"“Walk it off” then “good luck” - unsupported bipolar episode"

I have had Bipolar Type 2 for 5-6 years. My first manic episode in the last 6 weeks has completely blown up my life, and the way I was treated by my psychiatrist and South Metropolitan Health Service (SMHS) WA made it even worse. Instead of feeling supported, I felt I was dismissed, blamed, and basically told to come back when I’m even more unwell.

When I first started having delusions and manic‑type symptoms, I told my psychiatrist clearly what was going on: feeling like I had an “evil aura,” believing my dog could see my evil spirit, religious and soulmate‑type delusions, sleeping only a few hours but feeling wired, being extremely restless and reactive, spending thousands of dollars impulsively, and then crashing into suicidal thoughts and planning. Their response was not to urgently review my medication or take my psychotic symptoms seriously, but to tell me to 'walk and sleep in a dark room' for four weeks, as if I could just lifestyle‑hack myself out of a terrifying first episode. My psychologist was telling me I 'did not look well' and 'was not presenting with clarity,' but my psychiatrist still brushed off the seriousness of what I was describing.

Only after things kept getting worse did my psychiatrist finally admit they were “out of their depth” and say I needed hospitalisation. There was no real plan, no careful handover, and no meaningful medication adjustment, just, essentially, “you should be in hospital” and then a discharge that felt like “good luck, you’re on your own.” Being told to walk in the dark, then abruptly told I was too complex, left me feeling like a problem to get rid of, not a patient to care for.

This episode has destroyed key parts of my life. My university grades have dropped from the 80s down into the 50s because my concentration, memory, and stability have been shattered. I’ve had to stop EMDR and trauma treatment, which I had been working hard on, because my mental state is too unstable to continue safely. I cannot work at all because my mood, thinking, and functioning are so disrupted, and my finances have already been hit by impulsive spending during the episode. This isn’t just a “rough patch”; it has derailed my study, therapy, and ability to support myself.

After being dismissed and then abruptly discharged by my psychiatrist, I turned to SMHS WA as my next hope for proper help. On the phone, I explained that this was my first serious bipolar‑related episode, that I’d had psychotic delusional experiences, intense sleep disturbance, weeks of restlessness and abnormal behaviour, impulsive spending, and a depressive crash with suicidal planning, and that my psychiatrist had basically told me they were out of their depth and discharged me. I asked a very reasonable question: “What am I going to do to prevent psychosis again?”

The response I got from SMHS I felt was infuriating and terrifying. I was told I’d have to wait four months to see a private psychiatrist. I was told that because my parent “didn’t notice” I was in an episode, it meant I wasn’t in hypomania or mania, as if my parent’s interpretation (who sees my symptoms as ‘just my personality’) counts more than my experience, my psychologist’s observations, or the actual symptom pattern. I was told that the psychiatrist won’t change their mind, it must be your trauma, neatly, I feel, dumping everything back on trauma instead of acknowledging clear bipolar‑type and psychotic‑like features. And when I asked again how to prevent psychosis, I recall I was basically told, “I don’t know, maybe when you have another episode, you can present yourself for assessment.”

So after my first major episode: complete with delusions, massive sleep disturbance, impulsive spending, suicidality, and a huge impact on my functioning, I was given no medication adjustment, no short‑term safety plan, no active follow‑up, and told to wait months and come back when I’m worse. In my opinion, that is dangerous and unacceptable. It feels like the system’s message is: “You’re not believed until you’re in full‑blown psychosis in front of us, and even then, we might just send you away.”

There was nothing about this experience that felt caring, compassionate, or evidence‑based. I felt gaslit by the focus on whether my parent “noticed” an episode, invalidated by my psychiatrist’s initial advice to just walk and sleep in the dark, and abandoned by the “good luck” discharge and the SMHS response. I am angry because this was my first manic like episode and I did exactly what people are told to do seek help early, and I was still left unsupported, unsafe, and watching my study, therapy, and work capacity fall apart.

I am sharing this story because people experiencing a first bipolar episode with psychotic‑like symptoms should not be told to walk in a dark room, should not be discharged with “good luck,” and should not be told to wait months and only return when things are worse. We deserve timely assessment, serious consideration of our symptoms, medication and risk‑management plans, and services that don’t seemingly rely on family minimisation to decide whether we’re “sick enough.”