On The Level: January 2025

ON THE

LEVEL Scotland’s e-magazine for people living with bipolar Winter 2025

INTO THE DRAGON’S DEN!

Managing Business & Bipolar

RESEARCH CORNER:

Men and bipolar

Big Membership

News!

in 2025!

Finding a better balance

bipolarscotland.org.uk

Foreword / Winter 2025 Happy New Year to each and every one of you!

I have to admit that I’m not a fan of January and the tidal wave of expectations that often come with it. In the past, I’ve often felt under pressure to commit to some form of ‘new year, new me’ promise or challenge (usually something fitness or weight-loss related) and, when I inevitably fail, I’m left stranded with my own self-loathing – as well as several pounds of unshifted Christmas weight.

Not this year. I want to start 2025 fresh and ready for the challenges and opportunities ahead and to do this I know I need to focus on self-care: getting better sleep; making time for family and friends; maybe even finally starting the expensive sewing project that’s been gathering dust on my bedroom shelf for over a year…

With all this in mind, I wanted to focus this issue on the conflicting emotions that New Year can bring. Because although society pushes us to be motivated and raring to go with our self-improvement plans from the moment the last rowdy line of Auld Lang Syne is belted out at the bells, we all know that’s just not the case for everyone. And that’s okay – mental health doesn’t work to a calendar.

For many people living with bipolar, detainment in hospital marks their lowest point in their journey. While this is a distressing topic, we feel it’s important to know your rights and so our friends at the Mental Welfare Commission for Scotland have pulled together a helpful guide on page 22. Graham Morgan, who works for the MWCS and has his own lived experience, provides his own reflections throughout.

Lived experience continues to pulse at the heart of everything we do and so we’re chatting to three entrepreneurs who have successfully built their own businesses while managing their bipolar so if you’re looking for an instant hit of inspiration then look no further than page 6. Many of our peer workers and volunteers also have lived experience of bipolar, giving them unique and important insight into the lives of our members and the challenges they face – meet one of our amazing Peer Support Workers, Lynsey Mackenzie, on page 10.

There’s plenty more to get stuck into so pour yourself a mug of something cosy, get comfy, and have a read (with a cheeky self-care snack on the side).

Don’t forget – if you have something you’d like to share with On The Level, please email editor@bipolarscotland.org.uk with the subject line ‘On The Level’. Our next edition will be out on Wednesday 26th March; we need all contributions in by Monday 10th March.

Sian Dolan Editor Image: Vecteezy.com

Contents

6

Into the Dragon’s Den! Balancing Bipolar with Business

12 14

RESEARCH CORNER: Men’s Experiences of Bipolar

David Carr: Bipolar Disorder, ADHD – & Me Edited by Jamie Stewart and Sian Dolan.

Please note that the views and opinions expressed in On The Level are not necessarily those of Bipolar Scotland.

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Submissions: If you would like to submit a piece of writing, a photo or an idea to be considered for future issues of On The Level, please get in touch with Sian Dolan (editor@bipolarscotland.org.uk) We would also love your feedback about On The Level.

Send us an email or reach out to us on social media.

You can find us on Instagram (@bipolar_scotland) and Facebook (@bipolarscotland) ©Bipolar Scotland 2024 T: 0141 560 2050 Scottish Charity No. SC021705 E: info@bipolarscotland.org.uk Company No. 163305 bipolarscotland.org.uk

Image: Vecteezy.com

Meet Our Fabulous Fundraisers!

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Noticeboard PET LOSS SUPPORT

For many of us, the loss of a beloved pet can have a devastating impact. If you’ve lost a pet, whether through death, enforced separation or theft, please don’t face the pain alone – the Blue Cross Pet Loss Support team are on hand to support you.

The UK-wide service offers a free and confidential helpline, webchat, email and Facebook group to help you find support when and where you need it. Here’s how you can get in touch: CALL: 0800 096 6606. Someone will be available to take your call between 8.30am8.30pm every day.

EMAIL: plsmail@bluecross.org.uk and they’ll respond within 48 hours.

WEBCHAT: Visit https://www.bluecross.org. uk/pet-bereavement-and-pet-loss and click on the chat icon at the bottom right of the page. Open between 8.30am-8.30pm.

FACEBOOK: https://www.facebook.com/ groups/bluecrosspetloss Click ‘join group’ to post and read discussions from people who have been through pet loss.

Image: Pexels

VOLUNTEERS NEEDED

We are looking for help from people with lived experience to develop the GRAASPEarly research program. GRAASP-Early aims to investigate the role of pharmacists working in general practices enabling physical health monitoring and medication reviews for people receiving antipsychotic medicines (adults 18-65 years old).

If effective, GRAASP-Early may help with early identification and treatment of heart disease and/or diabetes, reducing the risks of disease complications and deaths due to avoidable causes, and minimise the risk of adverse medicines effects. However, we need your help to develop the research program and guide the research team.

If you have lived experience of antipsychotic medicines and are interested in helping, please get in touch with Chris Johnson by email at: Christopher.Johnson@nhs.scot

CALLING ALL CARERS! The Mental Welfare Commission for Scotland carries out a themed visit on an annual basis.

These visits focus on people who have similar issues, or are in similar situations, across the country. We publish all our themed visit reports on the Commission’s website. This year, our focus will be on carers.

We have developed an online anonymised questionnaire to help gather the views of families and carers and would appreciate it if you could spare around 15 minutes of your time to share your views and experience – the form cannot be saved and so you will need to set time aside to complete the questionnaire in one go. You can access the questionnaire here: https://forms.office.com/pages/responsepage.aspx?id=veDvEDCgykuAnLXmdF5JmmqV5zjlU1VNo6IpCEmxy9VUQlk5NEFKMk9JVjczSkVETTBJU1pVRDhPSy4u&route=shorturl By completing this form, you will help us have for the first time, the broadest understanding of family and carers experience in dealing with services in their carer role. It will help us produce the report that may have recommendations for services, Scottish Government and possibly other organisations.

Thank you!

TAKE CONTROL WITH SELF-MANAGEMENT TRAINING • Do you want to learn coping techniques and strategies to help manage your bipolar?

• Access the tools you need to help you identify – and ward off – your triggers and warning signs?

• Discover more about medication management and preparing for the future?

If so, our Self-Management Training can help!

The next block of our popular in-person Self-Management Training will kick off in West Lothian on Sat 8 & 9 February.

This two-day course is designed to help you self-manage the symptoms of living with bipolar. As with all our groups and courses, it’s free for all Bipolar Scotland members. Book your place today at https://bipolarscotland.org.uk/ self-management-training/ or email training@bipolarscotland.org.uk for more information.

Images: Pexels/Vecteezy.com

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Into the

Dragon’s Den Written by Gillian Sheriff

Typhoon Ten Delicious vegan street food with a conscious

Typhoon Ten is a popular vegan street food truck famous for its ‘dirty vegan street food’. Founder Sam Christie gives us the background on starting her business and what she’s learned along the way.

What inspired you to start your business?

Vegan food outlets at big events are few and far between so there was an opportunity. We originally intended on starting with a marquee at markets, but I had a hypomanic episode and convinced my friend to jump in and buy a huge van, I had zero kitchen experience and not a clue what I was doing so it was a fast learning curve! When my episode passed, I thought, ‘Right, I need to make this work now’.

What challenges do you face while running a business and managing bipolar?

Stress and lack of sleep are massive triggers for me and that’s basically what my summer is made up of now. There’s also a lot of admin and behind the scenes work which can feel overwhelming at times and if it comes to a point when I’m not feeling my best, it can be difficult to get on top of.

works and what doesn’t, and how to balance working with my mental health.

What advice would you give to someone with bipolar who is considering starting their own business?

It can be tempting to take on loads of work, especially at first, but you have to weigh up what the cost will be to you personally when it comes to your wellbeing. One of the great things about working for yourself is that you have flexibility – I’ve ended up doing admin or applications during bouts of insomnia and that’s fine! Everything gets done when it works for me.

What do you do when times get tough?

I always try to remember that episodes pass when I’m in the midst of one. I also love a list – I break things down into smaller steps and it helps get me started when something feels overwhelming.

What are the advantages?

I wouldn’t have my business were it not for the bipolar. I can also be really focused, creative and productive at times, which is really useful.

How would you say bipolar has impacted your business journey?

It gave it a jump-start then it’s made me be more selective. When I first started, I said yes to everything and ran myself into the ground.

With time and experience I’ve learned what

Typhoon Ten: https://www.typhoonten.co.uk/

Mindsets Personal training with a focus on mental health MINDSETS is a Glasgow-based personal training business set up by Ewan Grant.

Formerly a music lecturer and tutor, Ewan decided to pivot into the health and wellness industry and launched MINDSETS in 2024.

He offers tailored personal training to inspire people to maintain an active lifestyle to improve both their physical and mental health.

What inspired you to start MINDSETS? I know first-hand how lifestyle changes and routine can really benefit mood. I liken myself to a human Apple watch; I monitor all of your symptoms and help you keep on track. This is how I personally deal with bipolar – I have a very strict routine; exercising, meditating, drinking water and eating a certain diet.

It helps me take less medication and also helps with the side effects of the medication.

MINDSETS is not only for those with bipolar – everyone can benefit.

What are the biggest challenges you’ve faced running your own business?

I would say stress over cash flow, winning new clients and then retaining those clients.

However, I would say the fact I do a physical job helps; it is difficult to be stressed when you’re tired! I used to sit behind a desk all the time and then my mind would run but now I am always physically tired, so my stress levels are proactively managed.

point and there’s a strength in that spark that will make you stronger than before.

What advice would you give to someone thinking of starting their own business?

If you are doing something you believe in, then it won’t feel difficult. I think the point of having your own business is to be free. It also instils a sense of pride – I think a lot of people with bipolar want to prove that they can do anything as well as anyone else.

Be yourself and don’t understate the power of being nice to people and doing your job well.

A lot of my business has been built up through old-fashioned connections, word of mouth and making face-to-face connections with people. Have confidence in yourself.

Is there an inspirational quote you turn to when times get tough?

“We can’t control all the variables in our lives.

It’s about what we do with opportunities revoked or presented to us that determine how a story ends.” – David Goggins

What are the main advantages of running your own business?

You can plan your own routine; you can make everything work for you according to your own schedule. If I need to take a day off or move my schedule around, I have the flexibility to do that. I’m pretty good about knowing when I need to take a rest. The point is having the freedom to live my best life. A healthy and fulfilling life that uses the negatives and turns them into positives for myself and others.

How has bipolar impacted your business journey?

You often have a feeling that you can do anything. It’s not necessarily a positive part of the illness, but it can help you chase ideas – you’ve just got to maintain it and not become unwell. There’s a spark that goes off at some

MINDSETS is offering a free taster session for On The Level readers. Get in touch with Ewan via Instagram (@mind.setscoaching) or drop him an email at: mindsetscoach@gmail.com Image: Vecteezy.com

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The Highland Yoga Collective Wellbeing with a social impact The Highland Yoga Collective is a yoga studio, operating as a social enterprise, based in Nairn in the Scottish Highlands.

It was established by Fiona Palmer in 2020 and offers an inclusive and nurturing environment which brings people together through yoga, movement, stillness and community.

What inspired you to start you own business?

I was diagnosed with bipolar in my late thirties, and I had practiced yoga on and off, but I found that yoga and mindfulness really helped me come to terms with my diagnosis. I saw the impact it had on me and some of my friends and I wanted other people to be able to access it.

also gives you a lot of empathy for others.

It is almost like a superpower – it is just the shadow side of it, which is very difficult, even getting up some days can be a challenge.

People often say that bipolar is both a gift and a curse.

What advice would you give to others thinking about starting their own business?

Trust your own instincts and your vision and be true to yourself. A lot of people keep ideas in their heads, so it’s the people that have the courage to put their ideas out into the world that can make a difference. I love it when people come along and tell me, “I thought I couldn’t come, I thought this wasn’t for me”, and then to see them week after week – they become like family.

What makes The Highland Yoga Collective unique?

I wanted to create somewhere that was inclusive and at the heart of the local community. So, we made sure our studio was very supportive and safe for people that had physical and mental health issues. We don’t tell people what to do – we let them find their own path. It’s really about breaking down societal barriers so that people can participate.

What are some of the challenges yo have faced?

It started off as a bit of a rollercoaster as we opened during the pandemic in 2020. We began small and we’ve now grown to offer over 1800 hours of free classes, workshops and events to over 500 people in 2023. We also have a board of directors and I’m very lucky because when I get ill, they can help me.

I’ve really been able to talk about my journey and be open about my diagnosis, which is lovely.

What are some of the benefits of running a business with bipolar?

Multitasking – you can spin a lot more plates!

I’ve got a photographic memory and when I’m on top form I am very creative. It probably sparks everything. I am very good at starting things and giving momentum to a project. It

Connect with The Highland Yoga Collective @Highlandyogacollective on Instagram or email highlandyogacollective@gmail.com

SPOTLIGHT ON:

PEER SUPPORT WORKER Get to know Lynsey Mackenzie, one of Bipolar Scotland’s amazing Peer Support Workers!

How did you become a Peer Support Worker for Bipolar Scotland?

I was working as a childminder and due to a lot of stress that came with being self-employed, I had started to feel like I needed a complete change in my career.

I knew I wanted to work in a role that helped people, and I felt like my strengths lay in helping other people to cope with and manage their mental health. I had been stable for a long time and had learned a lot of coping strategies and so reached out to Bipolar Scotland to train as a volunteer to gain more knowledge and experience of working in the charity and mental health sectors. When the role of Peer Support Worker came up, I was lucky enough to get the job.

Can you explain a little about what your role involves?

I work in both the Beyond Diagnosis and Peers Together services to help support anyone who is struggling. Beyond Diagnosis focuses on supporting people who have been newly diagnosed with bipolar and need support coming to terms with their diagnosis or to help them set goals and coping strategies to get well and stay well. Peers Together is for anyone who is struggling with their bipolar symptoms and needs a little extra support.

The support I give looks different for each peer – for some it means being a listening ear, for others it involves more recovery focused goals. I share my own experiences with bipolar and my recovery with the people I work with as well to ensure no one feels alone in what they are going through.

What does your typical day look like?

My day usually starts by checking to see if any of my peers have been in contact since my last shift so I can respond to them as quickly as possible and then I start my appointments. Each session I have lasts between 45-60 minutes, depending on what each peer needs that day, and each appointment is very varied.

With bipolar being a very individual experience it’s important to go into each session with an open mind as to what they need most from your time together.

I take half an hour between each of the peers I work with to take some notes on what we have talked about so I can reflect on our time together and best prepare for our next session.

What do you like most about being a Peer Support Worker?

I have always enjoyed helping other people and being able to give support to someone who needs it is really rewarding. I also love getting to know new people and hearing their stories and experiences and working in peer support allows me to meet a lot of people from different backgrounds that I maybe wouldn’t have had the opportunity to meet in my everyday life.

What do you find most challenging?

I think being able to switch off at the end of the day can be quite hard for me. I meet a lot of people who are experiencing really difficult situations and I’m naturally quite a reflective person, so I find it really important to practice self-care to look after my own mental health.

Has your role changed how you view or manage bipolar?

I have always viewed bipolar as a very individual experience, so I don’t think it’s changed my view on it, but it has definitely changed how I manage it. I learn a lot from my peers and their experiences are just as valuable as my own, so I find myself adapting my own self-care practices, trying new things that I hadn’t considered or known about before and looking at things from different perspectives.

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Bipolar disorder, ADHD - and me

by David Carr

It was my internet soul brother Ryan – who I’ve never met and who lives in New Zealand – who first put ADHD on my radar. Ryan is an astute social commentator and redistributor of memes on subjects from mental health to late-stage capitalism to capybaras.

Ryan lives with bipolar disorder. This I knew. His expertly curated shitposts often speak to the painful absurdity of the illness.

But then Ryan started posting about the challenges of his comorbid ADHD. And – again – I felt the shock of recognition.

I have written previously that my bipolar disorder is in remission. But as the chaos calmed, I was faced with the reality that there was – something else – up with me.

Certain negative aspects of my life, certain behaviours, certain challenges, could not be explained by bipolar disorder alone. Prompted by Ryan’s memes, I began to recognise in me the patterns of ADHD – specifically, ADHD with inattentive features.

I learned that some fifteen to twenty percent of adults who live with bipolar disorder may also have ADHD. There is no rule to say that we are rationed to just the one disorder.

be absent minded, I am messy, I am disorganised, I procrastinate.

But isn’t that fairly normal?

Well – something becomes a disorder when it impacts negatively on your life. As the tide of my bipolar disorder ebbed, I was left with a residue of life disasters which it didn’t explain.

I am preternaturally poor at business and personal finances. This has cost me dear.

I am notorious for losing my phone or wallet. My inattention to boring, routine tasks – paying bills – leaves me with avoidable messes. I often have to pay the ‘ADHD tax’ of late payment charges. I get the times of appointments confused – my dentist is making a lot of money out of this. At work, I was often disorganised and repeatedly disciplined for having a messy desk. The messiness extends to my home and until recently, was greatly detrimental to my mental health, a source of shame and fear of visitors. It goes on.

The life implications of my behaviours have led me almost to suicide – and that is all folded in with my bipolar depression.

When you tell people that you have bipolar disorder, they nod sympathetically – but generally lack the experience to know what it means. That was pretty much my level of knowledge of ADHD. I thought it was all about children being unable to sit still in class.

I will be upfront at this point. I don’t – yet – have a formal diagnosis. With my psychiatrist’s support I am awaiting assessment. But the more I learn about ADHD – particularly from the ADHD community itself – the more I’m realising that I fit a pattern.

My own ADHD traits are that I can

Where do I go from here?

I am finding that simply learning about ADHD – including its neuroscience – has helped me find ways to cope.

Understanding the concept of ‘executive dysfunction’ was a key breakthrough.

It’s also helpful to know the basic neurophysiology of dopamine receptors and their role in motivation and reward.

I am understanding that much of my ADHD manifests itself in the maladaptive things I do to cope. One example – I am somewhat time blind – but always needlessly prompt. What people don’t see is the effort this takes – arriving stupidly early for my train having spent two hours doing nothing until it is time to leave. This is ‘Waiting Time’ in ADHD terminology.

But the ADHD brain can be hacked.

A big one for me has been untidiness.

It is preferable for me to spread out ever-expanding nests of my belongings rather than tidying them away, ostensibly so that I can find them easily. Which – obviously – doesn’t work. The way my brain works, I find it difficult to rein in

the chaos. But a good, good friend has introduced me to the concept of ‘body doubling’. Over a few weeks, we sorted out my mess together – not only her physically helping me but also providing me with the structure and motivation to do it myself. I’ve learned to reprogramme the source of my dopamine hit so that housework has become almost – almost!

– a joy.

The key has been understanding that my life messes were not my personal failings but resulted from the way my brain is wired. It is wired also – I believe – with powers of hyperfocus and creativity. I am – as the memes say – neurospicy.

I am slowly learning to strategise around my neurospiciness. My ADHD may have done me lasting life damage - but at least I now know that it wasn’t my fault. This is no small thing.

So big hug reacts to Ryan for starting me on my ADHD journey. I look forward with anticipation to more of his hi-jinks and tomfoolery.

Image: Pixabay/ Vecteezy.com BIPOLAR SCOTLAND 13

RESEARCH CORNER Research corner is coordinated by researchers from the University of Edinburgh.

If there is a topic you would like to find out more about, or if you have suggestions for this section, please get in touch. You can contact Amber Roguski at amber. roguski@ed.ac.uk.

Men’s Experiences of Bipolar: A Photo-Elicitation Study

The transition into a new year can be a time for reflection, as well as a time for looking ahead to the future. Our first guest author of the year is Dr Rob Dempsey, whose recent research used qualitative methods such as photographs and interviews to explore men’s experiences of, and reflections on, bipolar.

Why focus on men’s experiences of bipolar?

We know that there can be gender differences in the experience of bipolar, yet bipolar tends to be evenly split between men and women in terms of prevalence. There is a lack of reliable statistics on the prevalence of bipolar amongst those who identify as non-binary or who have more fluid gender identities. What research has been conducted has suggested some differences in key symptoms and outcomes between men and women, but this literature is a little messy and unclear. Studies have also not explored men’s experiences of living with bipolar. In fact, men are often under-represented in qualitative studies of the experiences of bipolar.

Given that men’s experiences were not being captured in previous studies, we conducted a small-scale, in-depth, qualitative study of men’s experiences of bipolar, focusing specifically on how men make sense of and manage bipolar and related symptoms. This project was led

by Dr Craig Burman as part of his Professional Training in Clinical Psychology under my supervision with my colleague Dr Helena Priest. Rather than do standard interviews, where we ask a series of questions, we took a photograph-based approach.

What is ‘photo-elicitation’?

Photo-elicitation is a novel way of conducting qualitative research. There are slightly different approaches, ours aims to empower participants to direct the interview with a researcher based on photographs they have taken of objects or places that represent their experiences. The difference with a traditional interview is that the researcher-interviewer only asks a series

of very broad questions (e.g., ‘what does this photograph mean to you?’). This approach means that there’s less emphasis on the researcher-interviewer’s questions, and a much greater focus on the participant and the stories they share via their photographs.

We had previously used this approach in a study of people’s quality of life and experiences of living with chronic pain and paraplegia (see Hughes et al., 2019). Here, we had asked six people to take photographs of things that increased or decreased their quality of life.

What really stood out to me as a researcher was how detailed, complex, and unique these participants’ stories were, how empowered the participants were to tell us about their experiences, and how well the photographs elicited these stories. We felt this was an ideal approach for our men in our research.

What did we find in our study?

We sampled six men with experience of bipolar (aged 28–71 years) who had quite different experiences in terms of how long they had been living with a bipolar diagnosis and in the numbers/types of mood episodes experienced.

We asked the participants to spend a week taking photographs of any objects, places or situations that represented their experiences of managing bipolar. The participants chose their best six photographs for discussion with Craig (the interviewer). The discussions were recorded, transcribed, and then analysed using Interpretative Phenomenological Analysis (a form of qualitative analysis which focuses on ‘sense making’).

Our analysis identified four themes in the data (see the below open access paper for more details). What was very noticeable in the data was the men’s sense of ‘making room’ for bipolar and the possible disruption this caused to their lives. Bipolar, for our men, was often about managing a broad range of challenges, not just limited to their moods or bipolarrelated symptoms. A sense of acceptance, that bipolar can be disruptive and that future mood symptoms are likely to occur, was common throughout all the interviews and important to our men. This was especially true for making room for low moods, not just the highs.

So, what did we conclude?

Of course, this was a small-scale qualitative study. Our participants provided rich detailed stories, guided our interviews, and very kindly donated their time for which we were extremely grateful.

For our men, living with bipolar was complex, challenging, and required the acceptance of a significant amount of disruption. The lack of specific discussion of masculinity was interesting and similar to other research suggesting that bipolar can (for many) be a prominent part of someone’s identity. How well this applies to other groups and genders would be interesting to know.

The unique, individual, nature of our participants’ experiences of living with and managing bipolar really highlighted the need for individuallevel support, especially from clinicians. How someone living with bipolar ‘makes sense’ of their experiences seemed particularly important, not just managing mood symptoms or preventing relapse (both being a focus for many healthcare staff).

Another interesting observation from our data was that the men didn’t really talk about masculinity or their male identity much in the interviews. Although we hadn’t specifically asked the participants to think about their sense of masculinity when taking the photos, we had anticipated masculinity (of some form) to be a key discussion point in the interviews.

The sample did have some complex identities, and many were keen to demonstrate their sense of identity beyond bipolar. One of the most striking photos (in terms of how it was discussed) was by a participant we named ‘Nelson’ (a pseudonym). Nelson took a photo of his wardrobe, with his clothes and work shirts of different colours for each day of the week organised for the week ahead. Nelson talked about how this organisation deliberately challenged the perceptions others have of people with bipolar being unpredictable. For Nelson, his organisation, and the clothes he wore at work, portrayed his identity beyond bipolar and was a means of him challenging the potentially stigmatising attitudes others might have about his bipolar experiences. What seems like a straightforward image of some smart work shirts prompted a wide discussion of Nelson’s life, his perceptions of others’ views of bipolar, and his own sense of identity.

Image: Vecteezy.com

Read the full paper (open access): Burman, C. J., Dempsey, R. C., & Priest, H. M. (2022).

Exploring men’s experiences and sense-making of bipolar disorder diagnoses and mood management: a photo-elicitation investigation. Clinical Psychologist, 26(2), 198–210. https://doi.org/10.108 0/13284207.2021.2018572 About the author:

Rob is a Senior Lecturer in the School of Psychology at Manchester Metropolitan University and a Chartered Psychologist with the British Psychological Society. Rob originally conducted his PhD research on bipolar and autobiographical memory at the University of Manchester and has since broadened his interests to explore the social influences on a range of health experiences (including bipolar, suicidality, social norms, amongst others). https://www.mmu.ac.uk/staff/profile/dr-robertdempsey Image: Vecteezy.com

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Jamie’s Diary Physical and mental health Hello everyone, I am sitting writing this at the tail end of having had tonsillitis. Not to worry – I was given antibiotics and have been well looked after. The experience, however, got me thinking...

I seem to get much worse mentally when I become physically unwell and I seem to unravel in front of people, unable to regulate my moods, much to my frustration. I have learned to apologise less because I am always saying sorry, but I have found some acceptance – it’s not my fault. My outbursts are minimal and wellintentioned, but still out of character.

I don’t get embarrassed anymore – ever. I couldn’t really work out why; I think it is because everyone I care about has seen every single side of me.

The people I respect have accepted me and that in turn has made me accept how I am. If you ever feel ‘less than’ or if you ever feel imperfect, please look around you. We are all imperfect.

That’s what makes us unique.

I know I am lucky my physical health is pretty good, and I still have that fire in the pit of my stomach that pushes me on. But today I am a little more emotional than normal. I think it’s these non-penicillin antibiotics...

So, I am going to put my feet up and watch Little House on the Prairie…

I mean Rambo – round 2!

I hope everyone is well. Please look after yourself.

Much love, Jamie :) P.S: Have you ever watched Little House on the Prairie? It is lifeaffirming stuff!

The balance of physical health and mental health is a complex one and I can let things slip physically when I am focused on my thoughts. In truth, I don’t know if I will ever fully master it.

Image: Vecteezy.com

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Voices of experience

Survey Results Lived Experience Report Highlights Need for More Permanent Psychiatrists to Improve the Continuity and Quality of Care VOX Scotland has launched their report Your Views: Psychiatrists in Scotland and called on the Scottish Government to work with them to develop and implement an action plan to improve the experience of people across Scotland who receive psychiatry care.

The report documents the findings of a VOX Scotland survey looking at the experience of those who have received care from a psychiatrist under NHS Scotland within the past five years and builds on data provided under Freedom of Information detailing the use and cost of locum psychiatrists in Scotland’s health boards.

The survey, carried out over the summer, received almost 500 responses covering every health board area, giving a comprehensive picture of care experience across the country, and highlights the scale and impact of the use of locum psychiatrists with almost one third of respondents having received care from ‘all’ or ‘mostly’ locum psychiatrists in the last five years and almost two-thirds expressing that they felt receiving care from a locum had negatively impacted the continuity of care they received.

Launching the report, VOX Scotland Manager, Natalie Stevenson said: “The responses we received showed a direct correlation between access to a permanent psychiatrist over a sustained period of time and the quality and continuity of care received. Most respondents who received locum care saw two or more psychiatrists, and this often resulted in low continuity

of care, poorer outcomes and significant distress.

Across more than one hundred qualitative answers from those with experience of locum psychiatrist care, whilst some reported receiving a high quality of care, many shared the detrimental impact of their psychiatrist(s) changing over short periods of time.

The growing lack of permanent psychiatrists is a significant cause for concern, both in terms of the impact on those receiving care and cost to health boards. We echo calls from the Royal College of Psychiatrists in Scotland to urgently address the need for better recruitment and retention of NHS Psychiatrists, and a systematic cessation of non-qualified locums acting as consultant psychiatrists.

Our findings also highlighted areas where action is desperately needed in the provision of psychiatry care across the board. This includes improving transitions for people moving within the mental health care system, and greater training and support to ensure the care provided aligns with all elements of the core mental health standards.

We look forward to presenting the findings of our research to the Scottish Government and working collaboratively to ensure a strong future workforce, full delivery of the core mental health standards, and better-quality psychiatric care for everyone who needs it.”

VOX Scotland’s Recommendations

VOX Scotland erience) (Voices of eXp on their wishes to pass ks to an th sincerest land ot Sc ar the Bipol ok to ho w rs be mem e th time to answer . survey

RECOMMENDATION 1 Improve continuity of care, by systematically reducing reliance on locums in psychiatry in Scotland. There should be particular emphasis on reducing the use of locums who do not have the qualifications required for substantive posts (MRCPsych and CCT/CESR).

Simultaneously, increase permanent posts with particular attention to those geographical areas most in need of permanent psychiatrists and to the particular needs of rural and remote island communities. This plan should ensure people are not suddenly left with no care at all.

As part of the recruitment and retention strategy, address the disparity between the pay and conditions (including flexibility) received by locums as compared to permanent psychiatrists ensuring substantive posts are attractive and sustainable. Consider how health boards can cap expenditure on locums.

RECOMMENDATION 2 Implement a standardised system of psychiatrist job titles/roles which reflects the training and qualification levels achieved. Implement a clear and consistent system across health boards, where communication on the status and title (whether locum, permanent consultant, trainee) is transparent and open in communications with those who are being cared for.

RECOMMENDATION 3 Ensure that all psychiatrists are routinely trained in trauma-informed proactive racial bias and cultural competence, and neurodivergence both in terms of recognition and diagnosis and in understanding and adapting care to meet needs and this training is regularly reviewed and updated.

RECOMMENDATION 4 Ensure relevant training, support and implementation takes place for psychiatrists to meet all elements of the core mental health standards, with emphasis on ensuring individuals can be involved and engaged in decisions about their care, awareness and promotion of advocacy rights and services, and a fit for purpose, impartial and authoritative complaints and feedback system as standard.

Read the Your Views: Psychiatrists in Scotland report in full here: https://voxscotland.org.uk/your-views/

RECOMMENDATION 5 Focus on making transitions work for individuals, whether from inpatient to outpatient care, CAMHS to adult psychiatry, adult to older adults’ psychiatry, or moving from one psychiatrist to the next, understanding the importance of continuity of care and of structured meaningful beginnings and endings.

Have clear reasoning for discharging patients and ensure conservations are had with individuals before discharge decisions are made. Ensure good communication with other services and mental health nurses (as per the Scottish Mental Health Nursing Review underway) particularly during transition, with the individual concerned clear on the plan and ways to get in touch.

Image: Vecteezy.com

BIPOLAR SCOTLAND 19

Fundraising Heroes!

Have you recently raised money for Bipolar Scotland? If so, we’d love to share your successes in On The Level! Email editor@bipolarscotland.org.uk

KILTWALK ABERDEEN Cassie Amos, her husband Dave and their daughter Lorelei (14), walked for Bipolar Scotland in honour of a beloved family member who lives with bipolar: “We have done the Kiltwalk three years in a row and always for a charity close to our hearts. Last year, Dave and I did it for Scottish Huntington’s Association and the year before Dave did it with our son Taylor (16) to raise funds for The Boys’ Brigade. We always say ‘go big or go home’ so we signed up for the big stride and raised £1120, which hopefully will help support the amazing work that Bipolar Scotland is doing.

We highly recommend everyone to give the Kiltwalk a go – we met so many wonderful people on our 18 miles and although my hips hurt by the end, it was a beautiful day and a great cause to raise money for.

As a family, we feel it’s important to support charities close to our hearts, and Bipolar Scotland has been a strong foundation of support for years.

We thank everyone who sponsored us, the team at the Kiltwalk, and all the kilties who make the day incredibly memorable.

KILTWALK EDINBURGH

Shelby Nisbet, Karen Minto and Catherine Garrity took part in the 2024 Edinburgh Kiltwalk in aid of Bipolar Scotland. We caught up with Shelby afterwards to chat about the day: Why did you choose to fundraise for Bipolar Scotland?

“We chose bipolar Scotland as I have bipolar myself and thought it would be good to spread awareness and raise money for a charity that meant something to us.”

What was it about the event that appealed to you?

“We have done a few in the past and enjoy that it is a walk and not a race. The Kiltwalk is great fun and has a great atmosphere.”

What did you enjoy most and what did you find challenging?

“We enjoyed the atmosphere and the challenge of walking 22 miles.”

How much have you fundraised? “£453!”

Do you have any advice you would like to share with others who are thinking about fundraising for Bipolar Scotland?

“They are a great charity and do great work for people with bipolar. They keep in touch regularly before and after your fundraising event and help you along the way.”

Sending a huge thank you to Cassie, Dave and Lorelei for their fantastic effort!

Fancy giving the Kiltwalk a go this year to raise money for Bipolar Scotland? Registration is now open – join the Kiltwalk in Glasgow, Aberdeen, Dundee or Edinburgh! Find out more here: https://thekiltwalk.co.uk/

Thank you, Shelby, Karen and Catherine – your invaluable support will help us to continue to deliver support to those in Scotland who are living with bipolar.

Free Membership

For All!

A message from our CEO to all Bipolar Scotland members, facilitators and group participants…

2025 will be an exciting year for Bipolar Scotland. We have lots to look forward to and plenty of opportunities for you to get involved too!

Following our consultation with members back in Autumn, we’re delighted to be kicking off 2025 with FREE membership for everyone who lives with bipolar or volunteers with us. This means that you and your loved ones can now access all the additional benefits that being a member brings, including: • Our bi-monthly magazine, ‘On The Level’ delivered straight to your inbox • Free access to our highly acclaimed SelfManagement Training • Opportunities to take part in research and consultations

You do not need to do anything; we’ll take care of it for you!

We’re operating on an ‘opt-out’ basis so you will automatically become a member unless you opt out by email. The information you provided when signing up for our support services or becoming a volunteer will be used to create the membership. If this information needs updating or you do not want to become a member, please let us know by emailing: info@bipolarscotland.org.uk Please share this news with all your friends and family and encourage them to join our growing community of support.

Keep up to date on our social media, website, or in the latest edition of On the Level to find out what we’re up to and the other exciting things to come this year!

With love, Jayne

• Invitation to our AGM and other Bipolar Scotland events This is a fantastic development which will allow us to grow our membership and further our reach across the country, working towards ensuring a good life for everyone in Scotland living with bipolar.

From January onwards anyone who attends our Peer Support Groups, utilises support through Beyond Diagnosis, Peers Together, volunteers, or attends training will automatically become a member. This doesn’t change the support you receive or how you receive it, but you can now enjoy added member benefits for free. If you still wish to make a financial donation you can continue to do this through our website or by contacting us at info@bipolarscotland.org.uk BIPOLAR SCOTLAND 21

Detainment & You Graham Morgan, an Engagement Worker at the Mental Welfare Commission, shares his own lived experience and thoughts on being detained throughout this article.

Please be aware that the following content discusses upsetting situations and may be triggering.

What Happens If I’m Detained?

In some cases, if you refuse treatment for your bipolar, you may be detained under the Mental Health Act, or ‘sectioned’.

This means you will have to spend time in hospital, even if you do not want to.

“I have been sectioned frequently, because I have been determined to harm myself, due to delusions that mean I feel I am evil and harming the world and those I love.

I hate it but without it I would almost certainly be dead and would have injured myself far more than I did.”

There are three types of detention: 1. Emergency Detention This allows a person to be held in hospital for up to 72 hours, while their condition is assessed. It can only take place when recommended by a doctor. Where possible, a mental health officer should also agree to it.

“Just vague memories. A mental health officer came to see me and told me I was detained. There was so much going on in my mind that I paid little attention to it.”

2. Short Term Detention This allows a person to be detained for 28 days. It can only take place if recommended by a psychiatrist and a mental health officer.

“Again, vague memories; I saw a doctor and a mental health officer. They quickly decided I needed to stay in hospital; gave me lots of paperwork; told me I could get a solicitor for free and an advocate. They would have already been in touch with my named person who was someone I trusted and once I had created an advance statement; looked at how I said I wanted to be treated. This wasn’t always adhered to, which the hospital has a right to do. I had nurses next to me to stop me harming myself. They didn’t always succeed but did on most occasions. I was lonely; mainly because I was so ill it was hard to speak.”

3. Compulsory Treatment Order This has to be approved by a tribunal. It allows treatment for six months initially but could be extended for a further six months and after that, for a year at a time. It could be in hospital or in the community. There are strict rules about when this can happen. The tribunal can only approve a compulsory treatment order if: • you have a mental disorder.

• medical treatment is available which could stop your condition getting worse or help treat some of your symptoms.

• there would be a significant risk to you, or others, if that treatment was not provided.

• your ability to make decisions about medical treatment is significantly impaired because you have a mental disorder.

“I spent months in hospital on a CTO. I had left my wife, and my son had decided he no longer wanted to see me. My world had fallen to pieces. I stopped sleeping and ended up in a very harsh place. My main memory of my tribunal was how wonderful it was to get off the ward and to feel the fresh air on my face. The tribunal

was quick. The panel tried to set me at ease but at such times, when no one seemed to understand me; it was still pretty difficult.

I have been on a community CTO for 14 years which is extremely rare. I know some people hate it; for me it means I have to see my doctor and my CPN and have to take my medication. I find it irritating but that is all. I am pretty sure it keeps me alive and helps me have the wonderful life I doubted I would ever have.”

What Are My Rights?

The use of compulsory powers is necessary. The law contains safeguards to protect your rights if you are detained.

For example, you have the right to appeal against the detention, and to nominate a named person who will look after your interests.

If you or someone you know is affected by this, you may find it helpful to read this Scottish Government guide “A short introduction to the Mental Health Act”.

(This document has not yet been updated with changes to the Act in 2015).

The Use of Physical Force Most people will understand that compulsory treatment means they do not have a choice. In some cases, it may be necessary to use physical force.

If you are in hospital for compulsory treatment:

• force can only be used if necessary.

If you are in your own home: • force cannot be used to give you treatment.

If you are on a compulsory treatment order in the community: • you can be taken to hospital and force can be used.

If you are unhappy about the use of force in your treatment, you can complain.

Your named person or independent advocate can help you.

“When force is used against you it is horrible. That is why the recent review of the law recognised that detention is a traumatic event. It can be humiliating and frightening but then, on the rare occasions it was done, it was to stop me harming myself or to make me take medication.

That upset me. I still worry about taking medication but everyone around me is convinced it keeps me well.”

For further information or to learn more about the Mental Welfare Commission for Scotland, please contact: Advice line – 0800 389 6809 Email – enquiries@mwcscot.org.uk Website – www.mwcscot.org.uk

BIPOLAR SCOTLAND 23

OVER TO

YOU: Your space to share your creative writing. If you’d like to submit a poem, story or piece of writing, please email us on info@bipolarscotland.org.uk with the subject line ‘On The Level Submission’.

One Day at a Time: Reflections on Family and Growth

By Mairead Clarkin Living unemployed feels like stepping into the shoes of a retired 60-year-old, with all the stillness and reflection that comes with it. After my mother shielded me from my family for so long, I finally reunited with them, and my aunt invited me for a walk to visit my other aunt and her grandson. I almost cancelled because I was feeling low, but I’m so grateful I didn’t. She treated me to lunch from Greggs — sausage rolls, a steak bake, yum yums, and a pineapple tart in honour of my mum. It was a small gesture, but it meant so much. The service was spotty; they forgot my sausage roll, but that didn’t matter. What mattered was being in her car again, listening to Ebony and Ivory, just like the good old days.

The fresh air did wonders for my spirits, even if it was just a brief outing. We reminisced about my mum, sharing stories that made us laugh, despite the bittersweet memories. She could be a real nightmare at times, and sometimes downright scary. But those ridiculous moments were what made her uniquely her. My mum was so deeply creative but never found the right outlet for it. I understand that now — her

struggles, her drinking. We both agreed she probably had bipolar disorder too, a realization that brought us closer as we shared our truths.

We also spoke about less deep topics like Netflix recommendations, shopping and I’m a Celebrity Get Me Out of Here. It was fun, not all doom and gloom. On our way, we picked up my aunt’s granddaughter from primary school in fancy Bearsden. It hit me hard; I miss picking up Michael from school.

He’s growing up so fast — Mr. Independent now, walking himself home. It makes my heart ache. I wish I could be more present for him, especially now when he needs me. Afterwards, I got a tour of my cousin’s beautiful new house. I couldn’t help but feel a pang of envy. It’s a reminder that I’m not at that stage in my life yet. But as I reflect, I know I’m better off where I am, with my dad and my son. Life may feel uncertain, but I’m learning to take it one day at a time. My aunt gave me some sage advice: to forgive myself and to stop dwelling on the past.

I must remember this.

The fresh air did wonders for my spirits, even if it was just a brief outing.

We reminisced about my mum, sharing stories that made us laugh, despite the bittersweet memories.

Image: Vecteezy.com

BIPOLAR SCOTLAND 25

BIPOLAR SUPPORT GROUPS ACROSS SCOTLAND We run online and in-person peer support groups across Scotland – friendly, safe spaces for anyone living with or affected by bipolar.

Here’s a full list of all our groups running during October and November. Why not talk to people who get it?

To access and online support group, please visit https:// bipolarscotland.org.uk/supportgroups/ , click on the relevant calendar entry to RSVP, and you’ll be emailed a link you can use to join the group at the appointed meeting time.

SCOTLAND-WIDE (all online) BIPOLAR BLETHER: For anyone living with or affected by bipolar in Scotland. Sunday 2 February and Sunday 2 March, 3-4pm.

18-30: For anyone aged 18-30 affected by bipolar in Scotland.

Wednesday 5 & 19 February and Wednesday 5 & 19 March, 7-8pm.

FRIENDS AND FAMILY: For carers and loved ones. Monday 17 February & Monday 17 March, 7-8pm.

REGIONAL AYRSHIRE & DUNDEE • Ayrshire & Dundee online group: Tuesday 4 February & Tuesday 4 March, 7-8pm.

• Dundee in-person (Dundee Volunteer and Voluntary Action, 10 Constitution Rd, Dundee, SS1 1LL): Thursday 6 February and Thursday 6 March, 7-9pm.

BORDERS • Borders online group: Wednesday 5 & 19 February and Wednesday 5 & 19 March, 7-8pm.

FIFE & FORTH VALLEY Fife & Forth Valley online group: Tuesday 11 & 25 February and Tuesday 11 & 25 March, 7-8pm.

GLASGOW • Glasgow City online group: Sunday 23 February & Sunday 23 March, 7-8pm.

• Highlands & Islands in-person (Café 1668, 86 Church St, Inverness, IV1 1EP): Thursday 6 February and Thursday 6 March, 7-9pm.

NORTH LANARKSHIRE North Lanarkshire in-person (Coatbridge Community Centre, 9 Old Monkland Rd, Coatbridge, ML5 5EA): Monday 10 February & Monday 10 March, 7-9pm.

PAISLEY • Paisley online group: Monday 10 February & Monday 10 March, 6-7pm • Paisley in-person (Methodist Central Hall, 2 Gauze St, Paisley, PA1 1EP): Monday 24 February & Monday 24 March, 6-7.30pm.

WEST LOTHIAN • West Lothian in-person (Bathgate Community Centre, Lindsay House, South Bridge St, Bathgate, West Lothian, EH48 1TS): Thursday 13 February & Thursday 13 March, 7-9pm.

• Glasgow City in-person (Premier Inn, Glasgow City, 187 George St, Glasgow, G1 1YU): Wednesday 12 February & Wednesday 12 March, 7-9pm.

• Glasgow West online group: Sunday 9 February & Sunday 9 March, 7-8pm.

• Glasgow West in-person (Partick Trinity Church, 20 Lawrence St, Partick, Glasgow, G11 5HG): Wednesday 26 February and Wednesday 26 March, 7-9pm.

HIGHLANDS & ISLANDS Highlands & Islands online group: Thursday 20 February & Thursday 20 March, 7-8pm.

Image: Vecteezy.com

BIPOLAR SCOTLAND 27

Want to get in touch with us?

Bipolar Scotland is based at: Studio 40, Sir James Clark Building Abbey Mill Business Centre Seedhill Road Paisley, PA1 1TJ You can contact us by phone between 9.30am – 3:30 pm, Monday to Thursday, on: 0141 560 2050, or by email on info@bipolarscotland.org.uk We’re also on Instagram: (@bipolar_scotland), Facebook: (bipolarscotland1) and X/Twitter: (BipolarScotland).

Charity Number: SC021705 Company Number: 163306 bipolarscotland.org.uk