Kay (name changed to preserve anonymity) shares her story of living in recovery from substance use and poor mental health.

My recovery from Bipolar began a year ago at the grand age of 51. As an adult, I’d experienced a lifetime of anxiety and depression. During my 20s, friends suggested I might have a personality disorder, which I ignored. In my 40s, it was suggested to me that I might have bipolar disorder. Having a serious mental illness scared me, so I rejected that and insisted that my problem was alcohol.

It was in 2015 that I decided to attend Alcoholics Anonymous. By that time my mother had cut all contact with me and I rarely saw my daughter. I had also been unemployed since 2008 and had no friends. The closest thing to friends I had were alcoholic boyfriends who just made my life more miserable. My neighbours thought I was “weird” or “a nutcase”.

I lasted three weeks in AA, as I couldn’t maintain sobriety after that time. Every time I tried to stop drinking, I seemed to go “a bit mad”. I had no idea that what I was experiencing was mania.

My life continued to go downhill and at age 49 I experienced my first ever police arrest. Some people with bipolar end up in hospitals and some in the criminal justice system. (On one occasion I had been taken to a psychiatric hospital by ambulance for suicidality; all the doctors were out and so there was no one available to assess me, so I went home with a friend). I insisted with police officers and sheriff courts that I had anxiety but as far as they’re concerned that’s not a justifiable reason for offending. My crimes weren’t serious. My mania had caused me to come across as “strange” and some people felt scared. Although I wasn’t worried about prison, being in the criminal justice system was, for me, the most stressful and traumatic experience of my life. I had experience of being physically abused as both a child and an adult, but no one had ever placed me in solitary confinement. I found that extremely harrowing and completely understand why many people with bipolar disorder who are imprisoned try to commit suicide. Solitary confinement is probably the worst thing to do to someone with bipolar disorder. But since I didn’t know I had it, neither did the police or courts.

Had I been diagnosed earlier, my life would have taken a different, more successful turn. Unfortunately, the late diagnosis in my 50s had taken everything from me, except my life.

It was my failure to do community service that led me to psychiatry. I knew the Sheriff wouldn’t accept “can’t get up in the mornings” as an excuse (this is hypersomnia which, like insomnia, is common with bipolar). And when I did attend community service, I started my mornings normally, but by the time I finished I felt high. The high made me want to drink which I didn’t want to do as I’d recently managed to stay sober for three months (albeit while manic and arrested for it). I didn’t want a fine or any further Orders, so being in the criminal justice system was the thing that coerced me into psychiatry. I now understand that denial and resistance are common with bipolar disorder, and mine was really strong as I’ve always been very strong-willed. To me, an admission that I might have a serious mental illness would make me come over as “weak”. I now understand that the opposite is the case and that strength is about asking for help, accepting the diagnosis and beginning the recovery journey.

During my year in psychiatry, I’ve tried five different types of medication. They all worked as mood-stabilisers but each had a different set of side-effects. I’ve settled on a combination of a mood-stabiliser with an SGA (Second Generation Antipsychotic) for sleep. I’m three stone heavier than I was before I started medication, but I prefer being “fat and happy” to “slender and suicidal”!

As soon as I began my first medication I noticed that I had less cravings for alcohol. Over the first six months, I drank less and less and in the following six months I didn’t drink at all. Then, out of nowhere, I found myself in a bar getting drunk. I realised that while I’d overcome my drinking-alone problem, I’m still not ready to enter a pub alone and just ask for a Coke. I can do that with friends who aren’t drinking, but not on my own yet.

It’s estimated that 50% of people with bipolar disorder also have a substance-abuse problem. Sometimes it’s difficult to work out whether the problem is bipolar or the substance-abuse, because drinking exacerbates and masks the disorder, and the disorder exacerbates the drinking (vicious cycle). This is why so many people with undiagnosed and untreated bipolar disorder find it hard to stop drinking just by attending addiction groups. The fact that I stopped drinking with ease after I started taking medication showed clearly to me that my underlying problem is Bipolar. That made me accept my diagnosis quicker than some people take to get to acceptance – because of the immediately life-enhancing effects of the medications. I had wanted for years to stop drinking alone and it’d been so hard; and now, it was actually quite easy! So I was grateful for the diagnosis and medications that put to bed the strong denial and resistance that’s characteristic of both substance-abuse and Bipolar.

I went into psychiatry homeless, broke, with no friends or family support, with addiction issues and in the criminal justice system. I now have a housing association flat, a decent income and friends who I met in the Lothian Bipolar Group. I have no fear of being arrested again, because even if I did become manic, my diagnosis would result in hospitalisation, rather than the torture of the criminal justice system (which persists for years from the time of arrest to leaving the community service, because the court process takes so long).

I feel rehabilitated by medication which also helps me to not beat myself up over the mistakes I’ve made in the past and the loss that I’ve endured. I wouldn’t consider having a “medication holiday” because I like who I am now. I am also confident that I won’t commit suicide because I wake up every morning feeling refreshed, rather than depressed. And I remain vigilant that, with Bipolar, everything can change in just one day.

Being in the Lothian Bipolar Group has helped me to learn about the condition and self-management strategies. We encourage each other to maintain self-care. Where my previous relationships were toxic, I now have supportive friends, some of whom don’t drink, and that’s very hard to find outside AA circles.

Although others may not be able or willing to forgive me for not being what they’d hoped I’d be, I’ve forgiven myself. I’ve achieved a lot in my life, mostly academically, but lost the most important thing in life – the love and support of a family. So I consider my Lothian Bipolar support group to be the first group of people that I consider to be “family” and am now ready to join other groups that may or may not be mental-health related.

Even though my recovery didn’t start until my 50s, I am grateful for this new lease of life that many addicts don’t experience, owing to the way in which substance-abuse can mask underlying mental health issues. I am grateful that I didn’t have to go to prison before I got to psychiatry. I am grateful for a beautiful flat with a beautiful view over Edinburgh (yes, I can live seven stories up and not be afraid of throwing myself out of the window). And I am grateful that I have turned my strong resistance into strong recovery.

I hope that my experience will assist anyone with a substance-abuse disorder to consider seeking a psychiatric assessment. It was not as scary as I thought it’d be and, in fact, I really enjoy visiting my psychiatrist now. I know that some GPs refuse to refer people to psychiatry until they’ve stopped using substances. This displays a lack of mental-health awareness on the part of some GPs, and if you find that to be the case, try self-referral or another GP.

My recovery journey over this past year has been one of the best years of my life. Thank you criminal justice system for giving me the push I needed; thank you NHS for psychiatry; and thank you Lothian Bipolar Group for being super friends.