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Emotional Instability

6 min read

This is a story about borderline personality disorder (BPD)...

Bipolar diagnosis section

If you've ever wondered about being detained against your will in a mental hospital - on a locked psych ward - then this is how it all begins... a 'section'. Being 'sectioned' means you're being legally detained under a section of the Mental Health Act (1983). The police can section you for 24 hours under section 136 of the Mental Health Act. After an initial assessment you might be sectioned for 28 days, under section 2. If you're assessed again you might be sectioned for 6 months, which is section 3. As you can see above I was sectioned under section 2.

I've been diagnosed and treated by 13 different psychiatrists. I've spent 10 weeks under lock & key on psych wards and a total of 18 weeks as an inpatient, receiving treatment for my mental health problems.

All the psychiatrists agree: I have bipolar disorder.

One unqualified doctor has been so bold as to ignore the fact that they completely failed their psychiatric long case, and ignore the fact they're utterly incompetent when it comes to making a sound mental health diagnosis. This unqualified doctor apparently read a book about borderline personality disorder and then tried to diagnose me, despite their obvious shortcomings and prior failures in the area of mental health. That pissed me off. That idiot doctor ignored all the years of evidence and the unanimous opinion of 13 specialist highly experienced and fully qualified psychiatric doctors, because their ego is over-inflated, and frankly, they're a bit of an idiot arsehole.

So. I have bipolar disorder. That's beyond question - it's been confirmed and reconfirmed. I've had a second opinion. I've had a third, fourth, fifth, sixth, seventh, eighth, ninth, tenth, eleventh, twelfth and thirteenth opinion.

I did not ask for a fourteenth opinion.

In fact, I made it expressly clear that I DID NOT WANT another opinion... especially one from an unqualified doctor who skim-read the first few pages of a book. Especially an opinion from somebody who I think lacks empathy and compassion for vulnerable people. People with mental health problems aren't safe around that unqualified doctor, who doesn't seem to have taken on board the fact that they failed their psychiatric long-case and are therefore unqualified to be practicing psychiatric medicine.

Furthermore, when we are thinking about a borderline personality disorder diagnosis we have to consider co-morbidity.

If a person is under a great deal of stress due to housing, job, finances, relationship and other external influences, it is not possible to diagnose borderline personality disorder, because of the co-morbid adjustment disorder. Adjustment disorder is just a fancy way of saying "your life is hell right now". Naturally, it's not possible to unpick mental health problems from the stress and anxiety that anybody would be feeling when their life's in tatters.

Just as a little reminder... I'd been through a breakup with my girlfriend, had to leave my apartment in London, move to Manchester, start a new job, I broke up with another girlfriend, tried to kill myself, lost my job, lost my apartment in Manchester, moved to Wales to live with strangers, ran out of money, got another job, went to Warsaw, went back to London and ran out of money again. That is more than enough stress to give anybody adjustment disorder, making any new diagnosis impossible. There is too much co-morbidity.

Also, when alcohol and drug abuse are co-morbid, diagnosis is impossible. This does present a bit of a paradox, because alcohol and drug abuse are quite often present in cases of borderline personality disorder, but they are also very often present in bipolar disorder too. There's a specific diagnosis for that co-morbidity: dual-diagnosis.

I know a lot about dual diagnosis because I spent 4 weeks in hospital seeing the country's leading specialist almost every day, and I continued to speak to that specialist regularly for a long time after I was discharged from hospital. While substance abuse was a problem in my life, my diagnosis was quite clear: dual-diagnosis (bipolar disorder & substance abuse disorder).

Finally, we must consider loss of status.

There are excellent data showing that loss of social status causes emotional instability. If you think about it, it's pretty obvious. Imagine that you lost your wife, your kids, your job, your house, your car, all your money, the respect of your friends & family... do you think your self-esteem would be intact? Do you think you'd be fine with that and you'd be carrying on with your life like normal? Of course you'd be emotionally unstable - it's a normal human reaction to that devastating loss of social status. You can't just say "it's just stuff" because it's not - it's intrinsic to your identity and your sense of wellbeing.

It's not possible to diagnose borderline personality disorder - also known as emotionally unstable personality disorder (EUPD) - when there are concrete and undeniable external factors that would contribute to a person's loss of self-esteem, social status and consequently make them emotionally unstable. It's simply not an appropriate diagnosis for somebody whose whole life has collapsed and is in ruins.

The arrogance of Dr Death to attempt to give an unwanted and unqualified fourteenth opinion, ignoring the unanimous verdict of thirteen highly qualified and experienced specialist doctors, is highly offensive and antagonising. This opinion was aggressively thrust upon me when I made my wishes crystal clear: "do not diagnose me, Dr Death, because your opinion is worthless unqualified irritating tosh that will only upset and anger me". The fact that Dr Death proceeded to do what the f**k they wanted anyway only serves to further prove how arrogant and lacking in any compassion they are... this is a person who's not even my doctor.

So, please don't play pretend-psychiatrist and give me your amateur diagnosis... I've spent 10 years in and out of the mental health system, and I've done extensive research of my own. Shove your crackpot theories about me up your ass.

I dearly wanted to get to the point where I've been symptom-free and medication-free for long enough to declare I'm 'cured' but for now I reluctantly accept the opinion of 13 very experienced and qualified specialist psychiatrists, who are experts in their field and highly respected. I accept their opinion - that I have bipolar disorder - and I reject f**king idiots who skim-read a few pages of a book and hardly know me. F**k off Dr Death.

I was disappointed to learn that I probably have type 1 bipolar disorder, not the milder type 2 that I thought I had, but I've had 6 months without medication and without an episode, so I seem to be managing the illness very well, especially considering the fact that I've moved 4 times, been in hospital twice, attempted suicide once, had 3 jobs, been through 3 countries, bought a car, narrowly escaped bankruptcy three times and finally managed to rent a new apartment and have a healthy happy relationship with a lovely girl. I mean... sheesh... that level of stress would send anybody insane, wouldn't it?

So...

I have bipolar disorder. That's it.

 

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Alcohol as an Anxiolytic

4 min read

This is a story about self-medicating for anxiety with wine...

Recycling

I keep my empty wine bottles behind the kitchen dustbin. The collection of bottles waiting to be recycled has grown very quickly, given that I've been polishing off at least a bottle of wine every day for months. Wine has been my unhealthy coping mechanism. Wine has helped me to get through 4 solid months of work, living out of a suitcase, dating, courting, buying a car, renting an apartment, moving home, two different jobs, three different countries, 12 AirBnBs and countless other anxiety-creating things.

It should be noted that during the last 4 months, I also quit a neuropathic painkiller called pregabalin, and a sleeping pill called zopiclone. The net result of quitting those medications was a vicious rise in my anxiety levels, as a result of the rebound from stopping taking them: withdrawal syndrome. It's hard enough to get off pregabalin and zopiclone under normal circumstances, let alone when you have huge upheaval and stress in your life.

A little over 6 months ago, I quit diazepam and alprazolam, which are both anxiety medications. They're better known as Valium and Xanax. They're highly addictive, and stopping them can cause a discontinuation (withdrawal) syndrome that can last for months and create unbearable anxiety levels.

So, the circumstances have created a hell of a lot of anxiety... a ridiculous amount of anxiety.

Alcohol has helped me to wean off the addictive medications and become medication-free. Alcohol has helped me to cope during incredibly stressful times. Alcohol has been my anxiety medication, during a time when my stress and anxiety levels would be unbearable for even the toughest person.

The ubiquity of alcohol is about the only good thing that can be said of it. Alcohol's effects are short-lived. Alcohol is a poor sleep aid. Alcohol is very unhealthy. However, it's not desirable to take benzodiazepines, Z-drugs and painkillers on a long-term basis, because they all quickly build tolerance and require a bigger and bigger dose to be effective. Valium also has a very long half-life, so you are affected by it 24 hours a day once it reaches a steady concentration in your bloodstream. At least with alcohol, you sober up pretty fast when you stop drinking.

The body's ability to eliminate alcohol is very impressive. Tonight is my third night without a drink and I've suffered no ill effects from abruptly stopping my daily boozing. It would be expected that I might get the shakes or something, given my chronic self-administration of large quantities of alcohol over a long period, but that's simply not the case - I just stopped and I'm fine.

My sleep was a little disturbed last night. My body and brain are re-adjusting to life without copious amounts of wine being tipped down my throat. I'm not feeling the benefits, and if anything I'm feeling a little worse than I was when I was drinking every day. That's to be expected: my body's repairing itself. The booze has been very hard on my body.

I've gained weight and I just feel unhealthy from a winter of misery, where I drank vast quantities of wine. I really need a mini-detox. I thought about having a sober April, but I don't see the point. Drinking in moderation is what I'm aiming to do, so I'll have a little break and then I'll try to drink less.

Having a break from drinking is important, because I need to get into better drinking habits now that the shitstorm of stress has passed. There was no way that I was going to be able to do anything healthy while I was still heavily dependent on alcohol as a crutch, during a really horrible period of my life, but now things are improving and my life is a lot more manageable.

Perhaps I'm one of the lucky ones who can take it or leave it. Perhaps I'm just normal - I'll use whatever's available and my behaviour is dictated by my environment. During stressful times of course I'm going to hit the bottle. During happier times, of course I'm able to make healthier lifestyle choices. Seems obvious, doesn't it?

So, alcohol's not great, but it's not all bad either. It helped me get to where I've got to today.

 

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Comorbidity

10 min read

This is a story about a sick man...

Psychiatrist letter

I didn't drink last night or tonight. I've stopped taking sleeping pills. I've stopped taking anxiety medication. I've stopped taking tranquillisers. I've stopped taking sedatives. I don't take antidepressants. I feel very unwell.

I woke up and I thought about getting some rope and going to find a tree to hang myself from. I've not really thought about hanging much, but it's been on my mind. I think about a last minute change of heart, where I might try to take the weight off the noose, but it would be futile - I would try and I would fail. I think about the uncomfortable final couple of minutes, where I'd be panicking as the hypercapnic alarm response would make me thrash around, trying to get air into my lungs. Hanging would be a brutal way to die, because I imagine that I'd be conscious for quite a lot of it, then I'd lose control of my bowels and some poor sod would find me strung up with soiled underwear. Somebody would have to cut down my lifeless body. Anyway, that seemed like one of the options this morning.

This should be a happy period of my life. I'm not homeless, I have friends, a girlfriend, money and a car. I'm not a drug addict. I'm highly employable. I have my physical health, mostly. I've got a local job which is very well paid.

What's going on? Why am I so depressed?

I'm trapped. I can't go backwards. I can't stay still. I can't go forwards. I need to keep moving forwards, but I've run out of rope; I'm at my wits end.

I should have taken some time off in-between the last job and the new one, but that's not the way things worked out. Make hay while the sun shines, they say. Don't look a gift horse in the mouth, they say. Somebody opened a briefcase of money, tempting me with it, and it seemed like a good idea at the time. It is a good idea. It's a really good idea to have a really well paid job that's a short distance away from where you live. The problem is, I've got nothing left to give.

I can't fail. I can't falter. I have to succeed. I can't go back. I can't stand still.

I'm so desperate to feel better, but I know that the answer doesn't lie in pills. I know that to take antidepressants would send me manic. I know that pills aren't the answer. I'd love to feel a bit better though. My bank balance would love me to feel a bit better. It'd be nice if I didn't keep writing things that worry and upset my friends and girlfriend. Such is life. These are the cards I've been dealt.

What's important to me? It seems like it's all about work and money, but that's a good place to start. Without work and money there can be no future. Without a future there's nothing to hope for - I might as well just give up. This is the strange situation, where work is making me unwell, but without work I'll get unwell because I'll get into financial difficulties and I'll have nothing to look forward to except bankruptcy.

Just a little bit longer... if I can just work for a little bit longer...

How much money did I lose in January and February to ill health? Was it £10,000? What does it matter? I worked as hard as I could.

I've managed to buy a car. I've managed to get a local job. I've got a girlfriend. I've got some money in the bank. These are major milestones; major achievements. Things are looking up in my life.

I need to impress some new people; prove myself. I've got a new routine to get into. I've got a load of new stuff to learn, and not the fun kind of learning - this is stuff I'm expected to know already. I've got to give a good first impression - I can't turn up to work hours late every day; I can't let on that I'm not very well.

I'm sick but I can't afford to be. I'm sick but there's too much at stake. I'm sick but I don't want to lose the amazing opportunity that's fallen in my lap. I'm sick but my life looks perfect in a lot of ways - why am I sick?

I don't want to accept that I'm sick but the anxiety and depression are unbearable. It's enough to drive me to drink, drugs and/or suicide. I want to run away from the source of stress. I want to hide under the duvet for a couple of months. I need to recover but I can't - there's too much work to do. I need time off but I can't afford to lose everything.

I'm the epitome of functional. I'm getting up and doing the things I need to do, even though it's destroying me. Somehow I keep putting one foot in front of the other. Somehow the things that need to happen keep happening. I'm keeping the plates spinning even though I'm sick. At times, I'm quite happy and contented. At times I'm a picture of good health and carefree joy.

I've worked hard - even if you don't think I have - to give myself some easier times. I've put up with horrible situations because I knew they'd pay off in the end. There has to be some reward, otherwise it wouldn't have been worth the stress and aggravation at all. It would be a lie to say that my life is purely miserable. Misery kind of stalks me though - I know it lurks just around the corner at all times.

"Cheer up... it might never happen!" somebody might say, but I really wish it would happen, because I can't stand the constant anxiety. I can't stand the fact that it is happening, and I know exactly how long it's going to keep on happening for because it's not very difficult to work out such things. I know exactly what to expect. I know exactly the way things are going to go. I know exactly what has to be done. I know exactly how awful it's going to be.

My mood would be a lot better if I could abandon all responsibilities and follow my mood. I know that time passes incredibly slowly when I'm having to kill time and suffer horrible periods with nothing to do at work. I know that it's incredibly toxic to my mental health to be solving the same problems I've done a million times before, but with a load of constraints that artificially limit me from being able to work and occupy myself - to keep myself busy. I know that isolation - working alone - is really unbearable. The last place on earth I should be right now is twiddling my thumbs, bored but chained to a desk with nothing to do and nobody to talk to.

I'm going through a difficult transitionary period. I should have taken some time off. I'm emotionally exhausted. I'm trying to switch mindset, from the isolation of the last job to the possibilities of a new opportunity. I know that I need to give it a few days, or a couple of weeks, to get settled.

Everything's so stressful and unsettled. I've got a new commute to get used to. Somehow, I've got even less of a home than I did when I was living in AirBnBs. I can't get changed. I can't have a shower. I can't take a shit. I can't make myself something to eat. How did I end up like this, with a stressful job and no place to call my own... no bedroom; no privacy. It sounds ungrateful, but it's just a description of my current situation, at times. It could be worse, perhaps - I could be homeless; destitute. I could be additionally isolated and lonely, living alone. It could be worse... it could be worse... it could be worse. There is gratitude, but there is also a heap of stress and anxiety that's beyond what I can cope with. I am grateful, but I'm also struggling.

What do I want? Do I want everything to be perfect right now? Do I want easy solutions, like swallowing pills? Do I think somebody should gift me everything I need, all wrapped up with a bow? Do I expect somebody to just give me the keys to a place of my own and wave a magic wand to move all my stuff? What about friends? Should I just snap my fingers whenever I need them, and snap them again when I don't want them around?

I don't know about any of this stuff. All I know is that I woke up and I thought about finding some rope and a tree to hang myself. I thought about walking out of the perfect opportunity that's fallen in my lap. I thought about letting everything go to hell in a handcart, because I've reached the end of my tether. I don't know why I think this stuff. Maybe I'm a bad person. Maybe I'm an ungrateful little shit. Maybe I should just fuck off and die.

I don't know what I'm going to do. I'm going to have another alcohol and sleeping-pill free night and hope that these awful feelings subside. I'm going to hope for a better day tomorrow. I'm going to grab my black holdall and take the show on the road.

I'm sick, but do I have to be? I think I know where the problems are. I think I know the solutions. I know that nothing's going to be perfect. I know that life is full of compromises. All I can think to do is to keep trying to set things up so that the very least number of things are causing me distress. I keep reducing the number of things that are unpleasant and broken, in the hope that at some point things start becoming a bit easier, because at the moment there are too many times when life's unbearable.

Maybe I need to quit drinking. Maybe I need a drink. I don't know. Too much change and too much that's unsettling. I've lived out of a suitcase for far too long.

Yes, underlying mental health problems are the obvious thing to point to, but what's the solution? Of course the little bit of me that's got some survival instinct left thinks that being medicated up to the eyeballs, living in a council house, supported living or institution is preferable to death. Is being alive without dignity or hope preferable to this life that's a fate worse than death? Isn't it all the same anyway? If the rewards aren't there and the suffering is unbearable, why bother?

I managed half a day in my new local job, and I felt sick, sick, sick.

Maybe tomorrow will be better. If it's not, I don't know if I can carry on.

 

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Emotional Exhaustion

8 min read

This is a story about a functional nervous breakdown...

Collapsed bed

I'm sleeping 12 to 14 hours a day, yet I don't feel refreshed. I'm commuting and I'm working, but I'm spending less than half as much time in the office as I'm supposed to, and when I'm there I'm not productive. I reach the weekend and all I want to do is collapse in a heap. I get stressed out about seemingly trivial things - buying a train ticket, booking a hotel, buying some birthday presents, social engagements, the pressure to be a good friend, the need to stay in contact with people. I feel like I'm going to burst into tears when I'm in the shower, or just before I walk into the office. I'm a complete wreck, but to an outside observer I'm a picture of good health and a productive member of society. My colleagues seem to have been duped - they compliment me on the work I've done and they want me to stay longer; they want to give me another project to do.

I had prepared myself psychologically for 6 weeks work in London, but it's been 3 months. I had prepared myself psychologically to get to the end of the contract, but not a single day longer. I'm barely managing to cover up the fact I'm very sick - I arrive in the office at 1pm most days, and leave just after 5pm. I don't turn up for whole days. I sit at my desk endlessly skipping through music, trying to find a song that will lift my mood, but I can't. Life's pretty torturous, even if there doesn't seem any reason why it should be.

Everything feels like it's going to require the expenditure of more effort and energy than I could possibly muster. I get exhausted at the thought of speaking to agents, or challenging myself to do something "new and interesting". What sounds like fun to you, is something that makes me feel even more anxious and depressed. I just want to curl up in a ball.

Those who are happy and healthy say things like "you're only one gym workout away from a good mood" or they suggest things I could do with my spare time. It doesn't look like much of a life, working and sleeping... oh I do quite a lot of moaning and complaining too, but surely I must want to learn to weave baskets or dance salsa, mustn't I? The truth is that I'm 99% shut down - I'm in survival mode, clinging on by my fingernails as I attempt to earn as much money as I can, as quickly as I can, so that I can afford to have a nervous breakdown.

"Nervous breakdown" sounds really shocking and alarming, but I'm actually quietly having a breakdown. I've had persistent paralysing depression for more months than I care to remember, but I'm somehow forcing myself to keep going. "You can't be depressed if you're getting up and going to work" you might say, but you seem to have forgotten that I'm bunking off loads of days, and going in to work 4 hours late on the few days when I do make it. I'm working the very bare minimum I need to, in order not to lose my contract. If I just collapse in a heap and refuse to leave my pit of despair, I lose everything. If there was any way in the world I could just draw the curtains and convalesce, then I'd do it, but I'm trapped by circumstances beyond my control.

I have a week and a half left to go, and then I've finished my contract in London. I have to do 4 more 3.5 hour train journeys. I have to stay in two more AirBnbs. I have to suffer two more Mondays (although I'm planning on bunking off at least one of them). It might not sound like very long - just 3 months - to have been travelling all over the place and doing a job that's been mostly isolating and lonely, and has left me twiddling my thumbs a lot of the time, but the time has really dragged... the time continues to drag.

When you're not feeling good, it really takes an emotional toll. It's really not nice to spend weeks and months, hating your life; hating your circumstances. Yes, I'm very well paid and there's no such thing as a perfect job, but the money really has not been great compensation for the psychological suffering it's caused. I'm perfectly capable of making a mercenary decision to earn a lot of money doing things I don't like doing very much, but it's damaging to my mental health. I really am at my wits end with the London contract.

Who knows what'll happen next. Maybe I'll have been made too unwell by the present contract to even think about the next one, until I've had some rest and recuperation time. You might think that I should be very well rested, because I've been having 3-day weekends and only working half days, but those things are a symptom of just how exhausted I am. It's very hard to explain how I'm emotionally exhausted, even though I seem to be physically rested. It's hard to explain just how draining things have been this year. Seasonal affective disorder, depression and a bit of residual rebound anxiety from medication withdrawal, have conspired to create a viciously awful low mood and sense of despair, which has been hugely exacerbated by being bored at work, with no colleagues to talk to or project to keep me busy.

Finding a new client locally is going to be stressful. I need to meet a whole load of new work colleagues and impress them. It's going to be exhausting. It's going to be destabilising. At the moment, I just want the current contract to be over, so I can curl up in a ball and not leave the house. I want to draw the curtains and turn off my phone. I want to collapse in a heap and yell "ENOUGH!"

It sounds to me like it's some kind of breakdown, but I don't understand why I'm still apparently quite functional. I don't understand why I'm not stripping naked and running through the streets, before smearing jam all over myself in the supermarket and talking in tongues, or whatever other image "nervous breakdown" conjures up in your mind. Perhaps you think of me uncontrollably sobbing, or going mute. Instead, I'm just kind of hollow and empty - I've got nothing left to give; the petrol tank has run dry.

The challenge, of course, is what I do next. Do I collapse and become so dysfunctional that there was no point in exerting myself? Do I lose all the gains that I've managed to achieve, because it was so costly to my mental health to push myself so hard? Have I stored up some kind of almighty breakdown, by limping along for so long?

I've been offered a contract extension. There's no way on earth I can do it, of course. Don't you understand? The money might be incredible, but I don't get paid if I'm not in the office, and I'm already almost at breaking point. Money's not going to get me out of bed. Almost no amount of money is worth the emotional damage that's being done; the emotional exhaustion of the situation.

Of course, there's an argument that I should have just taken medication to prop myself up artificially - to allow myself to be doped up and carry on with a job and a situation that's intolerable. There's an argument to say that it's me that's faulty, for not enjoying living out of a suitcase, working a project that I finished ages ago and just having to look busy, in an office all on my own with nobody to talk to. There's an argument that says it's me being a silly billy, and I should just pop pills and shut the f**k up and get on with life. That's life, right? Life absolutely sucks and it makes us want to kill ourselves. Life destroys every single ounce of happiness and wellbeing, and the only way to put it back is with powerful psychoactive medications.

On the flip side, I've been glad that I've kept my mouth shut and limped along to the end of contracts before, without making too much of a fuss. I'm going to get a good reference and I've earned quite a lot of money. This is the strategy: short-term pain for medium-term gain. I've left jobs on good terms before, and then found it's immensely improved my mood to free... free to do what I want; free from the oppression of a horrible job. I very much expect that my mood will improve massively when this contract is over.

There it is: I need to keep venting and complaining and whinging, because I've got another week and a half of hell to get through. It sucks, and I bet you wouldn't put up with it if you were in my situation.

 

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Stubbornly Refusing to be Cured

12 min read

This is a story about being bloody minded...

Hospital wristband

I've been subjected to the most bizarre accusation: That I can "get better" anytime I want; that I enjoy being depressed or somehow need to have a mental illness because it's part of my identity; that I want to be unwell. Part of the accusation hinges on my Twitter following - I'm accused of being two-faced: Writing blog posts and tweets which don't somehow manage to convey that sometimes I'm not suicidal.

I'm a bit confused to be honest. I don't think I could be any more authentic. I don't think it would be possible for me to be any more candid and open. My blog isn't supposed to be a diary, accurately recording the day's events. My blog is therapy for me - I write about the things that are upsetting me the most; the things that are causing the most pain and anguish.

Perhaps I'm being given credit where no credit is due. Perhaps I'm perceived as intelligent enough to be able to rationalise away my problems and force my moods to bend to my will. Perhaps the decisions I've taken out of desperation have been mistaken for choices. Perhaps my determination to stick with a plan which will boost my finances and continue to give me a lucrative career, is seen as deliberate self-sabotage: I'm purposefully making myself sick, in the eyes of my accuser.

I can see the positives and the negatives of different "choices" without assistance from somebody else to help me 'see'. I'm not so cognitively impaired that I need somebody to point out the bleedin' obvious to me. For everything that I moan about because it's making me ill, there are many benefits which make my choices worthwhile. My work, travel and living arrangements are not conducive to good mental health, but neither is poverty and hinderances that would make me less employable. The playing field is not level. I do not get to make unbiased choices - I've got to do what I've got to do, even if it's unpleasant.

I'm accused of being the problem. It's not the job, it's me. It's not the commute, it's me. It's not the lonely AirBnBs, it's me. Apparently, everything's all my own fault and I can choose to be healthy and happy any time I want, according to my accuser. Personally, I think that life's a lot easier when you've got money behind you and you've got a stable home life. Personally, I think that we are healthier and happier when we get the pieces of the puzzle in place: friends, family, a home, an income, financial security and something we're passionate about. Let's leave aside the blame game of how I ended up in the present situation. We can even assume that everything's all my fault if you want to, but that doesn't change the fact of the matter: I am where I am and I need to get back on my feet. Blame doesn't change my needs. Blame doesn't change my situation or my mood. To accuse me of fucking up my life AND deliberately keeping it fucked up is dumb. One of the big reasons why I'm suicidal is because I've tried so hard to fix the things that are broken, but it's been a miserable exhausting experience and my life's still pretty messed up. I really am trying very hard to get things sorted out. It's a lot easier said than done, I'm afraid. Sorry about that.

I think there's a lot of ego involved. People want to be helpful, but then they start thinking like they've understood me and I can be 'cured' with simple solutions. When the simple solutions to an oversimplification of my problems don't work, then the 'helpful' people get annoyed with me... like I'm deliberately messing up their useless suggestions. I seem to have really frustrated my accuser, that I'm so determined to be a real living person, with a real life, instead of some simple little thing that can easily be fixed. "Oh I'm so silly! How brilliant of you to point out the completely obvious solution to an easy-to-solve problem that I don't have! Thank you!" I'm expected to say all the time, on top of dealing with real life.

There aren't any quick fixes. Things take time and effort to get better, and it's exhausting. Things have to be done in the right sequence. Sometimes, it costs a lot of money to make changes. Sometimes we have to wait for the things we want and need, because we can't get them immediately. I can't - for example - switch jobs until I have a financial cushion to give me some runway to make the change. Every change I make brings with it a whole new set of problems, so I need to deal with things in a step-by-step way. There's a plan, even if somebody thinks that I can just teleport straight to the end goal. Sadly, life doesn't work like that - we have to suffer in the short and medium term, to achieve our long term objectives. You have to pay to play.

I'm not short of ideas for what to do when I have surplus time and money. I'm not short of ideas of what I'd do if I could do anything, because money's no object, but it's bullshit to suggest I'm able to just abandon my current source of income and go off and do something else. I can't be a student again. I can't be a poet or a dog walker or a sculptor or a circus clown. Life doesn't work like that. Even if I took a shitty McJob, I would still need to afford to travel to work every day for a month or so until I get paid. How do you think capitalist society even works? I'm making smart economic choices which are painful at the moment, but will give me the financial means to pursue something more rewarding and better for my health. I'm giving myself the working capital to be able to pick and choose my next options.

I might have spent some of today playing like a big kid and enjoying myself, but that doesn't mean that my mood can't be plunged dangerously low when reality bites: Monday morning will come around, along with the realisation that almost nothing in my life is quite where I want and need it to be. There's so much unpleasant hard work ahead, and so little reward in the short term, that it's quite understandable that I'd get worn down and decide to reject life altogether. What looks like a few short months of hard work to you, is somewhat of an insurmountable obstacle for me, because of the journey I've been on. I've fought my way back from nothing, and I'm still fighting, but yet it feels like I'm getting nowhere. Where's the reward for my effort? Why is life still so miserable, most of the time?

In the company of my friends, or going on a date with a girl - for example - life can briefly seem wonderful, but the bulk of my existence feels like packing and unpacking bags, moving from place to place, sitting at a desk and hating every second... unsettled and unpleasant. The dread of the rat race - the treadmill - is enough to cast a dark shadow over other times. When I should be enjoying the last few hours of my weekend, I'm already depressed about another week shackled to the job I do out of economic necessity. I make a fuss, but it's not over nothing and it's not me. I'd pick up dog shit if it paid as well as my current job... at least it would feel like I was making a real tangible difference to my local community, if I was doing something like that.

There are a whole raft of issues at play, including my desire to be free from medications. It might seem obvious that my depression could be 'cured' with pills, but it wouldn't be a cure - my depression is a reaction to my toxic circumstances. I don't want to become medication dependent, when I've worked so hard to wean myself off so many different pills. I'm quite close to being 100% substance free.

I want to plan a holiday. I want to buy a car. I want to dream, but dreams require money. The dreaming part is the easy bit. Life's a lot more complicated than it seems for a casual observer. It's easy to come up with a million "you should do..." ideas, but they're infeasible if you don't have the time, money, company, energy, motivation and a million other things that are the product of getting some building blocks in place: a home, a girlfriend, some friends, a tolerable job, some money in the bank, disposable income etc. etc.

There are myriad broken things in my life, and no quick fixes. If I haven't fixed something yet, it's not because I want it to be broken. I'm not choosing to be depressed. I don't want to be sick. I'm perfectly capable of imagining a life that would be healthier and happier, but it takes time, money and energy to make it happen.

Moaning on my blog is what I do for therapy. Moaning on my blog is what I do, because it's cheap and it helps me to limp along while I'm getting the cash together to be able to do whatever I want to do next. Moaning on my blog is not my identity - it's my outlet because there isn't any other healthy way to cope. I'm trapped by circumstances and there's no escape, except through the path I've "chosen". I do not choose to be depressed, miserable and suicidal.

I don't know why I'm accused of being the architect of my own depression, when I'm working so hard to fix my life. The accusations don't even make any sense - they just seem to be an egotistical version of "have you tried being more simple so that I can solve the problems that you don't have?" and "have you tried being me instead of you, because I think I'm great?".

I've exhaustively documented the challenges that I'm facing. It upsets me that somebody would want to oversimplify things, just because of their own ego and a desire that I should blame myself and generally feel like I'm lazy and stupid, despite the fact that I HAVE TO LIVE 24 HOURS A DAY WITH SUICIDAL DEPRESSION and I'm the one who does all the actual hard work fixing my life. Pointing out the blatantly obvious is not a hard thing to do. Leaping to incorrect conclusions is not a hard thing to do.

There is a prerequisite condition for having an opinion on "what's wrong with me" which is to have read what I've written. If you want to know what's wrong with me, I've exhaustively documented everything I'm going through right here. If you want to tell me what I should and shouldn't do with my life, it needs to take into account the reality of my day-to-day existence, which I have accurately explained the most challenging parts of on this blog. If you want to give me "you should..." type instructions, then they need to be grounded in reality or else I'm just going to ignore them. Please don't get upset when I ignore your unhelpful suggestions. Please don't accuse me of wanting to be miserable and depressed.

I've written more than I intended to. I'm wondering why I'm writing. What's the point? But, that's what this blog is. It's not an attempt to manipulate sympathy out of my audience. This is a living document that records my distress in unflinching detail. This is where I pour out all the stuff that's really upsetting me. Here's where I work things out that are going round and round in my head. This is therapy for me.

One other accusation that I've faced is that my blog is making me sick - my blog is causing me to get stuck, ruminating on things that I'd otherwise let go. I think that's bullshit. My blog is where I've been able to finally let go of things that have been upsetting me. It's taken a long time, and I've repeated myself A LOT but that doesn't mean it's not working. If you take a lazy glance, you might think that I always write about the same stuff and that I'm therefore stuck in a rut, but if you look at the full story, you must surely see that I've been through some pretty traumatic stuff and this blog has helped me to cope. Writing is my healthy coping mechanism. People don't often pull through the things I've been through, and go back to being healthy happy productive members of society. I give credit to this blog for allowing me to deal with things that would otherwise have caused me to lose my mind.

I could probably edit this down, or just delete it and rewrite it, but I'm going to publish it because I want the public scrutiny. I want to document what I'm going through. I want to capture a piece of my consciousness, without censorship.

Yes, I'm lashing out, but I don't deserve to be accused of not helping myself, when I'm working so hard.

 

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The Relentless Manipulation of my Moods Using Every Means at my Disposal

9 min read

This is a story about music...

Out clubbing

The only things that seem to be capable of making me cry at the moment are Disney movies and a 90-second passage from The Tempest, which is about dreams and sleep. I quote it now for your interest, and as I write this big salty tears are rolling down my cheeks:

Our revels now are ended. These our actors,
As I foretold you, were all spirits and
Are melted into air, into thin air: 
And, like the baseless fabric of this vision, 
The cloud-capp'd towers, the gorgeous palaces, 
The solemn temples, the great globe itself,
Ye all which it inherit, shall dissolve
And, like this insubstantial pageant faded, 
Leave not a rack behind. We are such stuff 
As dreams are made on, and our little life 
Is rounded with a sleep.

It seems remarkable to me that I'm not able to resist the mawkish and emotionally manipulative thrust of the Disney movies, and I blub in all the right places and even some of the wrong ones. To accuse me of being emotionally unstable or having a tendency towards inappropriate emotional responses to situations, is grossly inaccurate and untrue. I would agree that I'm unguarded; trusting... a little vulnerable and certainly quite naïve, although I would argue that I prefer to be naïve than cynical and guarded.

In terms of protecting myself from whimsically falling in love and getting hurt, I would say that I don't protect myself at all. My emotions go where they want to go and I let them. I use the "L" word very sparingly and tend to distrust strong emotions, viewing them as transient; fleeting. I favour loyalty above everything else. I've got no time for game playing and wimpy wusses who are afraid of getting hurt.

Under a railway arch in Vauxhall, I experienced what the children of doting parents must experience their whole lives - to be loved, cared for; adored. I felt a sense of contentment and security that had been absent throughout my bullied childhood. I felt the warm embrace - the hug, if you like - that had been absent in my life and had turned me into an insecure person who completely lacked self-confidence and a sense of identity. I'd been through 8 schools and lost countless friends due to my druggie alkie loser parents not giving a shit about the damage they were doing. The experience of clubbing under the railway arches was curative - this was the love that had been sorely absent in my life. The catalyst? MDMA.

Fifteen years later, my marriage was collapsing. I needed to go to hospital. I was admitted to The Priory thanks to my private health insurance.

It's actually unremarkable that I grew out of a brief period where I dabbled with recreational drugs - ecstasy - and went on to have a 15-year blemish-free career, before the stress of a toxic and abusive relationship tipped me back into the very state I was in when I was a child: in desperate need of some unconditional love. It seems obvious that depriving a person of their identity and security, and bullying them, would result in trauma and psychological damage. It seems obvious that the same negative stimuli would elicit the same negative response.

While I was in The Priory, I handed in my iPod after a couple of weeks. I had decided that I was using music as a way of manipulating my moods, in a similar manner to people drinking, smoking and using drugs, in response to stress and other negative situations. I decided that if I was going to take treatment seriously, I would have to avoid things which I could use and abuse to alter my mood.

Presently, we seem to think it's virtuous to deny ourselves all the things we enjoy. Cream cakes (too fatty), fizzy drinks (too much sugar), beer and wine (alcoholic), masturbation ("wanker", "tosser" etc.), spending money (too fun) and all the other things that make life mildly bearable are given up for January, while we run on a treadmill in a gym, or lash ourselves with a bunch of nettles or whatever the f**k it is that 'virtuous' people do these days.

When I was seized with the notion that pure devotion to a 'natural' life would lead to happier, healthier times, it became as obsessive as anything else that might be characterised as an addiction. I became addicted to making every single tiny health tweak in my life that I could. I cut out dairy and gluten. I washed out my sinuses with saline. I probably would have done colonic irrigation if I'd thought about it at the time. The whole thing was dumb - pure superstition and pseudoscience.

Today, I take dietary supplements - 5-HTP, tyrosine and magnesium - which are supposed to provide my brain with the building blocks it needs to restore normal mood and improve my sleep. However, I've also abused simple amino acids and even pure dopamine - in the form of L-DOPA - to put my brain into a completely unnatural state, with the intention of achieving an otherwise unattainable euphoria or level of performance.

I've abused stimulants to stay awake and give me the energy to dance all night. I've used prolactin-suppressing medications to allow me to have multiple orgasms. I've used erectile dysfunction medications to allow me to sustain an erection for priapic lengths of time. I've used drugs to move my mood up, down and sideways - attempting to 'play god' if you like.

How many drugs and medications have I tried? Two hundred? Three hundred? More? This is not hyperbole - I had the time, the money, the determination and the means.

If you think I'm an idiot who makes bad choices, I ask you to look again. Imagine what my upbringing was like before I discovered that there was this chemical - MDMA - that unlocked me from that miserable prison. Of course I was going to mistakenly believe that it was a trick that could be repeated. In my desperation to escape a toxic abusive relationship 15 years later, I tried heroin, crack and crystal meth - amongst innumerable others - and none of them grabbed me. I methodically worked my way through everything I could get my hands on - illegal drugs, legal highs and black-market prescription medications.

The net result was not a predictable one. Instead of being dead in a ditch due to poly-substance abuse, I'm now quite averse to any psychoactive substances. I'm one of the few people you know who doesn't drink caffeinated beverages. That I'm unmedicated for my mental health problems is not because I think I'm "well" but because I know that I prefer to suffer the symptoms - very few people you know are prepared to tolerate depression and anxiety, but I do so on a daily basis without medication to assist me.

There's a part of me that wants to quit carbs, quit booze and join a gym, but frankly I've got enough shit on my plate just trying to get up in the mornings and not kill myself.

I loosened the purse strings and bought a few new clothes at the weekend. I went on a couple of dates. I'm listening to euphoric dance music, eating what I want to eat and drinking quite a lot. Fuck it. Life's too short to be miserable.

Last night, a woman ran up behind me as I was crossing the road and started asking for money. I said "sorry". She launched into an escalating level of abuse, accusing me of saying "no" and for toying her when she was "begging [for my] help". She was too busy yelling and screaming horrible names at me to be interested in the fact that I would've helped her, absolutely. In fact I still would. Fuck it, even if she was just rattling for "B and white" (heroin and crack, also known as "dark and light") and she was short for the score, I'd have helped. You've got to acknowledge the complexities of life and human nature if you want to help anybody. Expecting everybody to be gym-going, kale-eating, alcohol and drug free totally fucking ridiculously 'virtuous' people is absurd. Most of us have a vice.

When I think about how long I lived without my cat to stroke, and without the pleasure of snuggling with a girl I'm really into, I'm surprised I made it this far. What's the point of life without a good healthy dose of oxytocin? Is life even liveable without the bonding hormone? I really don't think it is.

So, as we approach the end of Jinxed January, I'm throwing caution to the wind little by little. I'm buying myself new clothes and having a haircut, because it's great for my self-esteem. I'm dating and having sex because it's fucking awesome. I'm letting myself do a million little things that just make my day a little bit more bearable, because that's what life's all about if you don't want it to be suicidal misery.

There's a chance that all the little changes in my life will destabilise me. It's all quite stressful, even if it's also fun. I'm quite well aware that something as simple as a late night can throw my world into quite a lot of chaos, but sod it, life's too short and I've waited and been sensible for long enough.

I don't think I'm going to go clubbing and take any MDMA any time soon though.

 

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Lifestyle Choices

6 min read

This is a story about non-pharmacological interventions...

Clinical psychology

The word "choice" is a little unfair. To suggest that people could help themselves by making better lifestyle choices assumes that our choices are unbiased. It seems obvious that we'd choose low-fat, low-carb, low-salt options because they're better for our heath, but we're biased towards things that taste nice. It seems obvious that we'd cut alcohol, caffeine, drugs and medications out of our life, because they all have nasty side effects, but we're biased towards things which make us feel good. It seems obvious that we should work less, spend more time with our families and not commute so far, but sadly it's not easy to up sticks and move closer to our jobs and often we have to do jobs we hate because we need the money.

At my meeting with a psychiatrist today we essentially agreed that I can manage my disposition towards mood disorder using lifestyle choices, but it's going to take a lot of hard work. I need to exercise more, I need to change my job and I need to cut down or even quit my alcohol consumption. As well, I need to continue to have strict bedtimes, avoid caffeine, dim the lights after dusk, use a light box in the mornings and eat a balanced diet. I also need to resist the urge to spend money, take risks, be promiscuous and dabble with drugs. All fairly obvious stuff, but none of it is much fun.

Aside from some disagreement over whether I'm type 1 or type 2 bipolar, and the severity of my illness, I actually got on pretty well with the psychiatrist. To hear the words "you have a chronic condition that cannot be cured" is not very nice and my instinct was to argue that I don't have a condition at all - my symptoms have been a product of my environment; caused by the stress of my situations I've been in. In actual fact, I concede that I've had symptoms of bipolar for as long as I can remember... it's just that my bosses and work colleagues have always been very understanding of my highs and lows. A lot of people would get sacked for coming in to work two hours late every day, or shooting their mouth off and throwing a tantrum in the middle of the office, but there's a place in the workplace for somebody who can work for weeks without any sleep when there's a crazy deadline to meet. I agreed with the psychiatrist that I've got a lifelong condition, which will need careful management. It doesn't scare or upset me, because I managed my condition effectively for years before things got dangerously erratic.

To hear lithium and sodium valproate banded around as potential treatments is not what I wanted. I prefer to think that I've got a mild form of bipolar which can be managed with a medication like lamotrigine, or no medication at all. I consider that my 'high' periods have been hypomanic because I had no grandiosity, psychosis or paranoia. The psychiatrist considers me to be a fully blown manic depressive, because my manic phases have lasted more than a week. I think we'll have to agree to disagree, because my mania does not seem at all severe, except when exacerbated by drugs and sleep deprivation.

I asked about talk therapy. There's an 18 month waiting list. I'm being referred, but 18 months is a heck of a long time to wait for psychological therapy. Getting some kind of talk therapy has become a crusade to me, because I first sought treatment in 2008, so it's been 10 years since I asked and I still haven't received any therapy.

In short, I think I agree that I have a certain amount of risk towards becoming really unwell, but it's not destiny. I have a lot of hard work to do, and I have to continue to make so-called smart choices, when really my life's not a lot of fun and I still have to figure out how to pay the bills somehow. I do agree that there's something about me - call it an illness if you like - that means I have to pay a bit more attention to my lifestyle than others might, who don't share the same predisposition towards mood instability.

I went into the psych consultation feeling quite unique and special. I was feeling pretty proud of myself for being unmedicated and having dealt with a lot of things that were definitely wrecking my life. Then the psych helped me see that a lot of people who are bipolar have a similar story of reckless risk taking, money spending, hyper-sexuality, drug taking, getting into conflict with bosses, drinking too much and all the other things that lead to a point where lives get utterly screwed up. I suppose there comes a certain point where a person just can't continue to live their life a certain way - the end of the road. Where my inclination was previously to commit suicide, I'm perhaps slightly erring on the side of trying to mend my ways and crawl back into normal society over broken glass.

I can see the temptation of a chemical crutch to aid my 'recovery' but I'm still pretty adamant that I'm going to go medication free. Actually, the psychiatrist agreed with me that something like sertraline, or even lamotrigine, could push me into hypomania. Antidepressants have always had a mood destabilising effect on me in the past. There's something to be said for feeling miserable: it does somehow make you appreciate the better times, when they eventually arrive.

So, it seems like a rather well-behaved life beckons for me. I don't relish the prospect of having to always make sensible choices, but I guess I'm not a young man who can bounce back from anything anymore.

Hardly thrilling, but the saga continues. I'll keep you posted on how it goes, doing the boring mundane stuff.

 

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Antipsychiatry

9 min read

This is a story about doing no harm...

Pile of pills

Imagine that somebody says to you "you're so argumentative". What could you possibly say in return? You can't say "no I'm not" because then they'll say "yes you are and the fact that you're arguing proves it". There are lots of other quirks of the English language that allow you to box people in, such as asking questions like "so when did you stop raping children?" or some other kind of fallacy.

I'm not actually against psychiatrists and psychiatric medications. Every psychiatrist is different. Most psychiatrists who work in the NHS have to deal with society's very sickest and most dysfunctional cases. Every psychiatric bed in England is filled with somebody who is being detained against their will for 28 days, or more likely for 6 months. There aren't any spare psychiatric beds for people who are merely having a crisis and who are in danger of committing suicide - the NHS will call your bluff and leave you to die, as so many do, because mental health services are overstretched and underfunded.

The kinds of treatment on offer vary from snake-oil bullshit, such as CBT and other behavioural therapies, to chemical coshes that will put you into the drugged equivalent of a straightjacket. For sure, there are some very sick people who are psychotically disturbed, but powerful antipsychotics are not a panacea for all problems of the mind. In some countries, physical restraints are more commonplace. In the UK, we dope people up to the eyeballs.

If you've never lost your liberty you won't quite be able to comprehend how terrible it is. We're free-thinking individuals who move through the world according to our whims - the illusion of free will. When locked into an overcrowded psych ward, even if you asked to be hospitalised because you feared for your own safety, you might suddenly panic that you won't be able to get back out.

Ironically, you can't say "I'm not argumentative" when somebody wrongly accuses you of being argumentative, and it's equally impossible to say "I'm not mad" when you're trapped by psychiatry. The only strategy you can play is to be calm and patient and ignore the provocation, which is easier said than done. It's a very natural reaction to want to defend ourselves against unfounded allegations. To have our character criticised by somebody who doesn't know a damn thing about us, is incredibly insulting. When somebody who hardly knows us has the ability to detain us against our will, and even to have us forcibly medicated, then the situation is unbearable.

I don't doubt that psychiatrists believe they have their patients' best interests at heart, but there's no acknowledgement of the antagonisation, frustration, anger and upset that they provoke. Nobody should have godlike powers over any other human being. The line between sane and insane, sick and healthy, right and wrong thoughts... these are completely arbitrary. There can be no ultimate arbiter who decides who's normal and who's not - it's not right that anybody should sit in judgement.

Am I arguing that we should fling open the doors to our asylums and let the mental patients roam free? It's more complicated than that. A survey of the general public revealed that the vast majority of people wouldn't want to live next door to, work with or have their children play with a schizophrenic. It seems that those paranoid delusions are not so paranoid after all - no smoke without fire. Having had my case reviewed at mental health tribunal to decide whether to give me back my freedom or not, it appalled me how six people could sit and have a discussion about me as if I wasn't even present in the room. To button my lip and remain silent through proceedings; to maintain my polite and courteous façade - this was virtually impossible when my liberty was at stake.

Another thing that's deeply upsetting is the way that the patient is often mobbed. Ward rounds consist of sitting with a whole room full of people - usually a couple of psychiatrists and a couple of nurses - who sit stroking their chins while the patient explains the same thing for the millionth time: please stop ganging up on me and let me go. Of course, there are mental heath problems present, but the set-up is antagonising. Should we just let anorexics stop eating and die? Should we just let the psychotic do what the voices tell them to do? This isn't what I'm arguing for. I'm just pointing out that even the most sane amongst us would be driven mad by a jeering crowd, licensed to torment and keep their victims in captivity.

If you imagine that you might get to spend 10 minutes with the psychiatrist who has the power to set you free, once every week or every fortnight, all the decisions are more important than I can possibly express in words. If you're on a medication which is causing you intolerable side effects, in a psych ward setting which is causing you intolerable distress, you're going to have to wait a couple of weeks before you can have another go at trying to communicate your needs to the doctor... which you'll have to do through the foggy haze of powerful antipsychotic medication. "This man is making no sense" they'll say, because you've been drugged into a dribbling mess. What further proof could be necessary to show that you're an imbecile who could never survive outside the protective walls of an institution?

Experiments were conducted by investigative journalists, who deliberately got themselves committed to institutions, only to find they couldn't get out again - the system grabbed them. The harder you fight the system, the more you're giving the system the 'proof' that you really are mad. It's maddeningly self-perpetuating.

Very few of us have the ability to bring our racing pulse back under control, to lower our respiration rate, to relax our muscles. Very few of us possess the ability to react to incredible stress, by calming ourselves and being patient. The most antagonisingly provocative situation will elicit the most predictable response: people don't like having their freedom taken away, told what to do and being judged by strangers who pry into every aspect of their private life.

To have captive creatures to toy with as we please must make those men and women who wield godlike powers feel very full of themselves. "It's for your own good" is the well-worn defence for the indefensible. The very nature of the relationship is toxic to mental health. Mental health treatment cannot be imposed by those who know best, because they don't know best - psychiatry is such a young branch of medicine. Nobody really has a clue what they're doing. Long-term outcomes are abysmal and the mental health epidemic continues to grow apace. Clearly, evidence-based medicine is not being practiced.

Of course I don't think that psychiatrists and mental health nurses and all the other people who offer medical and complementary treatments for ailments of the mind, are bad people. Of course they're not bad people. I don't believe there's a Big Pharma conspiracy. The truth is though, people are sicker than ever before and the treatments aren't working. My objection is with those who talk authoritatively as if there are useful diagnoses and accompanying medications and therapies which are making a profound impact... it's just not the case at all. What's happening is abysmal, and nobody is admitting they've got it wrong - a lot of people aren't sick, they just hate capitalism and modern society.

Good science means controlling the variables. I've aggressively cut out all psychoactive substances. Tomorrow I shall tell my psychiatrist that I'm debt-laden and forced to work a job that conflicts with my values and needs. My malaise is a function of the conflict in my heart, knowing that banking is a morally bankrupt profession, loan-sharking and taking advantage of the most vulnerable. My prescription? The end of capitalism and the return to a society where we're intimately connected to our local communities... do you think they'll stock that in the chemist?

Getting my happiness and contentment back in the current economic climate looks to be an impossible task. However, to medicate myself because I'm having a sane reaction to an insane world is not a good course of action.

Of course, my psychiatrist doesn't have the ability to cure me of my intolerable situation. I've got to work. I've got to travel to where the jobs are. I've got to pay my bills and service my debts. But, I don't need medical solutions to a non-medical problem.

Why even go to see my psychiatrist, when I don't think they can help me? Well, it's obvious isn't it? If we keep sending people away with pills, then we keep proceeding with our delusion that they're working and things are going to improve one day. How many times a year do you suppose a psychiatrist meets somebody who's foresworn ALL psychoactive substances, including caffeine and nicotine, and is a functional high-achieving member of society, to all outward appearances? To say that a medical problem - suicidal depression and debilitating anxiety - doesn't have a medical solution is heresy, but somebody has to stand up to those who dogmatically decree that they have the solutions, when they demonstrably do not.

Being unmedicated is really horrible and I feel terrible, but I'm being a bit of a martyr because I've got a point to prove. One day I will escape from the burden of debt, the soul-destruction of bullshit jobs and the need to commute long distances, preventing me from forming social bonds and having a work:life balance. One day I'll get a girlfriend and a cat and a home of my own and all the other things that humans need to feel complete, and then we can re-examine the situation and ask if I need medication. Until such time as the major problems in my life still exist, then medication looks like a dangerous option, because medication is allowing our society to develop into a grotesquely unhealthy form. Just because medication allows you to do awful things, it doen't mean you should do awful things. If it feels wrong, it probably is wrong.

A certain proportion of society will always struggle to abide by its rules, its laws and its social contract. A certain proportion of society will be criminals and parasites - anti-social. However, when the vast majority of us are struggling and unhappy, then we've made a wrong turn somewhere; we've made a mistake and we need to retrace our steps.

I refuse to be labelled and drugged.

 

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This Time Last Year I was F**ked

11 min read

This is a story about the hands of time...

View from the loft

I have a breadcrumb trail of images that allow me to retrace my steps and understand where I've come from and attempt to estimate whether I'm spiralling downwards or slowly recovering. If I look through my photo library at the images and videos that I captured exactly one year ago, there are three strange videos that I recorded, which clearly indicate that I'd had a major relapse. Three days later both my kidneys had failed, my left leg had ballooned to twice its normal size due to DVT and my blood was toxic enough to kill me at any moment.

Every year for the past four, I've had a Jinxed January. It's true that depression, hypomania and addiction have reared their ugly heads year-round, but January is a particularly awful time. I cured the November wobbles by writing novels. I cured the December wobbles by cutting my toxic parents out of my life. The next problem I've got is how to solve Jinxed January.

My present strategy is to shackle myself to my desk, doing a job that I absolutely hate and is completely incompatible with my mental health. If I can survive this January without doing anything stupid and self-sabotaging, I should have the wind behind me and a downhill stretch of road to help me coast into the spring. The odds will be increasingly in my favour as the days get longer and the weather improves.

I'm emerging from the fog of addiction, intoxicating medications and copious quantities of alcohol. It was impossible for me to really comprehend how bad things had gotten, while I had so much toxic crap in my body. I'd lost all perspective and ability to perceive reality. I struggle to relate to a lot of what I've written in the last few years, because that person who was under the influence of such vast quantities of drink and drugs feels like somebody else. I can read my own words, I can see the distress and I can remember the things that were driving my thoughts and emotions at the time, but not everything in my world was entirely real and grounded in reality. I'm not seeking to distance myself from the things that my body did - including saying and writing things - but it's a little bit hard to imagine that it was me. If you want to get obsessive about blame and responsibility, then f**k you, buddy... go read somebody else's blog you tiresome bore.

Of course, I feel very bad about the way I treated - for example - my lovely girlfriend who gave me a wonderful Christmas with her family, cared for me when I was in hospital, and was extremely nonjudgemental and understanding when addiction got its hooks back in me. I didn't treat her well in the end. I regret it and I'm sorry. I did that. I'm to blame. I'm responsible.

However, in the context of unpicking everything, I can see that there are repeating patterns and things that trigger other things - cause and effect are very complicated to understand. To fully understand the likely consequences and plan ahead, like playing a thousand simultaneous games of chess against grandmasters, is a completely unreasonable and unrealistic thing to expect of me.

Searching back through my photo archives, I can see that I obtained a prescription for an antidepressant - bupropion - shortly before one relapse. I can see that I obtained another - California rocket fuel - shortly before an episode of hypomania where I broke up with the aforementioned brilliant girlfriend. In fact, whenever I seek chemical relief from depression, that's usually an indication of a desire to feel better at any costs, having suffered weeks and months of suicidal thoughts. Am I to blame for seeking relief from my intolerable feelings of depression?

Scanning through my library of images, I can see how I become obsessive over sleeping tablets and tranquillisers, as I rely upon the pills in order to cope with dreadfully stressful situations, which would send even the least-anxiety prone amongst us running screaming in the opposite direction from the source of the stress.

This time last year I was about to start work doing yet more IT consultancy for yet another bank. I was not incredibly enamoured at the prospect, but I needed the money. Circumstances conspired to force me back into an unhealthy environment.

Sadly, I'm not rich enough to do whatever I want, and I'm not even financially comfortable enough to do something tolerable - I've got to do the thing which pays the bills, and that's IT consultancy for banks, unfortunately. It's a fact of life that sometimes we have to do things we don't like very much.

So, I've avoided the antidepressants this time, because they always seem to send me loopy. I'm white-knuckling it to the end of Jinxed January, because I just need to get through this god-awful month, come hell or high water. I'm constantly reminding myself that even to dabble with so-called recreational drugs or get mixed up with girls in a big way, is likely to be destabilising. I live like a monk - work, eat, sleep, repeat.

Because of the extraordinary quantity of benzodiazepines I was abusing, I have huge holes in my memory. It feels like such a short time ago that I was hooked up to my own dedicated dialysis machine, on a high dependency ward. It feels like only yesterday that I regained consciousness with a machine breathing for me in intensive care. I managed a spectacularly terrible sum total of just 11 weeks at work in 2017, and virtually all the rest was pure insanity. I spent about 7 weeks in hospital, so with that 11 versus 7 ratio, you can see that my year was pretty messed up.

This year is brutally drug-free and medication-free. My brain screams in agony at the unbearable levels of depression and anxiety, but I've seen that to reach for any kind of substance for relief is opening the flood gates to fully-blown addiction. I'll convince myself that whatever chemical I'm using to feel better is not effective, and I need to take more, more, MORE! Before I know it, I'll be back on the supercrack.

It might seem obvious to an outside observer that my cyclical life is due to bipolar disorder, and I should rush to my psychiatrist and beg to be given mood stabilisers immediately. However, those who superficially observe me would remark that I'm very stable: I get up, shower, get dressed, have breakfast, go to my job, spend my evening watching TV and writing and get eight hours sleep. To the casual observer, I seem like the most functional and stable person who you could possibly hope to ever meet.

The reality of my existence is one of continuous battle with depression, anxiety and a craving to spectacularly self-sabotage with addiction. Getting out of bed in the morning and overcoming debilitating anxiety are comparatively easy, having built up the mental strength to overcome the urge to take one of the most addictive substances known to man. I'm not meaning to compete with those who find their lifes to be completely unliveable due to depression and anxiety, but merely to say that I've found it easier to overcome things which would have kept me bed-bound, after having been through what I've been through. Every cell of my body screams in protest at the bullshit I'm putting myself through at the moment. Every bit of my brain yells in agony at the daily punishment I suffer, but what does an extra bit of suffering matter compared with the endless comedowns and drug withdrawals I've been through?

As I look back on the last year, I realise I've been through opiate withdrawal from tramadol, codeine and dihydrocodeine; through benzodiazepine withdrawal from diazepam and alprazolam; through stimulant withdrawal from crystal meth and supercrack; through withdrawal from pregabalin and alcohol; through withdrawal from sleeping tablets like zopiclone and zolpidem. In terms of detoxes, I've had the detox from hell. In terms of quitting addictive medications, I'm a Guinness World Record holder. I really do deserve a medal.

As I look back on the last year, I realise I've been through so many health issues, housing issues, financial issues, legal issues, employment issues, relationship issues and everything else that would wreck your head and rob you of your sense of stability, comfort, contentedness and happiness. I'm surprised I'm not sleeping in a cardboard box, just to escape the clutches of a society that wants its pound of flesh at any costs. I'm exhausted by the constant stress of it all.

If I make it through Jinxed January, I have little to look forward to. There's nothing jump for joy about. Anybody who tells you you'll feel better if you quit the booze and the drugs and the pills is a fucking idiot. Anybody who tells you that you'll have improved self-esteem and all the other good stuff, if you get yourself off the streets and into a job, is a fucking idiot. I'm an extremely rare example of a judge, policeman and a social worker's wet dream - a bankrupt homeless mentally ill junkie who's got themselves scrubbed down and gone back to civilised society, but I've got to tell you in no uncertain terms that it's awful and I hate it. My life is a living hell.

Perhaps this is the ultimate comedown. Perhaps all the chickens are eventually coming home to roost. Perhaps this is the payback, given that I somehow miraculously avoided prison, a criminal record, bankruptcy and permanent health damage. Perhaps I'm finally paying the price for all that partying.

But, I haven't been partying. It's not like I haven't paid the price every time I fucked up. It's not like I haven't tried hard to do the all the right things and contribute to society. It's not like I've robbed, and manipulated and been a parasite on society. I've already paid for my transgressions. Where's the reward for getting myself sorted out? Why did I bother?

As I look back, I have rose-tinted glasses. As I look forward, I see the world through a blue filter. The past wasn't so bad and the future looks bleak. Perhaps this is the final stage of recovery from addiction, when my memory of the horrors of the past is becoming faded and I fondly reminisce about the few moments that were OK in all that insanity. It was certainly an easier life, to be on a rocket-ride to hell.

I try to look back and remind myself just how bad things were, but I find myself smiling and laughing in a way that I just don't when I think about the eight hours I spent going through hell at my desk today. In my mind, I perceive the present unpleasantness as far greater than anything else I've been through in the last year. That's strange, isn't it? To have suffered multiple organ failure, loss of my home, loss of my job, a suicide attempt, incarceration, getting sectioned, psych wards, addiction, loss of my girlfriend and all the other atrocious things that I went through in the last year, and the very worst thing is my current working arrangements.

Obviously, I think that my perceptions must be warped by my state of semi-recovery from addiction and other mental health problems, but I don't think it explains everything. There is something awful about being all alone in an AirBnb, working a job I hate because it's boring, easy and doesn't bring me into contact with a single soul... it's so lonely and isolating.

I'm churning words out into the ether, because I'm in such discomfort and I'm so afraid.

It's strange that I'm not afraid of ending up back in hospital, isn't it?

 

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Unholy Trinity

11 min read

This is a story about lethal combinations...

Three empty cans

Those who are familiar with the more extreme end of Grindr casual sex shenanigans will know that there's an unholy trinity of club drugs - crystal meth, GBL/GHB and viagra - which provide the sexual stamina for outrageously debaucherous f**kfests. To arrange drug-fuelled sex parties via the Grindr app is shockingly quick and easy. Under the influence of these drugs, one's sexual appetites are rarely satiated.

My own unholy trinity is far more prosaic - sleeping pills, tranquillisers and alcohol.

I never intended on becoming hooked on 'downers' and indeed I was very well aware of the physically addictive nature of the benzodiazepines. There is absolutely nothing that appeals to me about being intoxicated on CNS depressants. I do not enjoy feeling under the influence of the GABA agonists. For me, it was all about wanting the absence of something: the absence of panic attacks where I felt like I was going to die; the absence of interminable insomnia; the absence of the skin-crawling feeling of anxiety; an escape from a life that was unbearably awful.

Alcohol was a taste I had to acquire. Getting drunk was a necessary part of getting laid - Dutch courage. Booze was ubiquitous at work and it was necessary to be a drinker to get ahead in my career. I would have been a suspicious outsider if I'd been sober during the many drunken lunches, after-work beers and meals where wine flowed liberally. Alcohol lubricates the world of investment banking and I fully embraced the culture.

Valium crept into my life as I searched for something to help me manage the undesirable side effects of stimulant abuse. I thought I could swallow a couple of pills and sleep off the worst of my addiction without any consequences. I knew that I was playing with fire - to use one addictive drug to combat the effects of another - but that's the kind of addict logic that I applied at the time. I knew that if I abused benzodiazepines for more than a few months, I'd end up with a physical dependency that would cause me to have seizures if I abruptly stopped taking the pills. I did what I felt I had to do.

Sleeping pills never held any appeal. If there's one thing I'm really good at, it's sleeping. I quickly figured out that the best way to escape an oppressive and unpleasant world is to be unconscious. I can put myself into a zoned-out trancelike state and sit quietly for hours. I can spend all day dozing in bed, even after 12 hours of restful sleep. I'm a master of sleep. Why would I dabble with sleeping pills?

Some of the benzodiazepines have a very long half-life. If you take benzos - like Valium - for a long time, they never really leave your bloodstream. If you're addicted to Valium, you're just topping up when you take the pills. Strangely, it's possible to have insomnia when you're on tranquillisers - you just lie there awake, not caring at all that you're not asleep. It's restful, but it's not refreshing, if you know what I mean?

During one of the most difficult periods of my addiction to a powerful stimulant - a drug that sends me completely psychotically insane - I could hear helicopters hovering over my apartment. All the traffic on the road had stopped - I couldn't hear any motorbikes, cars, lorries, buses or trucks. Then, I heard a lot of yelling. To my paranoid drug-addled and sleep-deprived mind, this was the thing I'd been dreading: the police and the army were coming to get me and drag me in front of a crowd of people, to shame and ridicule me. The 'enemy' were coming to get me. Then, I heard a commentator announce that the first runners of the London Marathon were about to come past my apartment block. Of course! It was the marathon, the route of which travels right past where I was living.

I was still fairly traumatised by the whole marathon thing, even though I quite quickly figured out that the helicopter wasn't there to deliver a SWAT team clad in black uniforms in through my bedroom windows. I turned to diazepam to soothe my jangled nerves. I swallowed about 20 high-strength 10mg blue tablets. That's a HELL of a lot of diazepam. It didn't touch the sides. What I really wanted was to be unconscious. Sometimes, being tranquillised up to the eyeballs just isn't enough.

Zopiclone and zolpidem entered my life as medications to allow me to have a seemingly normal sleep/wake cycle. When I was abusing a powerful stimulant, it would not be uncommon for me to spend four or five nights without sleeping at all. The most nights I ever went without sleep was about ten, which sent me completely barmy, of course. As you reach the outer extremities of an impossibly bad stimulant addiction, strangely you yearn to have a normal appetite and normal sleep. The tranquillisers helped me to stay on top of stimulant psychosis, but I needed sleeping pills otherwise I was just going to die from a low immune system, or otherwise go completely and permanently insane.

I can't stress enough how important sleep is. Without regular refreshing sleep, nothing else is going to fall into place. There's no hope of improvement and recovery without sleep.

The sleeping pills - such as zopiclone and zolpidem - don't actually give you normal sleep. Sometimes you can 'wake up' and feel a little bit like you've been asleep, but you haven't been - you've been drugged. Your body and your brain kind of knows the difference between sleep and unconsciousness. When you suddenly jerk awake and you say "what! where am I?" then that's usually an indication that you've been drugged, rather than sleeping.

I used sleeping pills for most of 2017. I almost don't know how to sleep without them. When you get habituated into using sleeping pills, you can get very anxious about trying to sleep without them. The anxiety around getting enough sleep builds and builds. You spend horrible days at work where you're trying to keep your eyes open, and then horrible nights awake because you desperately want to get enough sleep to catch up, but you can never get enough. Bedtime becomes super charged with nervous energy and you have an incredible longing for a night of refreshing sleep. The more you want sleep, the harder it is to get it. Sleeping pills are addictive, because they take away that anxiety and deliver some kind of dependable nightly rest, even if it's not very refreshing.

I abused my little toxic trio of chemicals because they gave me back my life. My life used to revolve around the highly potent and addictive stimulant drug which I had unfortunately become incurably hooked on. My life was going to hell in a hand cart. I was on collision course with permanent psychosis. I was definitely going to end up locked up in a mental institution for the rest of my days. To fight fire with fire was madness, but it worked. Although it was very dangerous and I nearly died as a result of poly-substance abuse, somehow I popped out the other side intact.

I didn't drink alcohol since last Saturday. Once I start drinking, I don't seem to be able stop when I want to. I don't seem to be able to drink in moderation. When I get the taste of beer or wine, I glug it down and I don't stop until I think "oh dear, I've had too much to drink". Because of all the occasions when I've thought "I wish I hadn't drunk so much" recently, I've decided that not drinking is the safest course of action.

I've been taking sleeping pills all week. I need some sort of crutch dagnammit! How am I supposed to cope in such unfavourable conditions without something to help make life a little more manageable. To lose sleep would be bound to push me back towards strange strung-out thinking, and make me liable to say or do something stupid.

One week from today I will see a psychiatrist. It's been 8 weeks or so since I last saw a psychiatrist. I haven't been taking any medication - except for the aforementioned sleeping pills - and I'm wondering if I should cut my pills down to absolute zero. It would be really wonderful to say that I'm not a drinker, not a smoker, I don't have tea, coffee, cola or energy drinks, and I don't take ANY medication at all. It's so rare that a psychiatrist would encounter somebody who's completely free from ALL psychoactive substances. I think I would really love it, to have the psychiatrist ask me "so, how do you feel?" and be able to answer, knowing that it's me and only me, and not some version that's twisted by caffeine, nicotine, drink, drugs and medications. How precious would that be, to be my real authentic unadulterated self?

To get to this point where I might be able to be completely free from all mind-altering substances has been an almost impossibly unbearably awful experience that's put my life at great danger, as well as my livelihood. Why the hell would I put myself through so much suffering? Why wouldn't I go a little more easy on myself?

What I find with substances is that they're insidious. Every time you say "one cigarette won't hurt" or "one glass of wine will be OK" you could be setting off down a road that leads to a whole bottle of wine, two bottles of wine, a bottle of vodka. I'm never going to be some boring teetotaller, but at the moment my life is so unbearable that I'll keep pouring myself glass after glass of booze until the pain and the anxiety is blocked out and I'm blacked out.

My nightly sleeping pill habit is comparatively healthy. I don't increase the dose. The dose is measured. There aren't any fattening calories in a sleeping tablet. Sleeping tablets don't give me awful hangovers. There could be much worse things to be hooked on. However, wouldn't it be awesome to look the psychiatrist straight in the eye and say "I haven't taken a single mind-altering substance for a week now".

This week has been awful without my little chemical helpers, but maybe next week will be better, and the week after will be even better still. Wouldn't it be awesome if I break free from chemical dependencies?

Of course, I will have to admit that I had unbearable anxiety and suffered suicidal thoughts that very nearly killed me. I will have to admit that it would have been sensible to take the sertraline (Zoloft in the USA or Lustral in the UK) instead of trying to tough it out without, and abusing things which I really shouldn't have done. It's true that I could have developed a sertraline habit by now - the withdrawal syndrome is pretty awful, so I'd be trapped onto yet another addictive medication. Yes, it would have helped me to get through some super stressful awfulness, but I'm going to end up like the old lady who swallowed the spider to catch the fly etc. etc.

My friend who's a doctor is incredibly frustrated that "Nick knows best" as usual. They're mad as hell that I'm doing my own thing; marching to my own beat. It seems patently absurd to reject a medication that could be a tiny bit better than placebo, in as little as 8 weeks. So, why is it that I feel a little bit better today? Seems rather coincidental, doesn't it?

My week at work was awful. In fact, I was too unwell to work for 3 out of 5 days. My week was almost unbearable. In the interests of being fair and honest, I must admit that this last week has made me question my stubborn decision. I've wondered whether I made a mistake. Then, I remember that I'm closer than I've ever been to proving my point: that I can be stable, contented and happy without pills. I plan on rejecting all my diagnoses at some point. I plan on declaring myself sane. I plan on being 'normal'.

How does somebody become normal if the paternalistic guardian class can always say "that's only because you're on the right medication"? When it says "medication takes 6 to 8 weeks to become effective" what would happen if you didn't take the damn pills? That's what I'm finding out. It was super telling to me that people were so quick to say "told you so" when the game wasn't even finished - the results aren't in yet.

It's been awful, but I'm winning. Bi-winning.

 

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