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

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.

Tags: #bipolar

This is a story about justification...

What do you suppose this stack of laundry baskets and boxes full of clothes is? Perhaps this is a new modern art installation at the Saachi Gallery?

200 days ago - April Fools' Day - I was so paranoid that I believed that somebody was going to break into my ensuite bathroom on the 4th floor, and invade my bedroom. I was also so unwell that I believed I could secure my bedroom by tying my dirty laundry baskets to the door handle.

Paranoia does not generally trouble me during my day-to-day life: nothing to hide, nothing to fear.

I'm about to make a factual declaration that might shock and disgust you.

Men's libido will drive them to relieve themselves - through sex or masturbation - on a relatively frequent basis, depending on each individual. You might consider a man who masturbates every day to be a twisted pervert. You might consider a monk who has taken a vow of celibacy having undesired nocturnal emissions - he ejaculates in his sleep - to be the finest example of a man that is biologically possible, without castration.

Let's just re-iterate this for emphasis: biologically, the human race has evolved a reproductive imperative that is as strong as breathing, sleeping, shitting, pissing, drinking and eating. If you can stop doing all of the latter for a few years, then you're welcome to then argue the point with me.

If you consider the unpleasant combination of being so horny that you need to masturbate, with the belief that you're being watched at all times, then you might understand that it's an impossible situation, assuming that you value your dignity and your privacy. At present there are at least 3 webcams watching me and 2 microphones listening to me. Of course, I presume that no ransomware is recording me without my permission, but such software exists in the wild. How much do you trust the manufacturer of your phone and your laptop, to not co-operate with your government, giving them the ability to spy on you?

Nothing to hide, nothing to fear?

I'm guessing that you wouldn't want your family, friends and work colleagues, or even complete strangers, to see you tugging your todger; yanking your chain; bashing your bishop, or whatever your preferred euphemism is for masturbating to orgasm. I'm guessing that you'd find such voyeurism to be unacceptably compromising and distressing enough to destroy your mental wellbeing.

Do you note that I'm leaving aside any discussion of anything 'kinky' or not otherwise in accordance with plain vanilla biological imperatives?

Of course, we could all just have sex, and then we've got a partner in crime - we have safety in numbers; at least there's somebody else who's looking ridiculous with us, as we make the beast with two backs. However, this is not always practicable. Natural urges do not always align with the competing demands of the world around us. Sometimes, we are horny and single.

If you're thinking "eeeewww" or otherwise troubled by an undesirable mental image, you understand perfectly that the vast majority of us wish to maintain some privacy around this particular activity. I cannot relate to men who take a thrill from masturbating at somebody, flashing their genitals or sending unsolicited dick pics. I am not writing about the exceptional cases, where men act in an antisocial or illegal way - these matters are excluded from the discussion, because they are unusual and those men do not think and behave like I do.

In short, the only way that my behaviour seems at all unusual, is the exceptional lengths that I will occasionally go to in order to not be spied upon while masturbating. If we consider our desire for privacy, it doesn't seem odd. If we think about the fear of the indignity and shame of having explicit images and videos of us masturbating, shown to other people, that fear is not irrational - it would be extremely distressing, for almost everybody.

Just over 6 months ago my mind was shattered. Today I'm barely troubled by paranoia.

My paranoia doesn't come from nowhere - of course it needs a seed. The internal source of my paranoia is sleep deprivation, hunger, thirst and mind-altering substances: I have a choice over whether I disturb my mind with these things or not. The external source of my paranoia could be explained simply in this way: do you imagine that men in psychiatric hospitals no longer need to masturbate?

Ask yourself where it would be appropriate to masturbate, when you're being checked on regularly by nurses and support workers. Ask yourself whether you think you could quietly do the deed in a dormitory with other men. Presumably, you'd go to the toilet or the shower, wouldn't you? If you're masturbating in an institutional environment, with the noise of staff and patients all around you, does that make you a twisted pervert?

This topic is the most sensitive that I could write about. Nothing could shame me more than you knowing these deeply troubling things, which is why I write about them - I'm grasping the nettle.

If you care to read back through what I've written, you'll see that I stop short of painting an explicit picture - the images in your head are entirely from your own imagination. I'm not attempting to upset anybody, nor am I discussing matters that have no place outside of a basic human biology lesson.

I believe that honesty is the best policy, and I'm taking that to its extreme conclusion, despite the detrimental effect it seems to be having on me and my life. I started the questionable experiment, to publish my inner monologue, and I'm compelled to continue, even though it causes me a great deal of anxiety.

Why do I need to live in fear of people learning who I am and how I feel? Why would I need to wear a mask? Why do I need privacy, when so many are determined to sneak a peek behind the curtain anyway?

What happens when a person lays themselves bare, instead of letting paranoia destroy them?

Tags: #paranoia #writing

This is a story about being inspected...

Today the psych ward is being inspected by the Care Quality Commission (CQC) and the staff are so nervous that some of them feel physically sick. I try to reassure one nurse that they're doing their best, despite staff shortages and rampant drug use - the synthetic cannabinoid called Spice is ubiquitous throughout prisons and psych wards.

There's always somebody peering over your shoulder, sneeringly judging you. Is it any wonder that paranoia takes hold in a mind, destroying it? The United Kingdom has an exceptional ability to track the movement of its citizens, using simple conventional CCTV - no spy satellites even needed.

In the free West, we deride the Stasi and the KGB. We talk about China's vast number of people employed to snoop on their own citizens, but we don't acknowledge the work of GCHQ and the NSA. Have we forgotten Edward Snowden's revelations so quickly? The Government read your fucking emails and the police - the regular ordinary police - have a backdoor into Facebook to read all your private messages.

Nothing to hide, nothing to fear. If you believe that, why do you feel stressed if a police car is following you when you're driving, and a sense of relief when the police overtake you and disappear over the horizon? You have insurance; you've had your car's roadworthiness tested; you've paid your road tax... nothing to worry about, right?

It was only a short time ago that I was deeply indoctrinated by my schooling, that had shaped me into a meek conformist - I was fearful of defying any of society's rules and regulations. A family friend wanted to go fishing with me, and I said we needed to obtain a permit. "Our prisons are full of people who got caught fishing without a license" this friend laughed. "What are you in here for? Murder. What are you in here for? Fishing without a license" he continued jovially.

The city centre is crammed with 50,000 protestors preparing to march. I walk past a police cordon and I can hear a police officer yelling at me that I can't go the way I'm going, but I know that he'll be busy dealing with my obedient friend who will have stopped per the instructions. I keep walking, pretending to be unable to hear the entreaties to return. The policeman lets my friend go and we walk to the head of the march.

I'm sure that anarchy would be a disaster for sick and vulnerable people. I have no desire to see civilised society crumble. We can't all do whatever the fuck we want, whenever the fuck we want. Perhaps if everybody acted like I did, it would be the end of the world as we know it.

"Don't walk" says the sign in the United States. I jaywalk with gay abandon. Even in Manchester people look at me like I'm mad and suicidal, for the way I cross the road. However, it's done with such confident aplomb that nobody challenges me. I notice that people who are surrounded by plenty of steel and glass and plastic, such that they would suffer no injury at all if they killed me to death with their motor vehicle, do not give a single fuck about whether I live or die. In London, a motorist will slow down or even brake, to avoid killing a pedestrian, but these provincial plebs treat human lives with no such sanctity.

To live in a crowded city is to be humbled by humanity. To be detained against your will on an underfunded psych ward is to humbled, also. In the city, you are forced to confront your pathetic meaningless existence, as an ant crawling in its nest would be, if it had the faculties to perceive itself and its surroundings. But an ant's nest is akin to a row of gleaming skyscrapers, insofar as being a testament to what can be achieved by a society working together. On the psych ward, you are forced to confront your powerlessness over forces greater than yourself - society will exclude its troublemakers.

Perhaps you think I would endorse heroin being sold in supermarkets and that babies' pacifiers should be replaced with crack pipes?

As six police officers pinned me to the ground and my bum was injected with lorazepam, in the Accident & Emergency department of a hospital, I noticed a cleaner and a security guard nearby - some of the lowest paid people in society are often completely unacknowledged for the role they play in maintaining the division between the peasants and the aristocracy. My face was inches from the floor, but the policeman's trousered knee on my head was clean and so was the linoleum. Circles of red and green blinked at me - the police bodycams, videotaping the whole gruesome specatcle. I'd fallen from grace, but I hadn't slipped anywhere near the bottom - it's a long way down.

A friend whose judgement I trust and respect, tells me that I should drop the bad boy image of "the guy who got fucked up in Manchester". She knows that people are watching and I'm misrepresenting myself. She knows that people are lazy and won't look any deeper than the superficial image that I present.

Is my life - and the way I document it - by accident or by design? Do you imagine that when I'm writing, I don't think at all about how things are going to be perceived? The joke's on you if you don't read what I write with the prerequisite pinch of salt.

If you just dip in at random - like a care quality inspector - then you will get a random impression. On a good day you'll get a good impression. On a bad day you'll get a bad impression.

Do you think the graph above shows that things are improving? No. No it does not. Things are getting worse. Much, much worse. The data above shows conclusively that during the period under examination, there was a fourfold increase in the very metric that was supposed to be cut by 80%.

Do you remember blue tablet man? Well, anyway, he assaulted a nurse for giving him a yellow tablet (5mg of diazepam) instead of a blue tablet (10mg of diazepam).

A drugs dog sweeps the ward. The patients believe the dog can sniff out cigarette lighters. I ask the handler if the dog can sniff Spice and he confirms that it can. There's Spice everywhere on the ward, despite its deleterious effect on the mental health of susceptible individuals - prodromal schizophrenia can turn into fully-blown psychosis under the influence of the powerful synthetic cannabis, making it all the more concerning that it's so widespread on an acute psychiatric ward.

The patients here are the lucky ones and they know it. Everybody agrees it's better to be here with a warm dry bed and three hot meals a day. Everybody agrees it's better to be here, where the chances of being beaten up and/or robbed are minimal. With winter on its way, months of unimaginable suffering lie ahead of Manchester's homeless population, which has increased 1,100% in just 7 years - and a huge number of them smoke Spice.

Abandon hope all ye who entered the world from the mid-1990s onwards. What are the prospects for the youth of today, and the glut of graduates who were promised that indebting themselves and spending three or four years at university would be a good move?

Does it not seem like an obvious reaction to a decline in living standards, to retreat into drugged-up oblivion?

We're sifted and sorted and dissected by tests. We're examined, inspected and measured in every conceivable way. We never have any respite from the world's desire to label us, grade us and monitor us. The pressure to meet the expectations placed upon us is relentless. Some of us will crumble and have nervous breakdowns or be paralysed by anxiety disorders. Some of us will rebel and kick back at the suffocating environment that's desperate to eject and marginalise anybody who doesn't neatly fit in a box. Lots of subcultures have sprung into existence, with members exchanging knowing looks - these people are so much happier now that they have rejected the stereotype they were supposed to embody.

It saddens me that the hard-working staff on the ward are anxious and on best behaviour, when the other 364 days a year I know that they try their very hardest. This is just one of many psych wards, where the macro problems are greater than anything that can be influenced in the microcosms.

If you're going to randomly dip in, be careful to not make a lazy judgement based on a small sample size.

Tags: #nhs #hospital #mentalhealth #addiction #politics

This is a story about being counter-productive...

95% of my fellow patients smoke cigarettes. There's nothing to do on the psych ward, so I can see why they would. Cigarettes are a way to pass the time; to deal with boredom; to relieve some of the stress of being locked up with a load of mentally ill people; to self-medicate for all manner of problems.

Nicotine is fiendishly addictive and a psych ward is not the right environment to kick the habit. As a non-smoker I'm well aware that I'm not involved in the activity that dominates the lives of my fellow patients - obtaining tobacco, rolling cigarettes and harassing the staff to be let outside to smoke.

There is a small outdoor area which can be accessed via some steps, enclosed in a cage so that nobody can jump and injure themselves, or attempt to escape. Every hour, the door to the steps is opened for 15 minutes, and the smokers all cluster around the top of the steps, getting their nicotine fix. Nobody goes down the steps into the outdoor area - they remain in the cage.

I challenge the staff - why don't they leave the door open the whole time? Nobody could escape from the outdoor area, because it's surrounded by high fences. The outdoor area is well covered by CCTV, and it's no harder to keep an eye on people than any other part of the ward.

The standard response from the staff is that it's "promoting health" to deny nicotine addicts access to the only place they're allowed to smoke. I call bullshit on this, because there's no data to support the hypothesis. "Look around - everybody smokes... nobody is smoking less because of this rule" I say. The staff argue that the NHS can't be seen to be "promoting" smoking. This is a completely ridiculous idea. The nurses and support workers hand out the cigarettes and cigarette lighters - the NHS is intimately involved in the whole process of smoking, far more than if the patients were given the choice as to how they dealt with their addiction.

I'm in a dorm with 3 other men. It's a lot quieter than the single room right next to the TV - the TV blasted out for 19 hours in every 24 at full volume. The noise was unbearable. My fellow patients in my dorm report that they're lulled off to sleep by the rhythmic tapping of my keyboard, as I pound out these words. I was concerned that I was being a noisy nuisance, but they reassure me that it's quite the opposite - it's a kind of white noise that's relaxing, like hearing raindrops falling on the roof or hitting the windows, driven by the wind.

A guy is coming out of my dorm, but he doesn't sleep in my dorm - he has his own room. What's he doing down at this end of the ward? Then, my nostrils are assaulted by the smell of smoke. I push the door to the bathroom open and it stinks - there isn't even a decent extractor fan to get rid of the smell. I write a note and secretly pass it to a nurse, pretending to pass her my laptop to be charged in the office. I scurry away down the corridor but she yells after me "tell XXXXX about the smoking in the toilet" waving the note, right in front of the guy I'm dobbing in. I cringe - does she not know that snitches get stitches?

Another nurse comes to our dorm and she starts accusing one of my dorm mates of smoking in the toilet. I leap to his defence. "Who was it?" she asks, and then bellows out his name when I whisper the answer. The fact that many of my fellow patients have a criminal past and have been in prison, does not seem to concern the staff members. Perhaps there aren't fights in here. Perhaps they never see any violence. Perhaps my fears are unfounded. Am I being paranoid?

The fire escape is padlocked shut, there are no fire extinguishers or sprinklers, the break-glass buttons are enclosed in plastic boxes that prevent the fire alarms from being set off - a fire in here would be catastrophic. Yet, I am certain that there are at least 2 cigarette lighters that are being used in my dorm. The patients smoke openly when the staff are doing their handover between shifts, when there's absolutely nobody around.

I make subtle enquiries with my fellow patients - how do they feel about the restrictions on smoking? Everybody agrees that the restriction on access to the outdoor area is more about control than it is about "promoting health" - they feel that the staff have created a system that allows them to exercise dominion over their inmates. "Smoke time!" demands one of the more aggressive patients, banging on the window of the office. "Calm down! Stop shouting!" yells back a staff member. This is an artificial and avoidable situation - why does it exist, when it's creating conflict between staff and patients, and making people stressed and unhappy?

When I was confined to the ward I would have made use of the outdoor area to walk around, get some fresh air and get some natural light. However, I couldn't get past the gaggle of smokers clustered around the top of the steps. To leave the door open all the time wouldn't create this ridiculous situation, where all the patients are fixated on this controlling aspect of their lives.

It's saddening, to see 19 men all hanging around waiting to be given a lighter and be let out, like they're animals; pets.

In defiance of the pointless draconian controlling bullshit, a handful of patients have smuggled cigarette lighters and tobacco into the ward - it's not hard when some patients are allowed unaccompanied leave from the ward. "Have you got any bottles or lighters on you?" a nurse asks me when I get back from an outing - I'm not breathalyzed or searched, even though I'm carrying a bulging bag.

I suppose the privilege of being allowed to leave the ward could be revoked, as a punishment for misbehaviour. The chance of being discharged early and allowed home is also under threat, for any patient who's troublesome. Most patients are here for a 6-month stay. It's up to 6 months, but it's more often longer, not shorter. The reaction to not being allowed to go home is rarely handled well - can you imagine that people who are unwell are able to remain calm and represent themselves clearly and articulately, when their liberty is at stake?

In terms of mental health, nothing could be more stressful, adversarial and paranoia-inducing, than having doctors and nurses discuss you behind your back, having been peeked at through the curtains every 15 minutes - patients are literally spied on and judged. Life, liberty and free-will are all interfered with in an institutional environment that's a cross between a prison and a school. Notices on the wall tell us they promote "independence and well-being" while also telling patients the very strict times that they need to be at the dispensary hatch to get their medications. At 8:54am I'm harassed by a nurse to go for my 9am meds... I'm well aware what the time is and also well aware that to be early is to be turned away empty handed. At 11:54am I'm harassed to go and stand in line for some food which is not even being served until 12 noon at the earliest, and is often delayed.

I'm aware that I'm lucky to have a sought-after psych bed - many people who are having a mental health crisis will have no access to inpatient care. To bite the hand that feeds me seems churlish, but I do feel sorry for my fellow patients who can't articulate their frustrations effectively.

The only patient I know to have attempted to file a complaint is the guy who's relentlessly trying to get 8mg more Subutex out of the doctors... unwilling to go along with the treatment that will wean him off his opiate addiction and quite determined to sabotage his recovery, perhaps.

Nobody's stopping smoking because of the "health promoting" rules around access to the outdoor area, but I'm certainly missing out on exercise and fresh air because of it.

It all looks rather counter-productive to me.

Tags: #addiction #hospital #mentalhealth #nhs

This is a story about therapy...

Everybody's an expert on my mental health, it seems. I need to be exercising more, eating a balanced diet, abstaining from alcohol and mind-altering substances BUT not the ones the doctors want to give to me. But which doctors? Every doctor has a different idea of how I should be treated - which doctor should I listen to? Perhaps somebody else knows, because people have some very strong opinions on what I should be doing, considering that only a handful of individuals with whom I am still in contact, have known me for any length of time and have followed along. Only I know what I've tried before and what I haven't - what works and what doesn't.

Here, there's a student nurse whose dissertation investigated the benefits of exercise, in terms of potentiating - that is to say improving - the efficacy of medications. Not considered for a single second, was the control study which would have investigated the efficacy of exercise alone. This student nurse, who I find passionate and intelligent, was eager to suggest that I tried sodium valproate or lithium - both life-shortening medications prescribed to people who have regular episodes of mania where they believe they're Jesus reincarnated etc. Everybody thinks they've got a cure to a problem I might not even have - it was under a very dark cloud that I entered hospital, one must remember.

Externally, the perception of a psychiatric ward is that it must be a place of therapeutic activities and meetings with doctors to fine-tune my medications and cure me of my madness, making me safe to release back into the community again. Internally, my fellow patients perceive staff members as persecutors, jailers and masters of everything from food & drink, to bedtimes and bathtimes - a cross between a policeman, a teacher and a parent. Certainly, to have a blackboard on the wall is an incredibly dated nod to the classroom days of our youth. Note that the list of activities for the ward is completely blank, which I find quite accurate... not that I'm complaining.

The UK's stringent fire regulations for institutional buildings - hospitals, schools etc - mean that they look very similar. A company that manufactures and supplies the fixtures and fittings for a school will probably also supply those same items to a hospital. Everything needs to be built to last in this incredibly abrasive environment, where the footfall in the corridor would destroy even the most hard-wearing of floors, laid by a contractor who normally worked in regular houses. The finish is not just high standard, but the selection of the materials used has been honed over the years to create an interior that is easily mopped and wiped down, and very hard to damage.

As a patient, I find myself recalling my schooldays, as a dinner lady ladles goo onto plastic plates and I sip juice from containers that are identical to those that I had in my boyhood. Just like school, nothing much really happens except for crowd control. There is a little sifting and sorting, so the naughtiest boys end up in the shittest parts of the hospital, and the golden child will find themselves in the top class. However, it must be remembered that staffing a hospital is a job to quite a lot of people, and over the many years that they will work their job, any ill-founded notions of making a difference, will be thrashed out of them by the system. Nothing changes very much or very fast in massive organisations - you can't fight the system, or else you will drive yourself insane... that goes for both patients and staff.

It's very hard to not be driven mad by being hospitalised. It's a chicken and egg situation. For sure, nobody gets hospitalised without putting some effort into it. It's very hard to get a psych bed in the UK, unless somebody's gonna pay £5k/week for you to go into a private place. Of course, the patients here are here for a reason, but I have also experienced the terrifying moment where I realised that my liberty has been restricted. I just heard the jangling of a massive bunch of keys, carried by one of the staff members, as she passed my bedroom door. If I was to draw back my curtains, I would see bars on my window, to stop anybody climbing in or out. There are constant reminders that I'm here under lock & key, and to escape would require a little more social engineering (or climbing) than another secure ward that I was on in 2015, where I could have just walked out behind somebody who was leaving the ward, and then run away. To run away now, I would need to request an escort off hospital premises, and then I would simply get an Uber or perhaps I might have arranged a local cab company to have my getaway car waiting. I came into hospital with £1,150 in crisp £50 notes, so I have the financial means to grease whatever palms I need to.

Why would I want to escape though? Yes, you're right - to discharge myself prematurely would be a mistake. This isn't a very therapeutic environment, because staff spend so long spying - quite literally - on patients, which is absolutely dreadful for mental health: creating an us & them culture and exacerbating even the slightest hint of paranoia. If you value your dignity, privacy and liberty, psych hospital is not for you. There aren't any therapeutic activities. However, it is a safe place where my rent and bills are paid, I get 3 free hot meals a day, I get my own bedroom/office type thing which is quite generously proportioned and has an ensuite bathroom, and I don't need to cook, clean or otherwise worry about the responsibilities that burden nearly every other creature that was unfortunate enough to have been born.

Sounds nice, doesn't it? Perhaps you too would like a stay - mandated for up to 28 days on a section 2 - in the hotel "psych ward". Perhaps you imagine that it's a calm and restful place, where I get to sleep lots and read books. I think perhaps you're getting confused with that holiday you took to Tuscany last year. On a psych ward, you get woken up in the middle of the night by alarms going off, staff running in the corridors, yelling and screaming. On a psych ward, music blasts at top volume from patients' bedrooms, because headphones are not allowed lest we strangle ourselves with the cables. On a psych ward, one must evaluate the level that one's fellow patients are intoxicated by their cocktail of medications, and whether one has the energy to engage in their psychoses that are extremely repetitive - I've been here a week and I've learned a little of everybody's "thing"... their particular identity on the ward, which is characterised by an apparent madness, which is why we must remain here. I wonder what mine is? The staff tell me that I'm lazy - always just sitting with my laptop. Yes, that must be me right? Probably just watching mindless Netflix rubbish on it, right?

Ward rounds - when important decisions about "leave" are made - happen on Fridays and nothing else happens apart from waiting and hoping. Most patients here are hoping to get some leave. Some have not left the ward for nearly 6 months - considered too much at risk of running away, if they were allowed out of this super secure part of the hospital, accompanied by a staff member.

Gossip is rife, and everybody on the ward knows that I arrived with a wad of cash and was granted leave from the hospital almost immediately. I try to downplay these things, and now people have forgotten. When takeaways or shop orders are being placed, I feign not having any money, in the hope that I can alter my perception in the eyes of my fellow patients and the staff. I remember being called into the office, simply because some of the senior staff members wanted to have a look in my envelope, containing all those fifty pound notes. It's totally vulgar, and an accident of the illness that was stimulated into existence by the ridiculous sleep deprivation, stress and disruption to my medications and routine, over Tuesday / Wednesday / Thursday of last week, which followed my near-fatal suicide attempt... it should be expected that my behaviour would have gone a bit haywire, under the crushing pressures I faced.

Perhaps I will be "stepped down" to a less restrictive ward today. I had to pack my bags last night, because I thought I was being moved. I should have remembered that nothing happens very quickly in the National Health Service, but sometimes if you're quick, you can nip in before the system decides that actually you're getting ahead far too fast. I'm not really in a rush to go anywhere though - this ward is perfectly decent and I know the two spots where I can get 3G signal.

I'm here to recover, but I'm not here to feel completely isolated. Who do I know in the local area who can come visit me? Two months ago I'd never set foot in this city, and the company I've been working for has cut all contact and has been skulking around in a most unusual manner. I have nobody - it's a real ball-ache for any of my friends to travel, just for a 2 hour visiting slot. Even my fellow patients, who are locals, do not have visitors - the hospital environment is not exactly somewhere people would like to spend their free time.

Should I immerse myself in the daily rhythms and routines of the hospital? Should I hang around by the door to the kitchen, looking for food scraps to be tossed out? Should I hang around by the door to the yard, hoping to be let outside? I'm not a fucking dog. I find it immensely useful to maintain contact with those who are still in full possession of their marbles, while I'm in an environment where staff humour the patients - "is it Tuesday today?" one asks, and is told that yes it is, even though it isn't... is that useful, helpful, therapeutic?

I was very sick when I was brought in, without a doubt. Some incredibly stressful things still hang over me, like Damocles' sword. I have little power to influence the speed of my recovery, nor the speed with which those who have wronged me are forced to offer recompense. At least I'm in a safe place to pursue what is rightfully mine: to get money that is owed to me and recover my possessions. I'm in a safe place to make arrangements for housing and income, so that I don't fall flat on my face, as soon as I leave.

I'm glad I'm here, at the moment.

Tags: #mentalhealth #bipolar #suicide #depression #hospital

This is a story about pulling the wool over somebody's eyes...

Every day, between 6pm and 8pm, I get a visit from a different stranger. They all belong to Tower Hamlets' Community Mental Health Team, and specifically to the home treatment Crisis Team, but it must be a big team because I almost never see the same person more than once. Everybody's reaction is the same when I let them in: "wow! look at the view!".

The fact is, I have enough money to last me 2 more weeks, but then I'm not just skint... I'm actually insolvent. I have a lease that doesn't expire until September and I have to service various debts that I ran up, just trying to stay alive.

"Oh, you probably spent all your money on drugs" I hear you say.

Recently, I was on the dark web, looking for something for a friend - something to relieve pain that wasn't on offer on the NHS. Having located some vape oil, containing medical cannabis, I then couldn't resist the urge to continue window shopping. To my alarm, the worldwide supply of supercrack had dried up, due to the Chinese very effectively banning the production and sale of it.

There was one supplier - in the whole world - selling his remaining stock of supercrack. 10 grams. That amount of good quality cocaine might cost you £900. For 10 grams of supercrack, I paid the princely sum of $134.

How long do you think 10 grams of supercrack lasts? Well, we can work it out. A severe addiction might consume as much at 15 milligrams per day - that would be enough to not sleep for a whole day and night. So, easy maths then.... 10,000 divided by 15 = 667 days. One year and ten months, of daily drug abuse for $134. No. I did not spend my money on drugs.

So, back to the strangers in my home each evening. I sit them down on the sofa, next to the patio doors that lead onto the balcony.

Still somewhat wowed by the view, they can also see a number of expensive electronic trinkets lying around. The conclusion that is instantly drawn is that I'm not really in crisis, but in fact I'm wealthy, successful and totally in control of my life. They couldn't be more wrong.

I wrote about this the other day, but lurking behind the door into the kitchen, are a load of bottles for recycling. In theory, I've stopped drinking, but that's just a technicality. If you're in the grips of a mental health crisis or drug-induced behaviour, then you don't tend to have a glass of wine in front of the TV. Remarkably, I've had a bottle of white wine in the fridge, unopened, for over a week.

"Why don't you just have one glass and stop?" a psychiatrist asked me. I replied that oxygen would make the wine go off, so I needed to finish the bottle once it was open. She suggested a vacuum pump wine preserver, to which I replied that I bet I'd never be able to find one. The penny dropped, and she realised I was taking the piss. The reason why I don't stop is because I don't want to. Alcohol is an effective way of getting intoxicated, so you don't give a fuck about your problems... except I do seem to give a fuck in a strange way, because whenever I get ridiculously drunk, I punch my bathroom door so hard that it makes a hole in it. Then I wake up and think "why did I do that?" and I'm filled with regret.

Strangers who come in my house don't see my bedrooms. My main bedroom with the ensuite has got blood spots all over the floor from some accidental injury or something. There's lots of evidence that I imprisoned myself in that room, for some reason. In fact, there's lots of evidence outside the communal areas, that I've absolutely lost my mind at times.

Recently, being in possession of quite a good set of tools, as well as a box of screws, I set about attempting to screw a desk to the door of my spare bedroom, or something like that. The plan wasn't even clear to me. Once you lose more than about 3 nights of sleep, your priorities are quite corrupted. Instead of hydration, food and sleep, my focus switched to barricading the bedroom door. If you have a dark sense of humour, you may chuckle at the fact that as soon as I had completed my task, I then needed to undo my work because I needed to use the lavatory.

These are the kinds of things that are quite important if you want to understand just how sick I am, but the 'window dressing' which is my lounge, balcony and view, rather distracts from the piles and piles of dirty dishes, and overbrimming laundry baskets. The home visit team members walk away thinking "I must tell my colleagues about that awesome view", rather than "I must tell the doctor that the patient looked like he hadn't slept for days, or eaten much".

Can I fix things? I've pretty much given up hope. There just isn't time.

10 grams of supercrack certainly doesn't help, and I knew that a relapse would be one problem too many, on top of a giant shit sandwich. However, the things I've tried that are a sensible and realistic approach, have brought in way too little cash for way too much effort. I'd rather have my MacBook Air and iPad Pro, than a few pennies, even if they're surplus to requirements most of the time.

I could keep up appearances for friends and family, but I lived in fear of my work colleagues discovering that I suffered from mental illness for so long, that the exhaustion became unbearable. It was an open secret that I would be late to work during periods of depression, or not turn up at all. Everybody knew that I liked a drink, but I surrounded myself with other heavy drinkers. The problems worsened, and I had to run twice as fast to just to stand still. I came to London, knowing I could burn a bunch of bridges, and never exhaust all the options open to me, but it's bullshit, having to interview for jobs when you've got a 20 year career behind you and countless people who know you're good at what you do. Also, why shouldn't my friends know what's going on in my life. If they're true friends, they'll see that I'm still me, but I'm in crisis - they won't suddenly change their opinion of me, because of prejudice, although one close friend did and it broke my heart.

Don't lift up the rugs or look under anything: I've swept so many things under the carpet. Out of sight out of mind. I don't bear close scrutiny, but nobody looks very carefully anyway. First impressions count for everything.

After the insanity comes a further insanity - a paranoia that my flat is trashed and I'll never be able to bodge it up good enough to escape hefty bills for repairs that are completely over-inflated by the unscrupulous letting agents.

Where am I going to go? What am I going to do? The fact that you're asking those questions is the clue as to why I might wish to escape into alcoholic oblivion, or take supercrack. There are no easy answers. I know I keep going on about it, but the whole hospital/dialysis/job loss fiasco has left me questioning what the f**k I'm doing, working IT contracts in London, except for the staggering amount of money that it brings in. It doesn't compensate for the up-front stress, followed by the abject boredom and misery.

You'll probably find me sidling up to you in a bar in 20 years time - the known local drunk - and saying to you "I remember the time I lived by the River Thames and worked for the world's biggest companies" and you'll think that I'm some delusional twat.

I hope I just die before I suffer that indignity.

Tags: #mentalhealth #depression #alcohol #drugs #addiction

This is a story about habituation...

What a surprise! There's a small glass of wine left in the bottle today. How did I end up missing that? I normally drink the house dry, every single night. I've stopped buying gin, Pimms and other spirits, to avoid the temptation of a strong early-evening drink, to take the edge off the day; the nightcap that sends me to bed completely sozzled.

I'm not saying I've become some pious teetotaler who rather too proudly proclaims their abstinence, as if it makes them a better person somehow. I respect former alcoholics who know that once they pop they can't stop, but anybody who chooses not to eat or drink something because of their beliefs and values can bloody well keep it to themselves.

The French - during a water shortage - put up public notices saying "SAVE WATER: DRINK WINE". I fucking love the French.

I've been having my rocket fuel antidepressants for a few weeks now, but I'm sleeping 14 hours a day and I'm almost completely incapacitated by depression. The doc told me to take two pills a day, so I'm taking four, trying to speed things along a bit. The timing could not be worse. I need to be up and about, earning money, enjoying our all-too-brief British summer. Instead, I'm in bed with the curtains closed.

The friend who challenged me to 100 days of sobriety now takes 3 day breaks from drinking. I can't remember the last day where I didn't have any alcohol. Probably when I was in hospital, or maybe the day of the London Marathon, when I momentarily relapsed onto the really hard stuff: supercrack.

Perhaps that's one of the main reasons why I'm still depressed - it was only a month ago that I was convinced the sound of helicopters and yelling crowds, was an angry mob and the police, out to get me. Paranoia like that is awful. Supercrack is a Hell of a drug.

What a year. Starting well with a contract for Lloyds, but then suddenly my foot was numb and swollen. By the time I made it to Accident & Emergency, my whole left leg had swollen up. Acute kidney failure meant two weeks on dialysis and an operation to put a 25cm long rubber tube into a vein in my groin. Managed four days work then lost the contract - too sick to work. My flatmate had buggered off and owes me thousands of pounds in rent & bills; made a complete mess of my spare bedroom. Nobody knew why my foot was numb and I couldn't move it very much, despite being poked and prodded by various doctors. I was taking huge doses of opiates to manage the pain, and had to endure horrible withdrawal - nausea, cold sweats, diarrhoea - when I decided to try and get off the painkillers.

Gawd knows how long I've been taking Xanax and Valium for. I probably need a benzo detox. Opiate withdrawal is unpleasant but benzo withdrawal can kill you.

But, one step at a time. I'm going to try and only drink half a bottle of wine tonight. She wants to drink early and then stop; I want to drink late and then go to bed. It's going to be a test of my willpower, which is severely compromised by alcohol.

If tonight goes well, I'll try and do three consecutive days with no booze; see if it helps my mood. I'm sure my liver will thank me - it's already pretty busy trying to process all those chemicals I put into my body; all those pretty pills.

It's true, the more someting is ubiquitous, the harder it is to abstain from it. I hadn't dabbled in drugs for a decade, when the Dark Web brought a drug superstore right into my living room. Little packages of joy coming through the letterbox, allegedly. It's easier to get booze though. If you really have the thirst for it, you can nip to your local convenience store or even have it delivered to your door in London, 24 hours a day.

They tell recovering addicts to delete all their dealers' numbers from their phone; avoid friends who are still using drugs; change your lifestyle to avoid reminders of the places you used to use drugs. But what if you only ever did drugs on your own? What if you never met a dealer in your life? What if you could never forget the steps to access the Dark Web?

Why am I so hard on myself when I'm dealing with so much? Addiction, hospitalisation, psychiatric wards, mental health conditions, painful injuries, money worries, people owing me lots of money, need to get another contract, need to get a new flatmate, need to fix stuff up, need to stabilise and get into a sustainable position.

Alcohol's probably the most health-destroying drug; the most dangerous to quit if you're dependent; the most ubiquitous; the drug I've been abusing for the longest.

One step at a time.

Tags: #alcohol #drugs #addiction #mentalhealth

This is a story about infidelity...

Yo ho ho and a bottle of Xanax. We're off to take a sailing trip across the Atlantic to New York. I'm nervous, but she's with me - she's also an experienced sailor - so I'm excited and I'm sure that between us we can manage the voyage. At first we are heading towards Dover. Why are we travelling East when we need to be sailing West? Then, we are becalmed and a fog descends. The water is glassy and flat and the sails flap uselessly. A road sign appears and it becomes apparent that we are in London, on a road. We are towing the yacht on a trailer. I rack my brains, trying to think of the best marina with a hoist to lift our yacht into the sea. I can't think straight.

This is a dream, obviously.

Next, I'm approaching a nightclub, skipping the queue outside and heading straight for the entrance. I present my left hand to the bouncer, who shines a torch on it. I brush past him so confidently, and he's not really paying attention, so he doesn't notice that I don't have an ink stamp that says I'm allowed in. Nobody challenges me. I go past the dance-floor and into another room. I notice somebody sucking on a glass tube with what looks like shards of gold, or maybe honeycomb, being ignited with a lighter. Then, an old schoolfriend wants to show me something he's making. He's pouring chemicals into a large jam jar. He's making shake-and-bake methamphetamine. The crystals aren't perfect shards of ice, but instead they're a milky mess. I know the drug will be potent, but the solvents and other chemicals used are deadly. I'm afraid, but also drawn to it, like a moth to a flame. Somebody has prepared some lines of a white powder; it's being passed around. I wake up.

My doctor warned me that my new depression treatment - California rocket fuel - would lead to vivid dreams, but I've always had a lot of dreams.

In a way, my new dreams are better than the old ones. When I used to dream before, they were basically all the same: I have some supercrack and I'm trying to find a private place to take it, but every time I think I'm safe from intrusion, and I'm about to snort a line, somebody interrupts me. Then begins a stressful game of hide-and-seek where I'm trying to escape the voyeurs who wish to intrude on my private drug use. I never actually manage to get any drugs up my nose before I wake up.

Of course, drugs are still my mistress. I've got a virtually unlimited supply of opiates, in the form of tramadol and codeine. I've got stacks of benzodiazepines, in the form of diazepam and Xanax. I've got loads of Z-drugs in the form of zopiclone and zolpidem. I've got pregablin, venlafaxine and mirtazepine. I've got Viagra and Cialis. None of these chemicals seem to make the blindest bit of difference to my depression, and they're certainly not my drug of choice: supercrack.

I go to the chemist, and I have to give two signatures, because they're giving me medications that are controlled substances - they're illegal to possess without a prescription. I'm handed a carrier bag that's bulging with boxes packed full of blister strips containing capsules full of chemicals, or pills that have been pressed into certain shapes and sizes, with numbers and letters imprinted on them. Everything is so colourful. If I lose a pill on the floor by accident, I can identify exactly what it is.

I get confused at night, as I swallow 6 pregablin capsules (white with black lettering), 2 venlafaxine tablets (round and dark orange), 2 mirtazepine tablets (small lozenge shaped, light orange), 2 zolpidem tablets (tiny white lozenges) and a Xanax (an oblong with "XANAX" imprinted on one side). Sometimes I also take a zopiclone if I can't sleep (round white tablet). When my leg was in pain, I would also take 2 co-codamol with 30mg of codeine in each tablet (large white lozenges) and 2 tramadol capsules (green and yellow). Trying to remember if I took everything, and make sure I don't take anything twice, is quite difficult. I'm almost at the point where I should prepare all my tablets and check I've got everything before I greedily gulp them down. I can now swallow 6 tablets at once, easily.

My real mistress, and the beast that's out to kill me - supercrack - is tamed at the moment. I know that a lapse would be disastrous in my financially precarious situation, but I'm also so doped up that my libido and craving for supercrack is under control... for now. I'm not a superstitious person, but I feel like I'm tempting fate just writing these words.

I don't bother keeping a tally of how long I've been 'clean'. It's a ridiculous idea. If a person quits one thing, they start doing something else. A former gambling addict might become obsessed with fitness and go to the gym 7 days a week. A smoker who quits will probably start eating more, to compensate for the loss.

It might seem logical that the longer you're addicted to something, the harder it will be to quit and stay 'clean' but nobody seems to realise that the more times you quit and have periods of abstinence, the better you get at quitting and resisting temptation. Medically, the binge & quit cycle of drug taking is the most damaging, because the binges are so extreme: days and days without sleep or food, and huge doses of really harmful drugs, when your poor body has just about recovered and was starting to get back to normality.

Of course, the really harmful stuff is to relationships. She doesn't mention it very often, but she's worried about the next time I just disappear off the face of the Earth, and reappear skinny, sleep-deprived and suffering from all the nasty side effects of supercrack: paranoia, obsessive-compulsive behaviour and panic attacks; not to mention tachycardia, malignant hyperthermia and rhabdomyolysis. I'm no stranger to hospitals and psych wards.

If you meet me in person, I seem polite, well presented, somewhat smart and certainly confident and self-assured. I can make smalltalk and feign interest in other people's lives. I remember the tiny details that people tell me, which I can see are important to them, so that I can bring them up if ever there's a lull in conversation; an uncomfortable silence. There's no chance you'd peg me as a 'druggie' or a 'stoner' or a 'junkie'. I take perverse pleasure in contradicting and confounding the stereotypes.

Despite my ability to confidently bullshit my way through life, I do wonder if I'm as seriously sick as my doctors tell me I am. They can't make their mind up whether I have treatment-resistant major depressive disorder, bipolar disorder, borderline personality disorder or some dual or triple diagnosis of all of them, plus the substance abuse, of course.

On top of the chemical cocktails, there's a bottle of wine every night, just like every other middle-class professional. Lots of people would say that alcohol is part of the problem, but the last time I quit I quickly went hypomanic and lost my contract. Seems to be the story of my life: losing my contracts through ill-health. All the evidence points to chronic illness that makes me unfit to work, but my confident and upbeat attitude - plus my employability - has got me stuck in a groundhog day loop, where I work enough to pay the bills for a year, but then implode spectacularly and find myself without gainful employment, yet again.

Undoubtedly, my affair with supercrack wreaks havoc across every area of my life, but what about the depression? What about the hypomania? What about the fact I see everything in black and white, and I either love you or hate you? Even when I'm 'well' and functioning, I've still gotta be right: intellectual pride and arrogance.

I've committed to a new regimen of antidepressants, for the first time in years, so maybe my mood will improve if I can keep taking the pills regularly for 4 to 6 weeks... then we'll see if these blunt instruments of brain manipulation actually fucking work for once.

Meanwhile, money pours out of my bank account and the end of the runway gets ever closer, but the wheels of the aeroplane are still on the tarmac. If I can't psych myself up to overcome the depression, stress and anxiety enough to hide my problems and tackle the arduous task of getting another contract, I'm fucked. The house of cards will collapse quicker than you can say "fuck my life".

It's remarkable how much time I spend thinking about setting my affairs in order: making sure my life insurance pays out to my sister, making sure I've left instructions so that friends who've helped me out get repaid, making sure I've thrown away everything that's of no value, making sure that I've listed the details of all my bank accounts and creditors, making sure I've left enough money in my company so that my accountant can wind up the business and he gets paid, and also making sure that at least a teeny bit of my legacy is preserved: I've written a novel and this blog has about 600,000 words, plus photos. I always said I wanted to leave a smoking gun, in case anybody wanted to investigate how stress - mainly financial worries - can destroy a person and drive them to suicide. My biggest fear is being written off with a simple throwaway label: "mentally ill" or "substance abuse" or whatever... things are never as simple as that.

While most people are planning summer holidays and extended weekend breaks over the bank holiday weekend, I'm paralysed by the ever-approaching end of the runway, combined with debilitating stress and depression. Things look straightforward, because I've made life look like a walk in the park so far, but in fact I'm just very good at hiding the deteriorating situation, when my back's against the wall. Just because I can rescue myself in the nick of time, doesn't mean I can always do it, forever. I feel physically sick at the thought of the effort involved in doing what I do, all over again, even though it's a well-practiced tried-and-trusted formula.

Time just gets frittered away, which is fine when you're getting your regular salary and you spend most of your time at your desk just counting down to the weekend or your next holiday, but when you're in my situation, in a way, I'm dying. How do you think you'd feel if you were left penniless, homeless and with a bunch of vultures trying to take the clothes off your back? How do you think you'd feel if you know you can make everything alright again, if only you were well enough to work, but you feel sick and the thought of going back to the office caused you severe stress, anxiety and paralysed you; unable to cope or deal with the situation?

Tick tock goes the clock, and it doesn't stop. You have to run just to stand still. This is why it's so attractive to run away with my mistress and pretend my problems don't exist: escapism.

I want to escape this invisible prison.

Tags: #drugs #depression #suicide #mentalhealth #career

This is a story about nonlinear progression...

There's my bedroom door. As you can see, you can bolt it closed, which is a security feature I added myself. Later, I decided to slide a knife behind the wooden surround and screw that into the wood that surrounds the door. Then I decided that a second knife was probably needed, in case the first one snapped as the blade flexed. Then I decided that I needed something else and finally arrived at the decision to dismantle one of my crutches and part of my bed, so that I had a wooden slat and an aluminium tube, which in theory provided some kind of extra security.... I don't know. I'd been doing this for hours by this point, completely exhausted.

What you're really looking at is the mind, after losing five or six nights of sleep, skipping fifteen to eighteen meals, and being confined to one room, with all the windows obscured.

Who would want to come and do me any harm? Well, when you attempt to balance a crutch and a bed slat on a door handle at 4am - in total darkness - I imagine anybody within earshot would probably want to see me lynched.

I used to go and hide in the bathroom, because it had a proper lock, but then my flatmate unlocked it from outside with a butter knife. Luckily I was right by the door so I locked it again. He was only checking if I was alive, but it's strange how nobody talks to you when you descend into one of these periods of isolation.

In my mind, the lock on my balcony door had been picked. Then, the large glass patio door had been noiselessly slid open, and men clad in black wearing stealth shoes had been able to cross my wooden floor without alerting me to their presence. Meanwhile, more men clad in black, had entered my spare bedroom through a window. These men removed the 'security' features from my front door - for example, a hammer that falls on the floor if the door is opened, which is a kind of improvised intruder alarm - allowing more of their team to enter my flat and prepare to batter down my bedroom door.

Hiding in bathrooms is awful. The floor is freezing tiles and that's about it. There's plenty to drink and you can answer the call of nature, but other than that, it's just cold and boring. I spend half my time barricading the bathroom door and the other half looking through the crack under the door, to see if I can see the men in black in my bedroom. It's a really narrow crack and you can hardly see anything, so you start to imagine that you've seen things. This is why I've stopped hiding in bathrooms.

I have a bed that lifts up so you can store stuff underneath it. If you didn't know, you'd just think it was regular Ikea bed. I actually slept under there for 8 hours or so. It's fucking roasting and I'm sure there's inadequate air recirculation, but I seemed to survive.

Every time I get so hungry or thirsty or just fed up with the bullshit of it all, I take down the barricades and say "come on then, men in black, do your worst!". Then I usually just collapse in bed and sleep for hours and hours. Nothing bad has happened in my home, ever. The police have kicked the bedroom door in a couple of times at my parents', which is what triggered this whole paranoia. That's my parents for you: they'd rather have a door smashed off its hinges than talk to their son. I've tried the basics, like saying "use your words" but that's obviously too much effort for them.

That's the thing about paranoia: it doesn't come from nowhere. There are seeds and they grow into nightmares. Doesn't it creep you out, the idea of some twisted sick voyeur watching you while you take a shit or even just sleeping peacefully in bed? Doesn't it creep you out, the idea of your bedroom becoming a viewing gallery, where people come and go as they please, to watch whatever you're up to?

I haven't written in a while, and that's because I'd given up hope. I'd given up hope that my foot/ankle could be fixed and I could stop the massive doses of painkillers, that were making me so doped up I couldn't work. I'd given up hope that I had enough runway left, to be able to get another IT contract, especially after HSBC lowered my overdraft limit by the best part of £2,000. None of the sums added up. None of the calculations could show that there was a way that I could make my money last until I got some more income.

Then, a windfall from an investment I was managing on somebody else's behalf. A gift from a kind and caring person. Some help getting my spare bedroom ready to rent out to a flatmate - it had been left in an awful state by the last guy, who owes me approximately £6,000 - which will bring deposit money and cut my burn rate by half. Finally, I managed to get a bridging loan, which is getting paid into my account today. Turns out my credit rating is pretty awesome. One of my non-HSBC credit cards just had its limit doubled, so I can live on that to some extent. My interest bill is awful, but put in the context of what I can earn as an IT contractor, it don't mean shit.

I'm crashing at my girlfriend's so that I'm in a different environment. Also, because there are workmen replacing the planking on my balcony, but the amount of noise they're making, you'd think they were demolishing the entire block of flats.

The lounge/diner/kitchen massive room in my flat - with patio doors onto the balcony at one end and a dual-aspect panoramic view of the River Thames - is fucking awesome, but when I'm depressed I only go in there to get more unhealthy snacks, which I take back to my stinky bedroom, with the curtains drawn, to watch endless amounts of on-demand TV.

I don't like it when alcoholics describe themselves as 'in recovery' when they've been teetotal for years and years. I'm 'in recovery' in that I lost at least 14kg in body weight, since my peak (although that was somewhat skewed by fluid retention). I lost more sleep and skipped more meals than you'd ever believe. I need to recover. I need to catch up on sleep. I need nutrients and to allow my body to lay down a bit of fat. I need to have some time where I'm not worried about men in black kicking the door in, and where I can have sex with my girlfriend without worrying that some sicko voyeur is watching through a tiny gap in the curtains.

Working so hard, with such enormous effort and stress, to get out of hospital and get to the first day of my new job, was one of the most difficult, challenging and against-the-odds things I've ever done. I did it. I fucking did it. Then, to have it snatched away was a cruelty that broke me. It broke me. It broke my will to live. It broke my will to keep trying. I had to hide from the world for an entire week, just in shock, unable to allow myself to think, because my thoughts would have turned straight to suicide. I had to get through a week without a single bit of thinking, otherwise I was dead; it hurt me that badly and left me in such a shitty situation.

Since then, I've been careless with my life and everything in it. I've got an amazing girlfriend, but I risked losing her. I've got a super helpful friend who's always there for me, but I risked pushing them away. I know people are monitoring the situation through this blog and social media, and would act if they were worried, perhaps to send the police round to find my corpse. It'd be a better idea to just reach out and ask if I'm OK and say you're worried, using any of the tech communication channels we have - SMS, iMessage, Whatsapp, Facebook Messenger, Twitter DM... the list is endless.

My long-suffering girlfriend ended up speaking with somebody I know through my blog and Facebook, because he was quite rightly concerned. I'm really touched when I find out about these little webs of people who are like a safety net. Nets have holes and I might fall through one - as I have fallen through many of the cracks in life - but it does feel like I have more to live for, knowing that people care enough to speak to each other; share information; discuss what to do.

I'm now admiring my newly flat stomach (but seriously, don't do the supercrack diet) and feeling a little bit more relaxed about having some runway to get back to work once my foot/ankle is fixed... although ironically, I stopped taking the painkillers, but I broke my wrist, so go figure.

You'd seriously hate me if you knew everything about my charmed existence. I left my apartment which faces West - a view of almost every famous London landmark: Shard, London Eye, Tower Bridge, St Paul's Cathedral, Walkie Talkie, Cheesegrater, Gherkin, BT Tower etc. etc. - and I'm now recovering in my girlfriend's apartment which faces East, so I can look at the cable cars going over the Thames, the O2 Centre (a.k.a. the Millennium Dome), the Cutty Sark and Royal Naval College and other parts of beautiful old Greenwich.

I'm off most of the meds now. Coming off a high dose of Tramadol, I wondered why I was itchy, nauseous and sweaty, and realised I was junk sick. Opiate withdrawal ain't that bad really.

I've had an MRI scan of my foot/ankle, and on Friday somebody is going to test the nerve wiring from my foot all the way up my leg, to check for any broken connections. Then, there'll be another consultation and possibly an operation. Things are going quite quick because the NHS outsourced me to a private hospital.

Just need to remember not to get too relaxed at the moment!

Tags: #addiction #london #career #relationships

This is a story about dance, trance and magic plants...

On the left hand side of the picture above, we see drugs that are considered to be medications. That is to say, they are considered to have some useful function in the practice of medicine. On the right hand side of the picture, we see drugs of abuse. Drugs of abuse are considered to have no useful function at all, and have been made outright illegal in all contexts.

In the middle of the picture are pills that are sometimes considered medicine and sometimes considered drugs. Probably the best example I can give you of such a dichotomy is ketamine (not pictured) which is well known as a horse tranquilliser. In fact, ketamine should be better known as a general anaesthetic, and the drug of choice for paramedics to treat pain in victims of traumatic injuries, for example in the aftermath of a road traffic accident.

Dihydrocodeine is an opiate, and opiates are analgesic. Analgesics don't cause numbness, but they do increase pain tolerance. With enough analgesic, you could saw off your own leg and feel everything, but you wouldn't care about the pain. Anelgesics are painkillers. Dihydrocodeine is a painkiller.

Tramadol is an opiate, therefore also an analgesic.

Zopiclone, Xanax, diazepam and etizolam are in the hypnotic/sedative/anxiolytic category. Zopiclone will help you have a good night of uninterrupted sleep and wake up without a drug hangover: it's an excellent sleep aid. Xanax is a fast-acting, short-lived tranquilliser: it's great for stopping panic attacks, and might be useful if you're suffering a bout of unbearable stress and anxiety or struggling to drop off to sleep. Diazepam is a long-lived tranquilliser that's good for longer term management of stress and anxiety. Etizolam is a result of prohibition: it's an imitation of diazepam that used to be legal to sell and possess as a 'research chemical'.

MDMA is the abbreviation for 3,4-Methylenedioxymethamphetamine (and yes, I did just write that without having to look it up) which is more commonly known as Ecstasy, molly, mandy or generally as 'pills' in a clubbing/rave context. It's a stimulant and empathogen: it stimulates empathy. Its peak effects last 6 to 8 hours, but takes about 12 hours to wear off completely. The experiences can be very profound and long lasting. MDMA is extremely draining on the serotonin system of the brain, which can lead to a form of delayed comedown, coming days after taking the drug.

Crystal Meth is the commonly known name - thanks to the TV series Breaking Bad - of methamphetamine. It's a very powerful stimulant with effects lasting 12+ hours, and it disrupts sleep long after its desired effects have worn off. The more astute reader may notice that the final part of the chemical name of MDMA is the same as the chemical name of meth. As you might expect, there are similar effects: loss of appetite, increased energy and decreased need for sleep. However, while MDMA stimulates empathetic behaviour - hugging etc - meth tends to stimulate rather more hedonistic behaviours, such as fucking and masturbating to pornography. However, both drugs - being amphetamines - cause a man's dick to shrink to a little nubbin that's no use to anybody. Polydrug abusers might use sildenafil (Viagra) or other erectile dysfunction medications in conjunction with meth, in order to sustain a decent hard-on.

Spread out on the kitchen counter top, there's probably about £300 worth of drugs.

MDMA is extremely cheap, coming in at circa £10 per gram, which is enough for 5 very strong doses. Far cheaper than getting drunk in a pub or a bar. Pound for pound, MDMA represents excellent value.

Crystal Meth is the most expensive, coming in at about £100 per gram. Because of the crystalline form of the drug, it's far harder (although not impossible) to cut it with other things. Cocaine has an average street purity of less than 20%, because it's so tempting for every person who handles the coke in the chain, to cut it a bit and increase their profits. All white powders look the same, and numbing agents - like baby teething powder - will give the numbing effect that cocaine has. Crystal meth is generally pretty pure. It's usually smoked or injected. You do not want to mess with this stuff.

Diazepam is frighteningly cheap. 100 pills containing 10mg of diazepam each, will set you back £30 or maybe even less. The price has fallen drastically, from £1 a pill, to now 30 pence. It's important to remember that diazepam is a benzodiazepine, and the benzodiazepines are physically addictive. You can die if you take a load of diazepam and then stop taking it. It's not something you should mess with.

Xanax, by comparison, is very expensive. Because it's convenient to be able to take it and not be spaced out the next day, it's become America's favourite tranquilliser. The Rolling Stones might have sung about Mother's Little Helpers - referring to Valium - but now the housewife's choice is Xanax. Physically addictive, blah blah blah.

Zopiclone is nice and cheap and works really well without nasty side effects. The only problem is, becoming too reliant on it for sleep. At some point, you have to stop relying on pills and alcohol to get to sleep, and learn natural ways of making sure you can drop off and get your precious 8 hours. Try blue-light filtering glasses, not having any screen time after 10pm and sleeping with your smartphone and other electronics in another room, so there's no temptation to pick them up and start looking at Facebook or whatever.

Tramadol and Dihydrocodeine will take you on the journey to opium, morphine, fentanyl and diacetylmorphine (heroin). The cheapest opiate of all is heroin, because of the simple economic law of supply and demand. People fucking love heroin. I've smoked heroin on a few occasions and I enjoyed the feeling of carefree sleepiness, but I never got a rush of euphoria like I imagine you must get when you inject. I've never injected drugs. One should be mindful that the vast majority of new heroin addicts in America started their journey with opiates prescribed by their doctor - oxycontin, for example - and then moved to heroin because oxy is prohibitively expensive. Tramadol and codeine are pretty cheap, but they're also very weak compared with morphine and heroin.

There's no need to be afraid of any of these drugs in the sense that they're not going to leap down your throat and cause you to instantly become an addict who's prepared to murder your entire family for 50 pence, so you can have one more tiny little hit. These drugs are not like Venomous Agent X, which can kill you almost instantly if you absorb even the tiniest amount through your skin. You do not want to touch a pin head sized amount of VX nerve agent, but you can safely handle Ecstasy pills, shards of ice (crystal meth) and all of the other drugs pictured, and you will come to no harm at all.

Taking these drugs once, or even twice or three times, is very unlikely to result in addiction. You may enjoy the sensations; the experience, but it's quite possible that you might find the effects of the drug to be extremely unpleasant. Certainly, MDMA can be very intense and the intoxication of tramadol can be alarming. Interestingly, the calming effect of the benzodiazepines is often the best treatment for a 'bad trip' that you very much want to end. Sadly, there's no 'off' switch for most drugs. It's like when you've had too much to drink and you're throwing up: you wish that you could stop feeling so sick and that the room would stop spinning, but there's no instant fix.

To have this vast array of drugs just lying around, seems to invite disaster and is a risk in terms of the illegality of possessing so many controlled substances. Are you going to ring the police? Do you think I should go to jail? Is it right to ruin my life, because we should follow the law to the letter, even though the law is an ass?

To address the second concern: doesn't this invite disaster? I've had enough disasters in my life. I've reached a point where I'm rather sick of the drama and the near-death experiences. I'm rather sick of the paranoia and the comedowns. The drugs don't even work any more, because my brain has become so used to powerful narcotics. My brain is literally saying "you've been doing this shit for far too long". I'm almost at the point where drugs bore me.

Right now, I need tramadol, because I'm in a lot of pain because of my leg injury. The zopiclone will be handy when I run out of pregablin, which I'm using to sleep through my pain and discomfort. Having Xanax and diazepam lying around is never a terrible thing. At least benzos are a lot cheaper than a bottle of wine or two, a lot less fattening and a lot less liver damaging. It is a slippery slope though, and it is easier to get hooked on benzos than it is to become an alcoholic, because there isn't really a hangover per se, with the benzos.

The MDMA and the meth should probably get flushed down the loo. I'm too old to go clubbing/raving, and the crystal meth tips me straight into a hypomanic episode and turns me into a total sex maniac.

The dihydrocodeine will gather dust in the medicine cabinet, as a strong painkiller, in case I ever have a nasty injury again and the doctors are dicks about giving me prescription drugs to relieve pain. I do think that doctors in America have been foolishly over-prescribing opiate painkillers, because they believed the marketing of the pharmaceutical companies.

I'm sure you think that this cornucopia of chemicals is crazy. I'm sure you think this deluge of drugs is deranged. I'm sure you think this mass of medications is madness.

However, it's fucking hassle having to get a doctor's appointment, wait for the allotted date and time, and then persuade the doctor to give you what you want and need. There's every chance that the doctor may end up sending you away empty handed. Far better to have your own well-stocked pharmacy cupboard, and have whatever you need whenever you need it.

Of course, the nanny state is there to protect us from ourselves, which is why we arrest people who are about to climb mountains, don't we?

Prohibition has failed spectacularly, because it has created highly efficient black markets. Prohibition has failed spectacularly, because it has needlessly ruined lives of otherwise law-abiding citizens. Prohibition has failed, because the middle classes take just as many drugs as poor people, but the rich middle-class people are very rarely prosecuted. Prohibition has failed, because drugs are just as widely available as ever, and the main beneficiaries are corrupt customs, corrupt police and organised crime gangs. Prohibition has failed, because it fails to acknowledge the inescapable fact that people are always going to make, sell, buy and take drugs, no matter what the law says. Prohibition has failed, because it makes people paranoid and exacerbates mental health problems. Prohibition has failed because it directs money that could be used to help the tiny proportion of people who struggle with addiction, instead of using vast amounts of resources to persecute ordinary law-abiding citizens, who just want to smoke a bit of dope or take a pill when they go clubbing on a Saturday night.

You know prohibition has failed spectacularly, when the government makes mushrooms - which grow naturally in the ground all over the UK - a Class A drug, in the same category as crack cocaine and heroin. Are you fucking nuts? Are you fucking telling me that we should stuff our prisons full of people who picked a fucking mushroom in a fucking field?

Imagine this conversation:

Prisoner A: What you been nicked for?

Prisoner B: Murder. What about you?

Prisoner A: I picked a mushroom

That is quite genuinely the situation that the government introduced into UK law. I'm being quite serious here. Mushrooms are considered just as bad as crack cocaine. I wonder what the government were smoking when they made that insane decision.

As we know, when a government bans a drug, then clever chemists create another one that's almost identical. In America, they have a law that makes analogues illegal, so only whole new classes of drugs can get around their laws. All kinds of obscure chemicals - legal highs - burst onto the scene thanks to America's attempts to get clever with prohibition.

The UK government has gone a stage further and attempted to ban anything that has a psychoactive effect. That means that we're all 'in possession' of illegal drugs, because our bodies are stuffed full of chemicals that are psychoactive. It also means that drugs will simply get sold in 'kit' form: mix the ingredients at home and hey presto! There's your drug of choice. People will always find a way around the stupidity of prohibition.

The fear that has been stoked up by these terrible prohibition policies, has created a squeamishness about being able to have honest open conversations about drug taking. We should be well informed, not ignorant. We shouldn't be paranoid about being persecuted by the authorities. You have to be fairly brave to stick your head above the parapet. A lot of corrupt officials make a lot of money, through the ongoing boom times of the black market. There is an insatiable demand for drugs - and there always will be - which is why there is so much resistance to making drug taking into something that's safer, regulated, quality controlled and a well understood problem, rather than something cloaked in secrecy and hampered by stigma.

I've had problems with addiction in the past, but it makes me a stronger more well-rounded person, to have been through that ordeal and to know what difficulties are faced by people who become ensnared in the traps that have been set for them: draining their bank balance, destroying their health, and driving them to criminality. Why can't I talk openly about my experiences? Why do I have to be anonymous, hiding away with other 'dirty' junkies, in church halls where we self-flagellate for our 'sins' and hang our heads in shame.

Obviously I've had enough of prohibition, but I've had enough of being stigmatised and shamed into silence and anonymity too. I've had enough of people's wilful ignorance, when it comes to drugs and the lives of drug users. I've had enough of ridiculous horror stories and misinformation.

Perhaps you didn't even read this far, if you're the kind of person whose mind I'm trying to open, but perhaps you did, because on the face of it I'm an educated middle-class white professional man, working for prestigious companies in seemingly important roles. You can't quite imagine me smoking heroin, can you?

I'm challenging your preconceived ideas. I'm making you question what you thought you knew, and what you thought was obvious and without exception.

Tags: #drugs