Hi OP, I also have bipolar 1, this is a great thread, let’s try and keep it going! It’s so nice to hear from and interact other people living with bipolar disorder specifically, particularly people who are “higher functioning” with it I guess I would say, and not eg. in and out of prison/on drugs/generally leading super chaotic lives as many people with this illness unfortunately do and which tends to be the stereotype. I think someone else said there are more of us out there lurking in the shadows just getting on with life who you don’t necessarily know about as due to the stigma people often keep their diagnosis very quiet. I find this forum a relatively quiet corner of mumsnet generally, and because not all mental health problems are the same or cause the same issues, just like not all physical issues do, I sometimes find it hard to relate to others on here with different issues.
I am in the slightly unusual/stressful situation of being a doctor (GP) as well as having bipolar 1. Which adds more layers of difficulty in terms of who I tell etc. and also in dealing with the stress and high responsibility and long hours of this sort of job. There is no doubt the diagnosis still carries a certain level of social stigma. I work part time these days, I genuinely think the stress of trying to do the job full time would cause a serious relapse. It’s so great you’re able to stop work - I am super jealous! It’s one less thing to worry about juggling if you’re financially stable so well done for getting yourself in that position. It’s also great that you have a supportive DH who wants to hug you better (even if that alone is unlikely to work 🤣) - again I am super jealous as a divorced single mother without a new partner.
It sounds to me like you’re still coming to terms with your diagnosis. Which is fair enough, it’s a “big” diagnosis made relatively recently (in contrast I was diagnosed 18 years ago right after the birth of my son when I had what was my one and only manic/psychotic episode as I tend more to depression, and ended up under section - I was initially admitted informally “voluntarily” -had no clue what was happening around me by that stage - and tried to escape, nearly made it too 🤣).
I was on lithium for a long time then moved to lamotrigine as my mood stabiliser (I’m also on an antidepressant), as I felt the lithium was making me feel cognitively “slow” which I felt was making it harder to do my job. The lamotrigine was a lot better for me. I also wanted to be on something that I could get pregnant again if I wanted another baby, though this never happened due to the divorce basically. When I was initially admitted they put me on olanzapine but it didn’t bring me down from the mania at all and I went from a size 12. To a size 20 within 3 weeks (and have struggled to lose the weight ever since). I would never let them give me olanzapine again. I also can’t have lithium now due to being diagnosed with a sudden cardiac death syndrome as well which lithium can trigger, after my younger brother suddenly collapsed and died out of the blue.Anyway for you, the quetiapine sounds like a good suggestion, sleep is crucial, the first sign of mania for me was when I stopped sleeping.
In terms of worry about the future I totally get it and have had many of the same thoughts as you about it, I think they are normal and understandable concerns. As well as your worries I have an additional couple of worries about the future (sorry!). That when I am an old woman if I don’t have a lot of family and friends to speak up for me, people won’t notice or care when I’m getting more unwell and busy GPs won’t realise or if they do won’t bend over backwards to get me into a psych ward etc if needed and I will end up neglected and going quietly mad by myself (I still recall visiting an elderly patient with bipolar disorder as a medical student with a GP when shadowing and it was basically this situation). I also worry if I get dementia that I will be “stuck” in the traumatic postnatal era that I experienced in my brain…
In terms of where you live long term, like me, it sounds like you enjoy the peace and quiet of living rurally and I do think that benefits my mental health, so I wouldn’t move right away closer to town, just see how things go over the next few years while they tweak your meds and try to work out what works best for you and see how stable or otherwise you are. It sounds unlikely you’d not be legally allowed to drive for long periods of time given that you haven’t had significant episodes in the past. For me I eventually decided that if and when that becomes an issue I can always move then to somewhere that’s more accessible as a non-driver. Also Uber now exists in many areas! In fact I actually don’t drive myself (never learned then got banned for a year after my manic psychotic episode anyway which put me off trying to learn) and I manage though I’d say my area is semi-rural rather than deep rural.
Regarding who to tell and potentially passing on your genes, I am personally fairly open about my diagnosis except when it comes to work. I’d actually love to be more open at work as I think that’s psychologically healthier and I sort of live in fear of the GMC as I feel if I put a foot wrong and end up under them with a history of bipolar disorder I would definitely get struck off. Perhaps I’m being unfair to the GMC but they are not know for being fair to doctors! Especially these days. It causes me unnecessary stress at work trying to hide it. And I feel like I have to lie if I need a day off due to depression about what’s wrong with me which I hate. Also feel I have to save up all my sick days for being mentally ill, so have to struggle in with any physical illness unless I am literally in hospital. Anyway. I feel we don’t yet live in a world where patients would generally be accepting of having a doctor with bipolar 1, nor do we live in a world where I imagine anyone would hire me as a GP knowing about my diagnosis sadly. So only my appraiser and occupational health are aware generally. I have occasionally told a colleague or two if I really trust them not to blab, as it makes me feel safer if someone I work with is quietly looking out for signs of deterioration in my mental state, to help protect patients if I started to get unwell. Luckily I have always had pretty good insight when I am becoming unwell, including my one and only manic episode, so am able to step back when I need to. I have sometimes reduced my hours at work for a while if I recognise I am going downhill etc. As a single parent with a small child nobody queried this but I worry about how I will explain it now he is hopefully off to uni elsewhere in the autumn!
My friends and family all know about my diagnosis and understand (they also didn’t deal with my deterioration into mania well but I’ve forgiven them as nobody really understood exactly what was happening at the time, and it was all out of concern for me and my son), and my now 18 year old son also knows and has grown up with me being open about it with him. I find it helpful to have my family and friends know so they can also keep an eye out for me going downhill and let me know their worries/insist on my seeing a doctor etc, and yes as a pp said sometimes help remind me about medication etc when I am getting into a new routine.
I think if your kids are old enough to drive I would be honest with them about your diagnosis TBH. It might cause some worry/shock but I think that will be the case whatever age you tell them. Certainly I would worry a lot more about my son going off to uni elsewhere without understanding that he has a genetic predisposition to both unipolar depression and bipolar disorder, and taking care of his sleep needs and taking action at an early stage if he feels his mental health slipping. I have a second degree relative in the generation above me who had bipolar disorder and hung herself in her early 20s. So yes I do worry slightly about having passed my bipolar genes on to my son (especially as when I am depressed, which I am much of the time to some degree or other unfortunately, I am very pessimistic in my thinking), however I feel like I have it more in perspective many years down the line and don’t think about it loads. IF it happens (and it may well not), then who else better to support him than me as I have lots of lived experience. And I feel like I have a lot of good qualities in my genes too, some of which I think actually tend to go along with a bipolar diagnosis such as high intelligence and creativity. That makes me feel a bit better about it anyway, essentially he is my son and that may mean he carries some of my weaknesses but also my strengths.
Sorry this post is ridiculously long lol but you raised a lot of issues and as I am further down the line from diagnosis I wanted to explain how I’ve thought about them over the years.