Crying silent tears and trembling, Leah Charles-King queued at her GP surgery, clutching a handwritten message in her hand.
It read: ‘If you send me home, I’m going to kill myself. I’m suicidal and I need help now.’
‘It was that blunt,’ recalls the TV presenter, best known for Channel 4’s A Place In The Sun.
Just two days earlier Leah, then aged 30, had put on a bubbly performance on a live ITV show, but it masked a mental health crisis that had been brewing for some years. She had experienced periods of manic highs, when she became impulsive and barely stopped to rest, followed by crushing lows since her early 20s.
Leah Charles-King’s GP diagnosed depression and put her on antidepressants, but they didn’t seem to help – because she didn’t have depression
Place in the Sun presenter Leah Charles-King masked her anguish on TV
‘I would not sleep for days, not eat, but I was full of energy, rapid thoughts, very impulsive,’ recalls Leah.
‘I would also have periods where I would feel suicidal and depressed.
‘I could see something wasn’t right because I was very erratic.’
Her GP diagnosed depression and put her on antidepressants, but they didn’t seem to help, and there was a reason for that — she didn’t have depression.
The day she handed her desperate note to staff at her GP surgery, an ambulance was called to take her to hospital, where a specialist diagnosed Leah with bipolar disorder. What’s more, she was told the antidepressants she had been taking for years may have been making her symptoms worse.
While depression typically leads to intense sadness, pessimism and low energy, bipolar can lead to periods of those symptoms, but alternating with episodes of mania when people become intensely energetic.
Those affected may also engage in impulsive and potentially harmful behaviour, such as spending irrational amounts of money.
Despite the two conditions being ‘very different’ and requiring different treatment, ‘nearly 70 per cent of people with bipolar tell us they’d had a previous diagnosis of depression’, Simon Kitchen, chief executive of the charity Bipolar UK, told Good Health.
Diagnosis for bipolar disorder relies on an assessment by a clinician; the problem is that if someone with bipolar is misdiagnosed with depression, they could be put on medication that can exacerbate their mood changes.
‘Antidepressants have been found to be useful for some bipolar patients, but for the majority antidepressants are ineffective and may induce mood instability,’ says Guy Goodwin, an emeritus professor of psychiatry at Oxford University.
They do this by ‘activating brain networks that are predisposed to switching beyond normal mood into hypomania [a less extreme form of mania, which does not cause psychosis but can cause risky and reckless behaviour] — the drug causes the switch’, he explains.
Yet in a survey for Bipolar UK in 2022, 55 per cent of 2,458 people with bipolar disorder who were questioned reported being given antidepressants.
The charity also knows of cases where patients have been wrongly diagnosed with treatment-resistant depression when antidepressants fail to have an effect, in some cases leading them to be put on stronger medication.
The presenter had experienced periods of manic highs, when she became impulsive and barely stopped to rest, followed by crushing lows since her early 20s
Bipolar UK is now campaigning for GPs to ‘think bipolar before ever prescribing antidepressants for the first time,’ says spokesperson Mark Hayward.
The charity says it takes almost ten years on average to receive a correct bipolar diagnosis after symptoms first appear, despite it being very common, with more than a million people in the UK living with the condition.
‘GPs [are] pushed for time and assessing patients’ experiences and backgrounds takes time,’ says Professor Goodwin.
‘Patients with bipolar disorder don’t get the medical attention from mental health specialists that they need and that is a major problem: it is scandal really.’
Leah spent almost a decade going back and forth to her GP, before getting her correct diagnosis. This was despite raising her fear that she might have the condition, after catching a 2009 EastEnders storyline featuring a character with bipolar and identifying with her erratic behaviour. But her doctor rejected the idea.
‘My GP said, “There’s no way you can be bipolar — you’re too articulate”,’ Leah recalls. “You’re too self-aware. You’re too aware of your feelings and emotions and the state that you’re in. People with bipolar are crazy and you don’t appear to be crazy right now.” ’
Professor Goodwin, who is also a medical adviser to Bipolar UK, dismisses this as an ‘utterly ridiculous’ view.
‘Bipolar disorder is slightly associated with higher IQ and higher verbal skills,’ he says.
Leah says she was told however: ‘You’re just depressed — keep taking these antidepressants.’
Having been first prescribed them in her 20s, that’s what she did, but all the while her symptoms were ‘just getting worse and worse and worse’.
Bipolar disorder can be hard to diagnose, says Professor Goodwin, because while feelings of ‘worthlessness’ are easy for healthcare professionals to recognise as depression, the manic symptoms also experienced by those with bipolar ‘are difficult to recognise as illness’.
‘That’s because they often look like good health — increased energy, increased enthusiasm, increased involvement — and it’s only when that turns into something a bit more toxic, when it turns into irritability, aggression, not being able to sleep or concentrate, that it becomes more recognisably an illness,’ he explains. This side can also manifest as impulsivity, hypersexuality (with lots of sexual partners) and spending large sums of money.
Patients are also less likely to seek help when they are manic —meaning doctors won’t see their mood variability. In some cases people experience mania characterised by psychosis and hallucinations, where they completely lose touch with reality.
At her worst, Leah swung from feeling so depressed that she could barely get out of bed and ‘couldn’t even brush my teeth’, to suddenly changing ‘overnight’ and starting to display ‘full-blown mania’ (something that happened before she received the correct treatment).
At those times, friends would actually praise her for being ‘super hyper and energised’, believing her to have lifted out of her depression to be back ‘on top form’.
Yet she could snap the other way alarmingly quickly. Two days before her desperate note to the GP practice, Leah had put on a sunshine yellow dress and made her live TV appearance — just two hours later, a fearful friend had to talk her down from the top of a building.
‘I couldn’t take the mental torture,’ says Leah. ‘My friend talked me down and then I wrote that suicide note to my doctor.
‘I just felt “this is my last chance”. If I didn’t get help today, I knew what I was going to do, so I plucked up the last bit of strength that I had.
Experts warn that people should not suddenly come off antidepressants without first discussing their treatment plan with their doctor
‘I was so impulsive within this mania and fed up of all the pain and anguish that I’d had enough,’ she recalls.
After being seen by a specialist, Leah was given a combination of bipolar medication and talking therapy and her mental wellbeing vastly improved — she landed her dream job in 2021, a presenter on A Place In The Sun.
However, now in her 40s, she is still angry she spent so many years with the wrong diagnosis and treatment: ‘Antidepressants can make somebody’s illness much worse,’ she says.
But experts warn that people should not suddenly come off antidepressants without first discussing their treatment plan with their doctor, as this can lead to serious side-effects.
Professor Goodwin says that official guidelines recommend that treatment for bipolar disorder comprises ‘medication that isn’t solely antidepressants, but has an element of mood stabilisation about it.
‘Lithium seems to be the most effective against all manifestations of bipolar disorder — depression, mania and mixed states — [and] seems to be effective in a way that other drugs aren’t.’
For further information on bipolar visit: bipolaruk.org. If you need urgent assistance, you can contact Samaritans for free on 116 123; email: jo@samaritans.org; or visitsamaritans.org to find your nearest branch.