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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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Getting What you Want from Your GP

7 min read

This is a story about being on the sick...

Sick note

I'm regularly asked how to obtain a sick note and/or prescription for high-strength addictive medications from a GP, so I thought I'd prepare a handy guide to answer these frequently asked questions. Above you'll find a copy of a sick note that you can print out and fill in with your own details, so that you can bunk off work because you're lazy and entitled.

Of course, your doctor wants to cure you, which would be a dreadful outcome. It takes a lot of time and effort to ensure that your doctor doesn't actually give you what you need. Your GP can instantly relieve your ailments any time they want so it's important to remember what YOU want: ineffective treatment. You must always remember that you want the wrong treatment and resist any and all attempts to be persuaded to receive the correct treatment. If you do that then you should be fine. I mean, not actually fine... I mean sick, which is obviously what you want.

Proper preparation is essential. Make sure you have extensively researched your chosen ailment and know what all the likely treatments are so that you can refuse or say that you've already tried the ones that work. This is important. Your doctor will try to fob you off with something which has an overwhelming body of evidence that conclusively proves that it will cure you instantly, so you should be fully prepared to absolutely flatly refuse any of those treatments. Be careful, because your doctor will obviously try to trick you into becoming well again, which isn't what you want at all.

When demanding dangerous addictive medications, it's a good idea to scream, yell and aggressively and insistently dictate that you must be given what you want immediately. Obviously your GP may be alerted to your blatant intention of doing yourself harm with the "fun stuff" and your desire to remain sick and incapacitated, so it's important that you get irate and use ill manners in order to better communicate your want for large quantities of deadly pills.

While you're spending time with your GP, it might be a good idea to ask if the pills you're getting are the kind that are easily crushed and snorted. Ask if the pills contain an excipient or other additive which would make intravenous injection less pleasurable, and demand brands which have no such so-called 'safety' formulations. Find out if you'll get a bigger rush by combining medications and make sure your GP knows you don't care about any so-called contraindications. Your GP is an expert in the most fun ways to abuse prescription drugs. Generally, the less willing your GP is to give you a particular medication, the more desirable it is.

GPs often talk about the "analgesic ladder". Say for example you are hoping to obtain a prescription for codeine, which you can extract from co-codamol tablets using water that has been cooled to 5 degrees celcius or lower - filter the chilled liquid to get rid of all that pesky paracetamol. If your GP refuses to give you co-codamol, then you should climb the analgesic ladder and demand tramadol. If your GP refuses to give you tramadol, then you should continue up the rungs of the ladder, demanding buprenorphine, then morphine, then diacetylmorphine. Do not leave the GP's consultation room until you have obtained your prescription for pure diacetylmorphine. It's your right to have pure heroin dispensed to you via the NHS, because you want it and it's nice.

When demanding your sick note, make sure your GP knows it's yours and they should return it to you immediately. Make your displeasure loudly known that you were inconvenienced by having to visit your GP to get it back.

It's a commonly held misconception that you would have to feign illness in order to get a sick note, but it's a well-known fact that sick notes are in fact a certificate of bone idleness and it would look very odd if a sick person were to ask to be signed off work. It's imperative that you demonstrate that you're quite capable of performing a range of work-related activities and you have absolutely no reason at all to not be hard at work down a f**king coal mine or something. Take some heavy weights and a computer keyboard with you and repeatedly lift the weight up and down while doing star jumps and typing at 100 words per minute, to absolutely convince your GP that you're capable of doing any physical or mental task that would take place in the workplace, such that you're obviously urgently in need of YOUR sick note.

Did I mention eating deep fried battered lard cakes, smoking a thousand fags and drinking flagons of mead? It's important to demonstrate all the unhealthiest lifestyle choices that you can, in order to show your commitment to being unwell, otherwise your GP might mistakenly believe that you want to be cured or helped in some way. Leave your GP under no illusion that you have not even the slightest glimmer of desire to in any way help yourself.

Remember, it's you versus them. Seeing your GP is an adversarial conflict, where you want completely opposing things and you absolutely should not never under any circumstances not never no way agree or co-operate in any way whatsoever, or listen, or heed any advice or in any way allow yourself to be corrupted by your GP's intentions, which are completely out of alignment with your own firm decision to be sick and die. If you even listen to your GP a teeny tiny bit, you could be accidentally cured beyond your worst possible nightmares, to the point of being healthy and happy - disaster!

It's important to remember at all times just how much you love being miserable, sick, anxious, depressed, overweight, unfit, in pain and on your way to a premature and painful death. It's important to hang on to your main objective - remaining unwell at all costs - if you want to avoid your GP's devious attempts to cure you of all your ills and send you on your merry way as a productive, healthy and content member of society. It will take all your wits and cunning to outsmart every attempt to make you better.

By following this prescriptive guide, I hope you're able to obtain YOUR sick note and a prescription for vast quantities of dangerously powerful, fiendishly addictive and deadly medications which can be mixed to make you sick, dying and dead in horrendously toxic combinations. It's a difficult challenge to obtain the wrong treatment, but given that the reward is pain, suffering and death, it's worth the effort.

Just remember: your GP is not on your side. You and your GP want different things, and you should stick resolutely to your desire to have the WRONG treatment and remain sick and dying. Every time you trick your GP into giving you the wrong treatment, or refuse the right treatment, you're winning.

Good luck and STAY SICK!

 

[P.S. apologies to my GP if they should read this for some reason]

 

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Numb & Dumb

5 min read

This is a story about being medicated...

Various assorted pills

It would substantially benefit my bank balance if I was to swallow substances that would remove my brain from my skull and place it into a jar - a chemical straightjacket. My doctors are falling over themselves to give me pills that will put me into a warped kind of reality - an altered state - where my perceptions are chemically changed.

If you put your hand in a fire and it's hurting because your hand is getting burnt, you have two choices. Firstly, you could remove your hand from the fire. Secondly, you could take a drug so that you don't feel the pain or care about your hand getting burnt.

I remain absolutely convinced that I'm in a state of depressive realism that's allowing me to perceive the madness of our late-capitalist society. I see suffering and injustice everywhere I look. I see the ridiculous situation where powerful incompetent men are paid millions of pounds, despite screwing everything up, while the people who do the most essential jobs in society are paid a pittance. The poor give every penny they earn back to the wealthy men for the privilege of being alive. It's a bitter pill to swallow.

Why have we defined "functional" to mean doing jobs that we hate? Why have we defined "functional" to mean not rocking the boat; not challenging the status quo? Why are our most "functional" members of society the ones who are causing the most human misery?

To decide not to take medication is a political statement. To decline to have my body violated - simply to conform with a political system that I don't agree with - makes me into a kind of political prisoner. I'm a victim of "fit in or f**k off" culture.

It seems to me like most people depend on substances - alcohol, tea, coffee, energy drinks, cigarettes, nicotine e-liquids, antidepressants, anxiolytics, tranquillisers, sleeping pills, painkillers - and very few of us are able to live life substance-free. What is it about modern life that pushes us onto these addictive substances and keeps us dependent on them? Why should it be mandated to use psychoactive substances, just to live my life?

It seems deeply immoral to have constructed a society that's unbearable except with something to 'take the edge off'. It seems like a complete car crash of a situation that we have to reach for chemicals just to be able to function and fit in. It seems like bullying and coercion to me. I have deep ethical objections to a world that forces me to put substances into my body against my will.

I fought hard to free myself from my dependence on caffeine. Quitting coffee was challenging. Quitting tea was relentlessly difficult. Avoiding caffeinated beverages is tricky.

I had the good fortune of never becoming addicted to nicotine, except when addiction was forced upon me by my parents breathing their second-hand smoke all over me in a confined space, which was wicked and immoral.

I deliberately spend lengthy periods without alcohol, to clear my mind of all substances. Alcohol is ubiquitous and hard to avoid. There's huge amounts of peer pressure to drink.

Finally, I find myself fending off prescription medications. Without prescribed pills, life is very hard. It's almost expected that modern life is going to induce anxiety and depression in most of us, and so it's us who must change rather than us changing the circumstances that produce the unbearable mental health problems - we consent to having mind-altering substances put into our bodies, because we have little choice in the matter.

If you want money - and I imagine that you probably need it - then you're going to have to slurp tea & coffee, suck on your e-cigarette, get drunk and pop pills. We've arrived at a state where life is so utterly depressing and shit that we need all these chemicals to pretend that it isn't.

In the face of so many obvious problems in the world, is the answer to take pills that allow us to be wilfully ignorant and carry on regardless? In the face of the whole shambolic mess threatening to crumble into dust at any moment, should we be so coerced and bullied into medicating ourselves?

We live with incredible insecurity. Our jobs are utter bullshit and we could lose them at any moment. Our wages barely cover our living expenses, and in many cases they don't. Payday lenders and other legal loan sharks put us into a constant state of debt-laden fear. Our livelihoods are under constant threat; our homes. Where's the security? Where's the comfort? Where's the contentment and relaxation and happiness going to come from, in this bullshit merry-go-round of horrible jobs and insufficient money to ever escape from the rat race?

Eventually, it's all too much and we capitulate. "Give me something to make me feel better, doc" we say. We swallow our antidepressants, anxiolytics, tranquillisers, sleeping pills and painkillers because we can't afford to take time off to get better. We can't afford to drop out of the rat race. We can't afford to show any weakness. We can't afford to catch our breath.

The capitalists have got us right where they want us - numb and dumb. We're so f**king doped up that we don't realise how awful we've let things get. We don't dare to imagine a better world. We just keep chasing that ever-elusive dream that one day we'll get to quit the rat race, but we never will because we're all doped up to the eyeballs with enough drugs to tranquillise an elephant.

That's why I don't take the damn pills. That's why I'm going through the shit I'm going through - I want to experience reality and I don't want to be yet another dull-eyed slave.

 

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Drink Yourself Sober

10 min read

This is a story about escaping...

Empty wine bottles

I just realised that I couldn't tell you anything about how these wines tasted. I drank them without savouring the smell and the flavour. I drank all these bottles of wine on my own and I can't remember a thing about them. If I had to choose which one I enjoyed the most, I wouldn't be able to - I didn't drink them for enjoyment. I drank them to get drunk.

When I took a sip from my glass last night, I still had a very bad hangover from the night before. The wine tasted sour and unpleasant. I had been in two minds about drinking anyway, but something prompted me to drink - I think it was anxiety about fast approaching Monday morning and returning to the office; another agonising week doing a job I hate. There was anxiety about my financial situation too. I had run out of money and spent my final £10 on wine and a cheeseburger. I was skint.

Alcohol has become liquid diazepam for me. Alcohol is a very poor substitute for benzodiazepines though. At least with benzos you don't have dreadful hangovers. At least with benzos, you don't get a fat tummy from all the excess calories. At least with benzos, it's possible to be very precise with a dose. Benzos slotted pretty easily into my everyday life, in a way that alcohol doesn't. I would take a benzo to go to sleep, and another to be able to get up and go to work. I was functional on benzos. Alcohol is unhealthy. Alcohol is not going to lead anywhere except becoming unfit, overweight and suffering from various alcoholism-related illnesses. Taking my tranquillisers in pill form is far more preferable to having to guzzle gallons of booze.

Why would I be getting so intoxicated anyway? Surely my life is wonderful?

There's a little bit of loneliness and boredom. I'm working away from home and living in a hotel. There's nothing much to do except drink. I was running out of money, so it's not like I could go out and do things. Also, did I mention I was running out of money? When you know that you're running out of money, it's really stressful. Stress means that you can't relax and you can't sleep. Constant anxiety is a terrible thing. When you're running out of money, anxiety is constant. When you're not sleeping, anxiety is with you all night long, tormenting you. There are no easy solutions to my problems, but money's a good start. If you don't have any money, you might as well just get drunk.

"How do you afford to get so drunk if you've got no money?"

Well, it's about priorities. The six bottles of wine pictured above probably cost me about £42. How much would I spend on gym membership? How much would I spend on a night out seeing friends? How much would I spend wooing a girl? It's not possible to simply not exist, and still earn money. Earning money requires existence - nobody pays you unless you're in the right place at the right time. The only way to get me into a shitty situation that I hate - living out of a suitcase and working a job that makes me sick - is to oil me up with a load of booze or tip a packet of pills down my throat. It's completely necessary to have booze when I'm doing something that's otherwise incompatible with my mental health.

Thus, we arrive at my central theme: drinking myself sober. The route to sobriety does not just include abstinence. The route to sobriety also needs to include things that are compatible with life. Modern life requires money. The way to get money is to do a job that you hate. The more you hate your job, the more you'll get paid. I REALLY HATE my job, so they pay me LOADS AND LOADS of money.

I finally got paid today.

Now I have money but I also have a big booze habit. I was pissed out of my mind the whole of Christmas and New Year, because I really didn't want to go back. I'm quite an articulate fellow but I really struggle to quite convey just how unhappy my particular line of work makes me.

"Retrain! Be a famous pop singer! Drive Formula One cars! Be an astronaut! Be a professional footballer!" I hear you shout.

Yes, but there are economic fundamentals at play in the capitalist bullshit society we all live in. It makes far more sense for me to be paid absolutely bucketloads of cash, and suffer a very great deal, than to be paid absolute peanuts and suffer loads anyway for different reasons.

I got paid today.

An alcohol habit, I can deal with, I think. When I had a massive problem with sleeping pills and tranquillisers and painkillers, life was a different story. There was no way that I was going to be able to quickly and easily cut down my addiction to prescription medications. I was actually physically dependent on benzos to the point where I would have seizures and possibly die if I stopped taking them abruptly. I was trapped. Now I'm not trapped. I have a booze habit - I drink more than I want to - but it's manageable. I don't drink spirits. I don't drink every day. I don't drink in the morning. I don't get pissed at work. It's a much better situation than when I had such a bad benzo addiction that I was on diazepam around-the-clock.

Sleep is one of the reasons why I've historically had a problem with booze and benzos. Zopiclone is called a nonbenzodiazepine, but it's still a benzo. Zopiclone is addictive. I used to have a few glasses of red wine to help me sleep. When I discovered zopiclone it became my drug of choice for helping me to sleep. I took it for most of 2017.

Now, I'm doing all the right things for sleep. I practice good sleep hygiene. Lowering the lights, avoiding strong blue light, having breakfast, completely avoiding caffeine, having 5-HTP (a precursor to melatonin) and magnesium supplements. All of these things make a difference. I get a little exercise too.

But, on the flip side, when you stop taking diazepam, alprazolam, zopiclone, zolpidem, pregabalin, mirtazepine, lamotrogine and a whole heap of other sedative/hypnotic/tranquilising/sleeping-pill type drugs, you get a horrible amount of rebound anxiety and insomnia. Words can barely express how horrible it is to live with a constant gnawing sense of dread, doom and dismay. I'm not talking about a few nerves that can be waved away with bloody breathing exercises or yoga. I'm talking about living for 24 hours a day with the unshakable sensation that you're about to die. It's not something that's going to be fixed by your quack snake-oil cures, because it has a biochemical origin. What goes up must come down. If you take heaps of pills, they're really really hard to stop taking and you'll feel awful when you do stop taking the medication.

So, I've been self-medicating for the combined anxiety of running out of money, having to start a new job, doing work that I absolutely loathe and that makes me sick, having to live away from friends and family in a lonely isolating environment and not having any bloody money to spend to make it bearable, while withdrawing from bucketloads of addictive medications. I think £42 for six bottles of wine is a bloody bargain, when you consider that this unhealthy coping mechanism has actually helped me to cope. I've done it. I've bloody done it. I worked and I got paid - that wouldn't have been possible without chemical crutches to prop me up.

Hurrah for alcohol. Better the devil you know. It should be straightforward to now reduce my alcohol intake to healthier levels. Some moderate alcohol consumption is actually desirable. I can't imagine living on this shitty overcrowded rainy island, without wine and beer to drink. I can't imagine anything worse than living life completely sober.

Of course, there's a risk that I swing the other way, and my drinking worsens. There's a risk that I'll reach for the harder stuff - which I've never touched a drop of in my life. There's a risk that I'll lose control.

At the moment, I'm really chuffed with where I'm at with my addiction to substances. To have quit all those dangerously addictive drugs, and now be left with a very negligible habit is quite impressive. What does a couple of glasses of wine matter?

The next challenge is to try to stay off the zopiclone and taper off the tiny amount of pregabalin that I've been relying on. It's taken longer and it's been much harder than I thought it would be. I'm amazed just how terrible I still feel, as I reduce my dose of all the pills I was addicted to to almost zero. It's amazing just how much of a strong hold on my mind those pills had. I'd reach for those pills to go to sleep, and I'd reach for those pills just to cope with hideously horrible stressful shit, that made my life unbearably filled with anxiety. Now, I occasionally have some red wine. That's not bad is it?

I really can't decide which way to go at the moment. I'm not going to drink tonight, but I've had to take 50mg of pregabalin to be able to cope with anxiety. I shouldn't be stressed - I finally got paid - but it's going to take a little while for me to re-adjust to the new circumstances. I've been living with the threat of bankruptcy hanging over me for so long, I can't quite believe I dodged that bullet.

I'm not sure if anybody who's followed my turbulent ups and downs can detect any improvement or change from where I was at when I was under the influence of enough medications to tranquillise an elephant. It's really hard to gauge in myself whether I'm any different at all. Am I able to better perceive reality? Am I communicating with more clarity? Am I getting better? It's impossible for me to judge.

One thing that should be noted is that my decision to reduce and quit a whole host of highly addictive medications, alcohol and other substances, was my own. I also don't think I could have quit everything if I was forced to go cold turkey and quit abruptly. In fact, it would quite literally have killed me to do so - you can't just stop when you're physically dependent on substances. Alcohol, for all its faults, is at least available as a ubiquitous form of self-medication. If I'd had to rely on doctors to give me what I needed, I'd never have been able to get through such a torturous period of re-adjustment. It's inhumane to not offer any kind of substitute prescribing or realistic tapering of doses, to help people escape from the trap of addiction.

Yes, I laughed at the amount of effort that junkies will go to in order to get a tiny bit more methadone or subutex, but that's the point - you do you. You know what you can take and you go at the pace that means you succeed. You know what you need and you should damn well get it. Anything other than this is going to be doomed to failure, and cause undue suffering.

I've suffered and it's been hard. It's still hard. But, I got through something really tough and I still have the comfort of knowing there's a bottle of wine waiting for me in the off licence down the road if everything gets thoroughly unbearable. Hurrah for red wine.

 

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January Retox

6 min read

This is a story about performance enhancing drugs...

Zopiclone Tablets

As is often the case for people in the New Year, I decided to try to cut down on unhealthy habits. I decided to drink less, stop taking sleeping pills and stop taking a medication which is sometimes prescribed for anxiety. The net result has been an enormous rebound in my insomnia and anxiety levels. I was not at all functional this morning. I didn't go to work.

If you think that depression, anxiety and other mental health problems are due to a moral failing, you're an imbecile. "We'd all like to take the day off. People in Africa don't lie in bed because they're depressed" etc. etc. If you think like that then I'd like to curse you with a panic attack. Anxiety is a terrible thing - it's not just a feeling that can be wished away or accepted. The whole point about anxiety is that it's invasive - if it could be ignored, it wouldn't be anxiety.

Having spent most of 2017 physically dependent on benzodiazepines, it seems inevitable that I would have lost my ability to cope with low to moderate anxiety without relying on pills. Also, there's a lengthy period where the withdrawal from substance dependency creates a gnawing miserable round-the-clock inescapable anxiety, that makes every passing second feel like a year. To quit benzodiazepines is the hardest thing you'll ever do.

I was lucky enough to be able to concentrate on getting through the nasty withdrawal process. I was in a lovely environment to go through the worst of the horrible withdrawal syndrome. Because I didn't have so much pressure and stress, I was able to quit diazepam, alprazolam and pregabalin. I reduced my zopiclone by half. To quit those 4 medications in the space of four months is unprecedented. Well done me.

I had to go back to work. I was running out of money. The fact that I went back to work doesn't show that I was well; that I was recovered. The fact that I went back to work shows just how desperate my financial situation is. Necessity, not good mental health.

My mood improved when I got back into work. My destiny seemed to be in my own hands - all I had to do was work and money would come flooding back into my depleted bank account. However, the stress and pressure created intolerable anxiety. It was inevitable that I would drink more alcohol, as an unhealthy coping mechanism.

For a while, I've been less suicidal. I've even entertained some thoughts about what I might do when my finances are looking healthier. Surely to be thinking about the future shows a remarkable improvement from where I was, when I was having endless suicidal thoughts.

In fact, without the crutches of medication I'm still a sick man. I couldn't function today. I couldn't face the day. You might make light of how bad things were, but it was enough to make me immediately want to end things - to kill myself. In the blink of an eye, the tiny amount of hope, optimism and opportunity could be snuffed out. Without something to help me deal with unbearable stress and anxiety, I was very sick; incapacitated.

So, I feel forced back onto the pills. I feel like I have to choose: my money or my life. I'm being ransomed. What choice do I have?

You might struggle to relate if you've never suffered from anxiety that's so bad that it's paralysing. It's worth remembering that I've climbed cliff faces, mountains and jumped out of planes. I know anxiety very well and how to cope with it. I'm quite familiar with techniques for managing my own anxiety levels. I've done things that you'd probably never dream of doing because you'd be too afraid. I'm a fucking expert on anxiety.

Perhaps you could replace "people in Africa don't complain" with "it must be bad if Nick says it is" because you know I jumped out of perfectly good aeroplanes. I don't mean tandem either, where somebody else jumps and I'm just a passenger attached to them. When I jumped out of those planes, it was all me... I had to decide whether to jump out or not. I made those leaps of faith. I know what anxiety is. I'm qualified. I'm qualified to judge, and I'm qualified to say what's a tolerable level of anxiety, and what isn't.

I'd rather not be on any pills, but I have to choose: pills or my job.

The sleeping tablets probably aren't too bad, but the anxiety-reducing painkillers are preventing the nerves in my left ankle from healing properly. There are very real negative consequences for continuing to take a medication that I'd be much better without... if only I didn't have to work while I'm recovering.

Recovery is not a quick process. When you're talking about a clusterfuck of substances, then it can't be rushed. How do you suppose you'd cope with stresses that are barely tolerable at the best of times, plus a whole load more unpleasant feelings that very few people can ever handle? Talk to anybody who's taken a psychoactive medication for any length of time and they'll tell you: those things are an utter shit to get off, and most people never manage. Medication changes are one thing that most patients won't tolerate. Most patients get anxious even thinking about medication changes, let alone stopping their medications altogether.

From January 2017 until now, I've stopped tramadol, codeine, dihydrocodeine, pregabalin, zopiclone, zolpidem, alprazolam and diazepam - all at the max dose. Tell that list to any doctor and there'll be shocked disbelief. Patients just don't quit all those addictive psychoactive medications so quickly. There are consequences to quitting every single one of them. Quit tramadol and you'll have sweating, nausea, diarrhoea, aches and pains, and cravings for tramadol. Quit zopiclone and you'll have insomnia, restlessness and anxiety. Quit all of them and you'll be completely dysfunctional; your life will be unliveable; unbearable.

Thus, I'm forced to keep going with some of the medications, just to be functional. I can't lose my job. I can't lose that money. I'm financially fucked.

It's a catch 22 situation.

 

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