On the Level: Autumn

ON THE

STUDENT SUPPORT:

LEVEL Scotland’s e-magazine for people living with bipolar Autumn 2024

Helping you navigate your studies

DARREN MCGARVEY

shares his thoughts on lived experience

NEW LOOK ISSUE!

your life Regaining control of

bipolarscotland.org.uk

Foreword / Autumn 2024 Welcome to the autumn edition of On The Level!

There’s a definite chill in the air and the shops are bursting with spooky stuff (some are even displaying the dreaded ‘C’ word decorations), which can only mean one thing: autumn has landed.

As the nights darken and the weather inevitably deteriorates, it can be more of a challenge to take care of our mental health and general wellbeing. That’s why we’ve chosen to focus on the benefits of having your own mental health ‘toolkit’ in your back pocket – techniques and tricks you can use to help you navigate turbulent times and plot a course to calmer waters.

Our dedicated trainers, Kerry and Hazel, explain exactly what the self-management training course (SMT) involves and how members can sign up and start their selfmanagement journey on page 22. Our resident writer, David Carr, also shares his first-hand experience of managing uncomfortable flashbacks of darker times, sparked by past haunts; namely by confronting locations from his past and processing those uneasy memories head-on.

Recently, Bipolar Scotland’s Glasgow West support group were delighted to welcome a very special guest in the shape of Darren McGarvey – mental health activist, social commentator, author, rapper and podcaster. The evening was a huge success, and the audience was enraptured

by Darren’s eloquent and thoughtprovoking words on what lived experience means to those who have it and how it can be abused. Read all about ‘An Evening With Darren McGarvey’ on page 6.

Autumn also heralds the beginning of a new year for college and university students. For new and returning students who are also managing bipolar on top of their coursework, this can be a daunting

prospect, but there is support available to lighten the load. From arranging flexibility with deadlines to organising a mental health support worker, our Student Support guide will help you secure the support you need to keep your learning on the right track – check it out on page 24.

As always, there’s plenty to get your teeth into this issue. Don’t forget – this is YOUR magazine! We love to receive your comments and contributions, and welcome your articles, ideas, stories and poems. 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 27th November; we need all contributions in

by Monday 11th November.

Sian Dolan Editor

Image: Vecteezy.com

Contents

6

An evening with Darren McGarvey.

13

18

Understanding the role, responsibilities and objectives of the pharmacist.

Research Corner explains why diverse research participants are important for understanding bipolar.

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.

20

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

Are you a carer? Discover how the Mental Welfare Commission can support you.

BIPOLAR SCOTLAND 03

Noticeboard Soaring Support!

We want to send our grateful thanks to John Jack who bravely conquered his fear of heights and ziplined the Clyde to raise money for Bipolar Scotland. Our Fundraising Manager, Marie, popped along to the event to support him and grabbed a quick congratulatory chat after his heroic efforts: Why did you choose to fundraise for Bipolar Scotland?

“I wanted to help support and bring attention to a condition that I feel is not well recognised or understood. By fundraising, I hoped to raise awareness with my family, friends and work colleagues, and help contribute to Bipolar Scotland in its support for people living with bipolar in Scotland.”

What was it about the Zipslide event that appealed to you?

“It felt like a fun way to contribute (and to conquer a fear of heights!), plus it didn’t require excessive exercise or too much preparation time!”

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

“I was really lucky with the weather on the day of the event, given how much rain we’ve had this summer. I had great views over the River Clyde and managed to get some nice photos of the challenge. Taking the first step off the crane was a bit scary, but the views and overall experience more than made up for it.”

How much have you fundraised?

“To date, donations have reached just over £1000.”

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

“If you are passionate about supporting Bipolar Scotland, or simply fundraising in general, then just go for it! Bipolar Scotland were very helpful and made it very straightforward to take part in the event.”

You’ve Got Mail: Important Message For Members Please look out for a letter landing in your inbox from Jayne, our CEO, to consult you on proposed changes to our membership structure. We’d like to make membership free for people who are struggling during the cost-of-living crisis, while also encouraging donations from people who can afford to contribute. Part of the proposed membership structure would help us generate income from corporate members who have interest in mental illness and creating mentally healthy workplaces.

Please read the letter when it arrives and feed back to us no later than 28th October.

Date For Your Diary Bipolar Scotland’s AGM will be held on Monday 25th November 2024 at 4.15pm, at Clockwise, Savoy Tower, Renfrew Street, Glasgow. If you’re a member and would like to attend, please contact info@bipolarscotland.org.uk to reserve your place.

Free Creative Classes For Adults Nemo Arts Glasgow is a charity that provides free creative classes for adults and exists to support people in recovery from poor mental health. Their weekly creative workshops have a focus on mental wellbeing and can be joined either in-person or online.

A new programme of events kicked off on Sep 2 and includes: • Taiko drumming • Drama • Choir • Creative writing • Visual art • Guitar class There are still some spaces available within the programme so if you’re interested, please visit https://www.nemoarts.org/ to find out more about the workshops and fill out a simple referral form.

Volunteers Needed!

Scotland’s biggest mental health art exhibition, Out of Sight Out of Mind (OOSOOM), is looking for set up and invigilator volunteers to join their exhibition team. The exhibit launches on the evening of Tuesday 8th October and runs from Oct 9-Oct 27.

What the role involves: • Joining involves being at Summerhall, Edinburgh to help with tasks involved with the Out of Sight Out of Mind exhibition.

• Joining the Exhibition Team is an opportunity for people who have their own experience of mental health issues.

• No art experience is necessary, though you might have an interest in art.

• You will be working alongside the exhibitions Planning Group, CAPS staff and Summerhall staff.

• Full guidance will be given on any tasks, and there is usually a range of different things to do.

• Teas, coffees, soft drinks, and snacks are available whenever you need them.

• If you will be at Summerhall for a whole day, then lunch is provided.

• You can be reimbursed travel expenses from/ to Summerhall from within the Lothians – just ask for an expenses form.

GET IN TOUCH To arrange your shifts, for any questions, or to let us know of any change, please contact: Sophie, OOSOOM Exhibition Assistant Email: sophie@capsadvocacy.org or exhibition@capsadvocacy.org Mobile: 07929 751 911 For anything else: Pam, Arts as Advocacy Manager E-mail: pam@capsadvocacy.org Mobile: 0798940263

Images: Pexels/Vecteezy.com

BIPOLAR SCOTLAND 05

Meeting...

Darren McGarvey

Prizewinning author, activist for social justice and rapper Darren McGarvey was a welcome guest at the Glasgow West support group.

ice Chair of the Board of Trustees and facilitator for Glasgow West, Victoria Reid, was delighted to welcome Darren to the group:

“I first came across Darren’s work 20 years ago in Paris when, homesick, I had tuned into Radio Scotland online. It was a programme about ‘Neds’. Darren’s interviews with some groups of young people, deemed outside society, were so refreshing in their genuine curiosity, care, respect and urgency. People without an established place in society, written off by many, were opening up, being trusting, and expressing themselves beyond their immediate peer group. This was new to my ear. Not formulaic, but genuinely enquiring.

Darren’s ‘lived experience’ has been at the core of his work as an author of two remarkable books on social justice: Poverty Safari and The Social Distance Between Us. It has also featured largely in his television work, namely: ‘Darren McGarvey’s Addictions’ and ‘The State We’re In’. Darren has a lively presence on Twitter X and a podcast; he has delivered a Radio 4 Reith Lecture, ‘Freedom from Want’. Most recently he has performed at The Fringe: ‘Trauma Industrial Complex – Trauma and Oversharing in the Age of Lived Experience’.

For me, going back to those early interviews of Darren’s, there was an opening up of trust, experience and expression that could only come about because he was so candid and unguarded himself. It’s a risky process, certainly in a public forum (in contrast to our own here). For those reasons, Darren proved a fitting guest.”

This event was funded by GCVS Glasgow Community Mental Health and Wellbeing Fund and supported by the team at Bipolar Scotland. Darren talked and did a Q&A in the first hour, before participating in our usual support group circle. The event was well-attended, and people came from Glasgow City and North Lanarkshire support groups also.

Darren’s words struck home to many of the audience…

David Carr shares his thoughts on an evening spent with Darren McGarvey.

Darren’s interest is in lived experience: what it means to those who have it and how it can be abused. While he does not have bipolar disorder himself, he brought together some strands from his own experience of trauma and of addictions and their corresponding peer support environments. In his view, the story of lived experience is still to be told and people are afraid to tell it. His forthcoming book will delve into the concept of lived experience but not without controversy.

Darren is impressively articulate. Engaging and insightful, he started by talking about how he encountered hip hop culture – an environment in which authenticity is a currency – which first gave him a voice. The work of artists from 50 Cent to Kanye West to Eminem is informed by their various traumas.

from those for whom it is advocating. This does not always happen – voices are not always heard or, if they are, the stories told do not result in positive outcomes for their tellers.

Many of us, myself very much included, struggle with how to use our lived experience. Do we disclose? How? When?

To whom? Darren’s words struck home to many of the audience, who shared their own experiences.

This was a stimulating and thoughtprovoking evening, with much relevance to our support groups. If you get a chance to see Darren speak – take it. And look out for his book on lived experience.

We all want someone to hear our stories.

There is a sense of community in sharing, as is done at support groups, and we all want to be seen, heard and validated. But can this sharing ever be dangerous? Darren referred to the ‘fool’s disclosure’ whereby we cannot ‘undisclose’ and are at the mercy of others as to how our disclosure is received. It becomes public property.

Lived experience has its perils. In the digital age, authenticity has become commodified.

Content providers, incentivised by algorithms, are encouraged to overshare.

People in reality shows are expected to put themselves on display in a way that will maximise ratings. Darren spoke also of his own experiences with social media and how what you say can be met with unexpectedly hurtful hostility.

Darren has been informed by Standpoint Theory (from feminist thought) the stance that activism needs to include points of view

Bipolar Scotland is grateful to Darren McGarvey for sharing his experiences and views with our group and we wish him all the very best for the future.

BIPOLAR SCOTLAND 07

Walking Through The Streets of

Memory

by David Carr

trolling through Glasgow recently, I paused. This was the No.7 bus stop where a stranger once asked me if I was OK. I wasn’t OK. I was in a deeply depressed place, my sagging demeanour obvious and signalling the internal weight I was carrying. I mumbled something and got on the bus, close to tears.

The memory of that bleak time still haunts. Passing that bus stop, surrounded by a hostile architecture of omnipresent scaffolding, cast up a reliving of that dreich, dark day when I just didn’t want to be here anymore.

Location is a strong trigger for me. Both my depressive and manic episodes carry with them powerful and painful memories which can come rushing back, unrelated to my current mood state, but dragging me back to a place or time.

There’s the Clyde Tunnel, which calls to mind driving to work, in tears, to a job that was doing me harm. Or the Asda’s branch where it all became too much, and I had to abandon my trolley. There is the derelict belfry at Leverndale hospital, which loomed over my stays there.

Memories of my manias come rushing back when I pass by places where I acted strangely, misbehaved, or had a public freak out. I shudder when I recall certain bars and cafés. Or the street where I buttonholed passers-by to harangue them about something or another – some grand theory constructed by my

delusional mind. Certain locations are ‘cringe points’ which remind me of my disordered behaviour, and I self-stigmatise, unable to let myself off the hook for being unwell.

The issue for me, even years down the line, is how to process my episodes when I am surrounded by and immersed in them. My way of taming the memories came from a somewhat outré source: In the 1960s, the other avant-garde Marxist art theorists of the Parisian

Situationist International, coined the term ‘psychogeography’ to describe the effect of a geographical location on the way people feel and behave. One of the tools the Situationists employed to explore psycho geographical concepts was the ‘dérive’ – the technique of wandering around an environment. The purpose of the dérive is to wander through a landscape, usually urban, with the aim of letting go of daily concerns and becoming aware of its psychological features.

My entry point for psychogeography has been through the novels of Alasdair Gray, which are imbued with a strong sense of place. Glasgow permeates his work – and his work permeates Glasgow. For me, to walk around Glasgow is to walk through Gray’s landscape. More than once I have wandered through Kelvingrove Park to Park Circus in homage to Gray’s ‘Poor Things.’

But that is arguably mere tourism. The dérive can have a deeper purpose.

I recently had the experience of supporting a close relative through a psychotic episode. They had memories – some powerful, some vague – of places

they had wandered while ill. But they have a switched-on circle of friends who have helped them to process by walking them through events and piecing together the fragments. This walking through has been literal: revisiting places in safe company and acknowledging their disordered state, rather than letting painful memories fester.

I was given no such support following my episodes, and for many years I would simply avoid certain places. But that is life-limiting and can’t go on forever. At some point, I will have to pass that bus stop, that bar, that street.

So now as I drift through the city, I have inoculated myself against my memories. That is, rather than letting those memories sneak up on me, I have confronted them, sought them out. I have become a tourist in my own mind.

Confronting the psychogeography of my illness takes me through a contemporary city but reminds me of a landscape and a state of mind removed from my present, mentally healthy self. The ability to wander around places I have haunted in the past has given me strength, perspective, closure.

BIPOLAR SCOTLAND 09

SPOTLIGHT ON:

BOARD OF TRUSTEES Introducing David Reid from our Board of Trustees.

WHAT ATTRACTED YOU TO THE ROLE OF TRUSTEE AT BIPOLAR SCOTLAND? Helping with charity organisations and giving support has always been something I’ve wanted to do, but family commitments and working life were always a barrier for me to take my interest further. Although I worked in different roles within the banking industry for nearly 20 years, I learned that the things I enjoyed most about the role and found most rewarding was when I was truly helping people. As my children got older and my daily commute reduced with working from home, I wanted to see if I could reinvest my spare time to leverage my skills and experience, which included a number of different roles in the digital/ mobile space, project management and leading delivery of large-scale change.

After several years as a Trustee helping a charity in Fife, I learned about a vacancy that had become available with Bipolar Scotland. Although I don’t have bipolar, I do have some experience of mental health issues – my eldest daughter is housebound due to severe anxiety and stress, and I am the mental health ambassador at work. After conducting some further research on bipolar disorder and speaking to some of the other Board members and CEO, I felt I was a good match for what Bipolar Scotland were looking for. In return, I can give something back to support a worthy cause.

WHAT IS THE ROLE OF A TRUSTEE? Trustees are usually volunteers who help contribute and collaborate with other Trustees and Board members to

discuss and decide how charities are run.

This includes managing the finances and resources responsibly, setting objectives, making key decisions, looking at immediate and longer-term strategies, and overall acting with a duty of care towards Bipolar Scotland. We meet four times a year, and as a Trustee we attend whenever possible for a 2–3-hour meeting. We also typically help with preparation of any agenda papers/spotlights we need to present, and with papers and key reports distributed in advance – pre-reading is a must so you can attend meetings with an informed understanding.

WHAT ARE YOUR GOALS AS A TRUSTEE? I have several goals, one of which is to further my understanding about the condition and learn more about its impact to the daily lives of those affected.

In my experience, there is a common misunderstanding about the bipolar condition, and as my awareness and understanding increases, I’m keen to be an advocate of awareness about bipolar.

I’m also looking to get insight about what’s involved in the management of Bipolar Scotland and get a better feel of the services and support the charity provides, and how it helps those in need.

COULD YOU BE OUR NEXT TRUSTEE? We’re looking for someone with experience of senior leadership in fundraising to join our Board of Trustees. If you, or someone you know, has been a Director of Fundraising, Managing Director, charity CEO or similar, we would love to hear from you!

The role of Trustee is unremunerated, but we do reimburse out-of-pocket expenses. If you, or someone you know, would like to arrange an informal chat to find out more before applying, please contact Jayne Laidlaw directly: jaynel@bipolarscotland.org.uk

Image: Vecteezy.com

WHAT DO YOU ENJOY MOST ABOUT BEING A TRUSTEE? I enjoy learning more about what the charity does and getting a better understanding of how it functions. A key part of the role is working alongside others, and it’s great being part of a team that are all working towards the same goal and seeing how each Trustee brings their own unique skills and viewpoints into our discussions and decision-making. It’s also enjoyable to do something that you’re passionate about and invested in, so on a personal level there is a ‘feel-good’ factor about the role.

WHAT QUALITIES MAKES A GOOD TRUSTEE? Having the right mindset is key, but the right experience also helps. Being a team player who likes to engage and collaborate with others is a must, as is being open and actively listening to many voices. You also need to be passionate and up for a challenge!

Having experience as a charity Trustee clearly helps, as does fundraising experience or business development. Ideally, lived experience is beneficial as it underpins the foundations to the charity’s success. The role is very varied and can be complex at times, but it is a rewarding experience and a great opportunity for an individual to apply their skills, expand their knowledge, and help contribute to make a difference.

BIPOLAR SCOTLAND 11

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’.

What Would I Miss?

by Colette MacFadyen

I think what I would miss most Is being real and tangible Of actually existing and living.

I would miss all the people I am connected with Both family and friends.

I would miss seeing the sun and the moon I would miss breathing I would miss living.

All the things that make life real The things I can see and touch The reality of living.

I would miss it all The people, the places All that is real and all that I feel.

Image: Vecteezy.com

Jamie’s Diary Finding Level

Hello everyone, Over the past couple of weeks, I have felt a little off, but I have kept working and I have felt okay, both physically and mentally. However, I was aware by my ‘ups and downs’ that something wasn’t quite right so I booked a blood test and low and behold – my lithium levels were off.

I don't know exactly what is wrong, or whether there is too much or not enough lithium in my system, but l will meet with the GP tomorrow. I’m glad l caught it now before I had some type of emotional breakdown. I’m aware I can get a little over-confident with my mental health: l know my moods and patterns so well now that, in my mania, l can convince myself that all is good, and l can handle it.

A plumber doesn't go into a job expecting to flood someone’s kitchen, does he? He thinks he knows what to do, how to apply his skills, how to handle things, but sometimes these things do happen.

Image: Vecteezy.com

I’m not an expert in mental health – absolutely not. But I do know how it feels to think you have a handle on things when you may not. I also know that these things can be frustrating but overall, it’s a reminder that we all have to get checked out, every now and then.

Stay well, friends. All will be okay.

Now, where is that mop...?

Much love, Xx

RESEARCH CORNER Why diverse research participants are important for understanding our health

by Raahat Manrai and Amber Roguski

We all need medical care at some point in our lives – and we all deserve to receive the best treatment, whether we need help with broken bones, blood donation, bipolar episodes or bronchitis. But how do we know what the best treatment or care option is for us out of the many we might be offered? This blog discusses the importance of diversity in research along with highlighting ways we can ensure that.

EVIDENCE-BASED MEDICINE In healthcare, the clinical experience of healthcare practitioners is coupled with findings from research to make decisions about which treatment is best for an individual.

This is known as evidence-based medicine and is considered to be the gold-standard for medical policy and practice. The research which informs evidence-based medicine varies from study-to-study and could involve:

• Observing people in their home environment • Trialing new medication or treatment • Asking people questions using interviews or surveys. The results from these studies are then often generalised to the wider public, which more often than not, leads to changes in policy and practice.

Because our physiology, anatomy and experience of the world differ from one person to the next, we don’t all respond to treatments and therapies in the same way. It is therefore important that our evidence-based medicine reflects the true diversity of humans, so that we understand how different healthcare options work for each type of person.

Unfortunately, though, this is often not the case. The clinical experience of a doctor or nurse will be limited by the types of patients and conditions they see – they might work in a wealthy area where patients are less likely to smoke and have a chronic health condition, or they might work only with children and teenagers. Similarly, the research that evidencebased medicine is based on can be biased by who participates in the research (‘study participants’).

Image: Vecteezy.com

BIPOLAR SCOTLAND 15

WHO TAKES PART IN RESEARCH? Even though there are efforts to reduce barriers to research participation and make it a possibility for everyone, there are still some groups of people who are often not represented in healthcare research studies.

Between May 2023 – April 2024, the countries who published the most healthcare research were¹:

1

USA

2

China

3

UK

4

Germany

5

Canada

6

France

7

Australia

8

Netherlands

9

Japan

10

Italy

This list reflects the reality of academic research: countries in the Global North have the most money, resources and power to conduct research. This can also be attributed to high amounts of funding going into research being conducted in Global North, which has led to a vicious cycle wherein highincome countries who already have access to resources get more funding. This leads to low and middle-income countries missing out on important opportunities to conduct research. This further leads to an imbalance between medical policy and practice within a global context.

WHAT IMPACT DOES THIS IMBALANCE HAVE? This means that the populations of these countries are more likely to be included in healthcare research as participants. Study participants usually reflect the majority population of the country where the research took place, which means that for

healthcare research, the majority of research is conducted on people of European ancestry.

This also means that study participants usually reflect other majority characteristics in a population such as being heterosexual and cisgender, and people with minoritised or minority identities are often underrepresented in research. This includes people with low incomes, people of child-bearing age, people at age extremes (under 18 and over 75), people with certain medical conditions (including mental health conditions), people who live rurally, and people in prison. You can find a list of identities that are underrepresented and under-served by research on the NIHR INCLUDE website². There are many different reasons for people not taking part in research: some people might not trust research healthcare institutions because of previous experiences, whereas others might be very interested in taking part in research but have never been reached by an advert for a study.

WHAT DOES THIS MEAN FOR BIPOLAR RESEARCH & TREATMENT? You’re probably familiar with several of the different treatments and management techniques for bipolar – medications, therapy, self-management. Research is done to investigate how useful each of these are for bipolar. You are also probably aware that there is a lot that we still don’t understand about the causes of bipolar. There is a lot of research currently underway to try to find out what changes in the brain and body might cause or contribute to bipolar and it is really important that this research represents the true diversity of people with bipolar.

Researchers need to collect better information about their study participants, so that we have a clearer idea of which identities are currently under- or over-represented in bipolar research.

We know that certain people are currently not represented in bipolar research, with under-representation of many ethnicities being one of the clearest examples. The largest Genome-Wide Association Study (GWAS) investigating the genetics of bipolar included 41,917 people with bipolar and 371,549 people without bipolar – all of whom were of European descent³. A recent multicentre neuroimaging study looking at longterm brain changes in bipolar included 307 people with bipolar, 83% of whom were from a ‘white ethnic background’⁴. This frequent over-representation of European ancestry in bipolar research has direct impacts on our understanding of bipolar and the treatment of people with bipolar from non-white ethnicities: for example, people of African ancestry with bipolar have higher rates of misdiagnosis and may have different physiological responses to bipolar medications like lithium⁵. Other papers highlight there are large gaps in our research and understanding of bipolar in older age people⁶, and that men are often under-represented in research looking at the experience of having bipolar⁷.

This blog is just an initial effort from us as a start, but we cannot do it without your help. As researchers, we are making efforts to include people from all backgrounds within our projects and always welcome recommendations to reach wider communities.

We also know that people with bipolar are not represented in other research not related to mental health/bipolar. Even though between 1-2% of the UK population have bipolar, only 0.66% of study participants in the UK Biobank⁸ have bipolar.

But why does this all matter? If we only study the brains, functions and experiences of some people with bipolar, it means that our current understanding of bipolar might not be correct or be the whole picture. It also means that treatments which we assume work for everyone, only actually work for the people they were tested on.

WHAT CAN WE DO? There are actions that we can take to make research participation more diverse and inclusive.

Researchers also need to remove barriers to participation, for example by paying people for their time spent participating or providing childcare during study appointments. They can also advertise research studies to wider communities by approaching support groups, using community-based sampling techniques and encourage participants to discuss the studies with their peers.

Let’s keep the conversation going! Feel free to get in touch if you have any thoughts, suggestions or recommendations. You can email us: r.manrai@ed.ac.uk and amber.roguski@ed.ac.uk HOW YOU CAN GET INVOLVED People with bipolar from all backgrounds and identities should consider taking part in research studies, so that their experience of bipolar can contribute to our wider understanding of the condition: Bipolar-related research: Bipolar Scotland, Bipolar Edinburgh and Bipolar UK often advertise opportunities for research participation. You can also contact your clinician or GP in case there are opportunities for you to take part in any NHS-affiliated research.

General health research: You can sign up to research registers like Scottish Health Research Register & Biobank (SHARE)⁹, or large cohort studies like Our Future Health , which will contact you when a potential study opportunity becomes available.

1 https://www.nature.com/nature-index/country-outputs/ generate/health-sciences/global 2 https://www.nihr.ac.uk/documents/improving-inclusionof-under-served-groups-in-clinical-research-guidance-frominclude-project/25435#what-is-an-underserved-group 3 https://pubmed.ncbi.nlm.nih.gov/34002096/ 4 https://pubmed.ncbi.nlm.nih.gov/34809987/ 5 https://pubmed.ncbi.nlm.nih.gov/29527766/ 6 https://pubmed.ncbi.nlm.nih.gov/34201098/ 7 https://doi.org/10.5964/ejop.v9i2.560 8 https://www.ukbiobank.ac.uk/ 9 https://www.registerforshare.org/ 10 https://ourfuturehealth.org.uk/ BIPOLAR SCOTLAND 17

MEET THE PHARMACIST Principal Specialist Pharmacist in Substance Misuse Alex Adam explains the role, responsibilities and objectives of the pharmacist in the mental health field.

THE ROLE OF THE PHARMACIST Pharmacists are often touted as ‘the experts on medicines and their use’, and this is where most of our professional education and training focuses. We are often part of the clinical team helping to advise on medicine choice, dosages and how to introduce or stop medicines safely. Pharmacists are also trained in more general healthcare, such as how the body systems work and how illnesses affect these.

WORKING WITH YOU Pharmacists are ideally placed to discuss with you how your medicine is working, when the effects are likely to be felt, and to discuss side-effects or concerns you might have about the medication. We can discuss your specific experiences and examine how likely that is to be due to the medication, and perhaps offer suggestions of what to do about it. A pharmacist will ask about when symptoms started, the timeline of their progress and whether they change – so it can be useful to keep a diary of symptoms and experiences, when things happened and how bad they were, to help us to understand what is likely to be happening.

Medicine choice is often much more about the individual person than you might think, particularly in mental health prescribing. How one medication works for someone else, even the dose, is no indication of how it will work for you.

Trying out the ‘best guess’ medication and working from there to see what is doing a good job, what can be tolerated and what causes more problems is often a journey which your clinical team, and the pharmacist, will support.

MANAGING SIDE EFFECTS Some side effects of medication are more common than others and may

be manageable or may need dosage or medication choice changes. As an example, weight gain is a common concern with some anti-psychotic medication. Pharmacists can advise around healthy eating (and what that really means), working out a recommended calorie intake and the need for exercise, as well as what results to expect and when. Keeping a food diary (such as the MyFitnessPal app) and discussing your food intake with a pharmacist can really help to understand why you are gaining weight.

THE POWER OF SELF-MANAGEMENT The evidence for a lot of conditions, is that mindset and self-management are as important, if not more so, than medications alone. Making positive changes to your daily day to minimise stress or anxiety, to increase opportunities for rest and recovery, to find things which bring comfort or happiness – these are all relevant to the care of many conditions. Physical movement and activity, such as walking, bring health benefits for the heart and lungs and muscles as well as for the mind.

YOU & THE PHARMACIST The majority of pharmacists you will meet are in the community pharmacy setting.

These pharmacists work principally in the care of the wider public and, as well as providing medicine supply against prescriptions, will offer advice and care for minor illnesses and ailments and treatment of a host of conditions within

their community. They are usually able to advise how to manage a condition or, if needed, guide on when and how to escalate to the appropriate care giver (such as the GP, physiotherapist, dentist, optician etc). Sourcing supplies of medication and working with GP surgeries to arrange prescriptions is a large part of the role to keep people supplied with the medications they need. Your interactions with a pharmacist may occur: AT YOUR GP PRACTICE Within the GP surgeries, there are GP clinical pharmacists, who are usually focused on prescribing quality and safety, review of medications, monitoring for effect and side-effects and ensuring that new guidelines and evidence for the best treatment options is put into practice. They also often deal with medication and treatment queries, transfers from hospital, and interact with the community pharmacists to make sure that prescriptions are supplied to keep medications available.

Image: Vecteezy.com

IN THE HOSPITAL Hospital pharmacists are generally found on the wards, and this is where the more specialist roles are typically found – pharmacists who have advanced training and experience in a particular clinical field, such as mental health. Pharmacists in hospitals are still involved in medication supply but are also involved in reviewing treatments and medications and either prescribing or advising prescribers on the best options for care – including letters to GP practices to recommend changes to current treatment.

WITHIN YOUR CLINICAL TEAM Pharmacists are found within the clinical teams in most settings you will encounter in your treatment journey. We are trained to understand how your medications work and what the best way to get the most out of medication is. Pharmacists are available within your communities, with no need for an appointment, so the pharmacist is often a good first port of call if you have a healthrelated query. We can either help or advise on how and when to seek further support and from whom.

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“I’m A Carer

“Get Me Out Of Here!” nlike the participants of the popular TV show, our challenges as family members supporting people with mental illness are not so short-lived, or as easily overcome. We may not be hanging over a ravine or eating the unmentionables of various animals but the issues we face are often distressing, life changing and can seem insurmountable. Quite simply, we do not have a get-out clause.

EMPATHY & EXPERIENCE At the Mental Welfare Commission, our aim is to protect the rights of people who have mental illness, learning difficulties, dementia, autism and related conditions.

We also want to support and inform their families. Our engagement and participation team includes officers with lived experience of mental illness, neurodiversity and a caregiving role.

HOW WE SUPPORT CARERS The team meets with people and their families who are using services via support groups, individual engagement and other events. We highlight the work of the Commission, inform people of their rights, and feedback their concerns. We also speak to people and their families on our local visits and on our advice line, which is a free phone line for people with lived experience and their families.

One of the other ways we can reach families is through our themed visit programme. For these visits, we speak to people about a particular topic over a fixed period of time to get a snapshot of the situation across the whole country. We then make recommendations in these reports that go to health boards and the Scottish Government.

THEMED VISIT REPORT: OUR MISSION FOR CARERS This year, we plan to look at carers for our report. We hear from families all the time about concerns they have so we reviewed recommendations from our recent themed visits and found those relating to families were repeated time and again, with no reported improvement.

Looking at these issues, along with a report written by our officer with caring experience, we identified several main areas of concern: • Families highlighted the difficulty they had getting any information about their relative and being involved in their care.

• We also questioned the knowledge of staff in relation to mental health laws and their understanding of information sharing.

• It was also clear that difficulties often arose at times of transitions, including when young people move to adult services, when people move from hospital to the community, or from adult to older adult services.

We felt it was important to look at these issues in more detail, so we are making plans to carry out a series of visits now. The engagement and participation team, along with local coordinators, will be linking in with carer organisations, carer centres and other groups to gather as much information as we can.

CARERS, CONSENT & CONFIDENTIALITY We plan to speak to as many families as possible to hear their opinions, good and bad, about the care their relatives have

received and how well they were included.

We know that people presenting in crisis often cannot give an accurate account of their circumstances or the events leading up arriving in services. Ideally, we would like to hear that their relative’s unique knowledge will be listened to and considered.

However, too often we hear that families feel disregarded and ignored with staff refusing to speak to them because of confidentiality.

It is not acceptable to breach confidentiality, but it is also not acceptable to refuse to listen to families and consider the unique and often vital information they have about their relative.

The Commission’s recent good practice guide Carers, Consent and Confidentiality outlines for families and staff what good engagement should look like. For example, staff should never refuse to speak to families, even if their patient has not given permission for information sharing, as their role in that situation is to listen and learn about them.

They can also reassure families in general terms without breaching confidentiality.

YOUR VOICE MATTERS For this report to be as comprehensive as possible, we want to contact as many families and carers as we can to get their opinions and concerns. We plan to contact carer organisations, carer centres and individual family members and to hold focus groups. We can be flexible and will fit in with what suits you and your family’s needs.

In the next few weeks, an online questionnaire will be available online – if you’re interested in taking part, we’ll be sure to share details in On The Level or on Bipolar Scotland’s Facebook page.

After publication of the report, we will also hold a focus group to hear opinions from families on how they felt the report was received and to look at the recommendations and how they can be taken forward.

CONTACTING MWCFS: Advice line - 0800 389 6809 Email - enquiries@mwscot.org.uk Website - https://www.mwcscot.org.uk/ Image: Vecteezy.com

Taking Back Control Discover the benefits of Bipolar Scotland’s Self-Management Training Living with bipolar can be a daily challenge. We rely on medication to manage mood, remain stable and prevent episodes – episodes that can have a detrimental effect on our lives and the lives of our loved ones. It can feel hopeless at times, but there IS hope and there are things we can do to give us more agency and independence when it comes to living with bipolar.

HOW TO GET INVOLVED Self-management training is regularly delivered online, and we have a few inperson courses around Scotland each year. The online training is accessible to all and is delivered in two-hour sessions, one evening per week (6.30pm-8.30pm) for four consecutive weeks. In-person training takes place over a weekend, with sessions running 10am-4pm on Saturday and Sunday. All courses are free of charge for Bipolar Scotland members, and our trainers, Kerry and Hazel, would love to welcome you along.

Details of our upcoming courses can be found at: bipolarscotland.org.uk/selfmanagement-training/ WHAT’S INVOLVED? You’ll join up to 11 other participants to explore what bipolar means for you, learn new self-management tools and strategies, and feel better able to plan for the future and take back control of your life.

BUILD YOUR OWN TOOLKIT Self-management training at Bipolar Scotland not only provides you with a better knowledge of bipolar, but also helps you to explore effective coping mechanisms for living well with the condition. It provides you with a ‘toolkit’, empowering you to regain control of your condition – and your life.

IDEAS & ADVICE A big part of self-management training is meeting others who live with bipolar, and helping each other with tips, tricks and advice from that lived experience.

Learning what works for others can often work for you, but it’s also just a great opportunity to discuss the challenges you face with people who ‘get it.’

It is important to be aware that there is a large discussion and participatory element of this course. With this in mind, we ask that participants feel in a robust enough place in their recovery to engage fully in discussions about bipolar and challenges related to self-management. We will cover the following topics across two days:

Acceptance

Coping strategies, medication, management and preparing for the future

Triggers and warning signs

Bringing it all together

WE’RE READY WHEN YOU ARE If you’re ready to make some positive changes in managing your bipolar, get in touch and we can get you registered for our upcoming sessions. We are happy to answer any questions you may have and, if you wish, we can arrange a phone call to discuss the course and whether it’s the right thing for you.

No matter where you are in your recovery, self-management training really can help you to ‘take back control’ so register on the website or get in touch with us via email at training@bipolarscotland.org.uk to start your self-management journey today

Training Testimonials Still not sure if Self-Management Training is for you?

Our members’ feedback may help you make up your mind…

“The interaction between everyone, including the trainers, was taken at a good pace and was appropriate and sensitive to how people were doing.

People were given time to share their own experiences, which was welcomed. It created a ‘we’re all in this together’ atmosphere where everyone was valued. The course content was excellent and informative.”

“There was good info about triggers, etc., plus lived experience stories were useful. With a lot of selfreflection and processing, I feel comfortable with the information I have received and hope to be able to take it and use at least a fraction of it in my day-to-day life to slowly start making small changes in my routines and such.”

“I learned a lot about myself on the course and I have a couple of things to work on, but it was well overdue and I’m very hopeful that my life will improve as a result. Thank you!”

“Trainers were warm and friendly.

Their approach worked well for content. A follow-up in a few months will be nice – a check-in to see how we are. Thanks Hazel and Kerry for your empathy.”

Image: Pexels / Vecteezy.com

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Support for students w s we move into autumn and Freshers’ week kicks off across Scotland, students are beginning to head back to universities and colleges after the summer break. While starting or returning to further education can be an exciting time, for some students the reality of getting back to the books while managing bipolar can be a daunting prospect. For many, the stress of deadlines, disruption to routines, seasonal changes, uncertainty about life after graduation and financial difficulties can take its toll on mental health.

Fortunately, there is a wide range of support available for students managing bipolar.

From arranging flexibility with deadlines to practical measures such as help with the cost of equipment or arranging a mental health support worker or study skills tutor, there is plenty of additional help to help you complete your studies and keep your learning on the right track.

We’ve pulled together an overview of what help is out there for students with bipolar, and how you can access support to make sure you get the most out of your time at university or college.

TALK TO YOUR FURTHER EDUCATION PROVIDER AS SOON AS POSSIBLE One of the first things to consider is talking to your university or college about your condition. Whether you are applying for a new course, or are a continuing student, it is strongly encouraged to share your bipolar diagnosis with your education provider as soon as possible.

for your individual needs, as well as signposting you to relevant support. The advice is clear: discuss your condition from the outset and work with your university or college to get the help you need as soon as possible.

THINKING OF APPLYING FOR A HIGHER EDUCATION COURSE? YOU MAY QUALIFY AS A WIDENING ACCESS STUDENT For those in the process of applying to university is worthwhile exploring if you may be considered to be a ‘widening access’ student. To identify an applicant’s full potential, universities and colleges look beyond grades, and will consider your individual circumstances during the admissions process. This is part of their commitment to address the current underrepresentation of certain groups within Higher Education, including those with mental health conditions. Indeed, Scottish universities now have some of the most progressive and inclusive admissions policies in the UK. Each university and college will have its own policy, so you should check their websites or contact them directly for more information on their widening access criteria.

A 2021 report by UCAS states that “applicant data shows declarations of mental health conditions are increasing and highlights that, when students do disclose, this can have many other positive effects for future intentions around help-seeking and how they view their own institutions’ support”

ACCESSING THE DISABLED STUDENTS’ ALLOWANCE (DSA) SCOTLAND DSA Scotland is a fund which students managing bipolar may be able to access to help with the practical aspects of studying. Support is available for a wide range of disabilities, including mental health conditions. DSA can be used to pay for a number of items including computing equipment, costs for printing, photocopying and paper, travel expenses and Non-Medical Personal Help (NMPH), such as note takers and mental health support workers.

Most further education providers have a wellbeing services team and disability advisors who can advise on what is available

For more information on DSA and how to apply visit: http://www.saas.gov.uk/guides/ disabled-students-allowance

Image: Vecteezy.com Written by Gillian Sheriff

with bipolar in Scotland

Student group member feedback: “It was thanks to my peer support worker at Bipolar Scotland and his advice that led to me applying for Disabled Student Allowance (DSA) and registering with the disability services at university in advance of starting my postgraduate degree.

“It wouldn’t have occurred to me to do this but I’m so glad I have. The university has been so supportive, offering me a wide range of support from deadline extensions to software which reads out text, records lectures and also a mental health support worker and study skills tutor. SAAS then helped fund this through DSA. All of this is in place to help me manage my course load to reduce stress and ensure that if I do need to return home or step back for a bit,

I will still be able to learn remotely and continue on the course. It’s a huge relief to know I have this support and I would highly recommend those embarking on a university course to consider applying for this and letting their university know.

It was a very easy process. The university submits the DSA form and puts forward recommendations following an initial assessment. It has certainly helped ease some of the worries I had about going back to university and now I can’t wait to get started knowing I have this support in place!” - Peer (Anon)

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 any 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 6 October & Sunday 3 November, 3-4pm.

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

Wednesday 2, 16 & 30 October and Wednesday 13 & 27 November, 7-8pm.

FRIENDS AND FAMILY: For carers and loved ones. Monday 21 October & Monday 18 November, 7-8pm.

REGIONAL AYRSHIRE & DUNDEE • Ayrshire & Dundee online group: Tuesday 1 October & Tuesday 5 November, 7-8pm.

• Dundee in-person (Dundee Volunteer and Voluntary Action, 10 Constitution Rd, Dundee, SS1 1LL): Thursday 3 October & Thursday 7 November, 7-9pm.

BORDERS • Borders online group: Wednesday 2 & 16 October and Wednesday 6 & 20 November, 7-8pm.

FIFE & FORTH VALLEY • Fife & Forth Valley online group: Tuesday 8 & 22 October and Tuesday 12 & 26 November, 7-8pm.

HIGHLANDS & ISLANDS • Highlands & Islands online group: Thursday 17 October & Thursday 21 November, 7-8pm.

• Highlands & Islands in-person (Café 1668, 86 Church St, Inverness, IV1 1EP): Thursday 3 October, 7-9pm & Thursday 7 November.

• Glasgow West in-person (Partick Trinity Church, 20 Lawrence St, Partick, Glasgow, G11 5HG): Wednesday 23 October & Wednesday 27 November, 7-9pm.

NORTH LANARKSHIRE North Lanarkshire in-person (Coatbridge Community Centre, 9 Old Monkland Rd, Coatbridge, ML5 5EA): Monday 14 October & Monday 11 November, 7-9pm.

PAISLEY • Paisley online group: Monday 14 October & Monday 11 November, 6-7pm.

• Paisley in-person (Methodist Central Hall, 2 Gauze St, Paisley, PA1 1EP): Monday 28 October & Monday 25 November, 6-7.30pm.

WEST LOTHIAN • West Lothian in-person (Bathgate Community Centre, Lindsay House, South Bridge St, Bathgate, West Lothian, EH48 1TS): Thursday 10 October & Thursday 14 November, 7-9pm.

GLASGOW • Glasgow City online group: Sunday 27 October & Sunday 24 November, 7-8pm.

• Glasgow City in-person (Premier Inn, Glasgow City, 187 George St, Glasgow, G1 1YU): Wednesday 9 October & Wednesday 13 November, 7-9pm.

• Glasgow West online group: Sunday 13 October & Sunday 10 November, 7-8pm.

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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