This is a story about observation...

Frankie is a people cat. He needs company. When we went away to France for a couple of days, he was lonely and wouldn't leave our neighbour alone. He invited himself into her lounge and wouldn't leave. When we got home, he yawned, stretched and padded over to greet us. He let us all know how much he missed his humans.

It would be rather sinister to say that I had been observing my fellow patients in hospital, but it was kind unavoidable. I don't really watch TV and I find humans much more interesting than most other things. I also bonded with my companions, and the staff.

It was a locked ward, but I was there voluntairily so I guess I could have asked to be discharged whenever I wanted. But I went there to be safe, so it seemed crazy to ask to leave when it took me 13 hours to be admitted, and I was in a place of safety.

It's a bit of a strange compromise though: safety under lock & key. I wasn't sectioned but, scarily, the consultant did consider it, which was a little ridiculous considering I had been safe for 6 days by that point. A section can be 72 hours, 28 days or even 6 months... terrifying, considering all I did was go to my GP one afternoon.

Anyway, hospital was brilliantly therepeutic. I managed to tackle a bunch of stressors in my life, with the help & support of the NHS team. My treatment was very holistic: drawing, sculpture, drama, cooking, socialising, plus non-judgemental chatting to mental health professionals, of course.

Medication plays a role too, but it's very unclear whether it helps or it hinders, in the long term. Sure, if I was having a psychotic episode - seeing and hearing things - and was a real danger to myself or others, pharmacological intervention might be unavoidable, but is it really necessary to medicate a functional, articulate, self-aware and coping individual?

When I presented to my GP, we had the briefest of chats imagineable. My GP only really needed to know one thing: I couldn't guarantee my own safety. I had tried to keep myself safe, but plans to kill myself had formed in my head. It was only a matter of time before I acted on them. Free will is an illusion. We are controlled by circumstances. Try choosing not to be in pain next time you stub your toe.

Wanting to be in hospital is a big deal. Psychiatric wards are not for the faint hearted. You will have somebody checking on you a couple of times an hour - especially at night - and people yell out randomly all night. People sing to themselves. People wash obsessively (or is it compulsively?). People shuffle. People mutter incomprehensibly. People steal your stuff. People ask you strange questions. People are aggressive. People are inappropriate. There is a lot of anger, crying, frustration, fear, boredom, confusion, despair... but there is also hope and optimism. Strangely, I find the environment to be calming. It's supposed to be. It worked for me.

Obviously, you can't have shoelaces, belts, razors, scissors, cables (e.g. for charging a mobile phone), curtains (including shower curtains), locks on doors, furniture that's too tall, windows that open more than the smallest possible crack, windows or mirrors that could be shattered... there's a fairly comprehensive list of safety considerations.

Here's a little picture of the space where you can get some fresh air:

Nice, isn't it?

Well, yes it kinda is. The fact that the NHS has gone to all the expense of designing something that is - presumably - to discourage people from climbing the walls and jumping off. I guess that most people aren't such a good climber as me though, so it works for the majority of suicidal patients.

People also have unmet needs that are fairly obvious when you observe them for a little while. As a lifelong non-smoker, it was obvious to me just how important nicotine was in the lives of almost all the patients. The hospital has been smoke free for nearly 3 weeks, which is a huge burden on staff, who must accompany patients off the hospital premises every time they need a cigarette. Yes, that's right, need... these people are psychologically drug dependent. Nicotine is an extremely addictive drug.

Luckily I had already eliminated alcohol from my life too, 3 weeks prior to hospital admission. I actually have a working theory that that it's the reason why I became so deeply depressed. It happened to me in 2008 as well, when I quit drinking. It's so hard to avoid alcohol though - it's so socially engrained - that conducting an in-vivo study has been very hard, but I've gathered quite a bit of excellent quality data now (I've agressively managed to control other variables).

Frankly, I'm a bit of an oddity. I'm completely unmedicated, abstinent from caffeine and all drugs and alcohol. I have been for a long time. I'm about as clean living as they come. A perfect test subject for an unethical experiement into whether mental health issues come about due to environment, genetics, diet, social factors, stressors etc. etc.

Why unethical? Well... quite simply, if my mood sinks too low, I will take my own life. It's really not a choice. I don't want to die - at the moment - but when those dark times come, I feel quite differently. You feel differently too, and that's why you're thinking "why?" or some version of incomprehesion. You don't know how it feels until you've been there, and I really do discourage a trip to the edge of the abyss.

It's ironic. I have no fear of death, but yet I am able to rationalise that it would be foolish to make an irreversible decision. I ride my bike through handlebar-width gaps between double-decker busses, I climb the tallest trees, jump out of aeroplanes, have my photo taken on perilous ledges with no ropes attached to me, and drive at the limit of control.

One of the staff in hospital suggested to me the other day that I could keep 1% in reserve, just in case of emergency. It actually didn't sound too crazy.

Please support the Junior Doctors if they strike, and any other NHS workers. They deserve better pay & conditions (October 2015)

Tags: #suicide #depression #bipolar #NHS #mentalhealth #drugs #alcohol #caffeine #nicotine #frankie