A Bipolar Doctor

In my opinion, the two most important things you can do to stay well (when you have a mental illness) is attend a Psychiatrist and meet with a Psychotherapist. Medication can help you control Bipolar Disorder, Psychotherapy can help you live with it.

I first attended a Psychiatrist in 1994. I was psychotic and he started me on antipsychotics. It was exactly what I needed. I spent a short time in hospital but would remain on medication for about two years. I don’t remember exactly how long but I got my life back and recommenced my medical career. In retrospect, this episode probably signified the clinical onset of Bipolar Disorder but it would be a few years before I was diagnosed for certain.

I had a severe attack of depression in 1998. My first son was just born and I had begun training in Anaesthesia in Cork. I didn’t want to see a Psychiatrist. I was convinced that if it became known that I had a psychiatric illness, my medical career would be over. Instead, I was prescribed antidepressants by my G.P. and I improved. I took a maintenance dose for years after but I never felt quite right. Life was a constant struggle, my relationship with my wife was strained and I was drinking heavily at weekends.

My current Psychiatrist first saw me in 2003. I was coming off the rails and had become very destructive. My wife persuaded me to meet with him and I reluctantly agreed. It was one of the best decisions of my life. I was admitted to hospital for nearly two months and diagnosed with Bipolar Disorder.

I remember crying when I was told. I knew enough to know that Bipolar Disorder isn’t easy to treat but there was also a great sense of relief. Now we had a focus and could plan to improve things.

Antiepiletics and atypical antipsychotics formed the backbone of my medication. The effect wasn’t immediate but life got easier eventually. I continued to have frequent mood swings and, with reservations, I started Lithium. That’s when the worm turned. Lithium is the key to my well-being. By taking Lithium, I finally admitted that I was Bipolar. Acceptance took much longer.

Over the ensuing years, my Psychiatrist and I tried a number of medication combinations with varying degrees of success and failure. We finally landed on my current regime about three years ago and life is definitely much easier. It takes a long time to get the recipe right. I still have mood swings but they are not as severe nor last as long as previously.

My Psychiatrist has supported me through some of the darkest days of my illness. He listens to me, he believes me and he includes me in the choices we make. That element of self-control is important to me. It empowers me and helps me to believe that I am greater than my illness. It is not the whole.

Through the depressions and the hypomanias, through the hospitalisations my Psychiatrist has guided me. He has also seen me when I’m well and done his best to keep me there.

I would be lost without him.

I started to learn about science when I was twelve years old. I enjoyed chemistry and physics but it was biology that really fired my imagination. It seemed to me that medicine was the logical way to learn more about it and have a career immersed in subjects that I liked and for which I had an aptitude. I decided then to become a doctor and I never changed my mind.

It was not an easy path. There was no history of medicine in my family and I was repeatedly told of how difficult it is to gain entry to medical school. I was advised to consider alternatives. But my mother in particular, and my then biology teacher, encouraged me to stick to my guns and I began to believe I could do it.

I can still remember the day, after my Leaving Certificate results had been decided, when the offers of college places were published in the news paper and I was given a position in UCC. I barely made the grade but it was enough. I had my foot in the door and that was all I needed. I ran all the way home from the shop where I bought the paper, full of excitement and delight. I think my parents were very proud.

The next six years had their ups and downs but I started work as an Intern in 1994. I had a psychotic breakdown within the first four months of starting work and I was to be out of action for a year. I repeated my Internship in 1996 and after a brief spell as a Medical Senior House Officer, I commenced specialist training in Anaesthesia in 1998. It was the same year my first son was born.

While I was training, I was diagnosed with Bipolar Disorder. In truth, I think it was with me all the way. Bipolar slowed and altered my career path but I was able to continue. I passed my postgraduate examinations and completed my training in 2006. I have been working as a Consultant Anaesthetist ever since.

Being a doctor is a huge part of my life. It is part of my identity. When I am well, I love my work. When I am unwell, it gives me focus and distraction. I have to put the needs of my patients before my own and frequently this takes my mind away from my own thoughts and problems. I am convinced that being Bipolar gives me an advantage. Having lived through fear and anxiety and surfaced at the other side, when an emergency arises, I can cope better with the stress and think clearly and act decisively to rectify the situation. Of course, there have been times when I wasn’t in a position to help others and needed help myself. The trick is to be able to recognise when that is the case and take some time out.

I’ve been fortunate. Some people suffer mental illness so severely that they have to abandon their careers entirely. Some people don’t enjoy the support that I do. For me, I try constantly to remind myself that the debilitating symptoms of being Bipolar have a finite half-life. The bad times pass and it’s possible to live a relatively normal life if you learn to cope with your illness and take care of yourself.

I love being a doctor. I love the contact with people, the challenge and the satisfaction it brings. But most of all, I love it because it’s my chance to give a little back.