What is Bipolar disorder? (Manic Depression renamed) Symptoms & Treatment

Dr Marianne Trent (: 00:00

What is bipolar disorder? What does it look like? How do you treat it? How might you recognise it, and how do you learn to live with it or live with somebody you love? Who might have it? My guest today has bipolar disorder himself, and we are answering all of these questions and more. I hope you find it so useful.

(: 00:29

Hi, welcome along to the Aspiring Psychologist Podcast. I am Dr. Marianne Trent. I'm a qualified clinical psychologist. I love introducing you to topics that help you to learn more about key clinical areas, which might be of significance for you in your clinical area of work or for those that you love or care about. Today. My guest and I are taking a deep dive into bipolar disorder and it is a completely brilliant episode. Even though I've been qualified for many years now, I learned so many useful things from talking to my guest, Sam, so I hope that you will find the same. I'll look forward to catching up with you on the other side of this. Hi, I just want to welcome our guest for today. Hi, Sam.

Sam Swidzinski (: 01:15

Hi, lovely to be on.

Dr Marianne Trent (: 01:18

Lovely to have you here and thank you so much for reaching out. I'm really excited to talk with you and to kind of bring information about your specialist subject. This is not Mastermind, but which is bipolar disorder, so it's lovely to have you here.

Sam Swidzinski (: 01:34

No, it's good. I mean, any opportunity that I can have to be able to talk about this important topic is a great pleasure, so thank you.

Dr Marianne Trent (: 01:42

Yeah. So just to help our audience to kind of get a feel for who you are and why you are talking to us about bipolar disorder, could you give yourself a little intro?

Sam Swidzinski (: 01:53

Yeah, I mean, I'm Sam. So the reason why I care so much about bipolar disorder is because of my own lived experience. So when I was 18, I was diagnosed, but it took a few years to be able to get that diagnosis in the first place, which caused some troubles. During my teen years, I was very, very fortunate to meet people that took me under their wing and were able to help me in terms of within the mental health field. And because of that I'm very, very grateful and I guess gratitude for them made me realise that I want to help others to be able to find the care that they need as well. So that very much inspired me to go down that route. So since then I've written my book, which is Winning the War with Bipolar, which is sort of a mixture of lived experience mix with research on how you can manage this disorder. Essentially I'm now completing my PhD in bipolar disorder, specifically about cognition and functioning, which we can I suppose discuss later in the podcast. And also I run a small educational organisation called Schologists, which helps in terms of hopefully inspiring the next generation of psychology students, which is of course a great overlap with what you, you're very passionate in as well. So yes, an honour to be able to be alive for starters, because I didn't always question I would be that, but also hopefully to be voice in this field and try to help it progress.

Dr Marianne Trent (: 03:31

Yeah, thank you so much for doing such a good job on that. And it sounds like a case of if you want something done, ask a busy person. You sound really, really busy when it comes to bipolar diagnosis. It's really common in my clinical experience that it happens much later than 18 and I appreciate that you'd had some kind of perpetual struggles before 18, but actually for me as a health professional, I'm pleased that you got that diagnosis relatively early, but I appreciate it. Didn't perhaps feel that way to you?

Sam Swidzinski (: 04:06

Yeah, I mean it certainly is relatively early and relatively being the important word there because when we think of that term, we think of in comparison to others, and I think I work considerably with bipolar uk. They're sort of the main charity that I'm associated with and support in terms of their work and bipolar UK found through the bipolar commission, which is massive research project led by people from Cambridge and KCL and lots of top institutions that it takes on an average nine and a half years to get a diagnosis for bipolar. So for me, it was only a few since I was first diagnosed, I was lucky. But the sad thing is that I know for myself had it taken nine and a half years, I'd be dead right now because already I was pretty close. So yes, it's definitely something that needs to be better.

(: 05:06

So in terms of the general field, but as to why I got an early diagnosis, that was like I said earlier, because I was very fortunate to meet people that took me under their wing. So I was a research participant in research projects purely in the first instance because I wanted a bit of money, I was not able to work because of my mental health. So I literally went to King's College to, okay, let's participate in this is an easy way to get a few pounds essentially. And then it ended up meeting people who helped me to get a diagnosis and then get the care I needed.

Dr Marianne Trent (: 05:47

That's incredible. So you were initially trying to help yourself but ended up helping yourself more than you could ever know, and it's led to really useful stuff for other people to be helped as well. That's really, really powerful for anybody that's listening to this as a total beginner. They might have heard of bipolar before, they might not even have heard of it before. They might have heard of it under its previous name, which used to be called Manic Depression, but it was renamed as bipolar disorder. Could you give us a very whizzy, quick whip through with what is bipolar disorder, Sam?

Sam Swidzinski (: 06:25

Yeah, I think you make a good point there that obviously before it used to be called manic depression. And now that I think about it, it's not really something I think about regularly, but I think almost it's actually a better name for the disorder sort of because bipolar is a word, people use it in so many contexts. So for example, the weather, it's a bit bipolar today or all of this type of thing. Or if someone has ups and downs in the mood or in their emotions in a particular day, they say, oh, you're acting very bipolar. So there's a lot of myths and misconceptions around what people believe that this disorder is. But in essence, what bipolar disorder is having periods of low mood or depression and then periods of high mood or mania or hypermania. So all it is is fluctuations of mood between extreme highs and extreme levels.

(: 07:24

Human beings all experience highs and lows over different periods of time. That's just the human experience. We're not robots, but with individuals with bipolar, those extremes are more extreme than the average person. So you could view bipolar disorder essentially as a spectrum of mood and essentially all human beings I suppose somewhere on that spectrum, it's just most people are not at the disorder level. So within bipolar disorder you've got several different diagnoses and the classic case of I guess the most severe in terms of the range of mood symptoms is bipolar type one disorder, where that is where you experience extreme highs in mood with what we call mania. And what mania is is it's high mood, so much so that it's causing significant impairment in terms of your functioning. So what I mean by that is often you're going to need to go into the hospital, you'll need to be hospitalised, or at the very least you are going to have significant problems in terms of your relationships and in terms of work.

(: 08:39

So it's going to cause basically a huge issue in terms of your life. So what do those symptoms look like? So typically you're going to not be able to sleep. So you might be able to get one to a few hours of sleep every single night, but you wake up with bounds of energy a hundred times more energy than everyone else around you. But that energy can be quite painful because when we think of a high energy state, it's not just happy. It can be very irritable or aggressive or it's very difficult to be able to manage. It's too much energy in the same way with flights of thoughts, your thoughts are running so fast that it's too fast. Your thinking is overly positive that it becomes grandiose and you can believe things that aren't real and so on. And it can even cause hallucinations and delusions.

(: 09:36

So the high mood of mania, I almost describe it as an incredibly high energy state. And the reason why I say that is because when we describe high mood, we think of it as, wow, that's a really positive thing. You've got high mood, that's great, that's fantastic. But it can get to that stage that essentially it's more of an energy based problem. So you have this extreme highs of mood and then you crash into a depression. So depression is the complete lack of energy or the incredibly low mood. You might want to sleep a lot, you might actually have problems with sleep, but you feel low energy. You lack pleasure in your day-to-day activities, and you struggle to find any satisfaction in your life. So this huge high to this huge low is essentially the characteristic of bipolar type one, bipolar type two. In terms of the severity of the extremities of going so high is less so because what you experience is something called hypermania, which is where the form of mania is not so severe that it's causing a significant impairment in your functioning.

(: 10:58

You are almost somewhat enjoying the process of the high and it might not have a dramatic negative impact on your surroundings. It might somewhat, so for example, you might spend recklessly and lose a lot of money. You might go gambling and lose all of your funds and everyone's very upset with you, but it is not going to lead to a hospitalisation or very, very severe negative consequences in your life. But the lows in bipolar type two tend to be longer. And for that reason, it's not one of those things that you would view bipolar type one is a worse disorder than bipolar type two. Instead they're just different in terms of how the mood varies. So in both you've got these highs and these lows, and then you've got also other diagnoses that are lesser. So in terms of the variance in mood, but in general, I suppose the main myth that is important to be busted is that, oh, your fluctuations in your emotions are like this every day.

(: 12:10

That means that you've got bipolar. And typically in bipolar it's long durations. So for example, the highs have to be at least four days to a week depending on the diagnostic criteria. And then the lows need to be at least a week or a couple of weeks. So you can have faster fluctuations, but you need to at least experience that to be able to get a diagnosis. So it's quite long periods of highs, long periods of lows. And then the goal essentially of treatment is to reduce the severity of that. So it goes from this, it's more like this,

Dr Marianne Trent (: 12:47

Thank you so much for that kind of run through of what it is. And also you're going to some really good examples of how it might present. And in my experience as a clinician, it's often the more manic behaviours that lead to somebody becoming known to mental health services, sometimes known to justice services, sometimes taken to place of safety because like you said, sometimes they can be quite wild, they can be really quite impulsive. You can feel like you're a millionaire, you might not be giving all your money away or it's different for different people, but it always can look quite extravagant. And like you said, there's almost that omnipotence or a grandiosity, which might, well, lots of my clients have told me it feels pretty good to be in a manic phase when you're in it. But the fallout from it and the trauma and the impact on your professional life, on your intimate family, friend's life can be really, really catastrophic.

Sam Swidzinski (: 13:56

And that's the main thing. I think if you experience full blown mania, you realise that, or similar states, you realise that the negative consequences of that are almost higher than of depression. The reason why is because depression, you're an incredibly low state, maybe you are suicidal, it's terrible, but the highs, it's the impact that has on everyone around you. So it's the relationships that are lost, it's the money that's lost. It's the potentially whole life that's lost. Either you could die or maybe sadly end up in prison. Anything's really possible because it's just an obliviousness to the consequences of action. And this is why the delusions grandiose delusions come into it. There's this thing, so for example, someone with mania, they might believe, okay, I can jump off of this roof and I'll fly because you genuinely believe that or just get themselves into these sort of very dangerous situations and you can die. So I laugh, but it's terrible. I mean it is almost impossible to manage to be honest in terms of that state because you're in a state of mind that you're not able to manage your behaviour because it's just everything's going too fast.

Dr Marianne Trent (: 15:35

Thank you for sharing that, isn't it? It's clearly powerful and it really connected to you that idea that the kind of lack of insight can really lead you and other people with bipolar to be so incredibly vulnerable. And in one of my earlier podcast episodes of talking about the concept of indirect self-harm, which is where someone isn't necessarily meaning to hurt themselves and on a low level it might be something like nibbling the skin on our fingers, but actually an extreme level, it can lead to not intentional suicide, which is kind of death by misadventure or whatever, but it's not someone's intent to end their life, but it does sometimes happen and people are so vulnerable, aren't they?

Sam Swidzinski (: 16:20

Yeah, they are. And family members as well deserve a lot of support and help through the process because essentially everyone's vulnerable during that time, which is the reason why it's very important to avoid those episodes. And this is why early diagnosis is incredibly important. So typically in terms of bipolar disorder, I mean you'd observe it in your clinical practise. I'm sure there's inclinations prior to having a severe mood episode of mania that someone might be susceptible to having that. And there's several things that might be involved. Firstly, it might be bipolar in their family. That might be one thing because obviously part of it is very much genetic, but also in terms of previous mood episodes, previous periods of somewhat highs and lows, but just not to that severe enough level. And because of that, technically it should be possible to be able to diagnose early and you can prevent such severe things happening. And that's why the issue of diagnosis is almost the most important one to solve because then you can get on the right medications for the right treatments in general so that you're able to better manage yourself, which also obviously involves therapy as well. So yeah, I'd say the best way to prevent the negative aspects of mania is to prevent it in the first place.

Dr Marianne Trent (: 17:46

Yeah. And are there any kind of known precursors other than family history of bipolar that might make it more likely that somebody would develop that?

Sam Swidzinski (: 17:59

Yeah, I mean definitely mean. We've talked before about the concept of trauma and in different types of trauma within the beginnings of bipolar disorder. And I think that the white trauma obviously can mean several different forms of trauma. I mean, for example, head injury can increase the chances of bipolar disorder in itself. So for me, I've got this big scar in my head here, and this scar came from an injury in school in which it was horrible. It was sort of a playground incident. A kid pushed me and then I went into the wall, smashed it, you could see my skull. So that was a very severe incident and I'm not really sure whether that was linked to starting with my bipolar disorder that was previous to it, but it's very possible that that did. And there's two sides to that. Firstly is the trauma of the physical trauma because it was a very severe injury, but there's also the side of the emotional aspects of it as well because that was bullying associated and a lot of, I guess anxiety that resulted from that incident, which led to me sort of having difficulties there.

(: 19:21

So I think that those things definitely can sort of lead to susceptibility. I think there's a lot of genetic environmental interaction, but also I do believe that personally I do believe that black and white thinking very much comes into play as well. So I think when we're having black and white thinking, we're sort of thinking, okay, this is very positive, this is very negative. We very much judgments on things. And I do think that in general, having black and white thinking or being taught it very early in life can lead to the concept of differentiation of states because sort of in bipolar disorder, obviously it's mood disorders of extremities at either side and essentially everything's all energy or everything's not. So it's just a personal view that I think that black and white thinking can be evolved. And for example, I was brought up very religious as well as a Jehovah's Witness. I, I've left the faith now, but I do believe that being brought up in a religion that does promote extremities somewhat in perception of the world, and I think it can sort of potentially increase the chances of that.

Dr Marianne Trent (: 20:59

Yeah, and it's interesting that you talk about organised religion. Is it fair to say that that's what Jehovah's Witness is religion that's kind of quite extreme and has the experience of othering and being othered and it's very much kind of separating you and the people in the faith from people outside of it. And I know from my experience of working with clients but also being in school myself, that actually that's quite tricky the way that you have to separate yourself in school outside of school, around Christmas, around birthdays, especially if you are in a western world where people like to buy a present on your birthday or might invite you to their birthday or their Christmas gathering, it's very difficult to be different when it's not necessarily your choice to be different. And I hadn't really appreciated until you said, and similarly with traumatic brain injury, I've qualified in 2011, we're speaking in 2024, I've had many years of working even with people with traumatic brain injuries before I got qualified and during training I didn't know about that, making it more likely that you would develop or could develop bipolar. So I think this is the real power of this podcast and of conversations like this that it teaches people who are relatively long in the tooth to know this stuff, but also how incredible to be perhaps in a much earlier career stage and already know this and be aware of that and have that on your radar.

Sam Swidzinski (: 22:33

Well, I mean, thank you. I think from this perspective, I suppose that there's a huge amount that I do not know, but the reason why, I guess I do know the things that I do know is because of a mixture of lived experience and then trying to understand that and unpick that by talking to my superiors who are very helpful in terms of building understandings. But yeah, I think in terms of traumatic head injury, there is a relation between that and having bipolar disorder, however, it's not obviously the primary reason as to why people tend to have it. But yes, what you mentioned as well regarding religion, I do think also this aspect of feeling different to others, I think that us and them type thinking can also lead to the generation of any type of mental health difficulty because if you feel very different to those around you, it causes a gap and it makes things very difficult. So I do definitely think he causes challenges

Dr Marianne Trent (: 23:48

And it's kind of making me think in terms of trauma of Bessel VanDerKolk's stuff of the body holding the score that you might be able to get through things physically in the moment that might be very challenging, but that the body will recognise and we'll store some of that and it might come out at later times.

Sam Swidzinski (: 24:10

Yes, I mean this fantastic book. But yes, I'd say, and you feel it. I think that it's something that people experience, right? Especially you go through a difficult stage in your life or a difficult thing and even you remember it, you literally feel it in your body, you might feel sick. There are certain stages that I feel the need to nearly throw up because of anxiety and things like that related to things. I think that the body really does take it in, and I think this sort of relates very strongly with bipolar disorder as well because it's an energy state. This is really why I like to bring it back to energy as opposed to mood because essentially high energy, it's like you're shaking like your legs move in constantly, psychomotor agitation, all of these things relate to energy in the body. When you're depressed, you almost don't move at all. You find it very difficult to move, your brain is working very slowly. So I like to think of it in that form and I do think that that relates to sort of the body very much and very strongly.

Dr Marianne Trent (: 25:15

Yeah, absolutely. I just feel like I'm learning a lot despite being a clinician that regularly works with people with bipolar. So yeah, thank you. From me as well. Is the answer always medication? Is it always lifetime medication? What are the options there?

Sam Swidzinski (: 25:33

So we are currently producing a paper and it is soon to be published regarding the natural history of bipolar. So what we mean by natural history is sort of what does bipolar look like in terms of the disorder itself, if you take away medication. And the way that we do that is by essentially looking at studies that are of people that aren't medicated slash studies which are older than the medications themselves. So this sort of analysis of individuals with bipolar. And so what the literature finds in a systematic review of essentially all of the studies on this is that 20% of people with bipolar disorder will only experience one episode essentially. And generally that tends to be a manic episode. So the other 80% tend to have a relatively recurrent illness. So they have great risk of episodes coming back and there's great variance in the number of episodes and how frequent they'll be.

(: 26:34

So there's great heterogeneity or great variance essentially in how people experience this disorder and what the episodes are. There's also great variance in what is the best way of treatment for individuals with bipolar. So for example, if you go online for example on Twitter, there'll be a lot of people heavily advocating for food changes for example, because the food changes that help them as an individual to improve in terms of their bipolar disorder and they strongly advocate towards that, whereas other people have felt medication has been the thing for me, you are wrong, it's medication that you need. And then other people say, only therapy, you don't need medication, you don't need to change food, you just need therapy. And it's worked for them. So I think the important thing of understanding within bipolar disorder is that although we can categorise people in terms of these categories based on how they're experiencing their mood, there's great variance in the best treatments for them, why they have it so many different things and there's more variance between individuals within the disorder than there are elsewhere.

(: 27:48

So everything's very different. So what I personally believe is that medication is probably important in the first instance, most likely at least as a way to try to solve the issue essentially, at least for the short term. The reason why is because it's the quickest thing you can do and is the quickest thing you can try. So in terms of that, you take some medication, it's going to decrease your likelihood of going into further episodes and so on. But people have done well with changing their food and changing and going to therapy alone and that works for them. So in terms of medication though, having it for the lifetime, I think for a lot of individuals with bipolar disorder, probably the majority, but I can't be sure and that none of us can be sure of that by a large proportion. At least likely we'll need it for life.

(: 28:53

But regarding therapy, that's also a massive aspect of it and it's something I should discussed very strongly in my book as well in terms of therapy, but also CPT therapy, one of the goals of the therapy generally is to create a sort of therapy blueprint by the end of the process and that blueprint, you're building this process to be able to understand, okay, this is the blueprint, this is how I maintain my good health. And by following that, you can prevent future episodes. How does that involve in terms of therapy? What is the importance of therapy in this? What it is is that you recognise, okay, what do I do to prevent the likelihood of getting bipolar disorder, of getting a bipolar disorder episode? What are the things that I need to, so for example, that might be okay, I go to sleep at the same time every night, I take my medication at that time, obviously I have a life, so I've got to try to somewhat vary that, but for the vast majority of the time, we try to be solid with that.

(: 29:55

Even if I can't sleep, potentially stay in bed because sleep is a massive one in terms of this food trying to be relatively stable in terms of drugs or alcohol, trying the best to stay away where possible, different strategies for different people. But basically you come up with a blueprint as to how to do that, then you come up with a blueprint. Okay, early symptoms, how do we identify those? When are they coming to me? What are these symptoms? And recognising those early symptoms before it becomes a full episode because then what you can do is for example, message the psychiatrist, maybe there needs to be a slight medication change. It might be that you need to change something in your lifestyle. There could be several different things you could do and then you stop it at that stage. And then finally, if you're in an episode, then having another action plan as to how you deal with that. But essentially having such a process through the form of therapy that you're able to do all of these things significantly reduces the likelihood of having an episode. So whether that works in conjunction with medication or not, I think slightly depends likely on the individual. There's going to be variation regarding that. But in my opinion, I think that for the most part, a mixture of medication and therapy is the best solution.

Dr Marianne Trent (: 31:16

Yeah, thank you so much for that. That was so useful. And often when I'm talking with clients, I'll be like, actually, one of the things we need to do is to make life a little bit more consistent, a little bit more predictable. It might feel quite boring, but actually it's the boring predictability that gives us all balance. And actually certainly where there's been cases of complex trauma growing up in chaos, things feeling unsafe, there may never have been any structure or this is actually we have our dinner at this time, we get up at this time, we take our vitamins at this time of day. This literally can be starting brand new afresh. With that kind of basic, what I would consider as a parent basic care, that's what I do with my children. I've got two of the beasts, but for some people that's the first time ever that they've had that level of attunement.

(: 32:18

And actually it can feel a little bit boring to begin with, but actually when we know that actually we exercise three times a week or even if we just do it every day and we have our dinner at about six o'clock and then we try not to drink much at night, so we're not having to wake up to have a wee literally really, really boring things. And quite often with my clients with bipolar, we are literally going through the basics of how are you sleeping at the moment? Are you eating? Are you taking care of yourself? Are you getting out for those walks that we spoke about? And just keeping a track so that if there are, like you said at the beginning, natural fluctuations in mood, we will have them due to grief, due to breakups, due to job changes, due to studying, just due to the weather. There are natural fluctuations, but it helps us to decide whether this is a fluctuation or whether this is actually a change of their bipolar state. Their presentation

Sam Swidzinski (: 33:19

And the consistency is just the most important thing. I mean, but there's something before consistency. I think actually now that I think about it, the thing before consistency is realising that you don't want to have bipolar disorder because the thing is that one of the main reasons why people with bipolar disorder aren't consistent is because they want to chase the highs, especially people. This is the reason why as well, I think that a lot of the time bipolar type two can actually be more of a trouble for people is because there's a lot of reason as to why to want the highs because the highs don't have the same massive negative connotations as it could do with someone with bipolar one. And there's a lot of reason to want that high. You have bounds of energy, you've got all of these great ideas, you feel fantastic.

(: 34:13

You're going around, you're running around doing all of these things. There might be some negative consequences, but not massive ones. So I think there's a lot, and that's why people take drugs. Why do people take cocaine or methamphetamine is to get that same thing that people with bipolar disorder experiencing naturally. It's funny because there's much older member of my family that likely had bipolar disorder, but she often said people pay a lot of money to feel the way that I think that I feel. So I think very much having this connotation that people pay money, so to have such dopamine related drugs.

(: 34:57

So I think that's a big one. And I think you've got to really realise, okay, this is not something that I want. This is not something that I want to continue in any way whatsoever. And from there then decide, okay, I will do whatever I can to be able to have the life I want. And I think the best way to do that is to realise that the best life is one that you can enjoy regularly and isn't so terrible the majority of the time. You want to have something that you're not short highs, you have got a consistently good life and you can create life for yourself. I was in a stage where a few years into my adulthood I didn't really have a life and I didn't realise that there was some significant changes I needed to make to my mentality through making them. I've created a great life for myself. I'm married, I'm having a baby now. I've got not too much worries financially. I managed to have created something quite cool. I am finishing up my PhD. Obviously it's been hard work, but it wouldn't have been possible if I hadn't realised that there's more to life than chasing a few moments of high. So yeah, I'd say that's the first one, and then you've got to do that. And then once you've done that, then you're able to be consistent, which is the best prevention essentially.

Dr Marianne Trent (: 36:35

Yeah, so powerful. And it's that idea of the highs may not be quite as high, but the lows won't be as low and generally we'll have more middle ground, more predictability, more consistency. And it actually reminded me of thinking about before I became a parent actually I probably had more highs that lasted for longer periods of time. But I would say there were also probably more lows that lasted for longer periods of time if you became single or upset or, oh, I can't do this. But generally speaking, since becoming a parent, even within any given, you will learn soon, even within any given day, you might be having the worst day in the world with the child. That's just not well that day or just really cranky and just screaming in your ear a lot. But there will also in that same day, be an incredible moment that just makes it all better. But I think generally speaking, having children has kind of given me more of that middle bounds. I haven't got a bipolar diagnosis, but becoming a parent has given me more structure and given me more of the middle ground. Does that make sense?

Sam Swidzinski (: 37:54

Definitely. And I think that this is where functioning becomes incredibly important because this is a massive problem with treatments for psychiatric illnesses in general, is that there's so much focus overall on symptom reduction and there's not enough on life boosting. What I mean by life boosting is just increases in quality of life and how do we increase that? It's often by increasing your functioning. So what I mean by that is how well are you functioning socially and occupationally in whatever way whatsoever? There's multiple different domains of functioning, but if you are able to improve in those things, then your life can improve and you can be happy. So that's I think, one advocate against medication or medication being the primary solution because medication can just up and up and up and up. If that's the only way that you're treating it and you can end up getting out of bed, you'll feel like a zombie type of thing.

(: 38:45

So ideally you want to be on a medication that once you've stabilised on it, you're able to actually live your life. You are actually able to do things and you're actually able to do the things that you want to do. So that's why I think that treatments, that's where therapy can come in as well. I'm trained in a form of therapy called cognitive remediation, which actually revolves around helping people to improve in their cognitive functioning and relating that to their occupational functioning. It's quite a simple form of therapy. It's not simple. It's simple from the therapeutic perspective because it's guided by sort of technologies online. So you've got a digital world, essentially it's a digital world, and you have real world related tasks that you as a therapist go through with the patient and basically you go through it and try to help them better problem solve through issues that they might relate in their personal life. And through that they can build in their sort of strategy use, which can then help them in terms of functioning in real life. So I experienced that myself. So I was sort of a

Dr Marianne Trent (: 39:53

Made yourself indispensable and I can see why you're obviously very good at what you do. And thank you for speaking so openly and honestly to help our audience to learn more about this. If people want to learn more about you and your book, where should they go?

Sam Swidzinski (: 40:11

So my book's on Amazon, you can look up winning the War with Bipolar and then through that you can find other things that I'm doing online. But yeah, my book, I'd say it's been mostly enjoyed by clinicians, funny enough, and of people who are sort of researchers, but it's very useful for people as well with lived experience because it sort of goes through I guess four steps very much related to funny enough what we've been talking about. The first one being understanding what is bipolar disorder in terms of understanding that in depth then about how can you make the most of therapy and psychiatric relationships following that sort of self-care strategies and then find the consistency. So that's sort of the four sections of the book. So it's quite a good, if I say so myself, way of going through the stages of bi.

Dr Marianne Trent (: 41:07

Brilliant. Well, how on brand was I today as a host for Guiding People through just why your book is such a brilliant read. Thank you for your time. I know that we are connected on LinkedIn. Is that a good place for people to kind and follow you and learn more about your work as well?

Sam Swidzinski (: 41:24

Yeah, yeah, LinkedIn as well. That's where I mostly am.

Dr Marianne Trent (: 41:28

Okay. Could you spell your surname or spell your full name for us in case people are listening an MP three rather than watching on YouTube?

Sam Swidzinski (: 41:36

Yeah, so it's Samuel, so S-A-M-U-E-L, and my surname, S-W-I-D-Z-I-N-S-K-I.

Dr Marianne Trent (: 41:46

Perfect. Samuel, thank you so much. And just thank you again. I know that this will help so many people. And just before we finish, if somebody's listening to this and thinking that they're concerned about their own mental health and that actually bipolar makes a lot of sense for them or someone else that they care about, what should they do?

Sam Swidzinski (: 42:06

So first off, I mean Bipolar UK is a fantastic organisation. So bipolar UK who I've worked with extensively have an e-learning package. They've also got a Mute Tracker app and they've also got the could it be bipolar campaign? If you look at bipolar uk and then could it be bipolar? Let's say that's sort of good starting place. You can learn a little bit more so that you might, I get a better understanding. You'll see my face pop up a couple of times. But in terms of that sort of good to grounding, then download the Blue Tracker app, try to figure out, just find out whether you think that your mood is high. And clinicians here in the UK have been told about bipolar UK and if you bring in the Mood Tracker app, there's something that you can discuss with the clinicians or your doctor in general and that can sort of support a diagnosis, I suppose earlier. I think as well, to be honest, the best thing that you can do, I realise not everyone watching is actually watching sort of a video of us, but essentially what you can do is get a piece of paper and you can plot out your mood over time. So what that looks like is it is impossible to describe if someone's not watching, but you've sort of got a typical a graph and in the middle this sort

Dr Marianne Trent (: 43:36

Like an XY axis

Sam Swidzinski (: 43:39

And in the middle of it it's sort of a stable mood. And then you plot over time on the xaxis, when has your mood been really high, when has it been low? And then that's a good starting point to discuss with a clinician, this is what my mood has looked like over time. And that can sort of help them to understand the picture and sort of guide them through why bipolar might be a particular diagnosis. And then they can use that as a guide as to how to say, okay, what was it like during this period? Can you explain how you, can you explain how you were acting? So you're almost guiding them through the process of your mood so that they can professionally be able to actually unpick whether they think that you've got the disorder.

Dr Marianne Trent (: 44:20

Great, thank you. And obviously if anybody's concerned about the risk to themselves or someone else, they should contact urgent care or emergency services to safeguard them or other people. Thank you so much, Sam. It's been a really, really brilliant episode and thank you. Please let me know if you need anything in future. No worries at all. It's been great to chat. Thank you. Oh gosh, how incredible it was to chat with Sam. And if you do want to connect with Sam or have a look at his book, please do check out the details in my show notes. Like I said to Sam, it was a real privilege to talk with him and I learned so much. Has this been useful for you? If so, please do rate and review the podcast series, which you can do on Apple Podcasts. You can also rate it on Spotify.

(: 45:08

If you're watching on YouTube, please do take a moment to subscribe to the channel, like the content and fling some comments around to perhaps share your favourite episodes with your friends. Come and let me know in the Aspiring Psychologist community, which is the home of the exclusive Marianne's motivation and mindset videos, you will not get them anywhere else. Come and join the free Facebook group and I'll look forward to seeing you there. New episodes of Marianne's Motivation and Mindset drop every Friday morning and each of these podcast episodes is available to you on YouTube. You Lucky Things From 10:00 AM on Saturdays with new audio podcasts wherever you get your podcasts available from 6:00 AM on Mondays. Do come and connect with me on my socials. I'm Dr. Marianne Trent, everywhere. Consider having a read of the books, the Aspiring Psychologist Collective, the Clinical Psychologist Collective, and of course Talking Heads and the Grief Collective too. And if it's your time and you are ready for the next step, you're ready to really get a grip on making your professional career in Psychology Sparkle in this upcoming application season. Please do consider joining the Aspiring Psychologist membership, which you can do for no minimum term from just 30 a month. I'm so blessed to have you to be part of my world and I'll look forward to catching up with you very soon. Take care.

Jingle Guy (: 46:33

If you're looking to become a psychologist with.