managing manic depression

by Sally Burningham

When Tom was nearly 18 he experienced his first episode of manic depression, although it was not diagnosed as such at the time. 'It came like a bolt from the blue and was a tremendous shock for the whole family,' Malcolm his father explains. Tom, who was in the 6th Form studying for A levels, had seemed quite normal during the week, but at the weekend he suddenly became hyperactive, laughing a lot and often inappropriately. 'His thoughts seemed to be racing ahead and he was unable to concentrate on anything for more than a few seconds. Although he seemed quite happy we were concerned that he was losing touch with reality and contacted our GP who arranged for him to be admitted to hospital straight away,' adds Malcolm.

struggling in the dark

© www.johnbirdsall.co.uk

Tom was heavily sedated when Malcolm and his mother, Ann, first visited him in hospital. However, over the next few weeks his drugs were gradually reduced and he was able to spend increasing amounts of time at home, leaving hospital finally at the end of three weeks. 'We were unable to glean very much information from the doctors about what had occurred,' Malcolm recalls. 'They simply described his experience as a "psychotic episode", but seemed quite unwilling to discuss it any further. Over the next few years we felt as if we were really struggling in the dark, worrying about whether Tom was on the right medication and whether he would cope.' Although Tom was in a fragile state he slowly managed to complete his A levels and two years of a university course, during which time he lived away from home.

taking control

'By the time Tom was 24 he had had two more "psychotic" episodes, both again of the manic variety, but we still had not had a diagnosis,' Malcolm comments. 'We began to realise that the medical experts often disagreed about these kinds of conditions and that the only way forward was to learn as much as we could for ourselves so that Tom, with our support, could begin to take more control of his own situation.' One result has been, that though very much appreciating the help that drugs can give, Tom has decided that the least possible medication works best for him. He takes medication as necessary and has had respites of two or three years between episodes.

leading a full life

For the last eight years Tom has lived in his own flat about a mile away from his parents. He looks after himself but has regular phone calls or visits from a community psychiatric nurse and, of course, support from his family. Although he is unable to work and has a low tolerance of stress or excitement he still manages to lead a full life. He has lots of friends and interests and is close to his older brother and sister who are very sympathetic and supportive. He swims and works out daily at a sports centre, does regular voluntary work, enjoys cooking and goes to lots of concerts.

coping as parents

Of course, like any loving parents, he and Ann have been through a whole range of emotions themselves. There is the anxiety as they pick up warning signs of an impending episode, distress at what their son is experiencing and, in the beginning, once an episode was over, denial about what had occurred. 'At first when Tom seemed relatively better, there was a temptation to think "that's it, it won't happen again," but now we do accept that episodes may occur throughout his life. Our focus is on making sure he is as independent as possible and has support to help him manage once we are gone.'

People with manic depression can behave in a very distressing way during an episode and as a result they may alienate those close to them. Malcolm believes they have only been able to maintain their good relationship with Tom by separating the illness from the person. 'He can say or do very hurtful things during an episode and we have to constantly remind ourselves that it is not Tom talking but the illness.'

the way forward

Tom is now well for most of the time. He has joined the Manic Depression Fellowship (see help and info) and has taken part on one of their self-management courses (see our feature on manic depression) to help him find ways of managing his own illness through recognising triggers and early warning signs and taking prompt appropriate action. 'We are full of admiration for the fact that despite dealing with a tough illness he manages to give back to others through his voluntary work and lead such a full life,' Malcolm concludes.

help and info

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organisations

Depression Alliance
35 Westminster Bridge Road
London SE1 7JB
Tel: 0845 123 23 20
E-mail: information@depressionalliance.org
Website: www.depressionalliance.org
National network of self-help groups for people experiencing depression. Offers a quarterly newsletter, national pen friend scheme and correspondence service with advice, guidance, support and fellowship to people experiencing depression, and their carers. Produces booklets and leaflets on various aspects of depression.

Manic Depression Fellowship (MDF)
21 St George's Road
London SE1 6ES
Advice and Information: 08456 340 540 (Mon-Fri 9am-5pm)
E-mail: mdf@mdf.org.uk
Website: www.mdf.org.uk
Provides advice and information for people with manic depression, and their families, carers and mental health professionals. Offers a quarterly journal Pendulum, a network of self-help groups for people with the condition, as well as their relatives and friends, self management training courses, employment advice, travel insurance, and members also have access to a legal advice line. MDF will send out an information pack upon request, which includes a publications list.

Mental Health Foundation
Sea Containers House
20 Upper Ground
London SE1 9QB
Tel: 020 7803 1100
E-mail: mhf@mhf.org.uk
Website: www.mentalhealth.org.uk
Working to improve the support available for people with mental health problems and people with learning disabilities. Offers information and literature on all aspects of mental health, including where to get help, information about specific mental health problems, treatments and rights.

Mind (National Association for Mental Health)
15-19 Broadway
London E15 4BQ
Tel: 020 8519 2122
Mind Infoline: 0845 766 0163 (Mon-Fri 9.15am-4.15pm)
E-mail: contact@mind.org.uk
Website: www.mind.org.uk
Campaigns for better mental health services in England and Wales, through its national office, regional offices and network of over 200 local branches, some of which also provide services. Publishes a range of helpful books and leaflets. Contact them for details of your nearest local group and for more information.

Rethink
30 Tabernacle Street
London EC2A 4DD
Tel: 0845 456 0455 (general enquiries) (Mon-Fri 9am-5pm)
National Advice Line: 020 8974 6814 (Mon-Fri 10am-3pm)
E-mail: advice@rethink.org
Websites: www.rethink.org or www.rethink.org/at-ease (for young people)
Dedicated to improving the lives of anyone affected by severe mental illness, by providing information, advice and advocacy services, raising awareness of mental health issues, and challenging the attitudes that create stigma. Website has sections on employment, money, benefits and legal rights.

Samaritans
c/o Chris
PO Box 90 90
Stirling FK8 2SA
Helpline: 08457 90 90 90 (24 hours)
E-mail: jo@samaritans.org
Website: www.samaritans.org.uk
The Samaritans exists to provide confidential emotional support to any person, irrespective of race, creed, age or status who is in emotional distress or at risk of suicide; 24 hours a day. Can be contacted by e-mail, telephone, writing, or by visiting one of over 200 local branches (details are on the website).

SANE
40 Adler Street
London E1 1EE
SANELINE: 0845 767 8000 (every day 12pm-2am)
E-mail: london@sane.org.uk (admin queries only)
Website: www.sane.org.uk
SANELINE is a national mental health helpline providing information and support for people with mental health problems, and those who support them. They can provide information on illnesses and symptoms, local and national mental health services, medication, treatments and therapies.

websites

Depression and Bi-Polar Support Alliance
www.dbsalliance.org
The DBSA fosters an understanding about the impact and management of these illnesses by providing up-to-date, scientifically-based tools and information written in language the general public can understand.

Royal College of Psychiatrists
www.rcpsych.ac.uk
Website contains informative factsheets on manic depression, and other mental illnesses.

SpeakUp!
www.speak-up.org.uk
This interactive website will enable people aged 16-25 to share their experiences of mental health services with each other as well as professionals, carers and people involved in community projects. Participants will be able to express their views openly, ask questions and exchange ideas online. It is hoped that this site will help to improve mental health provision across the UK.

Swings and Roundabouts
www.swingsround.mhmedia.com
Swings and Roundabouts are a group of volunteers who came together to produce 'Insight in Mind', a 27 minute film with an accompanying booklet which give an insight into mania and depression, as well as anti-psychotic medications. The aims of Insight in Mind are to enable carers, health professionals, family and friends to focus on the emotional and practical needs of individuals in distress and to challenge stereotypes, attitudes and prejudices. Visit the website for further information or to purchase a copy of the video and accompanying booklet.

reading

A Can of Madness: An Autobiography of Manic Depression by Jason Pegler (Chipmunkapublishing, 2002)
This book is a vivid and sometimes disturbing memoir about the experience of having a diagnosis of manic-depression
Get this book

Bipolar Disorders: A guide to helping children and adolescents by Mitzi Waltz (O'Reilly UK, 2000)
This text aims to help parents and professionals recognise, treat and cope with bipolar disorders in children and adolescents. It covers diagnosis, family life, medication, talk therapies and school.
Get this book

Coping with Depression and Elation by Patrick McKeon (Sheldon Press, 1995)
This book explains the symptoms and treatment of manic depression and offers practical suggestions on ways to cope.
Get this book

Living with Mental Illness: A book for relatives and friends by Elizabeth Kuipers and Paul Bebbington (Souvenir Press Ltd, 2004)
Provides explanations and practical advice on matters such as coping day to day and in a crisis.
Get this book

Survival Strategies for Parenting the Child and Teen with Bipolar Disorder by George Lynn (Jessica Kingsley Publishers, 2000)
Until fairly recently professionals did not think bipolar disorder occurred in children. Now, as it is being increasingly diagnosed, George Lynn offers clear, practical advice on recognising the symptoms, understanding medication and accessing the necessary support at school as well as managing the day-to-day challenges of parenting a child with bipolar disorder.
Get this book

(March 2002, resources updated December 2004)