The Stay-Well Plan: My life with mental illness

A mental illness diagnosis is life-changing. My life changed 40 years ago when I was an 18-year-old university student. I was one of the lucky ones. I have a strong family history of bipolar disorder. So when I first became manic, my mother, a registered nurse, was quick to diagnose it.

At a time when mental illness was shrouded in shame and secrecy, Mum treated bipolar disorder like any other illness. When I was admitted to a psychiatric unit at a Melbourne hospital, Mum sent me a ‘Get Well Soon Card’. Months later, unbeknownst to anyone, she completed an application for me to study nursing, even signing the application on my behalf. This demonstrated Mum’s determination to support my recovery in any way possible.

Mum helped me to accept that I had a life-long illness that could be treated, but not cured. Like others who suffer chronic illnesses, my challenge has been to control the symptoms so that they do not interfere with my life. With insight, education, experience and time, I learned to manage bipolar disorder, just as a person with diabetes must learn to manage her sugar levels. I learned to stay well.

Not surprisingly, the things that help to keep me well are the same things that help all people to stay well. I benefit from eating healthy foods (and avoiding too much junk), exercising, drinking less alcohol/caffeine, spending time with loved ones, avoiding negativity, having quiet times, managing stress, laughing and so on. We all do. However, with bipolar disorder, I also need to make specific changes to my lifestyle to stay well. With kindness and support of colleagues and close friends and family, I developed a ‘Stay-Well Plan’.

Although my Stay-Well Plan includes medication, equally important are my work, friends, local community, laughter, dog walking, sunshine, tennis, sailing, dancing and sleep. I do not take these everyday things for granted — they have made an enormous difference to my ability to live well with bipolar disorder.

My Stay-Well Plan has been modified over the years, as my personal and employment circumstances have changed. Two things, however, have not changed. The first is taking medication – my Stay-Well Plan has always, and will always, include a daily mood stabiliser. This is not negotiable. The second thing is the importance of my Stay-Well Committee – friends who provide ‘outside insight’. 

My Stay-Well Committee is my safety net. It currently has three members. When members tell me I am not OK, I trust them and intervene immediately. If I am speeding up, I minimise external stimulation (no internet, social media, TV or radio), take long quiet walks, eat healthy foods, read novels and, most importantly, have long sleeps. If I am becoming depressed, I exercise, stop drinking alcohol and socialise with friends.

I’ve also had to develop strategies to manage my work life, including workplace stress. When I am feeling a bit high, I can write a 10,000-word essay in one day. I am currently working as a writer/researcher, so that can be extremely helpful. However, I need to have some rules in my Stay-Well Plan to prevent transitioning from being a “bit high” to full-blown mania. For example: I never start work before 6:00 am and I always finish work before 6:00 pm. This is a golden rule.

Stay-well strategies work best when there is a sensitive and aware work environment. When I worked in ICU, I discovered night duty was a trigger. However, there was a policy that all full-time and part-time staff must do their share of night duty. The unit manager did not make an exception for me with bipolar disorder, so I worked as a casual.

After an episode of illness, an understanding and supportive workplace can assist a person in their transition back to daily life. Unfortunately, I did not have this at university when I was doing my PhD. My academic supervisor and Dean’s negative attitudes towards mental illness forced me to use the Disability Discrimination Act to defend my rights as a student. Mediation at the Human Rights and Equal Opportunity Commission resulted in a public apology, financial compensation and an undertaking by the University to educate staff about mental illness and develop policies to support students.

Negative attitudes are also surprisingly common among health care professionals. In fact, research in 2002 showed some health professionals believed those of us with a mental illness should not be allowed to practice medicine, nursing and social work. They believed we would disrupt health care services, no matter how well our illness was managed. With such attitudes, it is not surprising that I chose to keep my illness a secret when I worked as a nurse in 1980s and 1990s. I hope things are better nowadays.

People must use their own judgment when deciding whether to disclose their mental illness to work colleagues. When I worked as an ICU nurse, I did not disclose, mainly because my colleagues spoke about patients with a mental illness in a derogatory way. Back then, I didn’t have the courage to say: “I too have a mental illness”.

My colleagues only saw patients with a mental illness when they were acutely unwell. To change attitudes, health professionals need to know that people with a mental illness can get well, especially when diagnosed early and treated appropriately.

Since my Human Rights and Equal Opportunity Commission case in 1998, I choose to speak publicly about my illness, hoping stories like mine provide proof that people with bipolar disorder can aspire to full, happy and productive lives. Supportive and educated friends, family and workplaces who are willing to commit to the ‘Stay-Well Plan’ can help.   

If you or a loved one are dealing with mental illness and you’d like support, get in touch: call Nurse & Midwife Support on 1800 667 877 or get in touch by email. Sarah has also written about her tips for living with mental illness. Check out Staying Well: Strategies for Living and Working Well with Mental Illness.