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Stephen Fry: The Secret Life Of The Manic Depressive -

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(generated from captions) in a new play in this theatre '11 years ago, I was starring

in the West End. After just three performances, I walked out. of the next morning, In the early hours in central London to this lane. I came down from my flat I went into my garage, with a duvet I brought sealed the door and got into my car.' I think, two hours in the car. I sat there for at least, My hands on the ignition key. It was a suicide attempt. Not a cry for help. and took a ferry to Europe.' 'I drove to the South Coast I just knew I couldn't be at home, I couldn't in London, in England. come back to England. I really believed that I would never broke his silence last night "Runaway Stephen Fry he's been suffering." to reveal the torture that I've committed suicide, They all are worried that's the awful thing. I secretly returned to England 'But after a week, to this hospital,

that I was bipolar. and to a doctor telling me I'd never heard the word before, at the age of 37, but for the first time, that explained the massive highs I had a diagnosis

I had lived with all my life.' and miserable lows extremes of mood There's no doubt that I do have than just about anybody else I know. that are greater recommended I take a long break. 'The psychiatrist in the hospital I came here, to America. And for months I saw a therapist and walked up and down this beach. My mind was full of questions. Am I now mad? How have I got this illness?

Can I be cured of it? Could it have been prevented? just how serious it is Since then, I've discovered to have bipolarity

as it's also called. or manic depression, have it. Four million others in the UK end up killing themselves.' And many of the seriously ill MACHINE WHIRRS about my mental illness, 'So I've decided to speak out and it is a mental illness. who have it I want to talk to others about what triggered it in them, and how it took over their lives. to what still worries me. And I want to find out answers Was I diagnosed correctly? And am I getting better or worse?'

SCANNER BEEPS made by a Hollywood producer to me - 'Let's start with a remark or Jewish to get on here, "You don't need to be gay just bipolar." furiously energetic, He meant of course larger than life, endlessly creative. Manic types do well in Hollywood, for that matter. in all of show business seem to go with the territory Euphoric highs and crippling lows found everywhere else. and don't attract the stigma I've kept working Since my own diagnosis, and found ways to cope.

about my condition. But I've also kept quiet to fight the stigma, Now I want to speak out, and to give a clearer picture most people know little about.' of a mental illness Carrie Fisher, I'm visiting my old friend in the Star Wars movies. known to the world as Princess Leia She's on the edge of sanity. She's constantly... to be committed, You know, not mad enough to lead much of a normal life. but not sane enough at a great speed, When you're galloping along that you could ever take. it is better than any drug is saving you parking spots. God, if you will, on the radio for you. Songs are being played about everyone. You're just so enthusiastic enthusiastic about you. And everyone must be I've got a great idea. And you're just, "Come along, Let's go to India!" I've got this unbelievable idea.

(LAUGHS) Exactly. Then you start going way too fast. Yeah. that you're around. And you're faster than anyone And that's not fun. You're on the phone far too long, you're not getting any sleep. for you. Nothing is going fast enough Come on! Come on, keep up with me, you guys. that you're more talented, And even if it's not true you feel like you are. when you're a manic, Yeah, which is the battle. I am standing on rocks, planning speeches to the world. You know, I have a lot to say! in fact. I have messages from deep space, And I stayed awake for six days, and I did lose my mind. This friend of mine says to me, that you behave this way?" "Does your doctor know (LAUGHS) "What do you mean?" Then we sort of have an argument, and I cry for...four hours. And I am unable to stop.

something wrong with that. And I know there's I call this doctor. When I go in and I see her, we're talking and I'm laughing, and I'm spinning around in chairs. And the doctor says... that's bipolar. That's the diagnosis, That's manic depression. with such extreme moods and feelings 'Carrie had years of living before she got that diagnosis.' She's got it bad, you know.

film star accessory. It's not a rock star, It's a real mental condition every single day of her life. that she has to live with She's on medication. what she'd be like if she weren't. And you have picture 'A medical expert told me suffering from manic depression almost half of those aren't diagnosed at all. having symptoms like Carrie, It frightens me to think of people

what's wrong with them.' and not knowing TRAIN CLATTERS that's surprisingly difficult 'I'm told it's an illness to achieve a diagnosis. to pin down Now I'm diagnosed bipolar, is a disease of the brain. and bipolarity reveal a sign of what I have. So a brain scan will surely The research being carried out here in South London at the Maudsley Hospital

with bipolar ones like mine.' compares normal brains of the brain. Oh, my goodness. So we're coming right to the front the front of the nose And so we're just grabbing (LAUGHS) and then we'll scroll back through. And your chubby cheeks. That's my face, virtually. My little chubby cheeks.

By looking at a sample of slices from a brain, you can't tell, or can you, whether someone is bipolar? When it comes to bipolar, looking at a single subject's structural scan would not give us diagnostic information at this stage. Is there anything you see in my brain

that leads you to the view that I am bipolar? No. I think it's the short answer, very short answer to that. 'So there is as yet no brain test that can diagnose bipolarity. But I've been hearing talk of a bipolar gene. To find out more, I've come to have my DNA tested as part of the world's largest study of bipolarity based here at Cardiff University. They have 2,000 subjects already. And now for 2,001.'

Do I get my wallypop now? Thank you. So this is your DNA. My DNA, thank you so much. Oh, it's so attractive. I knew it would be. (ALL LAUGH) It's beautiful, isn't it? So which way now? OK, so we'll go up to look at the synchronome. You know it must be good just from the name. It's fantastic. Welcome to the synchronome, Mr Bond. So what we have found is that if you'd simply compared people with bipolar disorder against people without, we don't actually see any overall difference. Unfortunately, the press, as you know, they'll publish reports saying, "The bipolar gene" or whatever.

And that's completely incorrect. There will be many genes that are involved in bipolarity. 'So at the moment, there is no clear-cut test to show if someone is bipolar. How then do you tell? How was I diagnosed all those years ago? Well, a psychiatrist simply asked a lot of questions about my behaviour and my feelings. At Cardiff, Nick uses the same process but involving 200 questions to carefully build up a picture of a person's life history of manic depression.' We've developed a scale, when I found out all that information for me, I'll tell you where you score on our scale.

Looking back, times when you think perhaps something a bit out of the ordinary or unusual caused a problem or you needed treatment. Well, I suppose the first time I needed treatment,

I think I was 14. CLASSICAL MUSIC PLAYS 'In hindsight, my symptoms really surfaced here. But the problem for almost everyone was that they just looked like bad behaviour. I was nearly expelled from my prep school.

I WAS expelled from here.' It's very strange revisiting a place where one was so intensely alive

as to be almost in a constant stage of edginess

and I suppose what one would call mania now. Because I cut games, I was so often alone,

wandering around on the roofs. CLASSICAL MUSIC PLAYS I think I used to crawl over the roof for a mixture of risk and power, when you're looking down on people.

The effect of my behaviour was of course to make me unbearable, really. I mean, it's a show-off and a loudmouth...

..and completely impossible to handle, and disruptive. Oh, my God. See, thin. I may never have been a good-looking boy but I was once thin. I got out the Fry file. No. (LAUGHS) 'Meeting my old housemaster and his wife ensures an uncomfortable reminder of past crimes. Like being given permission to go to London, and then not returning.' We went to see films to the cinema. That's right, yes. One of which was The Clockwork Orange. That's right. Your father thought, "Oh, my God! Of all the films that he might have seen!" But I was consumed and gripped by it. Well, you should have been back. A lot earlier. I had the Metropolitan Police out looking for you. I never realised that. "Stephen has been a problem." (ALL LAUGH) The letter from Gerard Holden. That psychiatrist. He's suggesting various things. "Adolescent depression. Mild depressive illness rather than just unhappiness. Behaviourally, he can be quite infantile. I think Mr Fry - that's your father - may have mentioned that the advice given to him by doctors in London suggest that he might have some brain damage to account for this." That's a crude way of... Good Lord! "We were not aware of any drug-taking or sexual offences, however." Phew! Well, gosh... They didn't know much then. No, they didn't! (ALL LAUGH) And then the awful thing, which is the stealing, that gripped me. You didn't need money. You didn't need to steal. No. So odd. So you didn't know it was I who was the thief? I wouldn't have suspected it at all, Stephen, no. You laid a trap in Matron's... We did, which Elizabeth... That was you, you were hiding in Matron's room. I was in her bathroom. It was a terrible shock to see you. Strange, emotional turmoil I was in. Stealing things I couldn't possibly want. As well as stealing money, which I DID want, I suppose. Did I feel shame when I stole things? I suppose I did. But... There's something very extraordinary about going through... You know, going through a room where you're not supposed to be, looking for things. And it's like when you watch it in a movie. When the hero's burgling somebody's flat or something, it's very nerve-racking. Your heart is in your throat. And it's a real buzz. Considering I didn't do any sports or anything else, it gave me a kind of adrenaline rush, which sport is supposed to do. Maybe that's what it was. Whether it was part of a disorder that can be given a name, I don't know. It was bad enough for me to have to go to a psychiatrist anyway.

'That didn't lead to a diagnosis of manic depression, probably because, like the school authorities, like my parents, and to be fair, like me at the time, why would you have thought it was anything other than bad behaviour? So I was expelled

and just stumbled on continuing to steal as I went. By this time, I had progressed to credit cards stolen from the jackets of my parents' friends. This led to my next big manic episode when I used the money in the most grandiose way.' When I was about 17, going around London on a stolen credit card, it was a sort of fantastic reinvention of myself, or an attempt. I bought ridiculous suits with stiff collars, and silk ties from the 1920s, and would go to the Savoy and the Ritz, and drink cocktails. The morality of it never crossed my mind at all. I think it's more that when you're in a sort of grip of a manic fantasy, you don't really believe other people exist. You are the centre of your universe. Mmm. I wanted to be in there. And Stephen Fry sitting there.

And the white coats are so appropriate, aren't they?

The barman. They're nurses in a wonderful mental hospital. GATE CREAKS 'It didn't of course last. After months of travelling the country using my stolen credit card, I was arrested. I was sent to Pucklechurch Remand Centre.' So this is kind of what, in my day,

would have been a long sterile corridor with cell doors, and... Wow! It's just so different. of my life, actually, I had spent the last ten years of one kind or another. at boarding schools So this, for me, it was nothing. Really, to be honest. called prefects or schoolmasters, It was just, instead of being prison officers or screws. they were called that really twisted my guts The only thing was my mother coming to visit. on doing cryptic crosswords I used to be very keen and The Times' crosswords. And all the time I'd been away,

every single day. she'd cut out The Times' crossword And that's a simple demonstration of love and being there for me, and thinking of me. It was really stuck in my throat. How many times in your life would you have had an episode like that?

I would think... four or five of that extremity.

If I'm to take my past history, I sort of believe it's perhaps every five years a huge storm will come. I don't know but that's often the way it is. So, when would the first time have been that you'd had a depression? I would think it was about... (SIGHS) that manic experience. ..six months before

like that, When you've been depressed what's your self-esteem like? Oh, absolute zero. and walk to the fridge Stand up from a sofa is an act of unbelievable effort. is because you are a cunt. Everything that happens that's cos I'm an asshole. It's cos I'm a complete wanker, a Tourette's view of yourself. You kind of almost have You think of death all the time. Yeah. Even if you're not getting suicidal.

and aware of your own death, You're constantly aware of death and how welcome it would be. Right. That's when I tried to kill myself. 17. So you'd have been? Yes, I took as many as I could, It was with tablets, was it? in order to be as toxic as possible. as many variations as I could projectile vomit. Unfortunately, it just made me And I do remember absolutely not a cry for help. that it was a suicide attempt,

Looking back through your life, of depression like that just roughly how many episodes do you think you've experienced? Just roughly. I should say... OK. Five or six. is getting the picture. 'I think Nick Craddock But so am I. Adding up all that extreme behaviour what my eventual score will be. is making me a little concerned about Something that always bothers me some of these harrowing moments is whether I could have avoided if I had just been diagnosed earlier. a very controversial issue. But that's actually now psychiatrists seem only too happy Because in America, to diagnose children. As a result, Suzy Jensen, who lives outside San Francisco, has known for five years are bipolar.' that both her young teenage sons Nice to meet you. I'm Stephen Fry. Thanks so much for letting us come. Come on in. Thank you. No problem. Is there... I think you can say, when dot, dot, dot." "You know your child is bipolar You know your kid's bipolar when... ..they're putting their feet in a rage, through a plate-glass window for three hours after they have been raging remember what triggered. about something you can't even and dangerous behaviour. And certainly risky we had an A-line roof, he went up Ian, at one point, the narrowest point and was trying to walk with his eyes closed. of the A-line, you know, A little extreme, you know. I used to walk on roofs. (BOTH LAUGH) when their behaviour is so extreme You know your kid's bipolar evaluation done on Ian. that they had a neuropsych the results of the testing, And when I went to get in the lobby and said, the psychiatrist met me that I've been doing this, "In all the years you know, the results." I haven't been this concerned about, And he went on to tell me a story that Ian had told him about he was walking into a room with bare feet and could feel a sensation under his feet that he couldn't recognise.

All of a sudden, he looked down and realised that it was my dismembered body all over the floor that he was trotting over. Um, now, that is... (LAUGHS) You don't want to hear that, do you? It's concerning. Six. How old was he then? Six years old. or do you find it... Do you ever enjoy your mania,

No, I don't. ..real tough? I mean, I don't like it. like throwing something... When you do something bad, and I fight or something? I'm in a bad mood Yeah. Do you feel that's you? to be in a bad mood? That you're right I do, yeah. And the rest of the world is shit. I do. Yeah. 'Diagnosed at 11, Ian's now 16. expelled from school. By that age, I had already been reminded me of my own attitude.' So listening to him It's actually a drive, some need that he has. it's like it's feeding That's what I think too. You can see it.

Yeah, it is kind of a drive, something I need, something that happens. 'Ian's brother Todd is 13. He was diagnosed when only eight. His behaviour, even at the special school Suzie has managed to get both boys into, is causing problems.

she's called to the school.' While I'm with her, I'm normally not here until 2:30, from the administrator but I got a call a difficult morning, saying that Todd had had unfortunately, thrown a chair and had actually, at a staff member and hit him. Were you just cross? Was there a reason? I was just... I just wanted to take a walk

pumped and angry, cos I was kind of feeling and they wouldn't let me do that. So, er... You just got frustrated. I just kinda got mad. the chair at the guy. Yeah, and hurled I think I was eight nine, I was about, and there was a nurse at my school. And I was trying to do my laces up, and she told me to do double laces, and I didn't know what that meant. I actually slapped her right across the face. I've never known anything like that absolute rage inside me. And it was such a stupid thing because she'd told me how to do my laces up. After a blow, especially a major one, very often he'll just shut down like this. for three days. I know that he's suspended Three days. He's been suspended for three days? sees it as bad behaviour, 'I know Todd's school I feel a twinge of sympathy. but I have to say I recognise the rage, of powerful feelings being in the grip and the shame that comes afterwards. are different from me But Todd and Ian at the same age - in one key respect they KNOW they have an illness. speaking to psychiatrists in Britain On the other hand, I know from children at such a young age. that they don't agree with labelling The norm in Britain is 19. So I wanted to speak to the consultant who diagnosed Ian and Todd.' Are you having fun? 'Kiki Chang is well placed to talk about this, because not only does he run a research project at the prestigious Stanford University just outside San Francisco, but also he has a two-year-old child and knows that some of his colleagues would diagnose as young as that.' Once you get down to, say, age two or three, it's very normal to have complete dis-control over your mood. and laughing the next minute. Tantrums, crying one minute have colleagues who are clear But I certainly in three-year-olds, even. that they see it who I think were four-and-a-half, Certainly I have seen children who fit the bipolar criteria. and unsafe behaviour. They're having wild mood shifts or developing correctly. They're not functioning in their normal development. They're losing a lot of time over the '80s and '90s. Everyone remembers the rise of ADHD

would always say, And indeed the cynics "This is a new fashionable label to put on a bad kid or disruptive kid." I want to be careful to say that. I don't think we're over-diagnosing. I think by increasing the diagnosis, you're catching more people.

It's good because then it leads them to a bipolar diagnosis, and they realise there's something going on that may be treatable and it's not their fault. Ian, come take your meds. 'For Kiki Chang, diagnosis is good news. For Ian and Todd, it means medication. Ian showed me just how much he takes every day.' Welcome to our pharmacy! Yeah! (LAUGHS) We're proud of it. So you've got Prozac, Adarol. Uh-huh. Klonopin's like a tranquiliser type? Yes. I can tell they help me behave when I'm having a hard time. This is Ambien which I take... Sleeping pills, isn't it? Yeah. And Concerta, which I take in the morning. Concerta is, um... That's like Ritalin, kind of. It takes me the better part of an hour to stand and fill both of their medications. 'All of that to take the edge off a 16-year-old's wilder behaviour. What I think, I'm not sure. I know British psychiatrists are concerned about the harm strong drugs might do to young brains, especially when they're not 100% sure the diagnosis is correct. But if the drugs help Ian and Todd to avoid wrecking their lives, and their mother's, then surely that's a good conclusion. So would I have wanted diagnosis at 16 if it meant being on medication since then? I feel that in some ways I've been helped by my manic depression. And that complicates my view. Would I have had success without it?' ANNOUNCER: Please welcome your host for the evening - Mr Stephen Fry. 'Would you know me if I wasn't driven by its energy to be creative?' Oh, stop it. Thank you, how kind. I am delighted... ..honoured, and let's not be coy about these things, financially rewarded. This is a stressful time because... ..apart from anything else, you're making an arse of yourself, potentially, in front of people you admire. 'Now, stress is often a key factor that people say pushes them into manic depression and certainly when I was diagnosed, the psychiatrist told me not to work so hard.

Relax, avoid stressful situations. As you can see, I took his advice seriously.' Enjoyable, some people might imagine this kind of thing is. They're the same kind of people who think it's enjoyable to have someone

stub cigarettes out on your nipples in certain dark clubs and what I believe are called 'torture gardens' in the leakier areas of the West End. KNOCK ON DOOR Come in! And for the week leading up to it, I had the most appalling anxiety dreams in which I drop out of my clothes or pee myself and it rolls off the front of the stage. (BREATHES IN) Oh, God. I don't know if stress is what pushes me into a cycle of mania or depression. Because I can't think of a time in my life where I haven't been subject to stress. Happy? Yep? Happy? Ha! I remember that. Seven years old, ice-cream, holidays, that was happy. Not since then, really. (LAUGHS) So stress is something I can't live without. On the other hand, it is a dangerous thing. Well, no disaster so far. But it's hot work. I can't wait for it to be fucking over, frankly. Oh, God, here we go again! MUSIC AND APPLAUSE Cos I am delighted, honoured, and let's not be too coy about these things,

financially rewarded to welcome you to... CROWD LAUGHS 'Well, the real thing seems to go off OK for another year. I do manage to function despite my manic depression and I'm sure it does help me to succeed. And that's the problem with connecting stress to the onset of manic depression. My stress is your easy day at the office. One person copes, the other goes mad. I've come to Cornwall to see how manic depression wrecked the career, the marriage and almost took the life of a man who was once Lieutenant Commander on the royal yacht Britannia.' Here we are - Princess Margaret one side, Lieutenant Commander Harvey there, and Her Majesty the Queen, there. 22 years ago. And you were a well bunny then, weren't you? All was well. 'Four years on the royal yacht led to a senior posting in NATO. Under huge pressure working in a nuclear bunker, Rod became so deeply depressed he had a breakdown.'

My self-confidence seemed to be just slipping away. And my self-esteem... And I couldn't sleep.

Awful sort of feeling. Desperation. 'Eventually invalided out of the Navy, he still became Secretary of the Royal Yacht Club in Plymouth.

That lasted until at a prize-giving ceremony, Rod, now manic, awarded it to the wrong person. The real winner wouldn't accept Rod's apology.' Until in the end, I just lost it, and in front of all the spectators, I just shouted, excuse my French, "Fuck off!" and marched off into the night. I actually hallucinated by seeing the devil. Burning black coals of these eyes of the devil. That's what I saw. That was frightening. I believed I was Jesus at the time, you know. Though I didn't tell people that, because then I wouldn't have been Jesus. Yeah. 'Rod was brought back to England and sectioned at this psychiatric hospital in Plymouth. He was now overwhelmed with depression.' I was experiencing pain in my head. I'd be given a touch of hell. Yeah. I was meant to find out what hell feels like. So I contrived to escape from the hospital.

They let me leave the unit, to go upstairs, to turn right to the occupational therapy unit, unescorted, so I didn't turn right.

I kept walking through the main doors... the dual-carriage way... ..walked a bit down away from the roundabout... that vehicles could pick up the speed... ..waited for a lorry to come along... ..and then walked in front of it. I had actually compound fractures of both legs, every bone in my legs. Geez! I have to lower my trousers... OK. Fair enough. see the full extend, really. I've seen a lot of naval officers in this condition, don't worry. (LAUGHS) I'm not like this. Oh, my goodness, no. Oh, God. That is really extraordinary. Give us a twirl, as they say. That is indicative of what must have been a savage injury. 'That all happened over ten years ago and with medication, Rod says his condition has now stabilised. But twice a year, in the spring and in the autumn, he starts to feel the mania build again. And despite what's happened to him, he's reluctant to take extra medication to control it.' I believe there is another world running in parallel to the normal, in inverted commas, boring, which I find a boring world, that there is another world and that the curtain gets lifted, the veil gets lifted when I'm psychotically manic. Then I enter into the parallel world, and then I see things in a totally different way. CLASSICAL MUSIC PLAYS I will go into pubs, and I will see angels. I know that they know who I am. And I know who they are. And we have a tremendous sort of... between us because of a shared knowledge. Do you regret the fact that you were born with this strange disorder that is called bipolar or manic depression? It's a very easy question. Is it? And there's a very easy answer. No. You don't regret. No! Not for a second. Cos if you've walked with angels, all the pain and suffering is well worthwhile. Wow. 'You'll be pleased to know I don't see angels or the devil or think I'm Jesus. On the other hand, I agree with Rod. We, manic depressives, do love our manic periods. And I know that doesn't help diagnosis. When we're up, we're not ill. Don't be silly, we're fine! No need for a doctor. But that doesn't disguise the fact that Rod so nearly killed himself and that he really wanted to when he was in the grip of the other side of this illness. The legacy of any suicide for the family left behind is extremely painful. But when the cause is manic depression, suicide also leaves fear. The fear that the same thing might happen again with another member of the family. Because manic depression is an illness that's always handed down in families. And that's what's brought me further down the coast in Cornwall to see an old friend who's had to live with that thought since he was 18. That's when he found out that his father was bipolar.' Oh, I say. And this is where you would come every summer holiday? Yeah, we would.

Great memories for me as a child, I must say. We all used to sit out on deckchairs on that slate bit down there. Did you have lashings and lashings of lemonade? We did. (LAUGHS) It's very Famous Five. Oh, isn't it? Just wonderful. Just imagine having every summer holiday here. So, I mean slightly mixed emotions as you come back here, I suppose? Well, yeah, cos my father actually killed himself just over there, actually, so it's not the best bit of it.

One of the heartbreaking things about his suicide was that he actually went out with his sister, your aunt, and threw himself off that cliff in front of her. He dived off, you know. He wasn't messing about.

So I'm afraid they've all broken up a bit. Let's try to find a decent picture of him. There he is. That's your father. Yeah. The idea of having a loony father is just very sort of embarrassing and shameful, really. I was 18, I was so keen to sort of hide the whole business, really. Cos you just want to be normal at that age, you know. I just became morbidly aware of it and very, very depressed. And you get these panic attacks. My way of coping with it was to almost pretend it hadn't happened. Shortly after he died, I went away to Australia,

America and Mexico for two years, just running away from it, really. 'Rick returned and built a huge success story just miles from where his father died. But he also spent his life wondering if he'd inherit the condition that made his father kill himself.' I was always so worried about ending up like him. The thing is that he thought I was particularly like him and I think he was incredibly troubled by that. My father didn't show signs of it till his mid-40s, really. So, I mean, you know... (LAUGHS) I'm well over it now. Fortunately. But then I think about my sons too. Of course. My sons are still in their mid-20s, so there's plenty of time. Do you see a psychotherapist? I do. You do see one. Yeah. And that's helpful? Well, it is. I do believe only probably through seeing the psychotherapist

that really what happens to you as a child is indelibly printed on your brain. You know, they fuck you up, your mum and dad! 'What the research shows, is that if you have manic depression, someone in your family will have had it before you. Could be a grandparent, aunt or uncle, as well as a parent, and often they might not have been diagnosed. So there appears to be no warning.

But there will be somebody.

On the other hand, as Rick's experience shows,

just because your father has it doesn't mean you'll necessarily get it. But the worry remains for bipolar parents. Will I pass it on? And now for bipolar mothers, researchers have made another devastating discovery. Pregnancy itself and the act of childbirth are now proved to be enormously dangerous to the mental health of women who are already bipolar.' When I saw you, Gaynor, I said that in my opinion, the risks that you had of becoming unwell again in pregnancy or certainly following the delivery were very high. I think probably 60% or more. Yes.

The rate of risk you'd need to think about. 'Gaynor Thomas lives in Wales and is part of the same research study that I'm involved in. She's trying to decide whether she dare risk getting pregnant again, knowing that her manic depression has already led to unusual behaviour.' Oh, that one goes there. That's better. There we are. One there, look. Play with Mummy. I had kind of delusions of grandeur. Did you believe you were richer than you were, or better born or... You know, some people believe they're princesses or... Mine were quite religious in nature. One of the episodes, I thought... of God's chosen people, ..that I was one for want of a better word. able to heal people, I thought that I was

I thought I had special powers. And I thought that I'd been sent to change the world in some way. to gather a group of people at the time, I was seeing a psychotherapist were becoming very strange, and she identified that my ideas the equivalent and called in what would have been team... Right. of the community mental health ..who treated me at home. With medication, yes. With medication? And then came a very traumatic thing, for most people, which is pregnancy. a very wonderful thing And you did have a manic episode while pregnant. Yes. How did that show itself? The more religious side came in after I'd had Thomas. Well, I just thought he was... ..not just a special baby, but a VERY special baby. Like a messiah? Almost to that degree, yes.

Um, and that I kind of had been chosen to give birth to him and together we were going to change the world. It's such a small step and yet it's such a huge one, if you were to say it at a party. in terms of embarrassment Yes. (LAUGHS) is the centre of my universe," There's a way of saying, "My child is the centre of the universe." and saying, "My child of post-natal euphoria. Right. Initially, it was kind I couldn't sleep. But it became post-natal mania.

I called a psychiatrist and said, I was so excited, "I think I need to see somebody, are getting out of control." because things in a psychiatric hospital 'Gaynor was sectioned for a month. calmed her down, The drugs the hospital put her on that it might happen all over again but now she's frightened

if she gets pregnant. Ian Jones told me Gaynor is right to be scared.' Women with bipolar disorder have a very high risk of having a much more severe episode of illness in relationship to childbirth.

Often with psychotic symptoms like hallucinations or delusions. And really, these episodes can be some of the most severe episodes of illness that we see in psychiatric practice. Really? In all psychiatric practice? into maternal death The last two confidential enquiries is now the leading cause have shown us that suicide

around childbirth in this country. of death to women to have a brother or sister. 'Gaynor wants Thomas

is hard to ignore.' But Ian Jones' information the whole idea of having a baby. And it made me just rethink to have another child, I'm sad that I won't be able um... Perhaps for Thomas's sake. Uh-huh. the risks are probably too high. But I've got to accept that Down the stairs we go. Now... what might have happened. As you say, you don't know No. So it's... Slow down, slow down. (LAUGHS) I love the heels of his shoes. (LAUGHS) (THOMAS LAUGHS) 'Manic depression's capacity to destroy the lives of people makes it all the more important for it to be diagnosed early. But often it goes undetected

because of what most sufferers do to help them cope with the mood swings. They cover up their symptoms. Certainly I did for almost 20 years. It's called self-medication, or as you'd quite properly call it of drink and drugs. the taking of excessive amounts Vodka and cocaine in my case.'

is a stimulant, The effect of it is that coke

is a sedative supposed. and that alcohol so manic and energetic And I'm naturally often to calm me down. that I often took coke to go to any kind of party I found it very hard a couple of grams in my wallet. without knowing there were I just had to have them there. JAZZY MUSIC PLAYS about using a phrase I feel slightly embarrassed because it sounds like like self-medication you're sort of excusing yourself

or saying you're doing it for a noble reason. I did find, and this is the point, that it stops one from...

from feeling, in a strange kind of way. We've got an agenda to work out. You're no longer sort of depressed or manic. You're just going, you're just on. 'That's what I was doing all during my successful '80s and '90s. My friends, who if they'd thought about it at all would have said, "Heavy user," not, "Manic depressive." for the cause. They'd have mistaken the symptoms And that happens a lot. I went to university with, I did it with someone worked on the stage and telly with, and even made a film with.' it really manifested itself First time this film Peter's Friends. was at the time when I was doing

I was having a gloriously happy time and I had money. and I was in employment, My personal life was happy. there was absolutely no reason And so on paper, for me to be suddenly plunged of abnormal psychology, into this sort of pit this low mood. a shovel in your hand Good evening and why don't you get you lazy sod? and do a decent day's work, I wasn't drinking excessively then, of psychotropic substance, I wasn't taking any kind either prescribed or proscribed. And it came out of the blue.

a reason why you should be down, If you're down and you can see a certain clarity. then that brings with it But if there's no reason,

"Why am I feeling like this? you tend to think, I don't understand." If left to your own devices, the cycle of ups and downs you can often try and stop

through self-medication. Ingestion of alcohol, cocaine in particular. and narcotics,

But with me, the depression came before the substance abuse. as being Everyone thinks of depression but there's agitated depression. a very low despondent mood, where you're endlessly pacing There's psychomotor agitation and you're short-tempered. and you can't sleep by the River Thames, I rented a huge warehouse on my own. and just stayed in there or answer any phone calls I didn't open any mail for months and months and months. of rapid-cycling despair And just in this pool and mania. Three full bar optics of vodka to try to get you to sleep for three days, when you haven't been to sleep howling at the moon, just spending time in the Thames. and throwing your furniture Really? Which is what I did. equipment in the Thames. Yes, I threw all my electrical A long time ago, this was. down with their megaphones, saying, With the river police going up and in the Thames." "Tony, stop throwing things They did. They did know who you were? "There's that Tony Slattery." They said, off the telly. There's that Tony Slattery was a long time ago. Yes, that thankfully That was a dark hour.

is this question - So I suppose what I'm leading to is that here's a button. And if I were to press that button, you would take away every aspect of your bipolarity greatest happiness over the years. that still not caused you the

with who you are. But maybe it's had something to do Do you want to press the button? No. At the moment, because I'm in an equable state, I choose not to press the button. But I'd like to have the option.

Do you know, almost everybody I've spoken to has said that. 'It says something about manic depression that despite it being the greatest killer of all psychiatric illnesses, many of those suffering from it, if given a chance, don't want to get rid of it. If I'm honest, I don't.

But I came across one woman

press the button. who absolutely would Connie Perris lives in Birmingham, and is just in her 40s. that she divides her life Her symptoms are so severe into before bipolarity and after.' is coming in here One of the difficulties and feeling a bit paranoid. is someone looking at me, I see what I think

"Why is he watching me?" and I'm thinking, "She's following me." "He's giving me funny looks." And I think, And then clicks in the thinking. I'm getting paranoid again. Right.

People give me funny looks cos I'm giving them funny looks. 'Before, she was a lawyer, captain in the territorial army, a black belt in aikido and active in the community. Now, Connie can hardly get to the shops.' CLASSICAL MUSIC PLAYS When I'm very depressed, I slow down and slow down, and it gets to the point to which I'm not moving at all. Inside my head, I can see, I can hear, but somehow I just don't have the energy or the oomph to move forward. And it can be a bit embarrassing when I'm out in the shops and I'm just stuck there, not moving. So can I... Before we do that, can I just pace something down the corridor slightly cos I'm getting quite shaky? Of course, you can. Absolutely. I can feel the shake's getting slightly worse, so I just sort of... Have a pace to breathe. Just pace. That's a week's pills. Oh, wow! That is quite a serious slab of medication, isn't it? Yeah. There's two different ones that try to stop me going too high and too low - one slows down the swings, one stops it going too high. Stuff for my thyroid, because that also slows mood swings down. Something to help me sleep, and something to deal with the paranoia and other psychotic thinking. And then there's the mineral supplement to try and stop my hair falling out from the mood stabilisers. Golly wolly. Every day. Every day. BIRDS TWEET And in your depressions, have you considered the worse side of depression, which is suicide? Over a period of four days, I took an overdose, I stepped out in front of an oncoming train, I tried to drill a hole in my head with an electric drill, and I cut my wrists. (BREATHES IN) You dig a hole in your head with an electric drill? That is extreme. I was just so utterly despairing and I didn't think I could take any more. Mm. How do you see the future?

I don't see it. I try to take it a minute at a time, because at the moment, I don't see it. I'd like to, I really wish I could. But at the moment, I don't. I so very much bitterly resent having manic depression. I wish I could say otherwise, but that's how I feel. Yeah. I resent it deeply. 'Its perhaps a hard fact, but one we should face that of those people who have severe bipolarity and aren't receiving treatment, half attempt suicide.

And 20% succeed.

Having met Connie, I realise I was lucky originally to be diagnosed at the mild end of the bipolar scale. But that was 11 years ago. Now I'm concerned to know how my way of dealing with it will affect my rating on Professor Craddock's scale of mania.' Zero on that scale is somebody who has absolutely

no features of being bipolar at all. But between 1 and 39, that's somebody who has what we call sub-clinical episodes of mania. 40 to 59 on our scale is people who only get hypomania. So that's the milder episodes. And then 60 and above is the range where people experience full manias. From what you've told me, you would score probably about 70. Although to be honest, I wonder if you got close to having grandiose delusions

in that first episode. If you did, on our scale, that would actually put you above 80. Yeah. OK, well, yes, that's... Well, it's good that I'm not wasting your time. (LAUGHS) With any luck, my little genes may be of some help to you in your research. CLASSICAL MUSIC PLAYS 'Well, I didn't expect that. It's worrying that I seem to be getting worse.

Clearly I must now consider treatment. I haven't been on any medication since my original diagnosis.

Should I be? I think my life needs to change dramatically.' Closed captions by CSI