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Hi, I'm Sarah Schley. I'm from Western Massachusetts where I live in a beautiful rural space in the woods. I am a proud mother and grandmother. I'm also the founder of an international sustainability consulting company where I've worked with businesses like Nike and Ford and many more for over 30 years. But that's just a glossy surface. And I'm here to go deeper with you right now and tell you my story. So when I was 21, I was a senior at Brown University and I was kind of a rockstar kid. I had a 4.0, I had a bunch of feisty, warm friends and I was headed off to one of the best medical schools in the country. And then what happened to me in the flip of a switch was my brain stopped working. And it was a tailspin into a terrifying reality that I had no idea what was going on.

Suddenly, I couldn't add 2 plus 3 when I'd been acing calculus. I was too scared to leave the room and so horrible situation. So then what happened for me was over the next several decades, I suffered from this debilitating brain disorder and it took 25 years, 7 medications and 5 psychiatrists who finally get my diagnosis right, which is that I'm bipolar II on the bipolar spectrum. Now, most people have never heard of a bipolar spectrum. You may have as a clinician, but even many health professionals don't know what that is. So I think it's really important to... It's critical to distinguish between bipolar I, which looks like classic mania, up and down. Unipolar depression on the other end of the spectrum, and then all the kinds of bipolar in between, again, which I have bipolar II. So why is it so hard to diagnose? In people who have brains like mine. We don't show extreme mania and because we don't act manic, but we do have many of the same symptoms as classic major depression, lethargy, despair, suicidal ideation, et cetera. We're consistently misdiagnosed as regular depressed in quotes and given antidepressants.

In my case, that antidepressant is sort of poison in my brain and it induced hypomania and actually made me worse. So we could tell you a lot more about that, but it's absolutely critical that you get the diagnosis right, because people with bipolar, any kind of bipolar are twice as likely to take their own lives as people with unipolar depression. So getting it right is literally a matter of life and death. And in the average 11 years it takes to get the correct diagnosis. People with bipolar are suffering. They are friends and family. They're among the incarcerated, the addicted, the homeless, and in some cases tragically the suicided. So yeah. Got to get the diagnosis right.

So why is there so much misdiagnosis and why did it take 25 years for doctors to diagnose me correctly? I think many have the mindset that when they see someone who looks depressed, they're depressed, they're unipolar depressed, they're going to get given the wrong drugs. So what you have to do is if you see someone depression walk into your office in 1 out of 3 or 1 out of 4 cases, they may actually have some form of bipolar and you must screen for bipolarity, screen for bipolarity, screen for bipolarity. They're simple screens. They're available on the internet, they're available on my website, they're open to the public. And it's really essential that you do that to get the diagnosis.

So people aren't getting the wrong drugs, people aren't suffering, people aren't dying. This means listening to your patients and listening to what they say too. Because if you do give someone an antidepressant who's bipolar, and it may make them worse, you got to listen to them. Because if they come in saying, "Hey, I had this episode where I was up all night, or all of a sudden my husband's telling me I'm irritable." You have to know, "Oh, that may be because they are bipolar II." No mania, but hypomania induced by the medication, the antidepressant medication. So listen to your patients.