I found the transition from comprehensive school to medical school a bit tricky but by 2nd term I had found my feet. I fell in love for the first time and mistook what I now know to be my first manic episode as ‘love’. my thoughts were racing, I had pressured speech, I was frankly obnoxious at times and barely slept. I got a reputation as a piss-head and a cocaine user (the latter is untrue). I took risks like have sex on a fire escape and dislocated my shoulder after showing off my tight rope walking skills on the edge of a balcony. I also walked out of an OSCE thinking I was so brilliant I didn’t need to do the rest (miraculously I passed by 0.5%). After several weeks things settled down with the occassional low mood lasting a few months or daft, giddiness lasting a few weeks. I knew the other students had a nickname for me: ‘psycho’. It wasn’t until my 4th year when low mood turned into depression which turned into psychosis. My flatmate was trying to ruin me in a way I wasn’t sure about and I heard an external voice telling me I must die. My weight fell to 38kg as agitation and loss of appetite combined. I tried to hang myself in the wardrobe but mercifully I was unsuccessful. At this point I got help. I told a friend all about it. He wasn’t daft and said he’d always thought I had bipolar and threatened to drag me to my GP if I didn’t go myself. At that moment, I had no pride. There was nothing left so I went to see my GP – someone I’d never seen before. I started by saying ‘it’s about my mental health’ then cried. I left with a referal and some citalopram. I was diagnosed with bipolar 1 and. after a mixed episode on the citalopram, started on lithium. I was also refered to ‘House Concern’ for Psychodynamic Psychotherapy (I was sexually abused as a child). I’ve been on lithium now for over ten years. I’ve had three further episodes of mania and 3 of depression. I’ve fortunately not taken much time off work and have been very successful – i’m now a lecturer in psychiatry. I’m married but have moved away from where i was a student – I feel too much stigma. I also have told few of my colleagues and the NIMBY type comments from some of them ‘keep me in the closet’. that first step of accepting help kept me alive and got me well. If you are mentally ill, I’d say take that first step. I’ve never had a problem with my diagnosis being known to Occupational Health and no one else can know unless you choose to say. I only wish I’d got help sooner.