I met Sophie MacDonald for coffee on a quiet Thursday morning in Mile End. She was late, as expected. I had asked to meet at 10 o’clock to get her out of bed.
“I need to sleep,” she says. “If my sleep starts to tail off that’s a really bad sign.”
Sophie teaches music four days a week in East London, keeping Thursday free for creative projects: today, writing songs for a new musical. She is relaxed: loose clothes covered by a stylish down jacket to forsake the cold. She looks through the corners of light eyes, a fraction of a smile suggesting she wishes everyone would stop taking everything so seriously. The Lancastrian hint in her accent for some reason adds to that impression.
She returned to teaching recently after five years of severe struggles with bipolar disorder, depression, psychosis and stress. She wasn’t necessarily going to go back to a rigid school timetable but is grateful for the stability, and being able to function in society again.
“If you have not had such serious issues, you never think there might be a time when you are not even able to get a job,” she warns.
Now she is passionate about communicating with her students who don’t have the support she did, and don’t take enough time for themselves. Spiritual rather than religious, she feels there is a reason she is still here: to help vulnerable kids to realise that self-care is not selfish, and that they can overcome these struggles.
“It's hard to explain how hopeless I felt,” she says. “The key is coping strategies, not just waiting for a crisis. It takes work.”
Sophie can point to specific events that started her depression cycle. Aged sixteen her first boyfriend broke up with her. They had only been together for five weeks, but the stress and rejection made her skin flare up. It happened again at university when she had to compose atonal music.
“I felt I couldn’t do it,” she says. “This was meant to be the thing I was good at.”
A high achiever at school, she couldn’t cope with failure. It aggravated her skin, so she would isolate herself, feeling ashamed and worthless. Then she would self-sabotage, picking scabs to make them worse. Her mother had suffered with mental illness, and would often talk about how she hated herself. Sophie remembers wondering how someone could feel that way, but now saw herself repeating the pattern.
Things became serious in 2013 when, to outsiders, life looked perfect. She spent the summer in the Loire with her French boyfriend before starting a job at a top private school and a music therapy master’s. Again, Sophie imagined inadequacy, thinking she wasn't good enough to teach in a private school. The summer was bleak.
“I wasn't sleeping with the nervous energy,” she recalls. “When friends visited I isolated myself because I couldn’t have conversations.”
Anxious and fatigued, she lasted two weeks in the new job, and even less on the course.
“My brain was in fight or flight mode. I couldn't process anything,” she says. “That was really scary, being so depressed that my brain wasn’t functioning normally.”
Suddenly, she took off for Scotland, beginning a cycle of manic highs, depressive lows and delusional episodes that lasted three years during which she twice came close to losing everything: once in Scotland, on the morning an old man called Jimmy scampered down an embankment in the dark to talk to her as she stood on the brink. She doesn’t know who he was, or if he is to thank for her still being here.
I asked Sophie if she could remember how she felt during those years.
“It's like having a photo album with some amazing shots but you've lost half the film,” she says.
She recounts some events with good humour but feels there is a part of the brain that protects us from things it would be unhelpful to remember.
“Some of the experiences I had were a bit wrong,” she says, “but I haven't allowed myself to feel guilty because I don't really think it was me.”
She alludes to some in a visceral monologue: mood swings could make her hideously angry towards her family, then act like nothing had happened; at times she was needy and helpless, then felt such unbridled self-belief that she would apply for jobs from a psychiatric ward – and be surprised when she wasn’t allowed to go to interviews.
Her psychiatrists considered the first episode a blip, diagnosed depression with elements of psychosis, and prescribed high doses of medication. Life continued too fast.
“That was a big factor in becoming ill again: not observing the severity of the situation,” she says. “I wanted to forget it.”
Sophie moved to Cornwall and commuted to Bristol for the master’s, but hours on buses, isolation and the lack of sleep ground her down, and she took herself off her medication. When her boyfriend cut all contact, including on her thirtieth birthday, she was devastated. Only now can see it was the “best gift” he could have given her, because she could finally move on.
“It felt like he was responsible for me and could fulfil everything,” she says. “I thought if I wasn’t happy then he shouldn’t be. It was ridiculous and immature. You have to support yourself.”
And she knows he needed it too.
“That’s something I've learnt: it's not always about you.”
But at the time the relationship ended, Sophie moved to Bristol where things spiralled.
“Once it kicked off, it all kicked off,” she tells me.
Evicted from her house-share within days and removed from the master’s, she began living in hostels, eating in restaurants without money to pay, and was in and out of hospital again. Then one evening she took too many painkillers.
“That was the closest to f***ing myself up,” she says with characteristic understatement. “I just wanted everything to end. It's a bit of desperation, feeling so out of control that you just give up.”
Sophie was fitting in hospital, and close to needing a liver transplant, but so depressed she didn’t care.
“You think you’ll hurt your family, but they’ll get over it,” she says. “I started thinking about ways I could make it easier for them.”
Sophie spent seven months on a psychiatric ward, receiving a range of treatments that included Electroconvulsive Therapy (ECT).
“It was a bit One Flew Over the Cuckoo's Nest,” she says with a smile.
By now she wasn’t washing or speaking, and couldn't focus to read; her body was in survival mode. She agreed to ECT because the general anaesthetic meant she wouldn’t be awake for a while. She saw the same faces come and go on the ward, and could not face a lifetime in that cycle.
It all changed when she moved to the care of psychiatrist Ashutosh Kaushal, whom she nicknamed ‘Dr. Kash-Owl’ because “he looked like an owl with little round glasses.” He would listen and offer insightful questions.
“He was phenomenal,” she says, visibly more relaxed.
One day he asked why she needed other people to validate her. Suddenly she knew her outlook needed to change.
“I hadn’t realised how much I relied on other people's validation,” she says. “I was so pessimistic, and I needed not to put so much pressure on myself.”
For Sophie, being diagnosed with bipolar disorder was a relief. Previously, people just thought she was a bit down, but now she could explain.
“It's hard for people to understand who have never been depressed,” she says.
Sophie feels bipolar is different for each person, and so treatment must be fine-tuned; it’s not as simple as prescribing one universal concoction of drugs. For her, the “little owl man” got it right, and her journey is evolving. She reads Eckhart Tolle, watches Oprah, and listens to motivational speakers like Wayne Dyer. She also meditates, and keeps gratitude journals to focus on the good in others, shifting the focus away from herself.
“A lot of it has come through watching YouTube,” she says.
Her friends now say that she wasn’t herself back then: that she didn't seem to care. At the time, she was oblivious, but feels lucky these “guardian angels” were saving her from crippling bills, arrest and worse.
“There were lots of people who were looking after me and I didn't even know,” she says. “I stayed with friends for two weeks, and one didn't sleep because he was terrified I would go out at night.”
She now works with two old friends: a huge support, but one that has its challenges.
“They’ve seen me at my worst so if I’m down I worry they’ll judge me. I don't express myself day-to-day,” she says. “But that’s my issue.”
In many ways, her illness has brought her closer to her family; in others it has pushed them apart. Much of what happened was hard for her mother to witness, but Sophie feels she was safer that someone knew. Her father, a science teacher, has become more open in expressing his feelings. He took a year off to support her, then visited hospital every day when he went back to work, except once when he had an Ofsted inspection.
“I’m sure he has heard things he didn’t want to hear,” she says, “but it brought us closer in some ways.”
But she wonders if her parents’ immersion in her care created tension with her three brothers who saw the toll it was taking on them.
Medication played a big part in Sophie’s recovery, but her dose continues to decrease, and she is no longer under the care of the psychiatrist. Having made such progress, she hopes soon to remain healthy just by managing her lifestyle.
Now, her attention has turned to communicating her experience to help others. She has started writing a book, an A to Z of Wellness and an A to Z of Illness, in which she explores all facets of staying healthy. She also has ideas for how she can involve and educate the students in her school.
“On the master’s we had this idea to get people to keep a diary, then work with creative people to make art from it,” she explains.
She would like to adapt it for school and run a project with vulnerable students alongside creative teachers – art, photography, drama, songwriting – to create an exhibition with the text that inspired the pieces.
“There are definitely students with mental health issues,” she says, “but you don't talk about it unless you have to.”
It is all part of that feeling that there is a reason why she came through it all, feeling lucky that she emerged with her health and is getting better. And in a strange way, she doesn’t regret any of it.
“It was hideous, and I would never want to go that low again,” she tells me. “I'm not sure I can remember what it was like to feel that s*** all the time, but I have learnt a lot and, fundamentally, it has made me a better person.”
There were times when she would look at her friends and feel that illness had robbed her of something, but not anymore, knowing that, in the end, we can't compare ourselves to other people all the time. She can’t fix it all, but now knows how to work on it and take care of herself.
“It's not a computer game where you can complete a level then go on to the next,” she says. “It never ends.”
* name changed