ONE in three people are estimated to be affected by mental health problems in Scotland in any given year. I am one of them. I was once ashamed of that. Today, my recovery journey is something I look at with pride.
I live with bipolar disorder (type II). I was first diagnosed in about 2011, after a number of years of extreme mood swings and long periods of depression. I had been treated for depression since my teens, but it wasn’t until a combination of financial, work and relationship pressures combined in my mid-to-late 20s – creating a level of stress that I simply couldn’t handle – that the mood disorder truly revealed itself.
Bipolar type I is the type you are most likely to have heard of. It is defined by the presence of severe manic episodes that last for a week or longer, or require hospitalisation (often including extreme euphoria and risky behaviour).
In contrast, my version, bipolar II, involves periods of hypomania which are less intense than full mania. Hypomania still involves elevated mood, increased energy and potential risk-taking, but it doesn’t usually lead to the same level of dysfunction or require hospitalisation. In my case, it results in spinning up projects and developing new ideas. I take on far too much because I can get a lot done.
READ MORE: Alex Salmond pictured in his political career over the years
The key feature of bipolar II though, is that the depressive episodes tend to be more prolonged and disabling than in bipolar I.
My journey from being relatively well, to finally getting a diagnosis that made sense, was terrifying. I went from being a person who could usually handle (albeit not brilliantly) periods of being depressed, to being totally unable to function. My mood would change rapidly – up to three or four times a day. I would dissolve into a semi-catatonic state at the slightest pressure. Bills and problems piled up, I lost a business, my credit rating, friends and freelance work. I almost lost a house. I ignored my tax bills. I let people – including my family – down in truly spectacular fashion. I made undeniably terrible decisions.
And when I could face looking at the wreckage, perceiving all of my disasters as personal failures meant that spiral only deepened. The emotional and mental pain affected every aspect of my life. Just writing about it now creates a knot in my stomach.
Wednesday was World Mental Health Day and I noticed multiple references to it in the media which is hugely encouraging. There is no doubt that we have made huge progress in reducing the shame and stigma of mental health issues over the past few decades. We have not, however, made huge progress in reducing the prevalence. Quite the opposite, in fact.
Trends over the past decades have been going in entirely the wrong direction. A sharp increase in common mental disorders like anxiety, depression and stress has been recorded, particularly among younger folk. Between 2000 and 2019, the incidence of these disorders in 16 to 24-year-olds doubled.
Sadly, the pandemic just intensified these trends. In 2023-24, a record 3.8 million people in England accessed mental health services, up by almost 40% compared to pre-pandemic figures. This includes more than one million children and young people, with a notable spike in mental health issues among 16-year-old girls. The demand for services now exceeds pre-pandemic levels.
The Scottish Association for Mental Health (SAMH) reports statistics for young people that are horrifying, including that one in six young adults aged 18-34 has self-harmed, that girls are three times more likely than boys to report self-harm and that, on average, children and young people with mental health difficulties go an appalling 10 years between first becoming unwell and getting any help.
Work-related mental health issues are also a growing concern. Approximately 51% of long-term sick leave in the UK is now attributed to stress, anxiety or depression. This workplace strain, combined with external stressors like financial insecurity, has contributed to a £28 billion annual cost to the economy.
It used to be that it was hard to talk about mental health issues in any context. It’s still not easy, but the shame is diminishing.
Politicians and the media love to tell us that “it is OK not to be OK”, but words are cheap. The hashtags and the pithy catchphrases for awareness campaigns are all very good as long as they are not being used as an easier alternative to addressing mental health services, or indeed, as an alternative to addressing some of the things which could well be exacerbating the issue.
In 2024, there are plenty of things which could be, and probably are, exacerbating the issue. Life certainly isn’t getting easier for most people. A cost of living crisis, stalled wages, chronic underfunding of critical services and a relentless march to the political right are all contributing to the growing stress of simply existing.
And while not all mental health issues can be attributed to stress, there is plenty of evidence that when stress becomes overwhelming and prolonged, the risks for both mental health problems and medical problems increase. Research shows that long-term stress increases the risk of anxiety and depression, substance use problems, sleep problems and pain.
Even for an illness like mine, where there is evidence that genetics could be part of the puzzle, an underlying predisposition can be compounded by environmental factors – leading to a full-blown crisis. Common triggers include high stress – something my story certainly bears out.
Today, I am very fortunate to be well medicated. I have had the privilege of creating a life that works for me. I have learned how I can help my brain function well – and I have spent a long time developing self-management techniques which I can deploy when I need to. I have a support network – including people I could call in a crisis at 2am.
And still, it’s a daily battle. My recovery journey hasn’t ended. I continue to self-medicate unhelpfully at times. The drugs that keep me stable also slow my metabolism to a crawl. Sometimes you will see me at least two stone heavier than last time, and the next time I’ll be two stone lighter. It all depends on how successful my self-management versus my self-medication has been over the previous six months.
Stability doesn’t mean cured. I’ll take medication for the rest of my life. That medication sedates me at night, and I usually wake up with a chemical hangover. It puts me at increased risk of heart arrhythmia, liver damage and other delights. I have far fewer moments of crisis than I did in my worst times, but I still have them – often triggered by stress. Those times remain terrifying. The fear I developed of brown envelopes and of the phone ringing hasn’t left. Voicemail still makes me want to run a mile.
READ MORE: Nicola Sturgeon pays tribute to Alex Salmond
Someone once told me that recovery isn’t about being “fixed”. Recovery is about learning to live well in the presence or absence of symptoms, and in the presence or absence of medication. Recovery isn’t a journey with an end point either, it’s a process.
I’ve had a lot of good fortune in my life – and it remains a hard process. The thought of anyone facing some of the darkness I have, especially young people, without the support, the tools and the access to services they need, is absolutely heart-breaking and entirely avoidable.
Now that we’ve worked out how to talk about it, it’s high time we started working out how to deal with it. And it has to start at the top. It might be OK for individuals to say they are not OK, but the services that support them are far from OK, and that is shameful.
Why are you making commenting on The National only available to subscribers?
We know there are thousands of National readers who want to debate, argue and go back and forth in the comments section of our stories. We’ve got the most informed readers in Scotland, asking each other the big questions about the future of our country.
Unfortunately, though, these important debates are being spoiled by a vocal minority of trolls who aren’t really interested in the issues, try to derail the conversations, register under fake names, and post vile abuse.
So that’s why we’ve decided to make the ability to comment only available to our paying subscribers. That way, all the trolls who post abuse on our website will have to pay if they want to join the debate – and risk a permanent ban from the account that they subscribe with.
The conversation will go back to what it should be about – people who care passionately about the issues, but disagree constructively on what we should do about them. Let’s get that debate started!
Callum Baird, Editor of The National
Comments: Our rules
We want our comments to be a lively and valuable part of our community - a place where readers can debate and engage with the most important local issues. The ability to comment on our stories is a privilege, not a right, however, and that privilege may be withdrawn if it is abused or misused.
Please report any comments that break our rules.
Read the rules hereLast Updated:
Report this comment Cancel