30 years ago, Fiona was diagnosed with bipolar after four years of untreated depression. Although now retired, she explains how she has self-managed her symptoms and has maintained a long, successful working life.

I was diagnosed with bipolar disorder after four years of deep depression and two psychotic episodes. I was at the threshold of what I planned to be a glittering career. I was 31.

It was both a shock to be diagnosed with a serious mental illness and a relief that my unreal experiences of the preceding 18 months (including a suicide attempt and messianic delusions) were a known condition with recognised treatment.

For the next few years I learnt avidly about my diagnosis, reading books and pamphlets and subscribing to Pendulum, the journal of MDF, the Manic Depressive Fellowship (now Bipolar UK). For several years I did all this privately then took the courage to nervously attend an MDF conference and acknowledge my condition.

The conference was held in a small hall at the back of Westminster Abbey and there for the first time I met others affected by bipolar - a couple whose 19-year-old daughter seemed to have no hope of employment, who were encouraged that I was working and with a relatively responsible job in a further education college. I took part in several medical research projects. Even today the causes of bipolar are unclear and my own version of symptoms and circumstances that make me unwell may not chime with other people’s. For me, it can be a cocktail of the following:

● Lack of sleep
● Poor diet - for those years of depression I lived on a sandwich a day
● Suspicious thoughts about friends, colleagues or strangers
● Speeded up thinking
● Sense of urgency about pet projects
● Playfulness, punning or word play

As part of my self-management, I can monitor and address the first two and take action, by medicating at weekends to catch up on sleep or simply taking a Saturday nap and ensuring that I do not skip meals too often and eat well. The remaining symptoms tend to creep up on me and I consciously need to reflect or ask others for their take on how I am coming across. As when one National Poetry Day, I asked my boss if reading a poem at the end of a team meeting came across as inappropriate. It didn’t.

Triggers that are out of my control are the seasons (my episodes tend to occur around the times the clocks change in March and October) and I take special care of myself in the run up to these. I make sure I rest and eat well, check in with friends, cut down on socialising a little so as not to be too stimulated and ration my exposure to news and current affairs as world events can upset my psychological balance. I do not consider myself particularly sensitive but natural (the Japanese tsunami of 2011) and man-made (the Gulf War and 9/11) disasters often precede an episode.

Working in the public sector, I have had supportive employers in the main. To illustrate this: I had my first psychotic episode on day one of a new job at a university - so they hardly knew me - and technically I think I was in breach of contract for not showing up. Without hesitation I was given a month’s sick leave and when I did get back to work, I couldn’t have wished for better colleagues, supportive without prying. I had a second episode and my diagnosis within a year. As I was recovering and began a phased return to work, my boss collected me from the ward in the morning, drove me to and from the University several days a week until I was back home and up to speed.

Legend.

Another employer ensured I had an occupational health assessment on appointment so that appropriate and personal support was agreed and already in place when I joined the organisation. I should stress these adjustments are nothing onerous:

● the ability to travel to and from work half an hour earlier or later
● telling me if I was coming across differently, speaking faster or with ideas that are harder to follow than usual
● out of hours emails (by which I mean messages sent at 4am)

I have only been absent from work when hospitalised and the brief recovery period afterwards. So, whilst my career has not been as glittering as my ambitions, it has been successful.

My initial dread at being told my diagnosis has been replaced with the satisfaction of a job relatively well done, under the circumstances.

When I was in my second hospital, I attended art therapy and during one session I painted a watercolour of an impending storm for that what the newly acquired diagnosis felt like, something too powerful that might overwhelm me, that I might drown in - the therapist gently suggested this might be the kind of storm that would pass over without incident and although I didn't believe him, it stuck with me.

For me, over my forty years of working life, the diagnosis has not been the disruption some others know, rather half a dozen intense admissions to hospital (only one under section) to tweak medication, rest and recover.