Interview 36

Age at interview: 37

Age at diagnosis: 22

Brief Outline: Useful approaches include medication, Cognitive Behavioural Therapy, therapy, hospitalisation, self-help groups. Currently takes Lithium (600mg/day) and citalopram (Cipramil) 20mg/day.

Background: Suffered depression and attempted suicide after leaving university and starting work. He was diagnosed with bipolar disorder in 1989. Currently self-employed as a teacher. Has had a number of bouts of depression/mania. (Played by an actor.)

When he was suicidal, he looked at everything in terms of suicide, and he felt angry he was not allowed to die, but he has never been that low again. (Played by an actor)

I remember during those 3 weeks everything that you seemed to look at was a way, you know, you looked at it from a suicide aspect, when you went over a bridge and you thought, that might be an idea, or a knife in the kitchen, yes, that would be a good one. All horrible sort of thoughts, looking back. 

And then I got the... I was sort of like a zombie at that point, probably from medication partly, also because I was I felt I'd let everybody down' But yeah, during those 3 weeks at first I was sort of very uncommunicative and very obviously, people say my eyes just looked totally dead. And then, I was being quite closely sort of protected during that stage'. Yeah, and at times I've resented the fact that I wasn't allowed to die, as I had made it very clear in my intentions that I didn't want to be kept alive. But, as I say, that's in, you know, some of the lowest points, which I've never got to again. Although I have, you know, been depressed.
 

He had trouble expressing how he felt and he and others tended to explain his depression in other ways e.g. tiredness. (Played by an actor)

I suppose sort of from returning from the holiday, although I'd felt sort of tired and run-down. It was always a... always a tendency, certainly initially, for people to put it as something else, you know, rather than accepting, you know, you were diagnosed as a depression. 

You think, oh, I'm run-down, it's physical. And I think, you know, in some ways I still do that now. But I had felt quite sort of locked in and difficult too expressing very well. And I know I wouldn't.... I went through a phase when I didn't speak very much at all. But the psychiatrist came out and he put me on Amitriptyline.
 

Felt misunderstood by his psychiatrist who assumed he had something like 'schizophrenia', and asked him strange questions.

There was one day I was talking to one of the nurses and I must have said I wasn't feeling so happy and whatever, and so she got like a psychiatrist to come as like there's a psychiatric hospital about 2 miles from the, you know, the big general hospital. 

And he came and he asked me really strange questions [laughing], he was a foreign gentleman and he said.... And I said I'd heard like the nurses talking about me, which I had because like the nurses' station was quite near. And they'd been sort of saying like I was withdrawn and a couple of other things, I think. 

And so when I said I'd heard some people talking about me he interpreted it as a sort of schizophrenia type thing, and he was asking me had I ever thought of cutting off my penis, which was really a rather odd thing to be asked at that time.
 

Choose your counsellor/therapist carefully - you need to be able to trust them so you can be honest. (Played by an actor)

Make sure you are happy with your counsellor if you are going private and paying for it. Because if you can't be totally honest, it is a waste of money. It is like the way that certain people will get on and others won't, it is the same. If you come away from any appointment feeling like you haven't been honest then I think there are problems with that. The first time I saw a psychiatrist, I wasn't honest. If I had been honest, perhaps I would not have got so desperate.
 

People can go to support groups even if they are not feeling great since others understand, but it can be hard to combine people who are in a manic phase with those who are depressed. (Played by an actor)

I'm saying, I wasn't the only person who felt that way [laughing]. Well, yes, so it was sort of like self-help groups in the, well it was the Manic Depression Fellowship, a local group, but I think now it's called Mood Swings Fellowship and they're not the same'. Yeah, I think the ones where you go in person is' rather than just sort of going out with a group of friends or acquaintances or whatever, if you go to a group for depression, people, you know, a lot of the groundwork is already done, plus you don't have to make any effort there. You might have somebody who's not feeling so good one week who doesn't really, you know, doesn't...is not able to contribute a lot but it's nice for them, and it's not judgmental and you can share experiences, you can just have quite a lot of humour with things. 

Why is that important, the humour?

The humour. Because you all, I think you all know, you've all got that in common, really. I think I'm probably thinking more of a manic depression one. I've never actually been to a depression group, I have to say, not in person.

In manic depression there's humour around?

If people are a bit manic, it can set people off. On the other hand it can also not be very nice for somebody who's depressed. If you're depressed you don't want somebody ...who's high. But there again, if you're the high person you can't understand why everybody's not joining in. But if you have a good facilitator then they can help, which we did, I have to say.