Instead of embarking on a new career when she finished university, Debbie Sesula entered what she describes as “seven years of hell”. The normally outgoing woman became withdrawn, sad, and hopeless. As time went on, she’d have boundless energy one day and not be able to get out of bed the next.

“It was like a roller-coaster ride: I’d have periods where I’d accomplish so much, then I’d crash into the mire of despair and depression,” Sesula says on the line from her Vancouver home. “Then the suicidal thoughts came.”

Sesula attempted suicide and ended up in hospital, where she was diagnosed with bipolar disorder. She also ended up on the road to recovery. She now works in the mental-health field and is completing her master of arts degree in leadership.

As part of Mental Illness Awareness Week 2010, a Canadian Mental Health Association campaign that runs until Saturday (October 9), Sesula is telling her story to help others who might be going through their own version of hell.

“I’m living proof that recovery is possible,” she says. “Don’t give up.”

Sesula is the coordinator of Vancouver Coastal Health’s mental-health services’ peer-support program. An increasingly common approach in mental-health care, peer support is based on the concept that people who have overcome adversity can offer encouragement and guidance to others in similar situations.

Although research into peer support is limited, the modality’s effectiveness appears to be promising.

A study published in the journal Psychiatric Services last year looked at the Arlington, Virginia–based National Alliance on Mental Illness’s “peer to peer” program, a “self-empowerment, relapse prevention and wellness program” led by trained peer mentors. It found that people with mental illnesses who enrolled in the program reported significant benefits, especially when it came to knowledge and management of their illness, confidence, and being connected to others.

The same journal in 2008 found that peer providers could effectively help their clients address certain attitudes, values, and behaviours.

With at least one in five British Columbians developing a mental illness in his lifetime, the CMHA’s B.C division is hosting several events this week to raise awareness and help people cope.

Today (October 7) at the Richmond Cultural Centre (7700 Minoru Gate), for instance, medical doctor Susan Biali, cognitive-behaviour therapist Adrienne Wang, and naturopath Neetu Dhiman will be giving a presentation on how to deal with stress, depression, anxiety, and how to get proper rest. (More details on this and other events around Metro Vancouver are at www.cmha.bc.ca/.)

Sesula says that helping people understand the signs of mental illness is vital. Even when she was alternating between bipolar disorder’s characteristic extreme highs and lows, she didn’t recognize she had a health problem.

“I just thought it was burnout from university,” Sesula says.

Bipolar disorder isn’t easy to spot when it starts, according to Bethesda, Maryland’s National Institute of Mental Health. The symptoms may seem like separate problems and may not be recognized as parts of a larger problem. Bipolar disorder often develops in a person’s late teens or early adult years. At least half of all cases start before age 25. The NIMH compares bipolar disorder to diabetes or heart disease: a long-term illness that must be carefully managed throughout a person’s life.

According to the CMHA, symptoms of mania include feelings of euphoria, extreme optimism, and exaggerated self-esteem; racing thoughts; diminished need for sleep; extreme irritability; and impulsive and potentially reckless behaviour.

Among the signs of depression are overwhelming feelings of sadness or grief; lack of interest in daily activities; social withdrawal; difficulty concentrating or making decisions; irritability or feeling angry; loss of energy; and feelings of worthlessness, helplessness, or hopelessness.

Bipolar disorder tends to worsen if it’s not treated, according to the NIMH. Delays in getting the correct diagnosis and treatment make personal, social, and job-related problems more likely. People with the condition are also at higher risk for thyroid disease, migraine headaches, heart disease, diabetes, and obesity.

Bipolar disorder is usually treated with a combination of medication and psychotherapy. Sesula took a “cocktail” of antidepressants, anticonvulsants, and antianxiety medications for years. Although she isn’t against the use of pharmaceutical drugs, she doesn’t take any medications now. Rather, she says that the medications helped stabilize her moods while years of intensive psychotherapy enabled her to find coping strategies.

“Reality therapy” is one form of counselling that Sesula found especially effective. Developed by Chatsworth, California, psychiatrist William Glasser, it’s based on “choice theory”; in other words, all behaviour is chosen. According to Glasser’s website, the cause of almost all psychological symptoms is people’s inability to get along with the important figures in their lives.

“Unlike all other living creatures, only human beings are genetically driven by the need for power,” Glasser’s site explains. “We try to satisfy that need by using”¦external control psychology—literally trying to force people to do what we want them to do. This struggle has led to the symptoms described in the DSM-IV [Diagnostic and Statistical Manual of Mental Disorders].”

Sesula also swears by having a “me” day once a week, when she stays home to rest and relax. Another way she keeps her bipolar disorder in check? “Cats,” she says. “They’ve seen me through it all.”