Intended for healthcare professionals

Practice Patient's journey

My bipolar expedition

BMJ 2006; 332 doi: (Published 05 January 2006) Cite this as: BMJ 2006;332:30
  1. Suzanne G Johnston, adviser (
  1. 1 The Cairn, Brincliffe, Dhuhill Drive West, Helensburgh G84 9AW
  • Accepted 30 September 2005

Suzy Johnston, a writer, adviser, and author, takes us on the journey that is her life with bipolar affective disorder

When I received my diagnosis of bipolar affective disorder (manic depression) I was relieved. Finally, and at the age of 22, someone had told me that I wasn't going mad, wasn't barking, and wasn't going loopy or any of the thousand other things that filtered into my overwrought mind at 2 00 am every night. No, I had an illness and, although I had a long and bumpy road ahead of me, at least now I had a hook on which I could hang my symptoms. That, to me, was progress.

Road: an open way for passage or travel, esp. one between distant points; a highway

I first stepped, blind, shoeless, and alone, on to the rough and winding road that is bipolar disorder 16 years ago when I was 16 and in my final year at school. I became hugely depressed and was horrified how destructive depression can be—not only does it leave the sufferer unable to feel any emotion other than intense misery, it also removes the ability to reflect the emotion of others—for example, sharing in someone's good news—and this can be desperately isolating (box 1). Bipolar disorder is characterised by episodes of mania (overly elevated mood) and depression, both of which can have horrific effects on the sufferer. When manic, people may behave entirely out of character and be extravagant in their behaviour—for example, spending huge amounts of money well beyond their means, driving erratically, becoming delusional, etc. When they are going through a depressive episode their mood can be extremely low, and they may have thoughts of harming or even killing themselves.

Many people experience only one episode of either mania or depression and then go on to lead perfectly healthy and, for want of a better word, normal lives. …

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