'Doctors can't be depressed'

What happens when a medic has a mental health problem? Dr Liz Miller found out the hard way

Liz Miller was a doctor. Then she became a patient. No surprises there – people from all walks of life fall ill. But if you are a doctor it is different, and if it is a mental illness you are suffering from, it is doubly different. There is a sense that you have let the side down. When a doctor falls ill, the medical profession closes ranks and goes into collective denial.

"Doctors are brought up to think that they are different from patients. You have to believe you are not going to catch the diseases you are treating. It was part of the macho attitude in medicine – the attitude that a doctor who fell ill had breached a tradition, fallen from grace. It simply wasn't done."

Dr Miller's illness, manic depression (now known as bipolar disorder), struck in her late 20s and has shaped her life. But what has shaped her career was the way the medical profession responded to her illness – with incomprehension followed by rejection and denial. She responded by setting up the Doctors' Support Network for others in her position, and by writing a book – a guide to avoiding mental illness without the help of doctors, by noting your feelings and acting on them – something she says the medical profession signally failed to do for her. "If they had been nice to me, I need not have done any of this. It would have saved me all the trouble," she says.

Liz was 28 and training in neurosurgery in Edinburgh when she had her first breakdown in the mid-1980s. She was doing research on sodium metabolism, speaking at international conferences and had a promising career ahead of her. One professor called Liz "the brightest young thing in neurosurgery" in a decade.

"That was when things went belly up. It was a combination of things – I was the only woman in neurosurgery, I had found it difficult to settle in Edinburgh, my brother was going through a divorce, all my support network was swept away. I got depressed. Looking back I probably always had a tendency to depression and had not realised it. That was just how it had always been. Then I became manic, I stopped going in to work and I got sectioned. I ended up in Edinburgh Royal Infirmary."

It was the first of three breakdowns that led to Liz being placed in a locked ward in one hospital after another for her own safety. Her career in ruins, she struggled for a decade to get well and back into work, working as a locum GP and as an accident and emergency doctor, before the next breakdown put her back in hospital. It was a bleak time.

She ended up in the Bethlem Royal Hospital, one of the last true asylums in England, set amidst several acres of parkland in Kent. There she met for the first time other doctors with mental health problems like her own. It was a revelation. She realised that she had been colluding with the profession to deny her own illness, because that was a way of getting back to work and carrying on. Meeting other doctors afflicted by mental illness helped put her own problems in perspective.

"If there is a stigma and prejudice against mental illness in the outside world, it is 10 times worse in the medical profession. A doctor in a mental asylum is like a policeman who gets sent to prison, or an accountant caught fiddling the figures. I had always been proud of my brain, my ability to think on my feet and to know what to do regardless of what was going on around me. But having a mental health problem goes to the core of who you are. If you break a leg, that's a problem with your leg. If you have a mental illness, that's a problem with you." Liz was helped by what she says were the first truly empathetic psychiatrists she had come across in her perambulations around the mental health system.

"Psychiatrists tend to observe patients – they don't engage with them. I have met nice psychiatrists. One was a junior doctor called Raj Persaud – before he became well known as a writer and broadcaster. He was good at talking to patients and engaging with them. He was a good communicator and he tried to put things in context."

Feeling, possibly for the first time, safe and accepted, she finally acknowledged that she was ill, that her medical ambitions were dust and that she might never be able to work again. "Everything I had worked for had gone up in smoke – I had blown everything. Depression seemed appropriate," she said.

Liz's route to recovery began with the establishment of a self help group for doctors like herself. It was the mid-1990s and she and a colleague, Soames Michelson, put an ad in the British Medical Journal with a telephone number. They got scores of replies but when they went to see the Royal College of Psychiatrists to enlist the college's help, they were brushed aside.

"We told them lots of doctors were affected but they replied, 'Oh no, I think you'll find you are the only ones.' The profession was in complete denial," Liz says.

The Doctors' Support Network was the result which has now been helping doctors in difficulty for more than a decade. It has also contributed to a changed attitude within the profession, she says. Nowadays mood disorders are talked about more, both within and outside the profession, and there is a greater acceptance that doctors are prone to them like everyone else.

There is still, in her view, more to do. She is critical of the General Medical Council , the doctors' disciplinary body, which recently reformed its fitness to practice procedures. "In the past, doctors whose health was affecting their work were siphoned off into a separate stream by the GMC for assessment and treatment or removal from the register. Now, they have put them all together, examining whether their performance and skills are up to scratch, whether their behaviour is appropriate and whether their health is OK – and I think they are very different.

"Three friends of mine committed suicide while under GMC provisions. They were among nine doctors who took their own lives out of 214 who were under GMC provisions in 2004. If that had been an intensive care unit there would have been an investigation. I don't think that needs to happen. There has to be a better way."

Liz's own recovery – once she had accepted what she had lost, which was the hardest part – began when she joined the Manic Depression Fellowship, now called the Bipolar Organisation. She started as a volunteer, doing one morning a week. Then with the encouragement of the chief executive, Mary Fulford, she got involved in the self-management programme – which she describes as "the single greatest advance in the management of bipolar disorder since the discovery of lithium". The breakthrough came when she was asked to write a column for the Fellowship's magazine, Pendulum. "That was a lifeline. It enabled me to feel useful again. I hated medication, it always made me feel bad, and I wrote about looking for non-medical therapies. They were scientifically researched but not drug-based. At the same time I was setting up the Doctors' Support Network, talking to people, having parties and writing. I looked at my life and realised that I was doing everything I wanted to do – I just wasn't getting paid for it."

From those beginnings she gradually rebuilt her life. She taught herself how to manage her moods, and has not taken drugs for her condition for eight years. The key was accepting that she was responsible for them, she says. She now works as a part-time occupational health doctor and GP. She was supported by her husband, Richard, of whom she speaks with affection and gratitude for the support he showed through her illness. But eventually the couple separated and for the last three years she has been living with her new partner – a key factor, she admits, in her new-found equilibrium.

In 2008, Liz was voted Mind 'Champion of the Year' by the mental health charity, in recognition of her work at the Manic Depression Fellowship and her writing in Pendulum. She was also a central figure in Stephen Fry's documentary series The Secret Life of the Manic Depressive and now counts him as a friend along with the doctor and comedian Phil Hammond, who has supported her efforts "from the beginning".

Her book's message to the public and to the medical profession is that the way to mental health is to spend a little time focusing on how we feel and why we feel the way we do. Only then can we start to do something about it.

"I would dearly love to have that in the culture. It would help to give people control of their mental health instead of going to see counsellors or getting drugs from the GP. Understanding this has given me the tools I needed to change my own life."

'Mood Mapping', by Dr Liz Miller, Rodale, £12.99. To order this book for the special price of £11.69, with free p&p, go to Independentbooksdirect.co.uk

Heal thyself: Learn mood mapping

Dr Liz Miller explains how she learnt to take control of her mental health.

"Mood mapping involves plotting how you feel, against your energy levels, on a chart. I started asking myself how I felt because I wasn't good at understanding my moods. It is much easier to manage your moods while you are mildly upset than when you are seriously distressed. I wrote a diary four times a day and found what really mattered, how good or bad I felt, and how much energy I had. That gives you four moods – action, anxiety, depressed, calm.

"These are in turn influenced by five key factors: your surroundings, your physical health, your relationships, your knowledge, and your nature. If you are aware of your moods, when things start to go wrong you can do something about them. I realised that mood disorders are extreme variations of mood, rather than being separate from normal experience.

"Moods need to be balanced and managed. If you are not managing your own mood the chances are that someone else is, whether it be your boss, your partner, the Government or the advertisers who catch your attention at every turn. Getting control of your moods is uplifting and empowering – keeping control of them is life enhancing."

Bill Gates, founder of Microsoft and co-chair of the Bill and Melinda Gates Foundation
businessUber, Snapchat and Facebook founders among those on the 2015 Forbes Billionaire List
news... and what your reaction to the creatures above says about you
Homer’s equation, in an episode in 1998, comes close to the truth, as revealed 14 years later
Life and Style
ebookNow available in paperback
ebookPart of The Independent’s new eBook series The Great Composers
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Ashdown Group: Finance Manager - Covent Garden, central London - £45k - £55k

    £45000 - £55000 per annum + 30 days holiday: Ashdown Group: Finance Manager - ...

    Ashdown Group: Systems Administrator - Lancashire - £30,000

    £28000 - £30000 per annum: Ashdown Group: 3rd Line Support Engineer / Network ...

    Recruitment Genius: Graduate Web Developer

    £26000 - £33000 per annum: Recruitment Genius: A Web Developer is required to ...

    Ashdown Group: PeopleSoft Developer - London - £45k

    £45000 per annum: Ashdown Group: PeopleSoft Application Support & Development ...

    Day In a Page

    The difference between America and Israel? There isn’t one

    The difference between America and Israel? There isn’t one

    Netanyahu knows he can get away with anything in America, says Robert Fisk
    Families clubbing together to build their own affordable accommodation

    Do It Yourself approach to securing a new house

    Community land trusts marking a new trend for taking the initiative away from developers
    Head of WWF UK: We didn’t send Cameron to the Arctic to see green ideas freeze

    David Nussbaum: We didn’t send Cameron to the Arctic to see green ideas freeze

    The head of WWF UK remains sanguine despite the Government’s failure to live up to its pledges on the environment
    Author Kazuo Ishiguro on being inspired by shoot-outs and samurai

    Author Kazuo Ishiguro on being inspired by shoot-outs and samurai

    Set in a mythologised 5th-century Britain, ‘The Buried Giant’ is a strange beast
    With money, corruption and drugs, this monk fears Buddhism in Thailand is a ‘poisoned fruit’

    Money, corruption and drugs

    The monk who fears Buddhism in Thailand is a ‘poisoned fruit’
    America's first slavery museum established at Django Unchained plantation - 150 years after slavery outlawed

    150 years after it was outlawed...

    ... America's first slavery museum is established in Louisiana
    Kelly Clarkson: How I snubbed Simon Cowell and become a Grammy-winning superstar

    Kelly Clarkson: How I snubbed Simon Cowell and become a Grammy-winning superstar

    The first 'American Idol' winner on how she manages to remain her own woman – Jane Austen fascination and all
    Tony Oursler on exploring our uneasy relationship with technology with his new show

    You won't believe your eyes

    Tony Oursler's new show explores our uneasy relationship with technology. He's one of a growing number of artists with that preoccupation
    Ian Herbert: Peter Moores must go. He should never have been brought back to fail again

    Moores must go. He should never have been brought back to fail again

    The England coach leaves players to find solutions - which makes you wonder where he adds value, says Ian Herbert
    War with Isis: Fears that the looming battle for Mosul will unleash 'a million refugees'

    The battle for Mosul will unleash 'a million refugees'

    Aid agencies prepare for vast exodus following planned Iraqi offensive against the Isis-held city, reports Patrick Cockburn
    Yvette Cooper: We can't lose the election. There's too much on the line

    Yvette Cooper: We can't lose the election. There's too much on the line

    The shadow Home Secretary on fighting radical Islam, protecting children, and why anyone in Labour who's thinking beyond May must 'sort themselves out'
    A bad week for the Greens: Leader Natalie Bennett's 'car crash' radio interview is followed by Brighton council's failure to set a budget due to infighting

    It's not easy being Green

    After a bad week in which its leader had a public meltdown and its only city council couldn't agree on a budget vote, what next for the alternative party? It's over to Caroline Lucas to find out
    Gorillas nearly missed: BBC producers didn't want to broadcast Sir David Attenborough's famed Rwandan encounter

    Gorillas nearly missed

    BBC producers didn't want to broadcast Sir David Attenborough's famed Rwandan encounter
    Downton Abbey effect sees impoverished Italian nobles inspired to open their doors to paying guests for up to €650 a night

    The Downton Abbey effect

    Impoverished Italian nobles are opening their doors to paying guests, inspired by the TV drama
    China's wild panda numbers have increased by 17% since 2003, new census reveals

    China's wild panda numbers on the up

    New census reveals 17% since 2003