BEING called brave is a description that Rebecca Lawrence does not recognise.
Such is the stigma that still surrounds mental illness, she is considered by many to be courageous in writing about her experience as a psychiatric patient while also working as an NHS psychiatrist in Edinburgh.
Aptly named An Improbable Psychiatrist, the new book starkly reveals how she has battled bipolar disorder throughout most of her adult life, while also practising as a psychiatrist and, with her husband, bringing up three children.
Although her case is unique, she hopes that by sharing her own, often gruelling experiences, including receiving controversial electroconvulsive therapy (ECT) therapy, she can help others have a better understanding of mental illness and its effects.
The book also carries a message of hope by showing it can be possible to lead a mainly happy, satisfying, productive life while living with an ongoing mental health condition.
However, in an interview with the Sunday National, Lawrence acknowledged that mental health services are crying out for more funding and resources.
“Waiting lists are long and resources are not enough,” she pointed out.
“We need more funding, more psychiatrists, more psychologists, more nurses, more beds – just more of everything really.”
Lawrence (below) rejects a current theme currently being perpetrated in some corners of social media that there is an “overdiagnosis” of mental ill health.
“That’s just too simplistic – there’s a lot of both distress and illness, I think,” she said. As someone who has benefitted from antidepressants and ECT, she also takes issue with another current theme on social and mainstream media that many treatments do more harm than good.
“A lot of the medication is not particularly pleasant to take but that does not mean it is the wrong thing,” she said.
“It’s very easy to criticise psychiatric care but I was glad to get it.”
Being a both psychiatrist and a psychiatric patient, she is well aware of the difficulties.
“The resources are not sufficient, there are not enough beds and the treatments are limited in what they can do but that does not mean they are worthless,” she said.
“Sometimes I see people on social media saying psychiatrists are basically evil and doing these things for their own pleasure. Well, I don’t know anyone like that.”
While some of her treatments have been deeply unpleasant, Lawrence said her experience of losing a baby when she was 22 weeks pregnant was far worse.
“That was probably the most horrific time of all for me, and if I were asked what part of my life I would not want to repeat, it would be then,” she said.
Lawrence first became ill before this terrible loss, when she was pregnant with her oldest daughter, who is now grown up and has a baby of her own. At the time Lawrence had qualified as a doctor and was training to become a General Practitioner but when she became unwell, she ended up being admitted to hospital as a patient.
Still in her mid-twenties, she was diagnosed as having psychotic depression, and later with bipolar disorder.
Lawrence recovered enough to resume her training but the stigma surrounding mental illness, even within the medical profession, made her decide to abandon her aim of becoming a GP and return to her initial aim of specialising in psychiatry. “
A lot of people did not think it was a very good idea,” she said. “My husband’s face fell, and the rest of the family were not impressed. Even some of my doctor friends thought I was doing it to treat myself but if you were diabetic no-one would think anything of you becoming an endocrinologist.”
In order to distance herself from her own condition, she became an expert in alcohol and drug misuse and has now been working successfully as a psychiatrist for nearly 30 years, despite bipolar episodes which have sometimes required a return to hospital.
Continuing treatment and fighting stigma
Over the last couple of years, she has received several courses of outpatient ECT at the hospital where she continues to work and is still having maintenance treatment. However, while mental ill health is more openly discussed these days, Lawrence feels there is still a stigma, although perhaps more subtle than in the past.
She hopes the book will encourage more conversations about the subject as well as demonstrate there can be life at the end of the tunnel.
“I haven’t told my story to boast but to show it can happen, although I have been very lucky to have had the same psychiatrist for a long time and to my mind that is what should be happening,” she said.
“I might disagree with him sometimes, but that is okay and what has been best for me has been that continuity of care. I think that is something that is very difficult at the moment because of the lack of resources.” Lawrence said she also felt strongly that it is important to review diagnoses and treatments, despite knowing her condition will not miraculously disappear. “I am now just kind of accepting it is there,” she said.
“I have a diagnosis of bipolar disorder and I don’t think this will go away, although I am lucky that treatment keeps me well much of the time. “I am also a mother who has experienced loss and perinatal mental illness.
“The desire to be a mother and the feelings of grief when it went wrong were hard to bear and even acknowledge and sometimes, I think these changed me more than anything.”
The positive response of her family and others to her book has heartened her, however.
Lawrence added: “I hope my story may be of interest to some, and, even more, of comfort to others. “My story is, perhaps, unusual in that I was interested in psychiatry even as a medical student, but I learned what it was like to be a patient, an in-patient on a psychiatric ward, before I learned to become a psychiatrist.
“I have had, and continue to have, many different medications, even electroconvulsive therapy, and struggle with both the stigma and the side effects. ‘However, what I am trying to show is that with the treatment I have been able to live a pretty good life, workwise and family-wise so it has been okay.”
An Improbable Psychiatrist is published by Cambridge University Press
