Work, Life and Mental Illness with Sarah Russell

Mark Aitken
Sarah Russell lives with bipolar disorder — a common, but often misunderstood, mental illness. In this podcast, Sarah discusses the importance of health promotion, early intervention and staying well with a stay-well plan.
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Episode: 12
Guest Speaker: Sarah Russell
Duration: 37:45
Tags: Mental Illness
SoundCloud: Work, Life and Mental Illness with Sarah Russell

Introduction
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Sarah Russell lives with bipolar disorder — a common, but often misunderstood, mental illness. Sarah was diagnosed at 18 but trained and worked as a nurse while managing her mental illness, with periods when she was unable to work due to difficulties associated with her illness. I have known Sarah for many years. From time to time, we worked together. Sarah is an incredible advocate for the ability of people with mental illness to live full, happy and productive lives. She has written a book, A Lifelong Journey: Staying Well with Manic Depression/Bipolar Disorder

inside journey by sarah russellSarah often discusses the importance of health promotion, early intervention and staying well with a stay-well plan. 

Sarah is my friend, and I am part of her stay well committee. I asked Sarah to be my podcast guest and share her story about living and working well with a mental illness. As Sarah is passionate about supporting people with mental illness she readily agreed — her story is inspirational. 

Sarah has also written a pair of blogs for us: The Stay-Well Plan: My Life with Mental Illness and Staying Well: Strategies for Living and Working Well with Mental Illness

We decided to launch this podcast on R U OK Day 2019 to raise awareness of mental illness and the importance of mental health. R U OK is a suicide prevention charity that believes that a conversation could change your life, and so do we. 

If you need to talk, Nurse & Midwife Support is available 24/7. We are anonymous, confidential and free — no matter where you are in Australia.

If you have a story to share about living with a mental illness I would love to hear it — please email me at mark@nmsupport.org.au.

Your mental health matters!

Mark Aitken RN
Stakeholder Engagement Manager 

About Sarah Russell
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sarah russellDr Sarah Russell commenced her training as a Registered Nurse at the Royal Melbourne Hospital in 1982, soon after being diagnosed with manic depression (now called bipolar disorder). In 1987, she completed her critical care training at St Vincent’s hospital. She worked as an ICU nurse at the Royal Melbourne hospital while completing a Bachelor of Arts degree and PhD at University of Melbourne.

Sarah now works as a public health researcher and aged care advocate. She has been the Principal Researcher at Research Matters since 1999. Sarah is an innovative researcher who creatively engages people in qualitative research projects. Her areas of expertise are public health, mental health and aged care. She has considerable experience in community engagement and participation processes, and has a unique ability of bringing individual voices together to tell a powerful collective story.

Sarah has undertaken research with people who have a mental illness. Sarah’s book “A lifelong journey: staying well with bipolar disorder” filled an important gap in our understanding of mental illness. Personal stories in her book provided evidence that people with a mental illness can aspire to full, happy and productive lives. Last year she celebrated 40 years of living with bipolar disorder with a speech on World Bipolar day Deakin Edge in Melbourne, revealing – through her own personal journey and pioneering research – how people with mental illness can stay well. It’s a story not just about care and friendship, but about the impact of stigma, discrimination, and systemic failures.

Sarah has lived in Northcote since 1983. Her opinions about social, political and local issues are frequently shared in her letters and opinion pieces for newspapers. She believes democracy requires the robust and respectful contest of ideas.

Transcript
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Please note: In this podcast, we discuss Sarah’s experiences and the distinction between mental health and mental illness. It’s likely that everybody has experienced a mental health concern at some point in their lives. Ups and downs can be a normal part of being human.

When they are more extreme and cause significant disruption or distress, they may be a symptom of a mental illness that requires ongoing management. Some people may also consider themselves neurodiverse, but not mentally ill. Wherever you fit on the mental health spectrum, your mental health matters and there are steps you can take to protect it.

Nurse and Midwife Support podcast: Mental Health

Mark Aitken: Hello! And welcome to the Nurse and Midwife Support podcast, your health matters! I’m Mark Aitken, your podcast host for today. I’m the stakeholder engagement manager with Nurse and Midwife Support and I’m a registered nurse. Nurse and Midwife Support is the national support service for nurses, midwives and students. The service is anonymous, confidential and free. You can call us anytime about any issue you need support in relation to: 1800 667 877. Or contact us via the website at nmsupport.org.au

My guest today is Dr Sarah Russell. Sarah is going to talk about a book that she wrote; A Lifelong Journey: Staying Well with Manic Depression/Bipolar Disorder. Sarah has got a great story to tell, and it’s an important story about living well and working well with a mental illness. Hello, and welcome Sarah!

Sarah Russell: Hi Mark.

MA: Sarah, would you tell our listeners a bit about yourself and why you decided to write this book?

SR: I was an 18-year-old at university, and just really looking forward to being a doctor. I became unwell, after an intervarsity hockey trip. I think I had been becoming unwell over a period of about three weeks. Getting very enthusiastic, very energetic, it was terrific for the intervarsity hockey trip. I ran very fast and I partied very hard. But when I came home, my mother noticed that I was a little bit different. I think because of her own family history, she had had siblings with manic depression (it’s now called bipolar disorder); my mother noticed that I was fast. I think her antenna went up a little bit. One night, and I remember this night very well, I stayed up all night writing an essay. You can tell, if you look at my notes, I moved from being hypo-manic to becoming psychotically manic. My mother was incredibly quick to get me treated and diagnosed. Unfortunately, I did spend some time in hospital. I was mortified. I was absolutely mortified, to have a mental illness. Soon after, or maybe six months later, my mother organized for me to start training as a nurse. It was probably one of the best things that she could have done for me. I absolutely loved being a nurse. So, that’s how I got into nursing. It was a very roundabout way, but that’s what happened to me. I found myself as a student nurse at the Royal Melbourne Hospital in 1982.

MA: So, this all happened in the late 70’s, early 80’s era? When you had your first episode?

SR: Early 80’s, yes.

MA: Were there any signs before that?

SR: Probably looking back, in hindsight, yes. I won’t go into all of those details, but probably like many people, my signs of illness probably began when I was about 16. Manic depression and bipolar disorder are very easy illnesses to diagnose. If you have bipolar 1 (which I have) and you have a psychotic episode (which I had) and if you have a parent who is much attuned to the illness. I think that it’s because of my mother that I got diagnosed correctly. When you have a mental illness, some people don’t get diagnosed correctly for a very long time. I was one of the lucky ones. I was diagnosed correctly and treated properly from the very beginning.

MA: Your mother is also a nurse?

SR: She is. One of the things that I credit to my mother is that she treated this illness like it was any other illness. She didn’t make a fuss about it. This was an era when mental illness was shrouded in secrecy and shame. My mother was not ashamed, and she taught me to not be ashamed.

MA: I really connected with that in your book, actually. The importance of having the support of your mother, and her working with you to understand this illness and to manage it. Would you say that’s key?

SR: Absolutely. As I’m sure your listeners would know, no 18-year-old wants a lifelong illness that can’t be cured. It can be treated, but it can’t be cured. It’s a devastating diagnosis. With her support, I learnt to accept it. It took me some time, it didn’t happen overnight, me accepting having a mental illness.

MA: I can imagine.

SR: I had a doctor at the time who (and I think this was perhaps the thinking of the time) after a couple of years of having me on lithium (which worked very well for me) he took me off lithium. Very quickly, I became unwell again. I had a psychotic catatonic depression. Which, to be perfectly frank, I do not remember. But my friends and partner at the time certainly do remember. I just could not move. I was catatonic.

MA: Yes.

SR: I’m not sure if that was a mistake, to take me off lithium or not, but certainly without the lithium I became very unwell. It was very easy during my nursing training to just take time off. I became unwell at home, and I would just sit for three weeks. No one knew why, and that happened twice. He took me off lithium twice during that three-year training period. I think it was to test if I really had the illness or not, I’m not sure, but both times I was off lithium I became unwell very quickly. 

MA: That really speaks to the importance of what you see as a key component of staying well with mental illness is medication. We might talk about that a bit later, if that’s ok. You talk about your first episode of the illness and how it felt to be diagnosed with bipolar disorder. At that stage, you weren’t a nurse, so you didn’t have the knowledge that you would later have from your nursing. Can you talk a bit more about how that felt, as a young person?

SR: It was devastating, as you say. I didn’t have any information; I only had the support of a parent. Later, I can fast forward to where I am later as an ICU nurse and working in fact with you, Mark.

MA: Yes, we should disclose this to our listeners. As many of our listeners know, I have a lot of colleagues as podcast guests who I have worked with previously. I am very privileged to say that Sarah and I have been friends for over 25 years and worked together previously at the Royal Melbourne Hospital. 

SR: Yes, so Mark’s already aware of what happened to me. I was an ICU nurse for quite some time. Then I went back to university to do an Arts degree. I loved it. I then went on to do a masters and a PhD. During my PhD, I was partnered. We decided that we wanted to have a baby, and you can’t take lithium while pregnant.

I went to my doctor, who I didn’t see very often. In fact, I hardly saw him at all at that stage because I was managing this illness with medication quite well. I went off lithium, and he made a mistake. He should have asked to see me again; because if he saw me six weeks after I was off lithium he would have seen that I was hyper-manic. But he didn’t ask to see me again, so that was an issue that he later apologized for. At the time, I was hyper-manic and my relationship fell apart. 

Fast forward a little bit, I did have another psychotic episode. It was a devastating episode. The university did not handle it well, it’s all written in some of my blogs and my book, but the university did not handle it well and I had to take the university to the Equal Rights and Opportunity Commission. That’s not so important for this podcast, but what I did notice was that my nursing friends supported me very well. I was still working part time as a nurse. Mark, and others, they used humor and helped me to get through this devastating time when the university did not handle it well. That was the moment in my life, I was 34, an ICU nurse and I thought, “I am never getting sick again.” I went and I learnt so much about this illness, I developed what I called a “Stay Well Plan.” It has kept me well for 24, going on 25 years. I think that this insight I now have into the illness, and with the support of friends that I have like Mark, I have a “Stay Well Committee.” I think I can help other people to stay well, with the insight that I now have. 

MA: I think you’ve certainly done that Sarah, from what I can see as an advocate for people with mental illness. Also, choosing to tell your story about your journey with mental illness, was that difficult? To make that decision to tell your story?

SR: Well, it wasn’t difficult for me because the university supervisor told everybody in my department that I had bipolar disorder and it spread like wildfire throughout the university. So, I really had no choice on that. But once that happened, I decided to embrace it. Speak openly and positively about it, because I have learnt how to manage this illness. I publish about it, I write opinion pieces about it and I tell people. I speak very openly about it. That doesn’t mean that I advise everyone to do that. People need to make their own decisions, and hopefully they’re not in a situation where somebody else makes that decision for them, as was the case with me. But the decision to speak openly about your mental illness is a very individual thing.

MA: Yes.

SR: It’s like, do you want to talk about your endometriosis? Do you want to talk openly about your diabetes? People make their own decisions about whether they want to keep their medical history private or not.

MA: Was that a part of what led you to write the book?

SR: Writing the book was actually based on a research grant I got from Beyond Blue. They gave me a grant back in 2003 and I interviewed 100 people who stay well with this illness. The book is basically the story all of those people who stay well, I use their stories to show that there are many different ways to stay well with a mental illness. It’s not a one trick fixes all approach, it’s certainly not just about taking a tablet every day, although my mood stabilizer is a central part of me staying well. It’s certainly not the only part that keeps me well.

MA: Yes, it’s a part of your self-care plan for staying well with a mental illness.

SR: It’s an integral part. It’s a non-negotiable part. I think, people wouldn’t negotiate whether or not to take insulin for diabetes. If they have type one diabetes, they don’t decide whether or not they’ll use their insulin. If you don’t take insulin, and you have type one diabetes, you will die. If you have bipolar disorder, and you don’t take a mood stabilizer, you are putting yourself at risk of having episodes of bipolar disorder. So that, to me, is not negotiable. But, what I am trying to also say is that it is not the only thing that keeps me well. I would say that’s the same with diabetes, it’s more than taking insulin regularly. These long term chronic illnesses, whether they be physical or mental, require thought and decisions about staying well. You have to make lifestyle decisions as well as medical decisions.

MA: Yes, and Sarah you talk about bipolar as a mental illness. In the last few years, I think I’ve really noticed people starting to sanitize it a bit more and talking more about mental health. I wonder what your view is on that? Whether we try to sanitize mental illness to make it more palatable for people to try and understand and accept.

SR: I think that’s a really good question Mark. I personally think mental health is incredibly important for people. Mental health is around managing your stress, managing your relationships, managing all of the things in your life that can lead to your mental health being compromised. Mental illness is something that only 2% or 3% of the population has. These are in the DSM–5 (Diagnostic and Statistical Manual of Mental Disorders). I think one of the things that I’ve been really critical of is this push to say that one in five people have a mental illness, or a mental health disorder, I’m not quite sure what the language is…

MA: Yes, it changes.

SR: I’ve gone back and had a look at that study, that started that. It’s a complete myth. One in five people do not have a mental illness. But certainly, one in five people might have mental health issues around all of the things that I have just mentioned. I’ve certainly written about this as well. I think that using the word mental health has softened it. To be perfectly blunt, having an episode of mental illness is actually frightening for the people around you. It shouldn’t be sanitized, because it isn’t easy for people to watch their friend have an episode of schizophrenia, an episode of bipolar (whether that be manic or depressive). It is not easy to manage. I do not think we should be sanitizing that.

MA: I agree. You’ve said before that being supported by your colleagues who were nurses was really important to you. I think that’s what our service, Nurse & Midwife support, is all about. Supporting midwives, nurses and students who may need support for whatever issue that occurs in their life. Do you think it’s important that people in the first instance would reach out to a trusted friend or colleague to get support for an illness, or would you advise them to call Nurse & Midwife Support?

SR: This is, again, an individual choice. The most important thing, for me, in reaching out for support has been knowing that the person I reach out to will be non-judgmental.

MA: Yes.

SR: In my experience, many of my friends who are trained nurses have been incredibly non-judgmental about my mental illness. Maybe I just chose the right people in whom to confide, but that is the most important thing. I have noticed that when I tell people that I have bipolar, 99% take it so well. There have been people, who you instantly see will start to judge you for having that illness. It’s a really unpleasant thing to witness. If you can tell me that your service is going to accept people without judgement and are going to be supportive and give them ways to talk about their illness and concerns in their current situation, I would certainly advise them to call your service. 

MA: Thanks Sarah.

SR: But that doesn’t mean that they shouldn’t tell a colleague or a friend, because to do both sounds perfect to me. One of the things in that I established in my “Stay Well Committee,” back in 1995, was that some of the people on my committee are people that I see regularly. So that if there is a change in my behavior, and I’ve had some stressful things happen in the last 10 years. There have been shifts in my behavior, during those periods. It’s been wonderful to have someone to say, “Sarah, are you ok?” Because I’m not ok. That actually means that they think that I’m not ok. And that’s been fabulous. One of the things with mental illness is that when you’re getting sick, or having an episode, you lose insight very quickly.

MA: Yes.

SR: That may mean, if your illness has progressed a little bit, that you may not have the insight to call your service. But your friends may have noticed that your behavior has changed. My advice would be to have both. The service, where you can reach out to get advice and support. This is terribly important, because the thing that we can easily forget is how stressful nursing can be. It’s a stressful job. It may only be one shift where something happens that really upsets you; to have your service is wonderful. To be able to ring up and say, “Look, I have bipolar disorder,” or “I have clinical depression,” or “I have schizophrenia. I’m working well with it at the moment, but this thing has really bothered me and I need to talk to someone about this.” I think that your service is wonderful. 

MA: Before the person escalates into a place that is unsafe for them, or not optimal. Thanks Sarah. If anyone needs to call the service, a reminder that you can call us on 1800 667 877 or contact us via the website at nmsupport.org.au The service is anonymous, confidential and free. You can call us 27/4 from anywhere in Australia. Sarah, you’ve mentioned managing stress as a part of your “Stay Well Plan” and that nursing and or midwifery work can indeed be very stressful. We’re very interested in that, as a service. Many midwives and nurses call us and feel that they have ventured into unhealthy stress. I love your “Stay Well Plan,” that concept. I think every nurse and midwife should develop their own self-care care plan. We’re really good at developing care plans for our patients, so why wouldn’t we develop self-care plans for ourselves? Indeed, if we had an illness, like diabetes or like mental illness, why wouldn’t we develop a stay well plan? I think that’s fantastic Sarah. Can you talk a bit about, or provide some advice for nurses and midwives in regards to how to manage stress?

SR: Stress, again, is an individual thing. How you manage your stress is an individual thing. I know how I manage my stress, and we’ll talk briefly about that, but what I enjoy doing is different to what other people enjoy doing. I find when I am escalating, and I escalate when something stressful is happening in my life. I’m more likely to go high than low, but if I’m going high, the first thing I notice is that that thing is in my head all the time. And I can’t get it out of my head. So, the most important thing for me is to go somewhere where I can disengage from computers, telephone, television, radio, from any kind of stimuli. I go somewhere very quiet, and because I like to read novels and things I try to shift my thinking by absorbing myself into a good book. I go for walks. I try to eat very well; I’ve taken alcohol out of my diet completely. Perhaps the most important thing that a health professional would say is making sure that you sleep well. Sometimes I need to increase my medication to sleep well. Not my mood stabilizer, I have another medication that I take when I need to sleep and I’m not sleeping naturally. 

So, just as an example. If you, Mark, wake up at 3 o clock in the morning thinking about work, which many people do. You’re not going to get sick, because you don’t have a mental illness, whereas I might get sick. If I wake up at 3 o clock in the morning, because I’m stressed about something, I immediately reach for a tablet. When I was younger, I felt that that was a sign of weakness. Whereas now, I acknowledge that I’ve got an illness. It’s not a weakness, it’s not a personality disorder, it’s an illness that I need to manage. If I wake up at 3 o clock in the morning, I take something. If I’m getting depressed, for me, exercise is very important. More exercise than usual is very important. So, it might sound funny, because Mark knows me and I’m not very rule-bound. But I have a very rule-bound “Stay Well Plan.” I found that if I feel like shit, I can stay on the couch and eat chips and drink beer for two days. That’s how I respond to feeling shit. But on the third day, I am not allowed to sit on the couch and drink beer. I have to get on my bicycle for a ride, I have to ride to work and I have to ride home. That is just a rule. So, exercise is very important for me when I’m feeling low. There are other people who don’t enjoy reading novels or riding their bike. You have to find your own things that you enjoy, but the aim of managing stress is to somehow remove yourself from that stress. To somehow get it out of your head. People might find that having a massage might help, many people find that meditation helps. 

MA: Yes, I do.

SR: Or they find that walking their dog helps. There is a whole list of things. When we ran a “Stay Well Program,” we had a whole list of photos of different things that people may enjoy. People had to pick five of those. There are a whole range of things that people will enjoy, that helps them to keep themselves away from the stress.

MA: We talk about a self-care toolkit, and you choose from that toolkit what works for you. What works today may not work tomorrow, but there are other tools that you can use and you have listed some of those Sarah. The elements to staying well that I’ve identified with from your book and from your Stay Well Care Plan are:

  • Taking control
  • Understanding the illness
  • Lifestyle awareness
  • Insight
  • Interventions
  • Medication
  • Social support
  • Professional support

I think those are all key elements, are there any others that you would like to talk about? 

SR: Another thing is the importance of finding a good doctor. In many cases, that might be a psychiatrist. But there are good and there are bad psychiatrists. Or there are psychiatrists that you connect with better than others. My first psychiatrist was a shocker, there is no question about it now, looking back. My second psychiatrist is fantastic. I’ll give you one quick example: I found that jetlag makes me escalate. I’ve worked that out, but before I worked that out I came home from an overseas trip quite high. I recognized it and made an appointment to see him. He recognized it as well, as soon as he saw me. The first question he asked me was, “What do you think we should do?” So, it was a genuine partnership. I had just heard about this new drug, and I said maybe I should try that for a week, so I asked for his opinion and he said he thought that it was a perfect idea. He asked for me to email him first thing in the morning, after taking it. I have to say, after the first night taking it I was fine. But I took it for the week, as he suggested, and it was fine. But that question, “What should we do?” Showing a willingness to work in partnership with me, he knows that I’m very well educated about this illness. He knows that I’ve written a book. In fact, he’s one of my biggest fans in regards to the book. The doctor that you work with has to be someone that you like. I don’t see my psychiatrist now, very often, but I do know that he is at the other end of an email if I need him. I now work with my GP, get blood tests regularly and all of these sorts of things. I feel very confident that if I need to go back to my psychiatrist that I can go back in a heartbeat.

MA: And your psychiatrist is a key element in your “Stay Well Plan”?

SR: Having a medical person is a key element, yes. As I said, there were times earlier on when I needed to see him regularly. The thing about my “Stay Well Plan,” is that it’s dynamic. It changes as my life changes. I now work for myself. I don’t work in a toxic workplace, not saying that nursing is a toxic workplace, but I have worked in toxic workplaces and I don’t have that stress anymore. My “Stay Well Plan” has to be for my contemporary circumstances.

MA: So, you regularly review it, evaluate it, change it, add people in…

SR: And my “Stay Well Committee” has to change because I see different people depending on my work. For me, my “Stay Well Plan” has always had at least one work colleague on it. That work colleague was seeing me every day. Now that I work for myself, it’s a dog walker who I see every day. That’s one person on my “Stay Well Plan.”

MA: Thanks Sarah, your story about staying well and living well and working well with a mental illness is a positive story for you. What about the people who continue to have episodes of illness, despite following the advice of their doctors or despite their “Stay Well Plan”?

SR: This is not an uncommon story. Some mental illnesses can be almost intractable insofar as they can’t find a medication that works for them, or at the right dose. They do all of these things, yet they still have regular episodes. My advice is to keep trying. As we get older, we get wiser and we learn new things. You just have to keep trying; it is an illness that is difficult for some people to manage. Not just my illness, bipolar, schizophrenia is a very difficult illness to learn to manage. Clinical depression can be a very difficult illness to learn to manage. My advice is every episode of illness is an opportunity to learn more about your illness. It’s an opportunity to learn more about your triggers, what triggered your illness? What are the early warning signs of your illness?

Something I’d like to make a point about is that there are fact sheets about these illnesses. They write about early warning signs, but every fact sheet that I have seen, I would consider what they site as early warning signs as very late warning signs. I have early warning signs that happen long before those that are listed on the fact sheets. If people think deeply about what was happening prior to their illness, they may start to learn what those signs are. The earlier you intervene, the more likely you are to stop an episode of illness. So, again, just going back to your service. If you’re feeling slightly unwell, talk to NM Support and they may recommend taking a couple of days off work and going to do what you know will make you feel back in control. Taking two days off work is much more preferable to having an episode of these illnesses. In my experience, they take about 12 months to recover from. An episode, that is. 

MA: That really speaks to the issue that we hear from some nurses and midwives, that they would never disclose to their workplace that they have a mental illness. They fear the stigma; they fear that they wouldn’t be able to work. But, in fact, nurses and midwives can work with mental illness. As long as it’s managed and there’s awareness and insight. Do you think it’s beneficial for people to discuss it with their manager, so that their manager knows what’s going on for them and can be a support for them? Rather than fearing that they will be outed and stigmatized, as you were, because that situation becomes unsafe for them?

SR: Let’s be clear, I was unwell in 1995, when that horrible thing happened at the university. I think that as a community, we are much better educated, thanks to organizations like Beyond Blue and others that have helped to try and decrease the stigma. We also have much better anti-discrimination laws in place. It would now be against the law to discriminate against you on the basis of your mental illness. So, if your mental illness is managed, you are well. 

MA: And you can work.

SR: And you can work. These illnesses are episodic. You are not always unwell, with a mental illness. I am, here with you today Mark, it’s an unpleasant word but I’m normal. I always speak with this sort of passion. This is me. I’m normal. It would be against the law for a manager to discriminate against you on the basis of your mental illness, if you are well. I would advise you to talk to your manager, but there are good managers and there are bad managers. You know that, but a good manager is going to be understanding. I worked as a nurse during my PhD and I had a very good manager at the hospital. I only worked part time, she knew I had a mental illness and we worked with that. The problem for me during that time was that night duty was compulsory for everybody. She felt that she couldn’t make an exception for me, even though my exception was that I have bipolar disorder and I had recognized that night duty is a trigger. It’s not good for me to work night duty. She found a way around that, so that I could still work but didn’t have to do night duty. I did have to go casual, but that was the compromise. She didn’t want me to be treated differently to the other permanent staff. She thought that that would be unfair. That was her decision, and I accepted it as a compromise. 

So, to answer your question, I think that a good manager is going to be supportive and helpful. When you do need to take those two or three days off to get well, she’s going to be understanding of that. And it doesn’t happen very often, hopefully. For me, as I said, it’s been 25 years since I’ve had to do that. But I have taken days off. I call it stopping life; I have had to stop life a couple of times, just to get myself back to being well. I am hoping that with the new legislation changes and awareness that most managers would be good about that.

MA: I agree Sarah, and I think that they will be. If you’re listening to this and you’re struggling with this decision making around who to tell and ways to go about telling your manager, feel free to contact Nurse and Midwife Support to discuss this and anything else that you may wish to discuss in relation to this issue. Or any other issue that you need support for. Sarah, I cannot believe we’ve come to the end of this podcast. Time flies when you’re talking to a great guest such as yourself. Thank you very much for sharing your story, your wisdom and your knowledge. And your journey in relation to living and working well with a mental illness. Any final words of wisdom for our listeners?

SR: It’s been a pleasure to talk, and I wish everybody luck with managing a mental illness because if you manage it well you can have a full and productive and happy life. That’s the message I’ve been saying, for the past 25 years. We can have good lives, we can work well and we can be a valued member of our community.

MA: Thanks Sarah, and if any of our listeners would like to read your book, A Lifelong Journey, Staying Well with Manic Depression/Bipolar Disorder, we’ll put the link on our website Sarah?

SR: That’s great; we’ve talked about this before. They can order it through you, and I’ll forward the copy through. Can I make one more point? If they are suffering from clinical depression, or schizophrenia, this book is very helpful for other illnesses as well because it does talk about “Stay Well Strategies” and “Stay Well Plans.” Although, specifically, the examples in the book are related to bipolar disorder a friend of mine with a heart problem read this and said that it helped with her heart problem to make a “Stay Well Plan.” It’s taking a positive approach to having a lifelong illness.

MA: Indeed, and Sarah’s written two blogs which will be posted along with this podcast. So, stay connected to our website and you can access those and more information about living and working well with a mental illness. Thanks very much, and we’ll speak to you next time.

Thank you to Ausmed for making the editing of this podcast possible.