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Medication and stability - managing bipolar in a high intensity workplace

Posted Monday 12 November 2012

When I was diagnosed with bipolar 10 years ago I had no idea the challenges I would try and face balancing stability, medication and the career path I wanted to follow.

I discovered my love of Physics at school and I decided I wanted a career in research. I started studying Astrophysics at Edinburgh but a year in I was given a diagnosis of 'manic depression', prescribed a mood stabaliser and didn't think much more about what the long term consequences might be. Although the diagnosis came with a  bit of a relief, because I had known something hadn't been right for a while, I was fairly naïve to what challenges I might face.

I struggled through my MPhys and moved onto a MSc – and on the surface it seemed like I was managing. On the bipolar side I have moved from valproate to lamotrogine to lithium (plus fluoxetine as required) struggling to find that happy medium of a medication that would keep me relatively stable while not interfering with my ability to work.

In 2007 I was offered a place at Glasgow University to study a PhD in particle physics – specifically the search for the Higgs Boson at the LHC (some of you may have seen it in the news). It was my dream PhD place. I knew it would be hard work, long hours and a lot of travel, but it was what I wanted to work on and what I had spent years working towards. Despite having really struggled through my MSc year at Edinburgh I was determined to prove myself at Glasgow and took the risky decision to keep my medication to a minimal dose so that I could work to the best of my ability.

I watched Homeland during season 1 and saw Carrie taking the same chances. She worked long hours, worked through the night, barely kept on top of any medication and ignored the potential risks because provided she was still moving forward everything else could take the back burner.

In April 2009 things started going wrong for me. I had lived on the edge for 18 months, barely medicated. I had worked incredibly hard, spent a lot of time in Switzerland at CERN, but had not given much thought to looking after me. Just before Easter I ended up admitted to A & E and spent 3 days in hospital being treated for an overdose.

I was discharged, after convincing the staff I didn't need a referral to inpatient services and flew back out to CERN 3 days later for a week of meetings. I was in denial about how much control I had lost, but 2 months later I was back in hospital again and this time I ended up in a psychiatric ward for 9 weeks. 

When we meet Carrie in season 2 we see a different woman. Although she is still in recovery and that partly explains the change there is a very telling comment from her father who wonders 'if her lithium is too high'. I remember coming out of hospital on significantly more medication that I went in with – maximum dose lithium plus two antidepressants at that stage – and feeling like although I wasn't acutely unstable any more I had lost my edge and something was missing. 

That is the problem with medication, while the illness in itself can be catastrophic, medication can come with its disabling problems too.  When you work in a high intensity field, where being at your best at all times is vital, it becomes even more of a challenge. I wish I could say I have found the solution but, to this date, I'm still waiting to find it.

I am on yet another sick leave just now. Having tried a combination of lithium and quietapine after yet another hospital admission in winter 2010, I took the drastic decision to come off all medication earlier this year – in the hope that being unmedicated would give me back what I felt I was missing. It hasn't appeared to have worked either. 

I watch Carrie with interest week to week now and I am almost waiting to see if she starts playing around with her medication again...because the voice of experience in my head says that even although I should know better, that's what I'd do.

Mary Twaddle
You can follow Mary on Twitter.


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3 Comments

  • martin replied on 13 Nov 2012 at 16:38

    Thanks for expressing the dilemma of this condition, with medication you are safe yet unable to work at your best whilst without there is the risk of losing control. It really is that simple but to feel of value if work is important to you you have to experience life sometimes clear of medication.
    Sadly the frustration of broken plans and expectations can be crucifying.
    Wishing you well

  • Rebecca replied on 16 Nov 2012 at 06:02

    I can really identify with your blog post. I feel constantly torn in that dilemma with my bipolar medication of being 'stable' but then not feeling like myself and not being able perform at my best or under/unmedicated and losing any control. Despite several relapses due to stopping my meds 'just in case, this time, I can function ok' resulting in lengthy inpatient stays and usually more medications than I started on, I still come back to that same urge to meddle and see if I can get back that piece of me that's not there. It's an incredibly frustrating and at times devastating part of this condition. Thank you for raising awareness of it.

  • Seb replied on 18 Nov 2012 at 21:21

    Very interesting blog post there and one that is probably too common with mental health sufferers of different diagnoses. It's a tricky wire to walk if one decides to come off medication as wanting to regain your 'best ability' as you say due to the inhibiting side-effects that medication can impose.
    Currently I don't believe it's possible to control my medication further in the hope that I'd lose most of the 'worst side-effects' due to fearing I'd lose time off work and a routine to my current life.
    On the plus side its better being on my current medication than on olanzapine which must have its benefits but clearly has some strong negative effects as well.

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