Dr Louise Newson: [01:00:00] Hi, just a really quick one. We're really growing our podcast and I want you to help me. If you could just click subscribe or follow me below, it only takes a few seconds and it will really help. Anyway, back to the podcast. Bipolar is far more common than many of us think and it affects around 1% of people, but it can take nine years for diagnosis. So today in my studio, I've had Rosie Viva, who is an author, she's a model and she's a great advocate for bipolar. She has it herself and her journey has not been easy. We have a very open and candid conversation about what's like to have bipolar, how her diagnosis was made and what we can do to look out for it in other people. So Rosie, welcome to the studio.

Rosie Viva: [01:00:41] Welcome to me.

Dr Louise Newson: [01:00:42] Thank you so much.

Rosie Viva: [01:00:43] Thank you for having me.

Dr Louise Newson: [01:00:46] It's really nice you being here. And you know, I was saying to you just before we started that I'm not just about menopause. So sometimes people think, why is she talking to younger people? And, you know I'm really interested in the whole body. And every organ in our bodies, because I'm a general physician, but without a shadow of doubt, the brain is the most important organ in our bodies. And we sometimes have control over it, but sometimes we don't. And I'm just really keen to hear, like obviously I know your story, but lots of listeners won't know why you're here as a woman in your 20s, talking about mental health. So do you mind talking a bit about what's happened?

Rosie Viva: [01:01:26] So I'm Rosie, I'm 29, so it's nice to still be called in my 20s because I feel very sort of on the brink and ready to prepare for another chapter. But I speak very openly about living with bipolar disorder. It's something which I've sort of grown to realise is more and more important that I do as someone who's managed to get their life back. So I was diagnosed age 22. And I guess growing up, I always knew something was different, but I just didn't know what it was, and I didn't have the vocabulary to describe how I was feeling. I guess I was also hiding it and managed to mask it because my temperament is very upbeat. I'm not someone who is lying around with no energy all the time. It was always this mix of high and low. So after my episode, I just really struggle to find women in the media speaking about this. I couldn't see anyone under age 30 who I could relate to. And if I could, it was always on charity websites. It was never just flicking through a magazine. And so I think I just felt really alone and really abnormal. So that's why I got into speaking about it. And luckily I've sort of gained a lot more confidence in the last seven years by the people I've met and now understanding this is actually quite a mainstream illness. I guess 1% of people have it and one in 12 people are directly affected by having a loved one who suffers with it or if they have it themselves. So. Yes, it's something we should be speaking about a lot more openly.

Dr Louise Newson: [01:02:51] Absolutely, but a lot of people don't even know what bipolar means. So, you know, a lot of people think it's like a split personality or, I don't know, just...

Rosie Viva: [01:03:00] I definitely thought it was that.

Dr Louise Newson: [01:03:02] Yeah, so just explain, what it is?

Rosie Viva: [01:03:04] I've spoken about this for such a long time, but I do find defining it still the hardest question to be asked because even between the NHS or a charity I work with, Bipolar UK, the definition changes and also people who have it like to, you know, some people don't even like it to be called a disorder because that implies that something's broken. But in brief, bipolar disorder is a mood disorder, which means that your mood is on a much greater sort of breadth. So you go between a one, which is very depressed and very delusional right up to mania, which is sort of a nine and a 10. And at that point you can go into psychosis. There's two main types of bipolar 1 and 2, I have type 1, and that tends to include psychosis, whereas type 2 goes up to hyper mania and mania but you don't lose full control in the same way. And so for someone with type 1 you have to be on antipsychotics in order to sort of exist in this world, whereas for type 2, a lot of people sort of have more of a choice with medication. So that's my understanding. But again, I'm still always asking people with bipolar how they like to describe it and things like that, because it's so important to keep learning even when you have it.

Dr Louise Newson: [01:04:19] Yeah, absolutely. And I've spoken about this on my podcast before about, you know, as a doctor, I don't want to give someone a diagnostic label. You know, you don't really necessarily, I don't think it's very helpful to give people just a label without explaining what it is or why it's happening. And you know with a lot of the DSM, the psychiatric diseases, there's lots of criteria, almost tick-box. You know, it's not just which day of the week you're talking to that person. It might be which minute of the hour of the day that you're talking to them because, you know, our mood really changes throughout the day. And so just having a snapshot isn't usually that helpful, is it? And that can be really difficult.

Rosie Viva: [01:05:05] It's really difficult and I think it's why the average diagnosis takes nine years, from the point of seeking help. So that's not even someone who is feeling that their moods are extreme. That's someone who's actively going to a GP to talk about their mood. And I think what I've learned and what I see in a lot of young women is when you go to a GP and you suffer with depression, you very rarely think to mention that you also have good days because we're not programmed to look at people and see happiness as something which is a warning sign. When actually if I had spoken about what I was writing in my diary and these huge euphoric sort of epiphanies growing up, I think my diagnosis would have come about before reaching crisis.

Dr Louise Newson: [01:05:45] Gosh. Can, can you say what some of those things, what sort of things you were writing about?

Rosie Viva: [01:05:49] I mean, you can actually see in my diaries because I've written since I was 12 years old and I write for sometimes half an hour a day. There's a lot of sort of thoughts and overactivity. But even in my handwriting, I write in capitals when I'm manic and I write in sort of calligraphy style when I'm low. And even that, the shift in energy, the sort of obsession with life and the absolute sort of besotted outlook on everything, it just sounds very grandiose. So yeah, my language changes and in the same way when I am low, there's just very little perspective on what I have and hope. And it's, you know, we're dealing with those emotions, but we're not taught to look out and spot signs in ourselves. We're, I guess, a lot of the time too young to even, yeah, judge. [01:06:39][49.6]
Dr Louise Newson: [01:06:40] Yeah, well it's also, if you don't know about a condition yourself that you have, it's really hard to know, isn't it, what's going on?

Rosie Viva: [01:06:51] Yes, and bipolar to me was the English weather, and it was a teacher at school who threw rulers at kids. That was the only time I'd heard the word bipolar growing up, so I wouldn't have even thought to know it was something I could have and definitely not as a young woman either.

Dr Louise Newson: [01:07:05] No. So how did it take for your diagnosis?

Rosie Viva: [01:07:06] So the first time I seeked help was when I was 20 years old. So I'd been freelance for two years after school and I think my mum always knew that I was very sensitive. That was the way we described my character, but she hadn't seen the huge amount of sleep I needed in certain patches of my life. And so when I living at home, rather than abroad, I was modelling in paris for a few years after school, she said, look, this isn't normal. You're going to a casting, which is half an hour, and then you're asleep for five hours after. So I went to see a GP at 20 to start sort of saying, okay, something's not right and my mum's picked up on it before me. And that was when I was diagnosed with an underactive thyroid, which is very common for women with bipolar. So I guess that was the first time in the medical system, depression got noted down somewhere, but it wasn't until two years later that I got my diagnosis and in that time, that was anxiety, depression, which started getting in the way of work. It really sort of bubbled to a head around that time. So a lot of visits and a lot different doctors and a lot of different therapists. But unfortunately, till I actually went psychotic, no one thought, oh, this is bipolar.

Dr Louise Newson: [01:08:20] Oh, how old were you when you had psychosis for the first time?

Rosie Viva: [01:08:27] Twenty two. Very young. And I have to say, I'm very open-minded and I love speaking to people about this sort of whole experience, but you do see the world in a different way. And, I don't think I'll ever see the word in the way I saw it before my episode, because you're opened up to such a religious viewpoint. You read people's energy, you can see colours, your eyesight, everything. It's absolutely incredible until it's not.

Dr Louise Newson: [01:08:52] So you can remember it all very clearly?

Rosie Viva: [01:08:54] I think because I've spoken publicly, I have a better memory than a lot of people, because I've had to recount it so many times. But being in hospital, my memory is really bad. The first three months were a complete sort of haze. And I think, yeah, I mean, it sort of feels like when you're in a dream and you'll be speaking to your mum and then suddenly they'll look like your dad. That was happening in real life. And so I think I've blocked out a lot of that sort of heavy psychosis because it was just quite terrifying to be hearing voices and things like that.

Dr Louise Newson: [01:09:27] And, you know, you've written this amazing book, Completely Normal and Totally Fine.

Rosie Viva: [01:09:32] It's very ironically named.

Dr Louise Newson: [01:09:34] Yes, but you have put My Life with Bipolar Disorder. And you know you haven't hidden much really. I mean it's very descriptive, but also what saddens me really is that I did psychiatry 20, 30 years ago in a very deprived area of Manchester. But actually, when you describe the psychiatric hospitals, they don't seem to have changed much.

Rosie Viva: [01:10:02] No. I mean, because I was high, my memories of the psychiatric ward is so sort of rose tinted because at that level, anything is amazing. I thought the food was Michelin. But yeah, it was quite shocking. Like there were small things as I started to get a bit better. Like they wouldn't change what day of the week it was on the whiteboard. And I know you're unwell, but towards the end, I started feeling this is, you know, I actually don't know what's going on. I couldn't go outside. I had to ask permission to have a shower and it is a very weird world and I'm glad it's not a long term thing in my case.

Dr Louise Newson: [01:10:38] So I see a lot of women who've been under psychiatrists for many years, and they do become quite institutionalised, but I've visited a few of my patients as well, and one of them, I was really quite shocked at how sparse everything was, and how, you know, I know obviously if someone's having psychosis, you're not going to have things around the room that they throw. But actually, it just felt that a lot of their identity had just been taken away from them with their mental illness. And I don't know that that's a very useful way of trying to build the person back up sometimes.

Rosie Viva: [01:11:15] Yeah, it was, I mean, I don't remember being diagnosed. I was so gone. I was messaging my friends saying bipolar in capitals and trying to find emojis for a polar bear. So I was totally not with it. And I'm glad I didn't have my phone on me just because in the weeks leading up to being sectioned, I was sharing very manically online and to all my clients when I was modelling and that was very religious and delusional. So parts of having your things taken away are good, but then when it gets to the last stretch where you're really yourself...

Dr Louise Newson: [01:11:47] Getting ready to go back out.

Rosie Viva: [01:11:49] I think that sort of process, you can't speed it up in the last four weeks where you are allowed out for lunch, but in every night it would be nice for it to feel a little bit less clinical. It did save my life, so I'm very conscious not to be too negative, but yeah, definitely character building.

Dr Louise Newson: [01:12:06] And, you know, and you talk also about the medication that you've had and obviously medication is really important, especially if someone's having a psychosis, you know. But there are side effects of medication as well, aren't there? And it's always what suits one person might not suit someone else and it's just, it's hard, isn't it?

Rosie Viva: [01:12:29] It is. So in the last year or since releasing my book, so maybe even the last six months, I kept meeting women in London who have bipolar and it was all different industries. So I started a WhatsApp of us just to sort of exchange notes and send messages very sort of specific to this. The wildest thing is that all of us, and there's 12 now in the group, nobody has the same medication routine. And I think for the younger girls in the group who are still navigating sort of getting their stability back and being able to work again, that was the most frightening thing is that you can't sort of predict what's going to work and you have that feeling that maybe nothing ever will. So getting the medication routine right felt like the longest slog and I think that seven months is when you're most fragile and sort of suicidal because no-one can tell you with confidence what's gonna help, even doctors, which was a scary thing to look at an adult and they just don't know.

Dr Louise Newson: [01:13:22] No, and it is hard because you know the way people metabolise the drugs are different, the way they respond is different, and the way different drugs can interact as well can be really difficult. But you've found a drug that's helped you.

Rosie Viva: [01:13:38] I have. So I take quetiapine and I always say it hasn't cured depression and I definitely still get highs, but what it's done has made me less delusional. And I think in my case, that was always where things got a bit dangerous. So, I was about six months after hospital in such a suicidal low and I just remember the drug started working about two weeks after I started taking it, I asked my dad a question, which I didn't over-consider. And I just had this amazing moment of thinking, oh my gosh, it's just making room in my mind for not just this depressive thought. So it allows me to detach from it. And I guess off medication, it was just too all-consuming. So I don't really know what it does, but it helps me sleep. And mainly that's the sort of thing which keeps me most stable.

Dr Louise Newson: [01:14:25] Yeah. Did you have a lot of time when you weren't sleeping?

Rosie Viva: [01:14:29] I mean, up until 22, I just thought it was normal, but I remember in my first relationship, I was always awake at 3.30 ready to run. And I was always last out on a night out and that was just Rosie. That was just someone with a lot of energy. And I just thought that was normal and that everyone else was lazy. And then I guess since I always think there's two types of insomnia when you have bipolar, there's the one everyone else can relate to where you're frustrated at four in the morning that you can't sleep and you're feeling very upset and worried that the next day you'll crash. And then there's second type of insomnia, which comes in a high where I know I don't need sleep. And sometimes I just will stay awake till the morning and I'm not worried about it. But I know my body actually isn't ready to shut down. It's a really weird feeling.

Dr Louise Newson: [01:15:16] And you can tell the difference between those two?

Rosie Viva: [01:15:18] 100%, one's really enjoyable and all my thoughts are just, can't wait for the next day to begin. And the other one is the one my friends can relate to which is the most horrible thing to experience when you're tossing and turning and frustrated and worried about it. And they're just never happening nearby to each other. I have them both in different moods.

Dr Louise Newson: [01:15:40] And how much more common is bipolar in women compared to men?

Rosie Viva: [01:15:45] I actually believe it's an even split. I wrote that in my book and I think there was a lot of people at Bipolar UK who helped me sort of make sure that all the facts are up to date. So yeah, I do believe it is quite an even split with bipolar.

Dr Louise Newson: [01:15:58] Does it take women longer to be diagnosed?

Rosie Viva: [01:16:02] I wouldn't know that. I just know because most people with type 1, your diagnosis comes early 20s because of that psychotic tendency and so that can't really be missed. Whereas I believe a lot of women who have type 2, their diagnosis comes later, and menopause is a massive trigger, which I'm glad I'm aware of, because actually for suicide in women with bipolar, menopause is more of a threat than early 20s around diagnosis.

Dr Louise Newson: [01:16:34] Starting in April this year, I'm going back on tour across the UK with a brand new show, Breaking the Cycle: The Power of Hormones. I'll be visiting 40 venues and my aim is to challenge what we've been told about hormones, to unpick the science that's often overlooked, and to explore why there's still so much confusion and misinformation, particularly around hormone health. Our hormones influence everything. Our mood, our sleep, our metabolism and our future health. Every single cell in our bodies is impacted by hormones, yet so many people are still left without clear answers. So in this show, I'll be sharing research, some history, the real stories and some very uncomfortable truths. There will be moments that surprise and maybe shock you and plenty of opportunities to reflect and ask me questions. So if you want to learn, feel empowered and be part of a movement that's changing how we think about hormones, I'd love to see you there. You can buy tickets through the link in the show notes.

Dr Louise Newson: [01:17:43] When I've been looking up about bipolar, not just in UK, but globally, just out of interest, and I put in menopause and hardly anything comes up about how it does say it can worsen, but no one talks about hormones. And I find it quite surprising because our hormones are made in our brain. Our hormones, progesterone, estradial, testosterone, have really important roles in our brains and they also change the level of other neurotransmitters, so serotonin and glutamate and noradrenaline and dopamine, for example. And it's no surprise that when you have a drop in the progesterone, estradiol, testosterone, it can trigger all sorts of mental health issues, including bipolar. And we've known for decades that there's this association. And we do know that when women have their hormones back, it makes a huge difference in a positive way to their mental health. Yet there's very few psychiatrists that prescribe hormones. And the other thing, I don't know if you know this, but it's important really to know that antipsychotics can suppress your own hormone production. So I was trying to find out whether there are any guidelines because we know that when people are on antipsychotics, people often have their blood tests done, they have their thyroid done, they have the cholesterol done, they have a hormone called prolactin level done, but no-one does hormone blood tests. I got confirmation back from a very senior psychiatrist the other day just in case I was missing something and she said, oh, no, we don't. But we've known for decades that these hormones can block, or the hormones can be blocked by antipsychotics. So a lot of people will have an earlier menopause when they're on those drugs. I don't know if that's on your radar at all?

Rosie Viva: [01:19:27] No, I mean, I think across any illness, you just look, there's a website I've got very sort of hyper fixated on where you can type in what investigations are currently going on in the world around bipolar. So I'm constantly looking about subjects I'm passionate to understand more of, and it's never women focused. And that's always what's so sad, especially because the reason I find it so important to speak about this as a woman is that you know with hormones we're already worried about being crazy and impulsive so then to say oh I also have a mood disorder where I'm flipping and yeah it's just like oh do I have to admit both but obviously I do and I'm getting really confident that it's not something to be embarrassed by, but yeah I think women and research is something which is just so important and it's amazing for women like you to be raising awareness, so thank you.

Dr Louise Newson: [01:20:20] Well we've been excluded for many years from research and it was only the year I qualified in '94 that women were allowed really and more routine to be in studies. So all the work I did as an undergraduate was based on men because they didn't use women, I mean it's just madness isn't it really to think about it and then we know that it's too complicated really when women have hormones. But it's not because a lot of women and I don't know if any women in your group find that they, their symptoms, their mental health symptoms, worsen before their periods when their hormones drop.

Rosie Viva: [01:20:55] Yes, I mean that is me. I mean, for ages I was considering getting a PMDD diagnosis and then I just became comfortable with saying my bipolar cycles with my hormones and the two weeks before my period, it's just so obviously triggering the whole thing. And I guess in some ways it's the hormones, in some way it's taking you back to the day-to-day bipolar fears of, can I do this for the rest of my life? And I don't know what to do about it. But it's nice to know that there's other things to try outside of bipolar medications.

Dr Louise Newson: [01:21:26] But no-one's really spoken to you about trying to have your hormones balanced in those two weeks?

Rosie Viva: [01:21:31] No, I mean, the NHS is brilliant in getting you out the system. And the three years support after was so helpful. But I've been speaking to Westminster Council since I've been discharged because at no point was I told about diet and exercise and just because I've been on social media and I work as a model, I've always been interested in wellness. But that was something I've come to myself and most people have never even considered that sugar and all these things which can spike your mood is something we need to take more seriously if we have bipolar. So yeah, a long way to go.

Dr Louise Newson: [01:22:07] And it's very important because sometimes it's this downward spiral as well and you know people who are listening won't all have bipolar but many of us have had times where we just feel quite low in our mood and then you don't want to exercise, you don't t want to eat properly, but you know if you don't exercise and don't eat properly it makes you feel worse, but when you're doing this it can be really difficult and then you throw low hormones into the mix it can make a difference and there are some women who it's not just the level of hormones, so when people are menopausal, their hormones are low and they stay low forever. But when we're perimenopausal or have PMS or PMDD, it's the change in hormones that can shift change in mental health. So a lot of people find, especially their progesterone goes down very quickly before our periods and that change in the brain can trigger mental health symptoms. And we've known this for many years that actually having... the natural hormones back, so not the same as contraception, can make a huge difference to mental health. But often in medicine, people don't join the dots. Somehow people think hormones are for periods and mental health symptoms are just the brain and they don't realise there's a connection between everything.

Rosie Viva: [01:23:22] Yeah, I mean, it's something I'm so eager to learn more about because I think what I've learnt is I'm so sensitive to everything. Or if your brain is like this, I also have stomach issues and for a few years that was a real worry, but then when I sorted out my anxiety, that went away. And exercise, I feel like I've got into long distance running because I've noticed that these things affect me more, which is a positive. But I'm sensitive in every way. I even bruise really easily. So I'm like, yeah, I'll try anything because at least I'll see the effect, whether it's good or bad, I guess.

Dr Louise Newson: [01:23:58] Yeah and this is the thing. Sometimes in medicine we don't always have the answer but we'll try something and see if it helps and what frustrates me often is no-one's thought about hormones and hormones are part of the puzzle but often when people take hormones they just feel better. They might have more stamina because we know our hormones work in our muscles and our bones so it might find exercising is just easier, they might just feel more motivated. So even if they're not helping a specific mental health disorder they might be helping everything else around it, which all of these things feed together, don't they?

Rosie Viva: [01:24:32] And like you said, if it's making exercise easier, that then affects your mental health. So yeah, helping my energy levels is one of the most important things. I really try and have similar sort of sleep routines and my diet is very high protein and I think a 360 approach to bipolar is why I manage it. It's definitely not just the medication. That's probably about 30%, I would say, of getting better.

Dr Louise Newson: [01:24:58] Which is really important and I think more and more as patients we should be advocates for ourselves and for others as well. I think so often, and it was the way I was taught as a medic, is that you medicalise everything and you treat everything with a magic drug and everything will improve and that's not right because everyone as you say responds differently to different drugs but also our metabolism is different, the way we live is different and that is fine because we are all different but we have to be looking at like you say, everything as well, don't we?

Rosie Viva: [01:25:30] And I always say this, I'm such a believer that also surrounding yourself with the right people is so important when you have bipolar because a huge cause for a mood swing for me is if someone's off or I don't feel comfortable and I can't be myself. And I started really thinking, okay, how did I feel coming away from that person? I need to be more careful about who I'm around. If I'm choosing to not drink, I need make sure that people aren't cold with me and think that's uncool. Because I just, I can't always drink, I can't always be fun, so the last few years has been learning how important that is. It's been a game changer.

Dr Louise Newson: [01:26:03] It's important isn't it. I was talking to my daughter this morning with one of her friends, and they were saying about some guy who'd been really annoying for some reason or other. And the other, the friend of my daughter said, well, yeah, he's just full of insecurities. And then my daughter, said, really, I hadn't thought like that, but I'm always really insecure when I'm with him. And I said, that's because he's insecure. You're picking up on his insecurities, it's like when you're with someone happy, you always feel happier. If you're with someone who's low, you always feel low, that that's just human nature. And when you have bipolar or other conditions, some people are more in tune with other people's emotions. And it's important to, like you say, acknowledge it, because if you are with different people at different times, it could really affect your mental health, couldn't it?

Rosie Viva: [01:26:47] Yeah. And like you said I'm so conscious of how people make me feel, but also I guess the years after my episode I was so dependent on my mum and my mum only and that was making me feel like a burden. And so I guess, the last seven years has been spreading that weight across friends and learning that I can lean on my sisters as well. And now if one person is unavailable, I've got such a support network. And that was something I didn't know the importance of until now. I started therapy this year, which was very late at the age of 29, but it's just making sure there's multiple ways to prop yourself up rather than one person or one friend, which has been good to learn.

Dr Louise Newson: [01:27:29] Really important. So just, your book, it's been selling well. What's been the response from it?

Rosie Viva: [01:27:37] I think the wildest response is that it's exactly what I hoped it would be, which is a lot of young women messaging me. And I guess people with bipolar also, they don't see themselves in the media. And so I get a lot of very long messages about whether they're still in hospital or whether someone's son is really unwell. And weirdly that doesn't affect my mood. There's something really nice about social media that I'm always detached in a nice way. And I know that it can also be so detrimental to your health, but when you're speaking publicly about bipolar, it gives me a distance. There's no rush to reply. If something's really long and sort of heavy, I can take time to consider it. So it's been a really brilliant way to connect. I guess, yeah, the main thing is that people said it made them laugh as well, which I was happy about because I didn't want it to be a heavy book because there's too many heavy books about this subject. So a lot of people have messaged who don't have bipolar but found it funny and relatable, probably because of my awful dating stories, but I'm glad that it gave some joy, to be honest.

Dr Louise Newson: [01:28:38] Well, you do write it in a very light way. And I think because you're so much better, I knew that there would be a happier ending somehow. And I think that makes it a lot easier. But, you know, it's very relatable because, you know just talking when you're talking about family and different things, people can just relate and hopefully it will help them think more about recognising mental illness in other people as well.

Rosie Viva: [01:29:06] I think so. I think it's just, even having been aware of bipolar, it could have saved me two years off work and a lot longer to rebuild my confidence if I had even had a thought, oh, could it be bipolar? And I'm working with Bipol UK at the moment on a campaign around this. My acting debut is an awareness video because I think even if it was in your vocab or one conversation at school or in sixth form or a teacher mentioning it. I would have been curious to think about it, but it was just the lack of conversation and the shame around it, which meant right until sort of breaking point, I didn't even consider it was something I could have.

Dr Louise Newson: [01:29:44] So that is the thing, it can happen to anybody.

Rosie Viva: [01:29:48] Anyone.

Dr Louise Newson: [01:29:48] And it's the same as any mental illness, of course, or any condition can affect anybody, but the sooner it's recognised, the sooner people can hopefully be diagnosed and get the right treatments. So there's a happy ending. So I'm very grateful for you coming on. I always ask at the end for three take-home tips. So I going to just ask you very easily three things that people should think about if they think, have I or has my friend got bipolar? What are the three sort of flags that they should be thinking about?

Rosie Viva: [01:30:19] Three flags. I think, one, oh that's a really hard question because I've had friends who I think have bipolar and they've taken it really the wrong way and totally rejected the idea. So I'm not an expert on this, but I think one thing is to maybe find an article online, which is in the context of a more casual conversation. So, I wrote for Stylist when my book came out. And the reason I was so excited to do that is that's an article you could send on WhatsApp to someone or you know, over text. And if I received that before my diagnosis, it would have been less daunting than someone just saying, hey, do you maybe have bipolar? Here's an NHS website. I would have really rejected that. So that's one thing I would recommend doing. Another I would also say is just the worst that can happen with approaching someone about any mental illness is that at first they'll be quite defensive, but it's just like I said, if that then makes them aware of the word. If they then go away and look it up and find people online speaking about it, there's now people on TikTok, like it's really getting better in terms of it being a young audience. It's just putting the word on their radar. And then most people are curious. We all have ChatGPT now, we all have Google. So that's a bonus. And then the third one, I think, is just to educate yourself and be less fearful that it's a big deal because for many, especially with type 2, It's something which could go on for 10 years, but the medication is really brilliant and it's not a death sentence and people live really great lives with this illness. So I think it's going, reading articles, reading my book, reading a little bit about it and just not finding it a scary topic even just to discuss just casually.

Dr Louise Newson: [01:32:07] And keeping positive is really important. So thank you so much, it's been great.

Rosie Viva: [01:32:11] No worries, thank you for having me!

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