

It's there every morning and evening when taking medication, when I forget because I'm rushing, and suffer the side effects. I have a love/hate relationship with my medication. I know it keeps me well, but I don't enjoy the necessity of it, nor the side effects. The small side effects that seem inconsequential to being well, but over time irritate so much as yet another consequence of this damned illness. Sometimes I am exasperated by the unfairness of having bipolar disorder and having to deal with excessive sweating, night terrors, heartburn, gut problems and weight issues caused by medication.

Occasionally there are the big regrets, the realisation that your life has probably take a very different route because of Bipolar Disorder. When I started teaching in 2004, I had excelled in my teacher training and was selected as a Fast Track teacher. I never really succeeded due to periods of illness and ultimately because I couldn't work the way teaching needed me to- bursts of high intensity, long hours and then periods of complete rest. I was good at teaching, I enjoyed it. But I couldn't sustain it. Many people with Bipolar have similar stories of some success in their career, until illness brings them out or down in their career goals. I'm very lucky that I can maintain work, many people can't. However I can't reach to a higher level in any job or career without the pressure defeating me. It doesn't matter most of the time, but occasionally I get a feeling that I could have been really successful if it wasn’t for the bipolar weight around my ankle dragging me down.

Relationships can be strained when a person suffers from a mental illness. I know my illness has impacted all my relationships, with my husband, my children, friends and colleagues. I know I've lost friends as a result, I know my marriage has been seriously tested from it, time will only tell what effect t it might have had on my children.

I didn't always want this blog to be a purely negative account of life with Bipolar, but I do need it to be honest. I'd exchange it in a second if I could. For me the awareness that needs to be shared this Bipolar day is the everyday drudgery and difficulty that is living with this illness. The highs and the lows are what defines it psychologically, but the everyday impact is the draining reality of the illness for me.