![\"Rachel](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/05\/98542491-14728705-Rachel_Luby_a_37_year_old_mental_health_nurse_from_Pitsea_in_Ess-a-2_1747684612638.jpeg\")
<\/p>\nFor Rachel Luby, a 37-year-old mental health nurse from Pitsea in Essex, every day is a balancing act.<\/p>\n
Her bipolar disorder makes life a rollercoaster of barely predictable high, or \u2018hypomanic\u2019, episodes when she\u2019ll feel on top of the world and capable of anything for a few weeks. These are chased by devastating \u2018depressive\u2019 episodes during which she does not have the energy or impetus even to get out of bed.<\/p>\n
In her 20s, Rachel was initially misdiagnosed with borderline personality disorder (BPD) \u2013 the mood changes that people with BPD typically experience are intense and short-lived (several times a day), whereas the mood changes in bipolar typically last days or often weeks in between periods of stability.<\/p>\n
\u2018I felt the description didn\u2019t match my symptoms,\u2019 says Rachel.<\/p>\n
But as a result of her BPD diagnosis, she missed out on the right treatment, and it was only after a gruelling 20-year personal battle \u2013 including five hospital admissions and a suicide attempt \u2013 that she received the correct diagnosis, three years ago.<\/p>\n
Ironically, at the time Rachel was working in a suicide prevention team. She became so absorbed in the work, she stopped sleeping. \u2018I was working from 9am until five the next morning \u2013 to a very high standard,\u2019 she says.<\/p>\n
\u2018Everyone in the team thought I was doing a brilliant job \u2013 and I was, but I couldn\u2019t stop driving myself. I wanted to do better and better. Over several months, I drove myself into a breakdown.\u2019<\/p>\n
Unable to rest or find a way of calming her frenzied mind, Rachel meticulously planned her own suicide, including writing a directive asking medics not to resuscitate her and even drawing up the order of service for her funeral. Then she made an attempt to take her own life.<\/p>\n
<\/p>\n
Rachel Luby, a 37-year-old mental health nurse from Pitsea in Essex,\u00a0was initially misdiagnosed with borderline personality disorder<\/p>\n
![\"While](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/05\/98542483-14728705-While_in_hospital_she_spent_all_her_time_and_thousands_of_pounds-a-3_1747684612638.jpeg\")
<\/p>\n
While in hospital she spent all her time \u2013 and thousands of pounds \u2013 shopping online<\/p>\n
\u2018I was so afraid, I called an ambulance, which reached me just in time,\u2019 she says. Rachel was in intensive care for 11 days, which was followed by three months on a psychiatric ward.<\/p>\n
\u2018I was so manic I went for 20 days sleeping less than half an hour a night,\u2019 recalls Rachel.<\/p>\n
No medication seemed to help. While in hospital she spent all her time \u2013 and thousands of pounds \u2013 shopping online.<\/p>\n
\u2018Every day there\u2019d be so many parcels for me, they\u2019d have to bring a trolley,\u2019 she says. \u2018I\u2019d buy all the staff and patients presents, and loads of clothes \u2013 all of them outrageous. I was running around the ward in ballgowns.<\/p>\n
\u2018Taking into account my previous depressive episodes, the psychiatrist finally put it all together.’<\/p>\n
He said: \u201cI\u2019ve got something big to share with you… We\u2019ve reviewed your diagnosis from BPD to bipolar.\u201d \u2019<\/p>\n
\u2018It was a relief to hear him say it \u2013 but I\u2019d known since I was 18. Bipolar fitted, but my opinion had been silenced by the diagnosis of BPD.\u2019 Unfortunately, Rachel\u2019s experience is not uncommon. It\u2019s estimated that more than one million people in the UK suffer from bipolar \u2013 and, on average, they are misdiagnosed 3.5 times; and, after first telling a healthcare professional about their symptoms, they have to wait 9.5 years to get a diagnosis, reports the charity Bipolar UK. This can lead to a dangerous gap in care.<\/p>\n
\u2018Someone living with untreated bipolar is likely to experience ongoing symptoms which may get worse over time,\u2019 says Guy Goodwin, an emeritus professor of psychiatry at the University of Oxford.<\/p>\n
\u2018They are at much higher risk of making impulsive decisions with life-changing consequences, such as spending their family\u2019s savings, leaving a job or having an affair.\u2019<\/p>\n
Left untreated, the symptoms of mania \u2018can escalate into psychosis, with hallucinations or delusions, where hospitalisation and detention under the Mental Health Act is usually necessary\u2019, says Professor Goodwin.<\/p>\n
People with bipolar are 20 times more likely to die by suicide than the population as a whole.<\/p>\n
This risk is higher in those who are living with untreated bipolar, he adds.<\/p>\n
While symptoms can appear at any age \u2013 the condition affects men and women equally \u2013 research has found that almost 50 per cent experience their first episodes before the age of 21.<\/p>\n
There are two main types of bipolar. In bipolar I, manic and depressive episodes are more severe (for instance, longer), but less frequent.<\/p>\n
Those with bipolar II \u2013 which make up 40 per cent of cases, including Rachel\u2019s \u2013 experience less severe manic episodes but more intense episodes of depression and more frequent switches between the two.<\/p>\n
During a manic episode, people typically feel elated, confident and full of energy, with recklessness including extreme overspending or risky sexual activity common.<\/p>\n
During a depressive episode they\u2019ll feel sad and hopeless, prone to thoughts of self-harm and suicide.<\/p>\n
But some people with bipolar disorder experience periods of mania only, says Dr Thomas Richardson, an associate professor of clinical psychology at the University of Southampton, who himself has bipolar disorder.<\/p>\n
Stress and poor sleep can be triggers and the condition tends to run in families \u2013 research suggests the cause is up to 80 per cent genetic.<\/p>\n
Rachel can now laugh as she talks about her periods of mania \u2013 the relentless spending, grandiose thoughts and crazy schemes.<\/p>\n
\u2018During one manic episode, I thought it would be a great idea to apply diamant\u00e9 sticker dots to all the walls in my house. A few weeks later, I thought: \u201cOh my God, what have I done?\u201d But at the time, it seemed the best idea I\u2019d ever had.\u2019<\/p>\n
But the truth is, she says, living with undiagnosed and untreated bipolar is unutterably bleak.<\/p>\n
\u2018The highs at that time could last three or four weeks. The lows would last months,\u2019 she says.<\/p>\n
\u2018I\u2019d spend 23 out of 24 hours in bed, crying, not being able to read or study or even watch TV. I was just existing. There was no pleasure in anything. The only thing that helped was thinking about how I could end my life.\u2019<\/p>\n
With no \u2018test\u2019 for bipolar disorder, a diagnosis is based on both current and past symptoms, explains Professor Goodwin.<\/p>\n
![\"People](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/05\/98542461-0-image-a-32_1747681156193.jpg\")
<\/p>\n
People with bipolar are 20 times more likely to die by suicide than the population as a whole<\/p>\n
\u2018It can be challenging for busy GPs to pick up on warning signs in a short appointment,\u2019 he says.<\/p>\n
\u2018And even if a GP asks the right questions, a patient\u2019s answers rely on them having some insight into symptoms. Lots of people don\u2019t realise the periods of hypomania [a less severe stage before mania] can be a sign of bipolar.\u2019<\/p>\n
Instead, they may think they are just being incredibly creative or productive.<\/p>\n
The chef Heston Blumenthal, an ambassador for Bipolar UK, who was diagnosed in 2023, has described periods of mania when he felt like a \u2018superhero, when my imagination would go ballistic\u2019, followed by deep depression.<\/p>\n
\u2018For 50 years, I thought this was normal,\u2019 said Blumenthal (who appears in a BBC documentary about his experiences to be broadcast next month).<\/p>\n
Professor Goodwin says that a survey for the Bipolar Commission found that before getting a diagnosis of bipolar, 61 per cent of patients had first been diagnosed with depression and 21 per cent with anxiety. Other misdiagnoses include BPD or an eating disorder.<\/p>\n
\u2018Even if a GP suspects someone has bipolar disorder, it can be difficult to get a referral to a psychiatrist,\u2019 adds Professor Goodwin.<\/p>\n
\u2018Without a diagnosis, people can\u2019t get appropriate care. There are swathes of people with bipolar who could be functioning well, but who are unable to access effective treatments.\u2019<\/p>\n
This comes at a huge cost to them personally \u2013 but the failure to diagnose and treat people with bipolar is also costing the UK billions of pounds a year, according to data reported by the BBC last month.<\/p>\n
One of four children growing up in Barking in east London, Rachel was a happy, sporty child \u2013 but she can remember having \u2018quite dark thoughts\u2019 where she questioned the point of living, from the age of seven.<\/p>\n
\u2018By 15, I was withdrawn, crying all the time, just finding the world not a happy place,\u2019 she says.<\/p>\n
By the time she went to university, initially to train to be a teacher, she was in the grip of an eating disorder and had to drop out after her first year.<\/p>\n
\u2018I was depressed, hardly eating anything, crying all the time, no energy \u2013 I\u2019d be in bed for weeks,\u2019 she says.<\/p>\n
Looking back she can see this was the first of many depressive episodes which would dominate her life, yet she saw a psychiatrist only twice \u2013 once when she was 24 and again at 27 \u2013 when she was referred to the community mental assessment team by her GP.<\/p>\n
\u2018By this stage, I was self-harming, cutting and burning myself,\u2019 she says.<\/p>\n
\u2018A psychiatrist diagnosed BPD and discharged me back to my GP with a prescription for lamotrigine, a mood-stabilising drug which made the highs a little less high and the lows a little less low, but I was still struggling.\u2019<\/p>\n
Her 20s were lost to rocketing mood swings. During a manic episode she is unable to sleep for days, her mind racing with endless possibilities. \u2018It feels like being on a carousel at a disco,\u2019 she says. \u2018It\u2019s so fun and so fast, I don\u2019t want the feeling to stop.\u2019<\/p>\n
When Dr Richardson \u2013 who was diagnosed at 21, experienced his first manic episode when he was 18, he describes feeling \u2018elated \u2013 with lots of energy: I went from saving a few hundred pounds to buy some music equipment to planning an international business with linked bars and restaurants. I planned to help the homeless and give my dad, who\u2019d been made redundant, a job.<\/p>\n
![\"Some](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/05\/98542487-0-image-a-30_1747681108413.jpg\")
<\/p>\n
Some people with bipolar disorder experience periods of mania only, says Dr Thomas Richardson, an associate professor of clinical psychology at the University of Southampton<\/p>\n
\u2018After I\u2019d been awake for three days and nights, my parents called the out-of-hours GP and I was admitted to hospital. But even then, I felt irritated that no one else understood what a great idea it was.\u2019<\/p>\n
Just as quickly, a patient\u2019s mood can plummet \u2013 Rachel says it makes even simple tasks such as running \u2018feel like a marathon\u2019.<\/p>\n
\u2018Very quickly, within hours sometimes, there is nothing of any pleasure left, food doesn\u2019t taste the same, I can\u2019t listen to music,\u2019 she says. \u2018I\u2019m numb. Just sleeping and breathing.\u2019<\/p>\n
When the mood lifts, \u2018it\u2019s instant \u2013 the skies have cleared, I can smell and taste again \u2013 and I\u2019ll realise the world is actually a wonderful place\u2019.<\/p>\n
Now, thanks to the correct medication, Rachel has fewer highs and lows and they\u2019re shorter in duration. She takes a combination of drugs: lamotrigine, lithium (a mood stabiliser), sertraline (an antidepressant) and nitrazepam (a sedative) to help her sleep.<\/p>\n
She is also in daily phone contact with an NHS care coordinator who can quickly arrange a prescription for a sedative when she\u2019s tipping into hypomania, or check up on her when she\u2019s depressed \u2013 for her treatment hasn\u2019t completely eradicated her mood swings.<\/p>\n
In the fortnight before she spoke to Good Health, she\u2019d cleaned the house top to bottom every day, booked a \u00a32,500 holiday to Sri Lanka, and bought a telescope, five pairs of the same jeans, a flower-pressing kit and a home gym. \u2018It all made sense at the time,\u2019 she shrugs.<\/p>\n
There are financial repercussions. She estimates she\u2019s spent \u00a315,000 over two years on random items. \u2018I\u2019ve bought furniture, designer handbags and shoes \u2013 Louboutins! I never go anywhere.\u2019<\/p>\n
Both hypomania and mania can have \u2018a significant impact on someone\u2019s life\u2019, says Simon Kitchen, the CEO of Bipolar UK.<\/p>\n
\u2018Impulsivity is common, leading to risk-taking behaviour, which could include drug and alcohol misuse, overspending and hypersexual behaviour.<\/p>\n
\u2018A full manic episode can feel like a train racing down a hill \u2013 starting with extremely high energy where someone takes on multiple projects, spiralling into chaos.\u2019<\/p>\n
![\"\u2018Every](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/05\/98542469-14728705-_Every_day_there_d_be_so_many_parcels_for_me_they_d_have_to_brin-a-4_1747684612638.jpeg\")
<\/p>\n
\u2018Every day there\u2019d be so many parcels for me, they\u2019d have to bring a trolley,\u2019 Rachel says. \u2018I\u2019d buy all the staff and patients presents, and loads of clothes’<\/p>\n
Over 60 per cent of respondents to the Bipolar Commission report had lost a job due to their bipolar and 15 per cent their home.<\/p>\n
Rachel feels that with earlier recognition and treatment of her condition, she would have avoided months-long stays in hospital and the complete upending of her personal life.<\/p>\n
\u2018The impact has been very great,\u2019 she says. \u2018I\u2019ve only ever had one serious relationship. I don\u2019t imagine I\u2019ll have another \u2013 and I have very few friends outside my work.\u2019<\/p>\n
Yet despite all this, Rachel has managed to build a nursing career and holds down a senior job as a mental health nurse.<\/p>\n
\u2018I think everyone at work has always known there\u2019s something not quite right with Rachel, and they\u2019ve looked after me,\u2019 she says.<\/p>\n
Part of Dr Richardson\u2019s work as a psychologist is helping people understand when they\u2019re becoming unwell. \u2018Common early warning signs are sleeping less, socialising more, working longer hours, being impulsive,\u2019 he explains.<\/p>\n
\u2018The problem is the line where normal behaviour becomes mania is blurry \u2013 what is me and what is bipolar disorder is quite nuanced.<\/p>\n
\u2018In one study, it was found that a quarter of people with bipolar said they wouldn\u2019t want to be without it, while less than half wanted drugs to control their mood completely \u2013 because they felt they had enhanced abilities.<\/p>\n
\u2018Even as a clinician, there\u2019s a part of me that thinks I\u2019ll be more productive if I\u2019m just a bit high… It\u2019s something I discuss constantly with patients.<\/p>\n
\u2018It\u2019s a risky game, because if you go with the mania, you are almost certainly going to go too far very quickly. It feels fun at first, but you\u2019re going to lose control and go faster and faster until you crash and get hurt.\u2019<\/p>\n
\u2018But I want people to know that it isn\u2019t all out of your control,\u2019 he adds.<\/p>\n
To this end, Dr Richardson, together with his manager at work and his wife and parents, have a \u2018relapse prevention plan\u2019 for him. This involves \u2018working regular hours, taking a lunch break, making sure I exercise and get enough sleep\u2019.<\/p>\n
And his advice for when the lows come: \u2018You want to shut yourself away, but the key is to fight that urge: you need to go out, see people and try to stick to your normal exercise routine\u2019.<\/p>\n
And with the highs \u2018it\u2019s important to recognise that it\u2019s OK to have a big idea, but a useful rule of thumb is: can it wait? If it\u2019s so urgent and impulse-driven you can\u2019t sleep on it, then it\u2019s probably not a good idea.\u2019<\/p>\n
Rachel now works in a mental health call centre, where colleagues recognise she is good at her job \u2013 triaging people in the midst of crisis \u2013 because of her own experiences.<\/p>\n
Very often she will spot someone else with undiagnosed bipolar.<\/p>\n
\u2018They commonly have a diagnosis of depression or BPD, but if they\u2019ve just spent \u00a310,000 gambling and are now sinking into a deep depression, I\u2019ll be pretty sure that bipolar has been missed,\u2019 she says.<\/p>\n
She is able to marshal support for them, calling their GP to prescribe mood stabilisers and the home treatment team, or even organise a hospital admission.<\/p>\n
\u2018It\u2019s incredibly rewarding to be able to help.\u2019<\/p>\n","protected":false},"excerpt":{"rendered":"For Rachel Luby, a 37-year-old mental health nurse from Pitsea in Essex, every day is a balancing act.…\n","protected":false},"author":2,"featured_media":116220,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[192,92,105,16,15],"class_list":{"0":"post-116219","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-bbc","9":"tag-dailymail","10":"tag-health","11":"tag-uk","12":"tag-united-kingdom"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/114538445964465211","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/116219","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=116219"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/116219\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/116220"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=116219"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=116219"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=116219"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}