 Our sixth speaker of the evening is Julianne Armijo. She's a PhD student in the School of Nursing and a Family Nurse Practitioner. In her talk titled, What It's Like to be a Nurse with Bipolar Disorder, Julianne describes what it's like to live with bipolar disorder. She provides a candid perspective about being both a patient and a healthcare provider. By sharing her struggles and successes, she hopes that she can debunk misconceptions about this misunderstood mental illness. Through her research, she will seek answers about how not only to live but thrive as a nurse with bipolar disorder. But please be advised that Julianne's speech contains brief mentions of sensitive topics, including statistics on suicide and depression. And so the listener discretion is advised and we encourage anyone who might find these topics troubling to exercise self-care and seek support if needed. Some interesting facts about Julianne is that she's learning how to speak Icelandic and she's a licensed falconer who works with wild birds of prey. Please welcome Julianne. The Starry Night is one of the most recognizable paintings in the world. And it's one of Vincent Van Gogh's most celebrated works. But when I say Vincent Van Gogh's name, what else comes to mind? It's okay to be honest. Is it the visual of a severed ear? Evidence of a tortured artist? His birthday is March 30th. Now why do I know this? I'm a nurse, I'm not an art historian. And why is it important to my talk today? It happens to be World Bipolar Day as in bipolar disorder. Now when I say bipolar disorder, what or who immediately comes to mind? Maybe you thought of a famous actor or actress or musician. There have been plenty that have had well-publicized and sensationalized breakdowns like Kanye West. Maybe you thought of a TV or a movie character like Ozark, Silver Lighting's playbook or Homeland. During their time on our screens, they have very obvious, usually public meltdowns. But what about the rest of us? Those of us who don't live in those extremes all the time, those of us who experience our symptoms in silence. Did anybody think of University of Michigan President Dr. Santa Ono? He's been very outspoken and candid about his experiences with bipolar disorder. How about PhD student or registered nurse? That's me in the marshmallow suit circa 2014 by the way. For many years, I worked as a bedside nurse in the intensive care units. And when I started off, I began right at the bottom of the nursing food chain, which meant I had to work rotating day and night shifts and night shifts. Now, has anyone here ever worked a rotating or a night shift or known somebody who has? Do a show of hands. Oh, wow. How did you all feel or how did they feel when they were working those shifts? Not great. I'm guessing the core issue was sleep. Trouble sleeping for those without mental health struggles is tough enough, but for those with bipolar disorder, it can be catastrophic. In the simplest terms, bipolar disorder is a cyclical extreme shifting of moods and perception. Now, everyone here is familiar with changing moods in ourself and others. It's part of the human experience. But imagine your moods, your worst moods holding you hostage for days, weeks, even months on end. My mental health struggles began when I was 14, but working these rotating and night shifts was like adding gasoline to a bonfire. My sleep devolved into an utter mess and my mind began to change in ways that I couldn't understand or control and I had no idea why. Why can't I sleep for days? Why are my thoughts racing? Why am I crawling out of my skin? Why are the trees sparkling? And why have I suddenly decided to leave my nursing job and start an organic cranberry farm in the upper peninsula of Michigan? I don't even like cranberries. I think she might though. Why were my thoughts so jangled and discordant? And then let's fast forward a week later. Why did I suddenly cancel all my plans? Why did I suddenly ghost all these new acquaintances that I had just made? And why for the life of me could I not get myself up off the couch? Having to call into work sick with the flu. All of these symptoms I just described were a constellation of mania, hypomania and depression. And these cycles continue over and over and over again. It took me well over 10 years to come to a correct diagnosis. And whereas a nurse who was supposed to have the answers turned to find not only answers but solace. The answer was that there were no answers. But when we finally have our diagnosis in hand, what do we do with it? Through the power of proper medications and comprehensive mental health care, those of us with bipolar disorder can not only function but thrive, harnessing our creative energy and enthusiasm into great projects like doing a King Talk. But there's a gap in knowledge. Major depression, the type that doesn't have the cranberry highs and anxiety have been well studied in registered nurses. But there are more functionally debilitating counterparts. The bipolar disorders exist only as sparse case studies in the literature. Bipolar disorder is covered under the Americans with Disabilities Act, which ensures reasonable health or reasonable work accommodations. But the nurses that I know with bipolar disorder who have filed for these protections still feel unprotected. Why is that? Nursing is a seniority-based job, like many jobs, which means you paid your dues, which means that you're eligible for things like better vacations, bonuses, and including better work shifts. Now, on average, one of the most coveted nursing seniority benefits is getting to work a day shift. Now, in my discussions with sleep and bipolar disorder experts, their number one recommendation for workers with bipolar disorder is to, you guessed it, avoid nights and rotating shifts. So imagine, you're a brand new nurse, fresh out of nursing school, you know that you have bipolar disorder and you do all the things, jump through all the hoops, and you're ready to start your first shift as a new nurse on a day shift. But think about all the rest of those nurses on that unit you were just hired onto. And what are they thinking about this new interloper who has not paid their dues and is now taking one of their coveted day shift positions? It's like painting a gigantic bullseye on your back. And even those of us who have toughed out these rough schedules and have gained seniority still fear giving up our diagnosis because through words and actions, we observe our coworkers and they don't necessarily say the nicest things about those with mental illness. It's not unreasonable to think that they would think the same things about us, especially those of us who've had to spend time in the hospital for it. But why should our colleagues care? Why should society care and why should you care? Bipolar disorder has the highest suicide rate of all psychiatric conditions and it's approximately 20 to 30 times higher than the general population, 20 to 30 times higher. Now couple this with the fact that registered nurses have an above average suicide risk and together this theoretically puts registered nurses with bipolar disorder at an exceptional risk of suicide. Now that is a great reason to care about those who have made a career of caring for others. Through my research, I wanna find out how many nurses are out there living with bipolar disorder. I wanna find out their demographics, their experiences, I wanna find out everything because as a researcher, I wanna turn that information into action. I wanna find a way to help keep the bullseye off somebody's back. If our job puts us at risk of developing asthma, we don't question it. We don't base somebody's worth on it, we don't judge them. Their workplace provides them a respirator to help protect them. So why do we treat mental illness any differently when perhaps all we need is a mental equivalent of a respirator? Both of these conditions are entirely treatable and even possibly preventable. In healthcare, we are expected to be on our game at all times, but to be on our game, we need the backing of our team, our team being our colleagues and our employer so that we can win. And what is winning in healthcare? We know what winning is for the Wolverines, but what is winning in healthcare? To me, winning means that when you're at work, you're at your professional best and you're able to give all of yourself to every patient who walks through that door, many of them on the worst day of their lives. So the next time someone says bipolar disorder, I challenge you to think about it a little differently. Think about it a little bit more like asthma, a little bit less like ticking time bomb, a little less severed ear and a little more starry night. Thank you.