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.

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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.

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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.