Bipolar disorder: How I deal with it - with help from Reuters

I am a drug addict. But it’s not what you think.

I don’t crave heroin, crack, painkillers or any other substance that has ruined lives.

I am addicted to a drug in my brain that creates an elevated mood so powerful I feel there is no challenge I can’t tackle.

I have so much energy and creativity that I can churn out one story after another, charming people, even taking them along on this wave of elation - until I crash because my body can’t keep up with my mind.

When that happens, I am just like any drug addict desperate for another hit. But it’s worse.

Depression sets in and I am consumed by self-doubt, guilt and paranoia - mostly about failing at my job no matter how well I do.

That has been my number one trigger and the most difficult thing to deal with. I work overtime to avoid concluding I am failing at work. Ironically, that relentless work and self-inflicted stress ultimately makes me crash.

When it is really bad I feel like I would rather be dead than experience this excruciating pain and sense that there is no hope.

In both cases I tend to push people away. When I am on a high I don’t want anyone to get in the way. When I am low I don’t want anyone to interrupt my self-critical thoughts and self-doubts because they are so powerful they run my life.

What I am describing is bipolar disorder, or manic depression, one of the most difficult mental illnesses to treat.

For many years I tried to describe this condition to the few people I had told. I had caved in to the stigma around mental illness, and largely kept it a secret.

I am 54, with about 30 years of experience as a reporter. But it is only now that I have been able to explain what bipolar disorder is.

It is far more complicated than drug addiction but not in terms of what it actually is.

Bipolar disorder has nothing to do with sadness or being crazy, although at times when I look back at my manic episodes I wonder about my sanity.

It is simply a chemical imbalance in the brain that causes mood swings. It is an injury in the brain that never goes away and can have catastrophic consequences if not managed properly.

Managing the illness is the biggest challenge I have ever faced.

Beside me on a desk is what is known as a BEAM mood chart that my psychologist constantly urges me to fill out every day.

It literally takes one minute to mark down where I am - the stable middle ground? Moderate elevation? Severe depression? The illness is so overwhelming at times even the simple checking of boxes on a multi-coloured form is impossible.

Sometimes when I am high I don’t have time to fill it out because I am feeling so great. When I am rock-bottom, getting out of bed is a huge task. The general sense is nothing can help so why bother.

Managing the illness is the biggest challenge I have ever faced

I recently went public about my illness on Facebook because I am convinced that crushing the stigma of mental illness is the single most important way to relieve the suffering of bipolar people, who make up about one per cent of the population and have the highest rate of suicide among anyone with mental illness.

But being open like this would not have been possible without the critical support of my managers and friends at Reuters. I feel that I can reach out to my managers any time. When the illness becomes overwhelming, they encourage me to seek treatment.

I also have a system in place. I have given permission for my psychologist, who I speak to regularly, to give updates on my mental health to our UK Occupational Health Service who will update my Reuters managers.

I will write more about stigma and how it has impacted my life and others. But right now, I want to stress again that bipolar disorder is like any illness: diabetes, heart disease or even a broken bone.

It is simply an injury to the brain. The difference is you need more than medication because the illness can break through your meds. And I have tried many.

You need therapy because that chemical imbalance in the brain distorts your perceptions.

That is why I have learned, over 30 years, to quickly recognise where my moods stand and the limits that come with them. Not so long ago, a Reuters manager asked if I wanted to go on assignment to the IS-stronghold of Raqqa in Syria. Raqqa has come under growing attack from US-backed rebels and IS now only controls about half the city. I knew I wasn’t up to it, so I declined the opportunity. He understood and supported my decision.

I tracked my state of mind closely, and a month later, when I was more stable, I went in with the next rotation. Even then, when I stepped across the Iraqi-Syrian border, I started on a downward swing. The self-doubt and fear of failure set in and so did anxiety along with depression.

But when the stories began flowing, and I got positive feedback, I started back up on an upward swing.

The assignment was a success. But my management of the illness could have been better. Real success would have been to manage myself out of the low by filling in the BEAM chart and practicing mindfulness and writing notes to myself to isolate my thoughts, which makes them go away.

The BEAM​ chart was neglected. I was too low or too high to bother. The only notes I took were colour and quotes from the field for stories.

I visited London recently to discuss a better way forward. I have agreed with my managers that an Occupational Health expert at Reuters will now speak with my therapist before every assignment. That way, my managers can better understand where I am at and we can all feel more comfortable that I am managing my illness.

There are many other journalists at Reuters and elsewhere who have stressful jobs, whether it is covering wars or high-stakes financial markets or working on investigations that take months of exhausting digging.

Some of them are mentally ill, whether it is bipolar disorder or PTSD or depression. These additional challenges are best tackled by being open. Reach out to friends, colleagues and your employer. Only then will they really understand and help you fight stigma.

Michael Georgy is Reuters special correspondent for the Middle East. Since 1995 he has covered just about every country and conflict in the region. He was bureau chief in Cairo from 2013 to 2016 and in Pakistan and Afghanistan before that. He also covered OPEC for five years and worked in southern Africa. This article, written as a blog for sharing with colleagues across Reuters, is published here with his permission. ■