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#NaNoWriMo2016 - Day Twenty-Five

9 min read

Poste Restante

Contents

Chapter 1: The Caravan

Chapter 2: Invisible Illness

Chapter 3: The Forest

Chapter 4: Prosaic

Chapter 5: The Van

Chapter 6: Into the Unknown

Chapter 7: The Journey

Chapter 8: Infamy

Chapter 9: The Villages

Chapter 10: Waiting Room

Chapter 11: The Shadow People

Chapter 12: Enough Rope

Chapter 13: The Post Offices

Chapter 14: Unsuitable Friends

Chapter 15: The Chase

Chapter 16: Self Inflicted

Chapter 17: The Holiday

Chapter 18: Psychosis, Madness, Insanity and Lunacy

Chapter 19: The Hospitals

Chapter 20: Segmentation

Chapter 21: The Cell

Chapter 22: Wells of Silence

Chapter 23: The Box

Chapter 24: Jailbird

Chapter 25: The Scales

Chapter 26: Descent

Chapter 27: The Syringe

Chapter 28: Anonymity

Chapter 29: The Imposter

Chapter 30: Wish You Were Here

 

25. The Scales

The crisis team - part of the community mental health team - social services and the police had all been quite helpful when Neil had originally gone missing. The police had quickly discovered that Neil had left his phone, wallet and passport behind. All the services were very concerned about Neil's welfare and had attempted to establish his last known movements as well as searching for him. Because Neil was considered a vulnerable person at risk of suicide, there had been a lot of initial effort, focus and attention on helping Lara, Colin and the family to make sure he was found safe and well.

With all avenues exhausted, there was little more that any of the services could do unless new information emerged. Lara and Colin were main points of contact, liaising with a police detective who was in charge of the ongoing - but parked - investigation.

Frustrated with a lack of progress, two highly regarded private investigators were contacted by Colin. After initial discussions they decided that there was insufficient evidence for them to be able to pursue the case. The truth was that nobody really wanted to touch the case, because of the number of government bodies already involved: National Health Service, mental health services, the police and social services.

Colin had eventually taken matters in to his own hands and gone to the house to look for more clues, when he found the transactions that had led him to the ongoing prosecution of the businesswoman and her associates. Once he'd found the names of the defendants, it was a simple case of searching the register of directors and finding the trading address of their company in the public records.

Now, he was back at the house once again. He regretted involving Lara so closely, but she wanted to play an active role and had discovered vital information that he himself - a grey-haired man in his sixties - would have been unlikely to have been able to extract from anybody embroiled in the court case.

Colin had sounded out friends - retired police officers, solicitors and even a judge - about bringing their own case to court. "Not a hope in hell" were the exact words of one former Justice of the Peace. His sentiments were pretty much echoed by everybody else Colin consulted informally.

"Imagine if a person was selling rat poison as heroin" said Bill, the retired judge. "Now, if that person was to sell rat poison in place of sugar, they might be convicted of murder or manslaughter. But as soon as they sell it as heroin, they'll be convicted for supply of a controlled substance, even though rat poison is not illegal to sell per se."

"But that's insane! Surely the charge of murder should take precedence over the charge of supplying a controlled substance" protested Colin.

"Well, it's about the buyer. If the buyer thought they were buying heroin, then nobody really cares whether that junkie dies. The seller will be convicted as a drug dealer, not a murderer."

"So the law really doesn't care whether you sell a junkie sugar, caffeine, heroin or rat poison?" asked Colin.

"Yep."

"What if the buyer didn't know what they were getting?"

"What did they actually buy?" Bill asked.

"A controlled substance."

"What was it sold as?"

"A chemical for laboratory research."

"There's no chance it could have been confused for a foodstuff? Was it marked as hazardous? Unfit for human consumption?"

"Yeah. It's not like it was sold as sugar or anything" Colin replied.

"Well then, the only conviction you could possibly get would be for supply of a controlled substance."

To make matters worse, everybody advised Colin not to mention the drug use to the police. One whiff of drug abuse and the case would be filed in a dustbin marked 'lost cause junkie'.

Back at the house searching for more clues, he looked high and low before finally he decided to search the attic. Boxes of Christmas decorations and long-neglected exercise equipment, the attic contained very little else except for a disused hot water cylinder and a galvanised metal cold water tank. There was a chipboard lid on the tank and Colin noticed that it was an inch or so out of place, overhanging on one corner. Lifting the lid, there was a green plastic box floating inside with a black plastic handle.

In the kitchen, Colin towelled off the green box so it was clean and dry and took it through to the dining room. Unclasping the two black plastic latches, the lid was stuck tight until the airtight and dust proof seal released the pressure. Inside the box was grey foam to protect the delicate instrument contained within: a laboratory-grade weighing scale.

Normal kitchen scales might tell you the weight of something in grams, but not very accurately. If you needed to weigh 10 grams - approximately the same as a one pound coin - then your kitchen scales would be woefully inadequate. Even fine balance scales with small weights would struggle to weigh anything lighter than a gram. Some digital scales could weigh one tenth of a gram with reasonable accuracy: 0.1g. The scales that Colin had found could weigh at a sub-milligram accuracy. Less than 0.001 grams. Even breathing on the instrument or standing too near the table on a wooden floor would cause measurement fluctuations, so there was a special stand, cover and calibration weights to ensure the readings were accurate. The "quick reference" instruction manual inside the case was a hefty pamphlet.

There were some spatulas and a metal dish inside the green box. A tiny amount of light brownish powder residue was visible on the foam that held the dish and the spatulas. There was also a very small plastic resealable bag which was almost empty except for the tiniest residue of powder in the corners.

Colin spent the whole next day searching the Internet and phoning testing facilities, before he finally located a laboratory that would be able to swab and test the tiny traces of drugs that he had found. Using gas chromatography mass spectrometry, the lab was able to then search the 'signature' of the chemical compounds and to find a match in their database.

After sending the scales by courier to the lab in the Netherlands, it took 3 weeks before he got the results emailed to him. There was no conclusive match, but there were several compounds that were 97% similar to chemicals that were held in their database. He had been warned that a 99% match was the highest that he could expect anyway, so it was a good start.

Searching the Internet, he found detailed online encyclopedia entries for two chemicals, as well as a brief summary of a third. The compounds were stimulants from three different families of drugs. Two had been developed and patented in the 1950's and 1960's, but had never been marketed to the public because of serious side effects. Colin found a shorter acronym form of the full chemical name of each of the three compounds and started to search the Internet for more information.

Quickly, Colin was immersed in a world of online discussion forums. Thousands of Internet users from around the globe were talking about their experiences of self-experimentation with chemical compounds that had been abandoned by pharmaceutical companies or not even patented. Some of the chemicals had only been thought of as theoretically possible, but a laboratory somewhere in the world was cooking up these drugs for people to buy and try on themselves.

He couldn't read any more. What he saw was immediately horrifying. Hundreds of stories of addiction and horrible psychotic episodes, health damage and hospitalisations. Internet users were swapping stories about how awful these chemicals were and that they were the most addictive drugs they'd ever tried. Many lamented the day they ever first experimented. One message stood out as clearly as the obvious warning to never take these substances: accurate measurement was the difference between desired effects and overdose.

Perhaps Neil had two sets of scales, but one set alone was worth almost £1,000. If he had overdosed at home, surely he would have been found there along with his scales?

From what Colin had read, a powerful dose of those drugs was just 0.005 grams. If Neil had half a gram delivered from China, that would be 100 doses. The effects would last well over 12 hours. That meant Neil would have been on a nonstop drug binge for 50 days with just one free sample, assuming he was measuring accurately.

He felt sick. His son had got mixed up with something so dangerous that it had overwhelmed him and taken his life in the blink of an eye. There was no way to sugar coat this. Was there even any point in telling Lara and the family that Neil had been completely consumed by addiction and stimulant psychosis? In less than 6 weeks these powerful Chinese drugs caused him to flee his home to his final resting place.

 

Next chapter...

 

#NaNoWriMo2016 - Day Twenty

9 min read

Poste Restante

Contents

Chapter 1: The Caravan

Chapter 2: Invisible Illness

Chapter 3: The Forest

Chapter 4: Prosaic

Chapter 5: The Van

Chapter 6: Into the Unknown

Chapter 7: The Journey

Chapter 8: Infamy

Chapter 9: The Villages

Chapter 10: Waiting Room

Chapter 11: The Shadow People

Chapter 12: Enough Rope

Chapter 13: The Post Offices

Chapter 14: Unsuitable Friends

Chapter 15: The Chase

Chapter 16: Self Inflicted

Chapter 17: The Holiday

Chapter 18: Psychosis, Madness, Insanity and Lunacy

Chapter 19: The Hospitals

Chapter 20: Segmentation

Chapter 21: The Cell

Chapter 22: Wells of Silence

Chapter 23: The Box

Chapter 24: Jailbird

Chapter 25: The Scales

Chapter 26: Descent

Chapter 27: The Syringe

Chapter 28: Anonymity

Chapter 29: The Imposter

Chapter 30: Wish You Were Here

 

20. Segmentation

When Lara was working her day shift, she would get home at around 7:30pm and have an hour where Neil was vaguely compos mentis. He would take his medication at around 8pm and by 8:30pm his eyelids were heavy and he would be slurring his words.

"Time for bed, Neil."

Uncomplaining and compliant Neil would be led to the bedroom where Lara would help him undress and get under the covers. It was as if he was blind drunk: barely able to comprehend where he was or navigate the short distance to the bedroom on his own. It was alarming to see how heavily medicated he was, but Lara trusted the judgement of the doctors and had confidence that his health would soon improve.

During her night shift, Lara became aware just how little of the day Neil was awake and active. Sleeping until nearly 11am, he pulled on some clothes and lolloped down the staircase where she heard him collapse on the sofa. The sound of daytime television could be softly heard from the bedroom, but she knew he was half-dozing with glazed eyes, not taking anything in. Before she left to go to work in the evening, his mind seemed a little less cloudy, but he had little more than an hour before he had to take his 8pm dose of medication.

The change from his depressed demeanour was unmistakable. When he was depressed he was present, but also cold, withdrawn and a little passive-aggressive. He was hostile towards the world, fatigued, but his mind was still sharp. Now, he was a shell of a man: he shuffled around, slept and ate, but there was no living spirit within him. He was dead behind his eyes, which seemed more sad than the expression he wore when he said he didn't want to live anymore.

It was pretty clear when Neil skipped his medication. He would be wired: wide awake with manic eyes and an electric energy, restless.

"Did you take your meds?" Lara asked.

"Whose prescription is it? Mine or yours?"

"It's yours."

"OK. Good. You worry about your medications, I'll worry about mine."

He wore a fierce expression. He was upset, defensive, offended that she would question whether he was taking his drugs. It was obvious when he hadn't, but she couldn't press him further on the matter without an explosive argument.

At first, he only skipped doses sporadically. It was as if he wanted to occasionally remind himself what it was like to be unmedicated.

Returning home one day, Neil was not in the snug or in the bedroom. Looking in the box room and the spare bedroom, Neil didn't appear to be in either. As she walked through the hallway towards the kitchen, she heard a sound come from the cupboard under the stairs.

"What the hell, Neil? What's wrong?"

He was in the cupboard completely naked with a bright red mop bucket on his head.

"Get away from me! Shut the door!"

"What's wrong, Neil?"

"Don't let those bloodsucking bastards get in here. Keep the fucking bats away from me" he shouted, with his hands flailing in the air.

"What's wrong with your arms? They're covered in scratches."

This seemed to stir some memory in him that he had forgotten. He started attacking his skin.

"Insects. Ants. Under my skin. Look at them crawling under there!" he picked at something unseen on his arm. A little blood appeared where his fingernail dug in.

"Neil you're seeing things. There aren't any bats. There aren't any insects."

"Fuck off. Fuck off. Fuck off." he shouted, cowering in the corner of the cupboard and pulling the bucket down over his head as if it could protect his whole body.

"Please come out from there. You're covered in scratches. You're hurting yourself."

"Leave me alone. You're a liar. You're a fucking liar."

"What am I lying about, Neil?"

"You know what it is."

"What is it?"

"You know. You all know. Fuck off and leave me alone."

The crisis team convened an assessment with Neil's doctor, a psychiatrist, a social worker and a mental health nurse. Two police officers stood in the hallway. Lara hovered in the doorway of the snug looking extremely anxious. Neil was sat at one end of the sofa in his dressing gown.

"We know you've stopped taking your medication, Neil. You should have refilled your prescription a week ago."

"I told you. The side effects were intolerable."

"Yes, but the medication was controlling your illness. You need the medication to stay well."

"I wasn't unwell before I started taking it."

"That's not true. Your notes say you were very unwell. The crisis team have been in contact for quite a while now."

"I wasn't hearing things. I wasn't seeing things."

"That was because the medication was working."

"The problems started when I stopped taking the quetiapine."

"There you go then, see! The medication was working. Why won't you start taking it again?"

"I told you. I'm OK. I can't stand the side effects. I don't need the quetiapine."

"But you had a psychotic episode. You got very sick without the medication. You need the medication to control your illness, Neil."

"What illness? I was depressed. That was all."

"Neil. You're very sick. You're exhibiting all the symptoms of paranoid schizophrenia. We're all very worried about you. You're not safe if you're not taking your medication."

The social worker from the crisis team got up and took Lara into the dining room.

"Look, we're going to have to take him into hospital to look after him and to assess him."

"OK, when? How long for?"

"I think we're going to recommend that he stays for 28 days. He's really sick and we need to get to the bottom of this. He's clearly not coping at home. You've been doing a great job, but he needs to be looked after in hospital."

"So, you're sectioning him?"

"We need to make our final decision, but it's likely that he's going to go to hospital under section two. He's not well and it's the best thing for him right now."

"What happens next?"

"We'll find a bed for him at a local facility and then he'll be admitted. Once he's settled in you'll be able to visit. He might not have to stay for the full 28 days, but we need to make sure he's in a safe place where the doctors can properly assess him and help him get better."

"He's angry with me. He was furious that I called you guys."

"You did the best possible thing you could. He was a danger to himself. It's really great that you called us and we can start to get Neil the help he needs."

Lara wasn't able to get to the ward during visiting hours until the weekend. Neil didn't want to see her and refused to come out of his bedroom.

"I'm sorry Lara, he doesn't want to see you right now" a nurse explained.

After 3 weeks, Neil appeared back at the house.

"I didn't know you were coming home."

"They let me have some leave. Time off for good behaviour" Neil chuckled darkly. He avoided eye contact and he scowled.

"Are you OK?"

"Would you be OK if you'd been forcibly removed from your own home, bitch?"

Lara drew her breath sharply, as if she had been physically struck.

"Neil!" she sharply rebuked at the harshness of his language, but she was more hurt and shocked than anything.

"It wasn't like that" she said with a concillatory tone. "You were really sick. Do you remember what you were like? Do you remember? You were under the stairs with a bucket on your head. What was I supposed to do?" Lara asked, reaching out to touch his arm. Neil pulled away from her baring his teeth, his eyes flashing with rage.

"Stay the fuck away from me."

She knew she sounded patronising and he felt betrayed. He had been brooding in hospital and the situation was highly charged, but she wanted him to know that she hadn't meant to hurt him. It was painful to see so much anger and mistrust directed towards her.

"Look. I love you. I care about you. I just want to see you get better."

"You got all those people ganging up on me. You turned my own doctor against me. What right do you have to do that?"

"You were having a crisis, Neil."

"Stop using my fucking name. It's just me and you here. There's nobody else here. Fuck."

Neil stormed off. Lara heard the sound of shattering glass and then a yell of pain. She hesitated and then started to walk upstairs. Neil crossed the landing and went into the bathroom. Tentatively, she poked her head in the doorway.

"Fuck off. Fuck off and leave me alone."

Neil was wrapping tissue paper around his hand. There were blood spots on the grey tiles all over the floor around his feet.

"Why the fuck are you still stood there? Fuck off. FUCK OFF" he screamed.

Lara went into the bedroom where a full-length mirror was shattered. The glass was mostly clean but large dark red blood spots were soaked into the carpet, trailing through the hallway and into the bathroom. Neil emerged and walked into the spare bedroom.

"Are you OK?" she asked.

He slammed the door closed.

"FUCK OFF!" she heard him yell, muffled inside.

On Sunday evening Neil left the house without saying a word. Lara waited until about 9pm and phoned the hospital.

"Is Neil back?"

"Yeah he came back a couple of hours ago."

Lara was relieved. She had been torn, not knowing whether to phone the crisis team again or not, knowing that Neil would feel even more betrayed. She sunk into the sofa and convulsive sobs hit her before she'd even put the phone down.

 

Next chapter...

 

#NaNoWriMo2016 - Day Eighteen

12 min read

Poste Restante

Contents

Chapter 1: The Caravan

Chapter 2: Invisible Illness

Chapter 3: The Forest

Chapter 4: Prosaic

Chapter 5: The Van

Chapter 6: Into the Unknown

Chapter 7: The Journey

Chapter 8: Infamy

Chapter 9: The Villages

Chapter 10: Waiting Room

Chapter 11: The Shadow People

Chapter 12: Enough Rope

Chapter 13: The Post Offices

Chapter 14: Unsuitable Friends

Chapter 15: The Chase

Chapter 16: Self Inflicted

Chapter 17: The Holiday

Chapter 18: Psychosis, Madness, Insanity and Lunacy

Chapter 19: The Hospitals

Chapter 20: Segmentation

Chapter 21: The Cell

Chapter 22: Wells of Silence

Chapter 23: The Box

Chapter 24: Jailbird

Chapter 25: The Scales

Chapter 26: Descent

Chapter 27: The Syringe

Chapter 28: Anonymity

Chapter 29: The Imposter

Chapter 30: Wish You Were Here

 

18. Psychosis, Madness, Insanity and Lunacy

"How did it go at the hospital?" Lara asked.

"Dr Asref has written me a prescription for two medications and he's made the referral to the crisis team" Neil replied.

It was the third time he'd visited the small community hospital as an outpatient and the second time he'd met the psychiatrist. Lara had never even heard of the hospital, even though it wasn't far from their home. The hospital mainly dealt with mental health patients.

The first appointment Neil had as an outpatient was for an assessment with a mental health nurse, 8 weeks after his doctor had made the referral to psychiatric services. He'd spoken to the nurse for about 90 minutes, while a trainee listened in and furiously scribbled notes. The nurse was kind and easy to talk to. He seemed to know exactly what kinds of things Neil was going through and was able to second guess what Neil was about to say, which made Neil relaxed and chatty for the first time in months.

The second appointment was with the consultant psychiatrist. He was not particularly conversational and seemed to be almost rambling to himself about various diagnoses and treatment regimens. He had presented Neil with a stack of photocopies of information on various medications and the consultation was suddenly over. Neil was confused and a little cut adrift. Asking what happened next, he was told to wait for another appointment where he could say which medication he'd like to try.

"Did you get the mirtazepine?" asked Lara.

"Yeah, but the consultant said I should take venlafaxine with it"

"Two medications?"

"That's right" said Neil, rattling two boxes of pills at Lara with a grin.

He seemed happier but his behaviour was worryingly erratic and childish. He would say and do regrettable things with no care for the consequences, or he would burst into tears and leave things in a mess if anything didn't go well.

One day, Neil had suddenly decided to demolish the garden shed with the supposed intention of building another one, but he hadn't purchased any materials to construct a replacement. Lara found him in bed when she got home, dreadfully upset and stressed about what he had done. That evening, she had to move the contents of the shed that could be damaged by rain and store them in the spare bedroom, while Neil cowered under the duvet.

His energy levels had improved, but often he would stay awake all night on the Internet. When Lara came home he would want to tell her about all the things he'd found out about UFOs, conspiracy theories, quantum physics, stock market trading and chaos theory. Neil's eyes would be flashing wide with wonder and excitement, but his thoughts were jumbled up and he was talking so fast she could only pick up every third word. He would get frustrated that she wasn't understanding and storm off in a huff.

"Did you get a new diagnosis?"

"He can't make up his mind. He said he's still convinced that it's major depressive disorder, but he also mentioned borderline personality disorder and bipolar disorder. He wants to treat me as if it's treatment resistant depression" Neil replied.

"Who are the crisis team?"

"Well, it's a number to phone if I'm thinking about hurting myself"

"Are you still having suicidal thoughts?"

"Not really. I'm too busy with my project"

Since losing his job Neil had been obsessed with the idea of creating an out-of-the-box security system bundle that would include wireless CCTV and motion sensors. The house had become increasingly full of equipment from Far-East manufacturers that Neil was tinkering with. Lara worried about how much it was all costing. How did he intend to sell this system if he could even make it work?

"Can I have the crisis team number?"

"Yeah. I'm supposed to give it to you and family so they can phone if they're worried about me" he replied. "And to any employer, but I don't want work sending round their goons to spy on me" he spat.

Neil's employer had become concerned that he hadn't turned up for work and had called his emergency contact - Lara - to see if he was OK. Lara was working and hadn't been able to answer her mobile, so the police had been phoned out of concern for Neil's welfare.

Neil had ignored the knocking on the front door, hoping that the police would just go away. A neighbour let the police into the back garden and they jumped over the fence. Neil heard the officers shouting at the back of the house and knocking on the back door. Yelling from the back windows, the police had insisted he come to the door so they could see he was OK. Neil had begrudgingly complied.

Lara was weary from constant worry about how Neil. She was very much relieved that there was now somebody else to contact in an emergency.

"People care about you, Neil." said Lara.

"Why are you using my name?"

"What do you mean?"

"Is there anybody else here? Why have you got to refer to me by name?"

"I don't know what you mean"

"You're so fucking patronising" said Neil, storming off.

Lara could hear him go into the box room upstairs. She knew he would be pretending to fiddle with stuff, brooding angrily. He would probably sleep in the guest bedroom again, even though it was packed with junk and the bed was covered with stuff from his project. Perhaps he would be awake all night surfing the Internet, following some thread that captivated his interest. They were definitely not going to have any further cordial discussion tonight.

Picking up the tablet on the coffee table - an impulse purchase that Neil had made - Lara searched the Internet. Typing "borderline personality disorder" she wondered what borderline meant. Did it mean that it was a milder form of the illness? As she read the symptoms she decided that it didn't really seem like Neil at all. They'd been together for so many years and they were engaged to be married. The part about unstable relationships didn't seem to fit at all.

Searching for "bipolar disorder" she came across a number of symptoms that sounded much more like Neil's recent behaviour. Rapid speech and disordered thinking, irritability, spending money and risk taking. She read the word "hypersexuality" and felt a knot in her stomach. He'd shown relatively little interest in her recently, but she knew he was watching more and more pornography. With a kind of shamelessness she heard him masturbating at night and found discarded tissues littering the floor. He made little effort to hide his Internet browsing history.

"Delusions of grandeur" and "psychosis" were things that were a little hard to place. Lara had worked a night shift and she heard him on a phone conference call during the day with his boss and human resources. Neil had ended up yelling about how he knew more than "all of you put together" and how he would create a competitor company that would "crush you like a bug". She knew that he had become frustrated and enraged by the conversation which had been ostensibly about sacking Neil, but his crazed response was completely out of character. She put it down to the extreme stress of the situation.

He was withdrawn and distant. It seemed inconceivable that he would be hearing voices or suffering with hallucinations. In her eyes, Neil was still strong, rational, intelligent and in control. She trusted him. They had always been open with each other about household finances and shared the burden of balancing the books. Even though she was cross that he'd thrown away his job, she thought that it was necessary for Neil's health and that he'd easily get more paid employment when he was ready to go back to work. They had enough savings to cushion their loss of earnings in the short term.

Two days later, Neil had disappeared.

"What do you think I should do?" Lara asked on the telephone.

"Have you rung the crisis team?"

"No. I don't know what the best thing to do is"

"Well, he didn't like it when the police got involved" Neil's dad replied.

Neil's dad was a practical man and had become a useful person to phone when she didn't know who else to speak to. Lara's parents were very sympathetic towards Neil, but it meant that they tended to share and exacerbate her worries rather than offering simple clear-cut advice.

The crisis team had promised to arrive within an hour. That was early on a Saturday morning. Neil had returned home in the afternoon, but had barricaded himself in the box room and refused to talk to Lara. Some eight hours after she had originally got in contact, there was a knock at the door.

"Hello, Lara?" asked a balding man, slightly overweight and wearing rimless spectacles. A mousey woman waited nervously behind him in the darkness, clutching a bulging ring binder.

"Yes, Hi"

"I'm Dan. This is my colleague Sue. Can we come in?"

"Please. Please do. I've been waiting all day" said Lara, ushering the two visitors into the hallway. "Neil, there are some people here to see you" she called upstairs.

Dan and Sue stood awkwardly and Lara gestured towards the snug, where they entered and sat down.

"Sorry... Lara was it?" Dan said.

"Yes, Lara"

"We had a number of urgent calls come in."

"That's fine."

"I'm a social worker and my colleague Sue is a nurse. We're here to make an initial assessment and see how we can help. Can you tell me what's been going on? It's Neil isn't it?"

"Yes, it's Neil I phoned about."

Lara noticed that Neil was hovering by the door.

"Ah Neil. These people are from the crisis team. They're here to see if you're OK."

"I'm not" said Neil, half entering the room but not sitting down, surveying the scene with distrust.

"Hi, Neil. I'm Dan. This is Sue" said the social worker, leaping to his feet and offering his hand. Neil took it and shook it. Sue half stood up, but remained quietly in the background. "Can you tell us what's been happening with you?"

"I can't cope anymore. I feel desperate. Suicidal"

"I'm sorry to hear that, Neil. How long has this been going on for?"

"On and off for months. It got really bad this week."

"OK, I need to ask you some basic questions." said Dan, now looking at Sue. Sue opened her binder and readied her pen.

"Do you know what day it is today?"

"Yes. It's Saturday the 20th of August, 2016."

"Do you know who the Prime Minister is?"

"David Cameron. No, er, I mean Theresa May"

"OK, and where are we?"

"We're in my house"

"Are you hearing or seeing anything unusual. Any voices?"

"No"

"Are you receiving any instructions, do you believe you are able to make people say or do things you want?"

"No"

"Is there anything you're anxious or concerned about right now?"

"I'm worried I'm going to kill myself"

"OK. Thanks, Neil" said Dan, glancing at his colleague. "It says in my notes that you've never been in hospital, because of your illness. Is that right?"

"Yeah, that's right. I've never been in hospital in my life except as an outpatient."

"Well, I think the safest place for you right now is at home. Where your partner and family can keep an eye on you. The crisis team can come and check on you, to make sure you're OK. How does that sound?"

"I want to die"

"OK well psychiatric hospitals are pretty crazy places. You wouldn't get a lot of rest there. The staff don't have a lot of time to help everybody. You'll be much better looked after at home. Do you have anything to help you sleep?"

"I've got mirtazepine. That makes me really sleepy"

"That's great. Do you know where it is?"

"It's on my bedside table."

"Lara, do you want to get it for Neil? And a glass of water" Dan prompted.

While Lara was gone, Dan and Sue sat quietly smiling and then Sue's mobile phone rang. She stepped out of the room and let herself out of the house while taking the call.

Lara returned with the medication and a drink.

"OK, Neil. What you're going to do is take your usual medication and then we're going to come and see you tomorrow and the day after. We're going to come and visit you here at home every day until you're feeling better."

Sue now let herself back into the house and popped her head around the door.

"Dan, we've got to go."

"Alright, sorry it was such a flying visit, but we have to attend to an emergency situation" said Dan, standing up and smiling. Pausing for a moment and taking on a more serious expression he said "everything's going to be OK. Hang tight. We'll be back tomorrow."

"OK, thanks" said Lara, following Dan to the door. Sue was already outside, eagerly wanting to get away. Neil was sat on the sofa, a little dumbstruck by the whole experience.

The front door closed, Lara returned to the snug.

"That went OK. There'll be somebody coming to check on you every day. That's reassuring isn't it?"

Neil simply looked at her blankly and then went upstairs to bed.

 

Next chapter...

 

#NaNoWriMo2016 - Day Sixteen

9 min read

Poste Restante

Contents

Chapter 1: The Caravan

Chapter 2: Invisible Illness

Chapter 3: The Forest

Chapter 4: Prosaic

Chapter 5: The Van

Chapter 6: Into the Unknown

Chapter 7: The Journey

Chapter 8: Infamy

Chapter 9: The Villages

Chapter 10: Waiting Room

Chapter 11: The Shadow People

Chapter 12: Enough Rope

Chapter 13: The Post Offices

Chapter 14: Unsuitable Friends

Chapter 15: The Chase

Chapter 16: Self Inflicted

Chapter 17: The Holiday

Chapter 18: Psychosis, Madness, Insanity and Lunacy

Chapter 19: The Hospitals

Chapter 20: Segmentation

Chapter 21: The Cell

Chapter 22: Wells of Silence

Chapter 23: The Box

Chapter 24: Jailbird

Chapter 25: The Scales

Chapter 26: Descent

Chapter 27: The Syringe

Chapter 28: Anonymity

Chapter 29: The Imposter

Chapter 30: Wish You Were Here

 

16. Self Inflicted

"I should be upstairs saving lives and instead I'm here wasting my time here talking to you" the consultant harshly chided. "I'm needed in surgery helping patients who don't deserve to be here" he continued.

"We're picking up the pieces of your self-inflicted mess and that's not fair."

The staff and patients within earshot of the ward could not help listening in to the consultant's angry tirade. They cringed with embarrassment on behalf of the petite and ghostly white girl who looked the angry doctor straight in the eyes with a contemptuous stare. She seemed completely unmoved, which only enraged him further.

The consultant briskly walked off. Everybody in the vicinity had stood spellbound, watching the scene unfold and there was a moment of hesitation before anybody started to move around. It was deathly quiet before people resumed talking again. A male nurse who had been hovering near the girl's bed now came over to replace an empty drip bag. He studied her face.

"He doesn't know what he's talking about. I didn't choose to come here" said the girl.

"He's very good at his job. He's very respected in this hospital" the nurse replied.

"I don't dispute that. But I didn't want to come here and take up anybody's valuable time" she said.

The nurse stopped what he was doing and looked at her.

"The police brought me here. It wasn't my choice. I didn't want to come."

The nurse wanted to tell her to keep her voice down, but he knew that it would be hypocritical, given that the consultant had launched a loud verbal assault on the silent girl. She hadn't spoken a word to contradict him. In fact, they had never spoken. He had read her notes and marched into the ward to give her a lecture. The other staff were quite sympathetic towards this fragile creature who had been so apologetic that she had ended up in hospital.

Lara had to put two canulas into the girl's pale skin when she arrived on the ward. Inside the crook of her arm and down the length to her wrists, there were scarred track marks and pus-filled abscesses. Lara searched the back of the girl's wrists but couldn't find a single vein that hadn't collapsed.

"I'm sorry. That hasn't worked. We'll have to try again" Lara said as she pushed the thick needle of the canula into a vein in the girl's ankle.

"It's fine. Don't worry. I'm sorry it's so hard. I'm used to it" the girl said.

Lara knew that it must hurt, but the girl didn't make a sound, even when she slightly flinched with pain.

"I bet she can't feel a thing" muttered one of the other nurses to Judy, the ward manager. They were watching through the glass from the corridor.

"She detoxed in intensive care. She's probably in a great deal of pain and discomfort" said Judy with a stern look at her colleague.

The hospital was a fairly nonjudgemental place. Even when the radiographers would gossip about the strange objects that they had seen on X-rays, that had been inserted into mens rectums, there was still a lot of sympathy amongst the staff and sensitivity for the feelings of the patients. "Imagine shitting that out" Anne cackled, talking about a toy car that a man had "accidentally sat down on" and had been unable to remove himself.

On a general ward, those who stayed for any considerable length of time were the geriatric patients. The patients Lara looked after either got better and were discharged, or they got worse and were rushed off to surgery or intensive care. The old people took a long time to recover and had multiple health problems as their aged bodies slowly shut down and died. Young people were a relative rarity on the ward and there was something shocking about seeing somebody unwell when they had their whole life ahead of them.

The young girl on Lara's ward had been admitted with pneumonia, septicaemia - blood poisoning - as well as a number of infected abscesses. She had hepatitis B and C. She was HIV positive. Her blood borne diseases were not affecting her health but would severely shorten her life expectancy. This shocking prognosis was at odds with the defiant and beautiful patient who seemed so strong despite being critically unwell.

As an emergency admission, the girl was still wearing the same clothes that she had been when the police had brought her to hospital. Her thickly applied make-up was still plastered to her face. Her short skirt, boob tube, mascara, black eyeliner and bold lipstick unmistakably identified her as a sex worker. Her uncovered arms betrayed the fact that she was an injecting drug user, but the men who picked up street walkers wouldn't notice or care about such things.

"Do you want me to find you some pyjamas?" Lara asked, trying not to stare at the small scars all over the delicate flesh on the underside of the girl's arms.

"Only if it's no trouble" the girl replied with a grateful smile.

Rummaging in one of the store cupboards, Lara managed to locate some pale green pyjamas and a pair of beige disposable slippers wrapped in cellophane.

"Here" said Lara. "I'll put these on this chair and we'll get you unhooked from all this stuff when that drip bag is next empty" she said.

A drip fed into the canula in the girl's ankle. She had a blood pressure cuff and oxygen level monitor attached to her arm. A machine pumped fluids into her body. A catheter bag hung below the bed, half full of urine. The tentacles of cables and tubes spread out from the white sheets of the bed where she lay, to the surrounding machines and equipment.

Changed out of her clothes and into clean hospital-issued pyjamas, the girl had managed to quickly clean her face in the bathroom. Her complexion was unhealthy but she was clearly very young. Without her makeup, she was just a helpless sick child.

"Are you OK in there?" Anne asked. "Lara, is that you?"

Anne was stood outside the ladies' staff toilet. She had heard somebody sobbing inside. Lara emerged sniffling and dabbing at her eyes with toilet paper. Anne looked around to make sure nobody had noticed them, while Lara fussed with her handbag and tried to walk away as if nothing had happened.

"Whoa there girl! You're not going anywhere. We're going to mine. No arguing" said Anne.

Lara had stifled her sobs as they exited the building and headed to the nurses' accommodation block. It was the end of their shift but Lara had obviously been locked in the toilets for some time because the rush to leave the building had quietened down.

No sooner had Anne closed the front door of her studio apartment behind them, Lara burst into tears again.

"What's wrong? Is it that girl in ward D?"

"She.. she... she's so young" Lara snivelled.

"Yeah. Heartbreaking" said Anne in a flat tone.

"But she's got nobody. Did you hear the way Osborne spoke to her?"

"Well, he's got a point. Nobody forced her to start taking drugs" Anne said, pouring out two large glasses of white wine.

This made Lara sit up and stop crying, although her eyes were still filled with tears.

"That's such a cliché. You think she's to blame for her own problems? You think she chose everything that's happened to her?" asked Lara.

Anne sat down on the sofa next to Lara and handed her a glass.

"No. I'm sure she was abused as a child. I'm sure she was raised in foster care. I'm sure she's had a hard life. I just mean, some kids turn out alright and some don't. They're not born with a crack pipe in their mouths" said Anne.

Lara knew that her friend wasn't being harsh. It was no use for them to wallow in misery over every tragic case that crossed their path. Anne was being supportive and kind by looking out for her and giving her space to talk about this girl away from work, even though she was challenging Lara's sympathetic stance.

"I don't think it's as simple as Doctor Osborne makes out" Lara said, taking a gulp of wine, still unable to look her friend in the eye.

"He shouldn't have spoken to her like that. He was shouting. Everybody heard him."

"Yeah" said Lara weakly.

"I bet he feels bad about it now. He was just mad because it's so tragic that she's messed her life up so badly at such a young age."

"He's not her dad" said Lara.

"Yeah, but he probably feels a bit protective, like a parent. Like you say, she's got nobody."

"There were people from social services, the police, addiction support workers. They're all worried about her. Lots of people want to see her get better. She doesn't seem at all afraid about how sick she is."

"You know this is her third hospital admission this year? Doctor Osborne is as worried as anybody" said Anne.

"You can't lecture somebody like that" said Lara, catching her friend's eye now.

"You can't get so personally involved. I bet that's why you were crying, wasn't it? Because you didn't want to leave her and go home"

"Yeah. Everybody is judging her. Because she's a junkie and a prostitute" replied Lara, starting to cry again.

"It's not your battle. You can't save her. All you can do is make her as comfortable as possible while she's on the ward"

"During my shift" said Lara.

"Yes, that's right. During your shift. You have your own life too."

"Can I sleep on your sofa tonight? I want to get drunk" asked Lara.

 

Next chapter...

 

#NaNoWriMo2016 - Day Twelve

6 min read

Poste Restante

Contents

Chapter 1: The Caravan

Chapter 2: Invisible Illness

Chapter 3: The Forest

Chapter 4: Prosaic

Chapter 5: The Van

Chapter 6: Into the Unknown

Chapter 7: The Journey

Chapter 8: Infamy

Chapter 9: The Villages

Chapter 10: Waiting Room

Chapter 11: The Shadow People

Chapter 12: Enough Rope

Chapter 13: The Post Offices

Chapter 14: Unsuitable Friends

Chapter 15: The Chase

Chapter 16: Self Inflicted

Chapter 17: The Holiday

Chapter 18: Psychosis, Madness, Insanity and Lunacy

Chapter 19: The Hospitals

Chapter 20: Segmentation

Chapter 21: The Cell

Chapter 22: Wells of Silence

Chapter 23: The Box

Chapter 24: Jailbird

Chapter 25: The Scales

Chapter 26: Descent

Chapter 27: The Syringe

Chapter 28: Anonymity

Chapter 29: The Imposter

Chapter 30: Wish You Were Here

 

12. Enough Rope

"We could lose the house."

"You're getting hysterical. Calm down."

"You're jeopardising everything. Don't tell me to calm down. It's so patronising."

"I'm not well."

"Well, why don't you go back to the doctor and get another sick note then?"

"Now who's telling who what to do? Now who's being patronising?"

"Don't be so ridiculous. I've been so supportive of you while you've been unwell."

"Yes, and now you're acting like I'm doing it on purpose. Like it was deliberate."

"I know you didn't mean to get sick. I am sorry. I am sympathetic. But you have to be responsible too."

"I can't face it. I can't do it."

"You don't have to go back to work yet if you don't feel up to it, but at least see the doctor."

"What am I going to say? I feel the same as I did a couple of weeks ago."

"Say that. You need a sick note if you're going to keep your job."

"It's such utter bullshit."

"What is?"

"Everything. That job. This fucking treadmill. Our whole pointless existence. Working until we die."

"You know I can't pay the mortgage on my salary alone. How are we going to avoid reposession? How are we going to pay the bills?"

"I can't think about that stuff at the moment. I can't deal with it."

"All you need to do is go and get signed off work for another couple of weeks."

"I can't do it anymore. When's it going to end?"

"We can't do anything if you don't play by the rules. You'll get fired and you won't even be able to claim benefits."

"I don't want to be on benefits."

"I know, but how are we going to pay the bills if you're not working?"

"I don't know. Don't you think I worry about this stuff too?"

"It doesn't seem like it if you can't be bothered to go and see the doctor."

"It's not that I can't be bothered. I just can't face it. I can't face anything at the moment."

"Look, I'm sorry you're sick, but you're going to have to man up over this. It's already been two days since your sick note ran out and they're expecting you back at work."

"They shouldn't expect me back. I'm not well. I feel terrible."

"Well go and tell that to the doctor."

"How ridiculous. Expecting me to have to go to the doctor when I'm not well, to get these stupid pieces of paper to send to work. How can you expect that of a sick person?"

"That's the way the system works. Deal with it."

"I dealt with it for years. I kept this roof over our heads while you went off to university. I've been responsible. Now I'm sick. Somebody else needs to be the responsible one."

"I phoned in sick for you didn't I? I've had to answer all the questions your boss and your work colleagues keep firing at me. I'm sticking up for you. You just need to do this one thing."

"I can't do it."

"Fine" said Lara, storming out of the snug and up the stairs to the bedroom.

Neil slumped back down onto the sofa. They had both risen to their feet in the heated exchange. Neil thought about switching on the TV, but instead he just sat slowly stroking his eyebrows and staring blankly into space. His mind was locked on a single thought: "I can't".

Everything had ground to a halt at home. Neil barely washed, he never cooked, he never cleaned, he never left the house, he had switched his phone off and avoided all social contact. Lara didn't resent having to do everything on her own, because Neil was quite neat and tidy, but she couldn't understand why he wouldn't go and get another sick note from the doctor.

"He's driving me mad, mum" Neil overheard Lara say loudly from the bedroom above the snug.

"He's not well my love" Lara's mum said at the other end of the phone.

"I know, mum, but he's going to lose his job pretty soon" said Lara.

"Try to be supportive. It must be hard for him."

Lara made a noise of annoyance.

"I have been SO supportive" Lara replied through gritted teeth.

"Look dear, it's late. Let's speak another time" said Lara's mum, sensing that the conversation would soon descend into an unpleasant argument.

"OK mum. Bye."

Lara hung up her mobile phone and let her arm flop down to her side on the bed next to her. Her grip relaxed and the phone slipped from her hand and dropped onto the bedroom floor. Lara's eyes remained glazed and impassive, fixed on the ceiling with an unfocussed stare. She exhaled very slowly, letting the air noisily blow through her lips as if she was deflating.

It would be impossible to force Neil to do anything, but why would she have to? It was obvious what he had to do. The rational course of action was indisputable. The negative consequences of inaction were inevitable.

He hadn't come to bed by the time she fell asleep but when she woke up in the morning, he lay next to her fully clothed, asleep. She wanted to wake him up and resume the discussion but she couldn't; she had to get up and get ready for work.

Before she left, she looked back into the bedroom at his face. At that moment he seemed so untroubled, calm, relaxed. It was infuriating, enraging even, that he appeared unperturbed by a threat to their financial security, that he could easily solve.

What did he even do all day, when she was at work?

 

Next chapter...

 

#NaNoWriMo2016 - Day Eight

13 min read

Poste Restante

Contents

Chapter 1: The Caravan

Chapter 2: Invisible Illness

Chapter 3: The Forest

Chapter 4: Prosaic

Chapter 5: The Van

Chapter 6: Into the Unknown

Chapter 7: The Journey

Chapter 8: Infamy

Chapter 9: The Villages

Chapter 10: Waiting Room

Chapter 11: The Shadow People

Chapter 12: Enough Rope

Chapter 13: The Post Offices

Chapter 14: Unsuitable Friends

Chapter 15: The Chase

Chapter 16: Self Inflicted

Chapter 17: The Holiday

Chapter 18: Psychosis, Madness, Insanity and Lunacy

Chapter 19: The Hospitals

Chapter 20: Segmentation

Chapter 21: The Cell

Chapter 22: Wells of Silence

Chapter 23: The Box

Chapter 24: Jailbird

Chapter 25: The Scales

Chapter 26: Descent

Chapter 27: The Syringe

Chapter 28: Anonymity

Chapter 29: The Imposter

Chapter 30: Wish You Were Here

 

8. Infamy

The eldest brother could do no wrong in his mother's eyes. He was quiet and studious. The teachers at school said that he was destined for great things - provided he tried his best - which echoed his parents' long-held hopes for their first-born child. Despite being unpopular, bullied and having few friends, academic achievement was the only thing that seemed to matter in his life, or so he was told by the adults he came into contact with. Wanting to please those anxious faces that looked on, scrutinising every piece of schoolwork, exam grade and report from teachers, he had allowed himself to be moulded into the 'perfect' son. Dressed by his mother and developing no independent identity of his own, his impeccable manners and good behaviour had other parents clucking with jealousy, as their own children were defiant, argumentative and seemed intent on ruining their futures.

The youngest brother was infantalised; babied; mollycoddled. Adorably cute, he had a look in his eyes that could melt any heart and the entire family delighted in showering this child with physical affection and encouraging childish traits that were seen as funny and part of his delightful young character. The words he mispronounced were adopted, so that grandfather became "Gaduda" and a favourite uncle became "Cunigu". The babbling of a baby created an entire new and impenetrable lexicon that only the family knew and understood.

The middle sister held her place in the family as a gender-stereotyped girl. Dressed in pink and floral outfits, she had been showered with traditional toys like dolls, plastic ponies and role-playing sets for obedient housewives. She seemed to be developing normally, playing nicely with her soft toys - having make-believe tea parties for all her bears - as well as thriving socially at playgroup and school.

After puberty, the girl had grown into a young woman more quickly than any adult was able to comprehend or adjust to. When they looked at her they could not see beyond the image of a child that had cemented itself in their minds. Clearly, at the age of 13 or 14 she was still very much a child, but there was a kind of denial amongst family and teachers that this girl was maturing much more rapidly than her peers in a way that denied her a place as either adult or child.

At school, only the children could see what was happening to Lara.

Becoming quiet and withdrawn, Lara fell out of favour with her friends. She wasn't fun anymore. She didn't want to laugh and giggle and gossip and exchange misinformation. Talking about who had started their periods and what bra size they were having to buy, some confusing changes were slowly slotting into place, as the adult world careened into their carefree childhood existence.

The family were distracted. Lara's eldest brother was being coached for important exams and groomed for a top university place, even though his education had many more years until its completion. Lara's youngest brother had a streak of star-like quality now, and it was being considered whether the family would try to get him into a school with better drama and music facilities. A future in the performing arts seemed to beckon for Lara's little brother. The family indulged him as he sang, danced and generally entertained them, captivating every available bit of their attention.

Under the auspices of furthering her studies, Lara had started to travel into the city centre to visit the main public library. Without adult supervision, she had been free to peruse the shelves and select whichever books she wanted. Peeking at older girls and young women who she thought dressed nicely, she imagined that they could be the role models or peers that she seemed to be missing in her life. Listening in to snippets of conversation and looking at the books they chose, Lara came upon a cache of literature that was 'age inappropriate'. The elderly librarians didn't know much about the books that they stamped for Lara to take home.

Magazines provided a trickle-down of information through the girls in school. Well-thumbed copies of Just Seventeen were mostly read by giggling groups of 13 and 14 year olds, who pored over the agony aunt sections and articles about boyfriends. The children mostly came from reasonably wealthy and well-to-do families where they had led sheltered lives, but there were many who had been involved in fumbling trysts and could combine their first-hand knowledge with the information gleaned from the pages of teen magazines.

Lara drifted further from her original childhood friends who covered their bedroom walls with posters of boy bands and listened to saccharine-sweet pop music.

Print media slowly sexualised the schoolgirls, with magazines that were supposedly pitched at adults being more commonly read by 14, 15 and 16 year olds. These magazines - such as Cosmopolitan - featured sex positions and even blow-job techniques under titles like "How to Please Your Man". Fashion magazines were boring by comparison and Lara found Vogue pretentious.

There was a disjoint, a gap, between magazine articles that were light on any real detail, and what was shared between the braver and more adventurous girls who had experimented and fooled around with their first boyfriends. There was no romance in being roughly fingered by an overexcited 14 year old boy on a cold park bench, both tipsy from swigs of cheap cider straight from the bottle. The experiences were confusing, unpleasant even.

Lara had filled the gap with romantic and erotic novels, and the detail of not only the mechanics of the acts but also the feelings of love and lust filled out a much fuller picture of what boyfriends and sexual activities were all about. Lara started to feel contempt for the spotty horny boys at her school and the gaggle of catty girls who circulated vicious rumours about each other as well as boasting of experiences that were missing the caring caress and vital connection that Lara now desired in a boy who was as mature as she was.

By broadening her sphere of knowledge through reading, as well as careful observation of the mannerisms of young women rather than her peer group, Lara began to take on an aura of being quietly self-confident, knowing. As the school year wore on, she started to appear dark and brooding in a way that had a sultry kind of attractiveness. Lara wasn't becoming a goth but there was an intensity in her eyes that was extremely intimidating to other girls, as well as to her teachers. More and more boys started to take an interest in Lara. She was becoming more and more removed and aloof from day-to-day school life, making her seem unattainable. Rumours circulated that she had an older boyfriend who rode a motorbike.

The children elevated Lara to a status normally reserved for 'cool' adults. To treat Lara like an ordinary pupil brought anarchy to the classroom, as if the teachers had started calling each other names in front of the children. To her teachers, Lara was now untouchable, in the interests of preserving some authority. Lara wasn't interested in making trouble, so an uneasy truce came to pass. Lara would not show any disrespect for her teachers or contempt for her schoolwork, but no teacher dared to ridicule and belittle her for fear that they themselves would be laughed out of their class.

Nothing was especially wrong that warranted Lara's parents being contacted, but Lara was becoming feared and revered at school. The girls knew that their boyfriends' eyes were drawn to her and Lara could feel herself attracting an increasing number of staring faces. She started to become comfortable with male attention and would even delight in returning a boy's gaze in order to make him blush, caught looking. A kind of unspoken reputation made her unapproachable. No boy from her school was bold enough to try and speak to her anymore. The legend of the older boyfriend became cemented as fact, even though Lara by now had started to feel a little disappointed that the older boys seemed somehow immature. Refining her style, her sense of dress, in a subtle way that she copied from young women who seemed confident and happy, she started to draw attention from young men, some of it unwanted. These men were crass and crude, and harassed her. They had nothing cosmopolitan, cultured or urbane about them. They were likely lads who fancied themselves as a hit with the ladies. Lara was repelled by these ugly creatures who dressed in sportswear, had gold chains, earrings and wore far too much aftershave. These young men were only ever brave enough to make an approach when accompanied by a group of their friends, watching with a slack-jawed smile as the sullen Lara silently dismissed them with crushing indifference.

Lara imagined that when she left school for university she would find a completely different set of people. Young men who were more mature and romantic, she imagined a boyfriend who could be her equal; somebody she could respect. It wasn't that she was saving herself for true love, but more that she hadn't yet met anybody who measured up to her expectations. The more she read, the more she developed a better sense of the kind of guy she wanted to date, which included a kind of worldly-wiseness, experience and a self-assured manner that was lacking in schoolboys and men who hung around near schools trying to pick up teenage girls.

Age 15, with a mature body and the comportment of somebody older, Lara started to draw the attention of more predatory and silken-tongued men who attempted to woo her with more subtlety. Hanging around on the fringes of school social events and struggling to find a group where she belonged, several well dressed young men struck up casual conversations with her. At first, she felt as though she was beginning to make new friends and would perhaps soon have a new gang to hang out with. Brutally, she found that it was a ruse and these men would try and kiss and grope her after some perfunctory chat. Lara became despondent, beginning to lose hope that there was anybody out there for her who didn't want to just get in her knickers.

At weekends during a mild late September, she had taken to reading a book in the park on a favourite bench that was partly shaded, but still had enough sunlight that she was pleasantly dappled with warming rays. Today, there was a young man sat on one end of the bench who was ghostly pale, wearing a winter coat but still shivering. His coat was pulled up to cover the bottom half of his face, but his eyes were shining brightly, with dark rings underneath. He looked as though he was suffering with a fever and his forehead was a little sweaty.

Lara hesitated before sitting down, but she decided that the man's body language suggested he was trying to make himself as small and inconspicuous as possible. He seemed non-threatening and he was sat right at the other end of the bench. Lara took her usual seat and began reading, somewhat distractedly.

She imagined that the man would get himself up and off home to bed soon, but as the afternoon wore on, he was still sat there. Lara was hardly getting any reading done, but she had a stubborn temperament and was determined that she would attempt to read for as long as she normally would, even though her thoughts were filled with concern about the wellbeing of her companion on the bench.

Eventually, her patience ran out and Lara stood up to walk home.

"Are you OK?" she asked the young man.

The man lifted his eyes slowly to meet hers. There was pain behind them. Not physical pain, but something else. His expression of discomfort softened with her question, but he seemed shocked that anybody had addressed him or even acknowledged his existence. It was as though he thought he was invisible up to that point. There was something incredibly vulnerable and raw about this man; not just the sickness that he seemed to be suffering with. Lara felt a surprising protective instinct for this slim and pale young man who had a haunting gaze.

"I'll be alright" he said.

Lara started to leave and then she stopped.

"What's your name?" she asked.

"Sam"

"Do you have somewhere to go? You don't look well" Lara said.

"Yeah. I'm waiting for somebody. I had to get out of the flat. I was going crazy at home, waiting" Sam replied.

"Do you have a number for them? Do you want me to help you try and contact them?" Lara asked, confused and concerned.

"No. No. They'll turn up. Sometimes they just make me wait. Feels like forever" Sam said.

Lara didn't understand and she couldn't think of anything else to say or ask.

"Oh, OK. Bye then" she said.

"Bye. And thanks" said Sam.

"Thanks for what?" asked Lara.

"Thanks for asking"

When she got home, Lara could still vividly picture Sam's face. He was pale and sick but he was clearly a good looking young man. She was intrigued and also worried about what was going to happen to him. Was he going to be OK? He hadn't asked her name. She wanted to know what he'd meant; why he couldn't wait at home.

Lara wanted to go back out that evening and see if Sam was still on the bench. What would she say if he was? What would she find out if he wasn't? She resisted the urge to go back to the park.

 

Next chapter...

 

#NaNoWriMo2016 - Day Six

9 min read

Poste Restante

Contents

Chapter 1: The Caravan

Chapter 2: Invisible Illness

Chapter 3: The Forest

Chapter 4: Prosaic

Chapter 5: The Van

Chapter 6: Into the Unknown

Chapter 7: The Journey

Chapter 8: Infamy

Chapter 9: The Villages

Chapter 10: Waiting Room

Chapter 11: The Shadow People

Chapter 12: Enough Rope

Chapter 13: The Post Offices

Chapter 14: Unsuitable Friends

Chapter 15: The Chase

Chapter 16: Self Inflicted

Chapter 17: The Holiday

Chapter 18: Psychosis, Madness, Insanity and Lunacy

Chapter 19: The Hospitals

Chapter 20: Segmentation

Chapter 21: The Cell

Chapter 22: Wells of Silence

Chapter 23: The Box

Chapter 24: Jailbird

Chapter 25: The Scales

Chapter 26: Descent

Chapter 27: The Syringe

Chapter 28: Anonymity

Chapter 29: The Imposter

Chapter 30: Wish You Were Here

 

6. Into the Unknown

Going to university as a mature student had been hard work but a lot of fun. Lara was only a few years older than most of the other student nurses and their training wasn't like a normal degree course. 50% of the time the nurses did their university work in a building that was a long way from the main university campus. The other 50% of the time was spent in the clinical environment of the local hospital. Lara's university days weren't spent partying and skipping lectures - the workload was relentless and she was soon doing long shifts to gain all the necessary hands-on experience she needed to qualify.

With Neil's salary, savings, some money from her parents and a bursary, Lara and Neil managed to keep their home life relatively unchanged after Lara quit her office job to retrain. A little bit of belt tightening was necessary, but the couple managed to struggle through 3 years without Lara's salary.

Although she avoided living in a dirty and messy student house, Lara didn't miss out on any of the social bonding with the rest of her course-mates. During those three years at university, she made a lot of good friends.

After qualifying Lara's friends had been scattered all over the country. Some of them wanted to specialise. Some of them wanted to get jobs in particular cities or closer to family. There were a lot of jobs in London, which attracted many friends to move there, but Lara wanted to stay in the local area. For a lot of her friends, they were bored of the unremarkable university town they had spent three years in.

Working at a big hospital as a general nurse, there was a lot of variety in the day-to-day challenges. There were a lot of staff. There were a lot of departments. There were a lot of different procedures that could all happen within that large hospital building. The NHS had been closing smaller local hospitals, in preference for larger facilities, so that fewer items of expensive equipment had to be purchased nationally.

One of the few things separated from the general hospitals was mental health care. While the hospital had a handful of mental health specialists, they were in a psychiatric liaison role. Any physical health issues would be treated at Lara's hospital and then the patient would be transferred if they required inpatient care for mental health issues. There was a clear demarkation between general medicine and mental health and the few people Lara knew who had specialised in that area had followed a very different career track from her.

As a medical professional, Lara felt frustrated that she didn't know more about mental health issues and there was little opportunity at work to have a casual conversation with any of the doctors. The doctors in the hospital had specialised in the treatment of physical ailments, disease, surgery. She only knew a few doctors who she should speak to if a patient was behaving strangely. In Accident & Emergency the hospital would treat drug overdoses, alcoholics and people who had physically injured themselves while in a crazed state, quite often accompanied by police officers. The police normally had a better idea of what psychiatric issues the patient suffered from than the hospital staff. It seemed as though the police were at the front line of mental health issues.

Although she had bandaged lacerated wrists and dealt with patients who had swallowed handfuls of pills or poison by treating them with activated charcoal, Lara never really knew the story behind what had brought them to the brink of suicide in the first place, or what happened to them after they were physically healthy enough to be moved to a psychiatric facility. The patient notes for the nurses contained details such as blood pressure and medications. Very few details about the psychological problems that troubled these people were in the notes she saw.

When the weekend arrived, Lara found herself turning to the Internet to find out more about depression and how it was diagnosed and treated. It seemed strange that despite her training and experience, she should have to turn to websites for information, but she didn't know who to speak to. She knew friends had suffered bouts of depression, but it felt insensitive to phone them and say "Hey! You've been down before. What can you tell me?" Those friends who had become depressed never discussed the details of their prescribed treatment openly.

Lara knew her mum had become depressed after giving birth to her little brother. Her mum had sought help from the family doctor. Lara's mum said that a little time talking to the doctor about her feelings had been exactly what she needed. That was over 20 years ago. GPs didn't have much time to talk to their patients anymore. At the local doctor's surgery, Lara seemed to see a different doctor every time she visited.

Therapy conjured up images of whiney New Yorkers, self-indulgently talking about how their daddies didn't love them enough, on a psychotherapist's couch, spending hundreds or even thousands of dollars. Lara thought that to suggest counselling might make Neil more upset. Many people derided therapists as "quacks".

Having spent the week without socialising amongst their usual circle of friends, Lara now faced further isolation all weekend, as the couple cancelled their plans. There was little that Lara could do to help at home. Even asking Neil "are you OK?" could be a barbed question, when clearly he was not. It was very British to say "I'm fine thanks" as an automatic response whenever anybody asked how you were, no matter how dreadful life was feeling at that moment. Neil and Lara's parents had been raised in an environment of post-war austerity, where stiff upper lip and concealment of any inner emotions was considered the preferred way to conduct yourself. The touchy-feely stuff was not dealt with well by either family.

By Monday morning, Lara was relieved to be able to immerse herself back in her work. Throughout her shift she barely had a moment to herself to dwell on personal issues. For the sake of the patients and her team, it was imperative that she was positive and upbeat, concentrating, not distracted. She was expected to be a pillar of strength and exude confidence when patients were scared, in pain and discomfort. Context switching was surprisingly exhausting, but it didn't hit Lara until she left the hospital.

As the week wore on, Lara found that she was less and less able to carry the caring face she wore all day at work into her home. She felt like she had lost the support of both her partner and her social group and she could barely keep her own head above water. By Friday, some tiny slip of the mask must have betrayed how truly drained she felt, because the Ward Manager called Lara into her office at the end of her shift.

"Is everything OK, Lara?"

"My fiancée hasn't been very well for a couple of weeks, but I really didn't want to bring my problems with me to work, Judy, sorry" replied Lara.

"It's OK. You just look a little under the weather. I hoped you weren't coming down with something. Your work has been fine this week. No complaints from me" said Judy.

"Yeah, I'm fine. I'm just going to sleep all weekend and let my batteries fully recharge" said Lara.

"Well, look after yourself. Are you getting the support you need at home?" asked Judy.

"Yeah. We're getting by. I'm sure Neil's going to be feeling better and back to work soon" replied Lara.

"Neil. That was it. I remember you saying you'd got engaged, but I must admit I'd forgotten your fiancée's name. Any news on the wedding?" asked Judy, turning the conversation more light and casual.

"No, we haven't even started planning yet" replied Lara.

"Oh well. No rush" said Judy, glancing down at some paperwork on her desk.

"See you Monday. Have a good weekend" said Lara.

"You too" replied Judy, busily scribbling notes onto a yellow form she had been filling in when Lara had entered the office.

Lara fetched her coat and bag with some sense of relief, but also the nagging feeling that she had somehow trapped herself. Next week at work, she would have to work hard to keep a brave face on things. It would be harder now to admit that she wasn't coping well. All she could hope for was that things would be getting back to normal sooner rather than later.

Anne was hurriedly pulling on her coat as she jogged along the corridor to catch up with Lara, who was making her way to the lifts.

"What was that all about?" Anne asked.

"Oh, she was just asking if I was OK" Lara replied.

"And are you?" Anne asked.

"Not really" said Lara.

 

Next chapter...

 

#NaNoWriMo2016 - Day Two

10 min read

Poste Restante

Contents

Chapter 1: The Caravan

Chapter 2: Invisible Illness

Chapter 3: The Forest

Chapter 4: Prosaic

Chapter 5: The Van

Chapter 6: Into the Unknown

Chapter 7: The Journey

Chapter 8: Infamy

Chapter 9: The Villages

Chapter 10: Waiting Room

Chapter 11: The Shadow People

Chapter 12: Enough Rope

Chapter 13: The Post Offices

Chapter 14: Unsuitable Friends

Chapter 15: The Chase

Chapter 16: Self Inflicted

Chapter 17: The Holiday

Chapter 18: Psychosis, Madness, Insanity and Lunacy

Chapter 19: The Hospitals

Chapter 20: Segmentation

Chapter 21: The Cell

Chapter 22: Wells of Silence

Chapter 23: The Box

Chapter 24: Jailbird

Chapter 25: The Scales

Chapter 26: Descent

Chapter 27: The Syringe

Chapter 28: Anonymity

Chapter 29: The Imposter

Chapter 30: Wish You Were Here

 

2. Invisible Illness

The sense of dread and impotence had followed Lara around for her entire shift. Neil had showed no signs of improvement when she left him at home in bed, earlier that morning, to leave for work. She felt sure that he would still be in bed when she got home. He had turned his mobile phone off and she knew that he would let the landline ring until the answerphone picked up. There was no way of knowing how he was doing, but she had the sinking feeling that he wasn't improving. This was the fourth day in a row that he hadn't gone to work, and now she was starting to worry on his behalf about his job.

Lara had made a career switch to nursing, having previously worked as an office administrator. She was naturally caring and liked helping people. The office politics and limited scope to make a tangible difference in anybody's life had ground her down in the medium-sized company she used to work for, with its bloated management structure, endless bureaucracy and red tape. The National Health Service was no picnic, but working directly with patients and other front-line staff made the job far more rewarding than her previous career, where she had never met any of the company's actual customers.

Neil was a well respected and valued employee at the company he had worked for since leaving college. He was a CCTV and intruder alarm engineer, who travelled throughout the country, installing new systems, doing maintenance and repairs. Over the years, he had built up a lot of technical expertise and was now considered one of the most senior members of the team. He'd had the option to move into staff training or management, but he'd always preferred to remain "on the tools".

Most of Neil and Lara's circle of friends had originated from Neil's job, with Lara befriending the 'significant others' of Neil's male-dominated engineering friends. There had been a spate of weddings recently amongst the couples they knew and on Valentine's Day, Neil had proposed to Lara. They were engaged to be married some time the following year, although they had not yet started to plan the wedding.

Lara had received text messages from her female friends asking if Neil was OK, because their other halves hadn't seen him at work for a couple of days. What could she say? She knew it was unusual for Neil to be sick, but it wasn't at all clear what was wrong with him. He just seemed very fatigued and hadn't been able to face getting up or even phoning in sick. Lara had phoned his boss for him, while he buried his head under the duvet and pretended to be asleep.

It was easy to be sympathetic with Neil, because he was evidently going through a hard time due to something but the frustrating thing was that it was neither identifiable, nor would Neil go to the doctor to ask for a diagnosis. Through her own medical training, Lara knew there was nothing obviously wrong with Neil: no fever, no pain or discomfort, no nausea. In fact, no symptoms beyond the fact he looked tired, drained, stressed and somewhat afraid, in his facial expressions. She knew that he wasn't the type to complain about a bout of man flu.

The first couple of days that Neil was off work, she had attributed to the kind of duvet days when she herself would phone in sick, if she really couldn't face another boring day in the office. By the third day, she could hear her parents' derisory words about "yuppie flu" ringing in her ears, from her childhood in the 1980's.

The burden of having to phone Neil's boss each day had now escalated. He had politely but firmly reminded Lara that Neil now needed to go to the doctor and get a sick note, because he'd been away from work for more than three days. Neil knew this too, but hadn't acknowledged it. In fact, he'd made it subtly clear to her that he just wanted to be left alone. He didn't want her to open the curtains for him; he didn't want her to bring him food; he didn't want her to arrange for anybody to visit to make sure he was OK during the day. Little changed in his withdrawn demeanour from when she left in the morning for her 12 hour shift, to the moment he barely acknowledged her when she returned from work, except to say he was OK and he didn't need anything. The most animated that she'd seen him in four days was when she offered to phone in sick for him, which he said he'd be really grateful for if she did. She didn't seem to be able to do anything else to help. It was frustrating.

The drive home from work was very unpleasant for her. She knew the house would seem lifeless: no lights on. She knew that she would go upstairs to the bedroom in order to get out of her work clothes and see the motionless shape of Neil's body under the duvet, in much the same position as she'd left him in the morning. She'd know from the rhythm of his breathing that he was awake, but she would have to speak first. He would be polite, pleasant even, but somehow clipped and formal. The subtle cue was for her to leave the bedroom, turn off the light, and leave him with whatever he was struggling with. It cut her up to feel shut out, unable to help.

All of their normal rhythm and routine had suddenly disappeared, leaving a gaping hole in Lara's life. Their usual discussions about evening meals, cooking and eating together, watching videotaped television programmes or films, exchanging stories about their working day, planning the next social event, or talking about an upcoming holiday: all of this was suddenly gone, and Lara found herself eating on the sofa, alone, watching whatever was on TV at the time, but not really paying any attention to it.

The hardest thing was having nobody to talk to. Her parents had made their views about "work shy" people vociferously known and she didn't want to get into an argument, where she felt defensive about Neil having to take some time off sick. Most of their group of friends all knew each other, and she knew that by talking to even one friend, word would soon get around that something was wrong with Neil that was out of the ordinary. She dreaded to think what would be concluded in the speculative gossip at the dinner parties at each others' houses.

Lara started mentally preparing herself for friends dropping by the house to see if they were OK and if there was anything they could do. If there was nothing she could do, what could they possibly do? It would be easiest just to make excuses and try to shoo them away from the doorstep without even inviting them in. What would she say? How could she be polite and maintain the impression that their usual relaxed open house policy was in full swing, but at the same time swiftly get rid of any would-be visitors?

Despite a salary drop for Lara, the couple had still managed to get a large enough mortgage to purchase a modestly sized terraced house near the town centre that had plenty of space for entertaining guests. Under normal circumstances, Lara and Neil had a gregarious and welcoming nature and were given to spur-of-the-moment gatherings in their home with their friends. Several couples lived within walking distance, and impromptu cheese and wine, cards or board game nights were a common occurence.

The house had an attractive Victorian façade with a modern interior. The brick archway above the front door stated that the house was built in the 1870s. The previous owners had extensively renovated, building a bright open-plan kitchen diner extension at the back, and preserving a cosy but surprisingly spacious snug at the front of the house, with a cast iron fireplace and wooden fire surround. Furnished with carefully chosen second hand furniture that mixed shabby chic with pieces that could be mistaken for iconic vintage design, the house was punching above its weight for the meagre budget of Lara and Neil's income.

Decorating and furnishing their home had been a labour of love for Lara and Neil, and they were extremely house-proud and meticulous in how they had planned each room to accentuate the available space, light and few remaining period features. This hiccup in Neil's health was certainly no part of a master plan which had seemed to be going perfectly for the couple, up to that point.

Entertaining guests held a certain amount of desire for their friends to see their home improvements, and to show off their excellent taste in interior design and home-making. It was showy without being unpleasantly in-your-face. It was hard to dislike Lara and Neil as they weren't a couple obsessed with status symbols and oneupmanship.

Behind closed doors, the relationship was far from perfect. Neil's reluctance to turn down overtime and work fewer hours had led to Lara's desire to find a more rewarding career of her own. Financial pressures and resentment over each other's strong desire to satisfy their own needs and find fulfilment at work, had overspilled into many unpleasant arguments. Most of their friends chose to accept the happy, smiling, front that Lara and Neil presented at face value. Those who were closest to the couple could see the mask occasionally slip. The occasional unpleasant jibe; the twist of the knife; the obvious hints at an unresolved argument. There were issues that were festering, unresolved.

Nobody could say that they weren't a fully committed couple. They had been together a long time and had managed to come through a rather tempestuous and fiery initial period, before reaching a kind of uneasy truce. When in the company of friends, they were in fine spirits - and this was no act - but too much time spent alone with each other and trouble would inevitably erupt.

Neil was not self-indulgent in his convalescence, but he was completely unaware how isolated this left Lara, given the interconnected web of friends and connections to Neil's work that existed. Neil had no idea how burdened Lara felt, defending Neil's spotless record as a dependable hard worker, and as a sunny upbeat happy-go-lucky likeable social character. The man under the duvet in the dark bedroom upstairs would not want anybody to see him like that, and Lara knew it.

Whatever regrettable words had been spoken before, it was water under the bridge. Lara would not betray Neil in his hour of need.

 

Next chapter...

 

20-8 Days Later

2 min read

This is a story about the undead...

Sick

I got sick. I stopped blogging. I'm sad I broke my daily writing routine. I would have hit 365 blog posts by now, if I had kept going just a little longer.

When people say "keep going, you're doing really well" the sentiment is lovely. Keep going where though? Have I been there before? Is it a good place to keep going to? Also, what does it mean to be doing really well? Does it mean superficially? Is the most important thing to look like you're doing really well, on the outside? Are you doing really well even if it's all an act?

I'm no faker; no actor.

I do however have to do something that I can keep going with, while genuinely doing really well. My last contract could not keep going. I was not doing very well.

Perhaps getting sick wasn't an inevitable consequence, but it takes more than letting off steam through personal writing to harmlessly neutralise the 'toxic' build-up, due to months of stress, boredom, lack of stimulation, lack of social interaction, no new challenges, no creative outlet etc. etc.

Equally, my solo hack-a-thons have been challenging and creative, perhaps a little over-stimulating, and have made me sick through social isolation and stress.

There must be a cool project with a team here in London that ticks the other boxes.

Anyway, I need to get well again first.

 

Tags:

 

The Doors of Self-Perception

14 min read

This is a story about being objective...

Yardsticks

If you want to compare two measurements you have to use the same yardstick. If you are comparing two subjective things then how can you possibly draw any concrete conclusions?

At times, I have kept a mood diary. I rate my mood from 1 for worst to 10 for best. Who's to say that if I rate myself as "1" during prolonged depression that's comparable to "1" on a bad day when otherwise I've been feeling mostly normal?

During a lengthy period of depression, where nothing seems to hold any pleasure or enjoyment: subjectively, life is terrible. I also have periods when I'm generally in a much better mood, but something really shitty will happen. The shitty thing might feel like the end of the world at the time, but I'm not going to kill myself over it: I'll quickly get over it and move on with my life... so can it really be a "1" even if it feels like it at the time?

If your mood slowly improves or declines, over the course of several weeks or months, can you spot the trend? If you're suffering a lengthy depression, does your yardstick change? You might have a day where you just feel normal, but now you rate that 10, because it's the best you've felt in as long as you can remember.

Do you even remember how you used to feel, before you got depressed?

This might be why I have a tendency to invite hypomania, because at least it's clearly some kind of polar opposite from depression, even if I don't exactly feel "happy".

Defining "happy" has started to get really hard.

Going in search of happiness has been a disappointing experience. Anhedonia means the loss of pleasure and enjoyment of things that you used to get a kick out of. Finding that you no longer love the things you've always loved to do, is terrifying, because it's further confirmation of the way that you feel: "everything is shit".

I ended up completely rebasing my whole idea about what made a happy day:

  • "Got to work only an hour late"
  • "Didn't quit my job"
  • "Only drank one bottle of wine instead of two"
  • "Survived another week without being sacked"
  • "Got out of bed at the weekend before it went dark"
  • "Went to the shops"

I know that I must be unwell, because I used to have happy days that were more like this:

  • "Cooked a healthy dinner"
  • "Went for a walk or a bike ride"
  • "Took some cool photographs"
  • "Went to an event"
  • "Made a new friend"
  • "Did some work I'm proud of"

Now, I could do those things, but I don't feel like it. Often when I try to force myself to do things, I get very stressed about it and I find it really exhausting. When I get home I feel wiped out and that I shouldn't have bothered. I find myself out taking a walk and nothing takes my interest enough to photograph it. That's weird. I used to live behind the lens.

So, I started to bring in more objective measurements: movement data, alcohol consumption, number of social engagements, number of words written.

When I analyse the data, I think the most reliable predictors of my subjective feelings of depression, are movement and alcohol. Looking at last year, I was averaging 12,000 steps a day, and although I had alcohol binges, my average consumption was reasonably low. This year, I'm averaging 7,000 steps a day and drinking excessively nearly every day.

Now, you might think "walk more, drink less" would be the solution, but this assumes a causal relationship. Perhaps I was more in the mood to walk more and drink less, last year. Perhaps the relationship is the other way around and my poor lifestyle 'choices' are actually due to depression.

We often tell people to eat healthier and exercise more, to improve their mood, but perhaps it's the people who have a happier mood who are the ones more likely to eat right and be active. In actual fact, healthy eating and being more energetic could be a good predictor of happier people.

The cause-effect relationship is not always clear. Psychologists had published a paper that appeared to show that smiling made you feel happier. However, when the experiments were repeated, the results could not be reproduced. If you can't reproduce the results of your experiment, it's not good science.

A friend made the following amusing observation:

"People who are dying of dehydration can't just mime drinking water to quench their thirst"

I think this hits the nail on the head perfectly. While depressed people can eat healthier and go to the gym, they're just going through the motions. They're not getting the benefits that their happy counterparts are getting, and in fact it could be pure torture for them.

There's an experiment where a pigeon is fed at a computer-controlled random interval. What the researchers found was that whatever the pigeons were doing the first time they got fed, they then decided they needed to do again, in order to get fed. Let's say the pigeon was cocking its head to the side when the food was released, the pigeon will then start repeatedly cocking its head, and believe that it is causing the food to be released, when in fact it's completely random. Essentially, the pigeons had become superstitious.

It seems relatively random - unpredictable - when a depression is going to lift. Let's say you were trying acupuncture or homeopathy at the time when your mood started to improve: you might assume a causal relationship between the alternative treatment and the lifting of your depression.

Even a double-blind placebo trial is not exactly fair. Psychiatric medications do make you feel noticeably different. I would be able to tell whether I was taking an inert placebo pill, or something psychoactive. I would know whether I was in the control group or not. Placebos don't work if you know you're taking a placebo, so this could explain some of the mood improvements seen with antidepressants. The antidepressant might look effective, when compared with the control group, but it's the placebo effect.

Antidepressant clinical trials generally only take place over 6 to 12 weeks. Many common antidepressants take 6 weeks before their effects can even be felt. There is no focus on long-term outcomes in these trials, only that the medication should perform better than placebo.

Many trials of longer duration have shown that being unmedicated might be more effective in the long-term, than taking antidepressants. Pharmaceutical companies are not concerned with long-term outcomes. In order for a medication to be sold to the public, it merely has to be safe and proven to be marginally better than placebo.

You would have thought that taking antidepressants would be a lot better than not taking them, right? In actual fact, there might only be a 15% chance of you feeling better, but there's a 15% chance of unpleasant side effects. The very process of going to your doctor, being listened to by somebody nonjudgemental, and then feeling something even if it's not actually better, might convince you that you're improving, when actually your depression could be lifting quite naturally anyway.

Culturally, we have developed a strong superstitious belief in the power of medicine. We believe there's a pill for every ill. We believe that a man in a white coat can wave a magic wand and we'll be cured of any ailment; discomfort.

You only have to go into any pharmacy during the winter, to see signs that say "we have no medication to treat your common cold". The fact that doctors and pharmacists have to tell people not to waste their time with an incurable virus that has unpleasant but non-life-threatening symptoms, shows how strongly we believe in the power of medical science to save us from even a runny nose.

There is a clear difference between "feeling a bit sad" and depression. Depression is life-threatening. Depression has a massive impact on people's quality of life. However, we are often medicalising a non-medical problem.

If somebody who's feeling down visits their doctor and receives some medication that's basically a placebo that makes them feel a bit different - drugged - then their pseudo-depression will lift, because it was going to anyway. The non-judgemental medical consultation will also have marginally assisted.

However, those who have prolonged severe depression - to the point of suicidal thoughts - may find that their quality of life is actually reduced by medication, because it gives no real mood improvement, but it does have unpleasant side effects. The longer-term studies seem to back this up.

Through extensive research, I found a number of medications that are very rarely prescribed, but have been used for treatment-resistent depression. These medications are dopaminergic not serotonergic.

There are a whole raft of medications used to treat Parkinson's disease, that have been shown to exhibit antidepressant effects and can successfully treat patients who had previously been treatment-resistent.

In the most severe cases of depression, deep-brain stimulation has been employed with remarkable efficacy. Deep-brain stimulation had previously only been used on patients suffering from Parkinson's disease, to stop their tremors.

The idea of having electrodes implanted into my brain does not sound immensely appealing. Rats who have had electrodes implanted in their lateral hypothalamus will starve themselves to death, in order to press a lever thousands of times an hour, to stimulate their brains. Do humans who have had the same procedure, just stay at home hitting the button as often as they can? We have wandered into the territory of the neurological basis for addiction.

This is how I arrived at my decision to use a medication that helps people to quit smoking.

My very first addiction was to nicotine. I had no choice in the matter. My parents forced me to breathe their second-hand smoke. Because I was a tiny child, the concentration of nicotine in my bloodstream would have been very high. Second-hand smoke was responsible for inflicting an addiction onto me in my infancy.

In the UK, nightclubs, bars and pubs used to be filled with smoke, until July 2007. My addiction was therefore maintained through passive smoking. The timing of the ban seems to correspond with my first episodes of depression.

The stop-smoking drug called Zyban is actually France's most popular antidepressant. The French have found that Bupropion - the active ingredient in Zyban - is also effective for treating alcoholism. The link between addiction and depression seems clear.

I have a theory that my brain is in mourning. I was subjected to second-hand smoke throughout my childhood, and I spent a lot of time in smoky clubs and pubs. Nicotine withdrawal was something I was used to experiencing again and again, but what I'd never been through was a prolonged period of withdrawal, because I would regularly get a hit of second-hand smoke. It wasn't until the age of 27 that I was finally able to escape nicotine, because of the smoking ban, even though I have never smoked in my life. You would expect that such a prolonged addiction would produce a profound psychological effect, when my brain realised it was never getting any nicotine ever again.

I then experienced a later period of addiction. Although there were periods of abstinence, these never exceeded 3 or 4 months, and the total amount of time that I struggled with addiction is close to 5 years. The addiction was extreme. The drugs I was using have a much more profound effect than cigarettes. Still today, after 6 months of total abstinence, I get shaky sweaty hands and feel sick with anticipation at even the merest thought that I might be able to obtain some drugs.

Although Bupropion is a poor substitute for the addiction I once had, it does at least slightly soothe the aching sense of loss... the mourning.

Thinking about this more now, it seems obvious that I should mourn the loss of the love of my life. My addiction was so obsessive, overwhelming, all-consuming. How on earth can you let something like that go, with just a 28-day detox, or a 13-week rehab, if it's been a huge part of your life for years?

It should be noted that my mental health problems, which predated my addiction, compound the problems. To give an official name to my ailment: it's called dual-diagnosis. That is to say, Bipolar II & substance abuse. Yes, substance abuse is a kind of mental illness. Take a look at the kind of self-harm that addicts are inflicting and tell me that's normal behaviour. That is why substance abuse is classified as a disease.

Bipolar II is a motherfucker, because it comprises both clinical depression and hypomania, which are both destructive. Therefore, I'm actually suffering with triple-diagnosis and trying to fix 3 illnesses... although the hypomania is something that most people with Bipolar II wouldn't give up, and substance abuse is hard to stop because of addiction.

I haven't had a hypomanic episode in almost a year, and I've been abstinent from drugs of abuse for 6 months, therefore the final nut to crack is this damn depression, which might turn out to simply be the fact that - subconsciously - I'm depressed that I can't take drugs anymore. It feels like the love of my life has died, hence why I'm describing it as mourning.

How long it will last, I have no idea, and I've lost patience... hence resorting to a mild form of substitute prescribing. I successfully beat addiction once before using Bupropion. I beat it using progressively weaker drugs, until I was weaned from my addiction.

You wouldn't ask a smoker to quit without nicotine patches. Why would you expect somebody with an addiction to harder drugs could quit with willpower alone? The only slightly unusual thing is that the stop-smoking drug seems to be just as effective for addictions to things other than nicotine.

Perhaps we will one day treat all addictions as compassionately as we treat nicotine addictions. Certainly, there doesn't seem to be a lot of appliance of science, when it comes to treating addiction to anything other than smoking.

Subjectively, cold-turkey & willpower is a fucking awful approach to beating addiction. We have the scientific data to show that smokers are 4 times as likely to successfully quit, with nicotine replacement therapy and smoking cessation medications like Zyban.

Of course, a relapse would be disastrous, but haven't I already relapsed back into depression?

I've been on medication for 5 days now, and Bupropion should start to be effective within a week, so perhaps I will feel an improvement in my mood any day now. Certainly, my suicidal thoughts seem to have stopped, but that could be psychosomatic and also because my horrible contract ended.

You see what I mean about how hard it is to control the variables? Human lives are messy and complex. It takes vast quantities of data to be gathered over many years, not a 6 to 12 week trial with 30 people.

Also, there's an argument to say that your subjective yardstick is altered by your experiences. Your perfect 10 can become unattainable, except through the use of powerful narcotics. Does that also mean that the best you can ever hope to feel is mildly depressed, now that the bar has been set so high? My only hope is that my brain "resets" itself over time. The brain can downregulate parts that are overactive, in order to maintain equilibrium, so it can also upregulate... eventually. The big concern is neurotoxicity: have I irreversibly "burnt out" the reward centres of my brain?

6 months isn't long though. I'm going to see what happens if I can make it to a year. Presumably, there might be marginal improvements that have happened already, but are too subtle for me to perceive. The data actually bodes well: instead of spiking back up into hypomania, things have plateaued during the last couple of months.

This unethical self-experimentation doesn't yield any results worth publishing but it does give clues as to what could be worth researching. A sample size of one is not statistically significant, but it's important to me, because my life depends on it.

 

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