This is a story about artistic integrity...

He who pays the piper calls the tune. Does the piper ever get to play, for their own amusement and freedom of expression?

If you look at my life strategy, it's pretty insane. I've picked a career that uses skills that I mastered as a child, and I now find the job mind-numbingly boring, easy and soul-destroying. I've picked an industry which is essentially just keeping a running total of who owes who what: simple addition and subtraction. I've chosen maximum income, for minimum effort. My life is constrained - certain rules have to be adhered to - but I have set things up so that I can jump through the pointless hoops as effortlessly as possible.

My theory is, that if I were to mix work and pleasure, then it would break my heart whenever I had to compromise. Let's imagine my passion in life is painting. I'd like to paint 1970's sci-fi inspired futuristic cityscapes, clinging to the rocky surface of distant planets. Those paintings are very intricate; detailed. The attraction of that art, for me, is the sense of scale that's given when you paint thousands of tiny windows on the buildings, and lots of tiny people in space suits, wandering around in their futuristic world. However, there's probably only a niché market for such paintings, and they'd take hundreds of hours to paint. Commercially, I'd be far better off splattering a canvas with bright primary colours and calling it abstract modern art - it would take far less effort and would have a much broader appeal. In order to pay my rent, I'd be economically incentivised to produce crap that I hated, because it would be much more profitable.

My strategy is to earn a lot and not work very hard, so I have lots of money and spare time to pursue whatever passions I have, without compromise.

Of course, there is always compromise.

Luckily, there is a Nick Grant who is a rapper, a Nick Grant who is a photographer, a Nick Grant who is an expert in sewerage processing, a Nick Grant who is a lecturer in American Studies at the University of East Anglia, a Nick Grant who's a toastmaster, a Nick Grant who's an expert in credit risk management, a Nick Grant who's a researcher in the Elementary Particle Physics department at the University of Warwick, a Nick Grant who's the CEO of Severn Trent, a Nick Grant who's a Labour Party candidate, barrister and head of legal services for Sainsbury's, a Nick Grant who's the concertmaster of the San Diego Symphony Orchestra, a Nick Grant who's the strategy director for Cancer Research UK, and there's even a series of fictional Nick Grant Adventure books by Jamie Dodson.

This means that I can pretty much write whatever I want on the public Internet, under my real name, without the fear that most salary earning wage slaves would have, that our employers will discover our deepest darkest secrets, prejudicing our career progression and perhaps even jeopardising our employment.

However, ex-colleagues from places like JPMorgan and HSBC occasionally visit this site, and pick up juicy tidbits about the implosion of my life and see the thrashing of my legs, beneath the surface of the water, when I'm swanning about trying to look as serene as possible in my professional capacity. I have old bosses as friends on Facebook and following me on Twitter.

I took an insane gamble. Instead of locking down my social media to only friends who can be trusted to not gossip with anybody connected with my former employers; instead of editing and censoring myself; instead of setting up a pseudonym - a pen name - I write under my real name, with real details that leave me no plausible deniability, to say "it isn't me" and "it must be another Nick Grant".

I guess there aren't that many people who leave the privileged and highly paid world of financial services and IT, in pursuit of the risky dream of doing something more rewarding in an intangible way. Earning bucketloads of cash is all the reward you'd want, right? Why would you want to earn less money being an electrician? Why would you want to have all that stress and risk your life savings, trying to start your own company? Why would somebody who's been a steady dependable 9 to 5 worker, with decades of dedicated service under their belt, suddenly lose their mind and end up in psychiatric hospitals, drug rehab and homeless?

So many of us dream of making a big change in our lives, but when we face up to the reality of the risks, sacrifices and effort involved, we decide that maybe the timing's just not quite right... maybe we'll do it next year, or the year after. We end up boring our friends and family with our grand plans that will never be implemented: forever on the drawing board.

When somebody is mad enough to unshackle themselves from the golden handcuffs and give something a proper go, it's big news. There are hundreds, if not thousands of bored office-working drones, who are fascinated to know the details of the trials and tribulations of anybody who had the guts to follow through on a plan to retrain in a completely different field, or start a business. When you quit your soul-destroying job, you're the underdog; David taking on Goliath - your former colleagues want to live your exciting life, vicariously. Former colleagues are rooting for you to succeed. Former colleagues want to know if you fail spectacularly, to re-affirm that they made the right decision, staying in their nice safe boring jobs.

Bootstrapping means taking on projects where you're not beholden to somebody for the funding. The whole point of me doing a job I hate, is that it's provided the dosh to do whatever I want without having to kiss ass, kowtow and do things in a way that they approve of. The whole point of founding my businesses with my own money, was so that I could run things exactly how I wanted, without investors and lenders breathing down my neck and making stupid suggestions about my business plan.

When it comes to a personal memoir type project, where I'm pouring my guts out, I'm somewhat burning the bridge back to the straight-laced world of boring jobs for boring people with boring lives. I have a CV that says I've worked for various companies and I have various qualifications. People who get salaried jobs by sending off their CV and going for interviews, are not allowed to have exciting lives where they do things that don't neatly fit into boxes. The world that provides my income has a strict rule: fit in or fuck off.

So, I made a decision. I decided FUCK IT. I decided that I would just write whatever I wanted, whenever I wanted. I would be myself, I wouldn't censor, I wouldn't edit and waste time considering what the drones of the corporate world of wage slavery would think about my unorthodox life.

And so, with practice, my passion and - dare I say - my skill, is to document my innermost thoughts and feelings, publicly. It might not be art and it might not be commercial, but it sure as hell isn't compromised. I have moments of fear, where I think that I need to hide my blog, put a sticking plaster over the semicolon tattoo behind my ear, find out just precisely what my former colleagues are prepared to say about me: put them on the spot and say "look, do you judge me on the good work that you saw, or on the secret life that I chose to reveal to you?"

It drove me paranoid and crazy, trying to maintain a squeaky clean perfect professional image, whilst also dealing with all sorts of awful things in my private life. It exhausted me to the point where I lost my mind, covering up the fact that life outside the office was chaotic and unstable, and I didn't want anybody to know that I was just about surviving in grotty student flats, hostels, hotels and friends' sofas. I didn't want anybody to know that my engine had run out of petrol and was running on fumes. I didn't want anybody to know that I had no margin for error, no safety buffer: my finances were on the brink of total disaster.

Why should anybody know these things? If I get stuff fixed up and pick up where I left off, then who would be any the wiser? What people don't know can't hurt them, can it?

However, it hurt me. It hurt me every time a friend thought it was hilarious to tell my ex JPMorgan colleagues things that considerably damaged my reputation. It hurt me every time the grape vine managed to spread gossip about my attempts to find job satisfaction. "I heard you're an electrician now!" a colleague from HSBC who I hadn't spoken to for 6 years, said to me when we connected on LinkedIn. How the fuck do people find this stuff out?

"Oh you were in The Priory... like some kind of rock star. So cool!"

Not cool. That kind of stuff colours people's opinion of you. They make assumptions and whisper behind your back. "Shall we invite Nick to the pub at lunchtime?" somebody says. "No, better not... he's a recovering alcoholic, isn't he?" [I'm not, by the way]

What I write is repetitive. I have no idea what chapter of my life you're going to walk in on. I have no idea what I'm going to be writing about when you dip into my private world. So, I cover the same theme over and over again: I am me.

I'm no longer the straight-laced perfect employee with the immaculate CV. What are those gaps in my employment history? Well, in the context of me being your wage slave, that's none of your fucking business. You don't pay me enough to bribe me to act a certain way and to gag me. You don't pay me enough for me to compromise my integrity, my identity.

I've suffered enough boredom and I've been patient for long enough to have earned the right to be myself; the right to be creative; the right to express myself without hesitation; the right to not have to wear a mask; the right to not live in fear of negative judgement.

What happens if and when the worlds collide? Well, I've set the challenge: it's up to other people to decide whether to judge me on what they see in the office versus what they discover through my candour, in a totally unrelated context.

I'd love to make it into print. I have a penchant for debate, and strong views about government and society. At some point, my ambitions to be an author and to get involved in politics are going to be realised. Every word I write on the public Internet makes me more discoverable to somebody, somewhere, on some topic or other. If I simply wanted a book deal or to raise my profile, I could compromise and conform; I could channel my energy into being commercial and popular.

What does it mean to be authentic? You think it's some fucking option that we all have? You think it's a fucking lifestyle choice?

To be authentic is a risk and it's a privilege. You could lose friends and fall out with your family. You could lose your job. How are you going to find your true voice? The voice that speaks with childlike honesty; fearlessness; tapping into your live stream of thoughts, rather than the lines you've memorised; the act you've learned to play. It takes practice, to be able to express what you feel, rather than say what you think people want to hear. Many of us are disciplined to engage our brains before our mouths: to hesitate, withhold and communicate in a manner that conforms to social norms. We are coached and bullied into hiding our unique outlook and personality.

If I make myself unemployable, I'll be forced to try and monetise the things that I have a natural aptitude for. At the moment, writing is effortless, but I could push myself to write with more purpose, spend time editing and reconnect with some literary agents I started conversations with last year.

If I find myself barred from the land of boring jobs and immaculate CVs, then my energy - my creative output - will have to be expressed in ways that come naturally to me, not just easily. In a way, I'll be unbounded; unleashed; unchained. Of course, it invites hypomania to come and destabilise everything, but at least my crazy projects usually result in cold hard cash in my pocket and something else to add to my portfolio.

I'm scared. I can't play the game any more. I have a contract - ink dried on paper - and I can do the job with my eyes closed. I've been in hospital enough times with kidney problems to know when I'm in trouble, and to know when I can look after myself. I can't humour everybody with this "my health comes first" bullshit anymore. I'm the guy who's pissed copious amounts of blood on more than one occasion, and done the calculations: how long have I got before total organ failure will kill me? I'm the guy who knows when I'm in deep shit, and when I can take a calculated risk.

What scares me more than anything is going through all the same old shit I've been doing since I was a teenager. What scares me more than anything is playing the same fucking games, wearing the stupid fucking mask, and acting and speaking the lines I've learnt and spoken a zillion times before.

I've got a fairly simple plan: conform and comply just enough to get what I want out of some rich fucking banks who I don't give two shits about. The last thing I want to be doing in the world is help some dinosaur of a bank run a simple software project at snail's pace, but they're going to pay me a king's ransom to do it, and it gives me a tiny taste of freedom... I put up, shut up, suffer the boredom, and the reward for my patience is that I keep a bit of integrity; a bit of dignity; a bit of identity.

Maybe I should do this job or that job, people suggest. Wouldn't I be great as a carpet salesman, or a tyre fitter? Isn't my natural calling in life to be a supply chain analyst or a fork lift truck driver?

Maybe it's the mission of the company that I need to get right. Selling people financial products they don't need or want, and profiting on the margin between the borrowing rate and the lending rate, using fractional reserve banking, is hardly going to give you a warm fuzzy feeling, is it? Perhaps I should work for a charity that's managed to help a handful of individuals and a large number of donors to feel better about how disgustingly wealthy they are and ignore the fact that the gap between the rich and poor is growing. Perhaps I should simply find my place in the whole fucked up mess, where I can delude myself into thinking I'm making a positive difference.

But, I've seen too much. I know too much. I know that things are rotten to the core and it sickens me to emotionally involve myself, when everybody wants you to just STFU, keep your head down, do what you're told, not rock the boat and don't for god's sake solve any problems at the root cause.

Writing's the only time I can let rip and not get bogged down by the wilful ignorance and DGAF attitude of those around me. I'm not saying I'm superior and I've got all the answers, but I'm saying that when I get a hunch and I set out to prove my point, I've got plenty of examples of things I've done that have worked, when I'm free from constraints and naysayers.

I love this quote:

"People who say it can't be done should not interrupt those who are doing it"

Somebody's gotta be positive. Somebody's gotta do the math, calculate the risks and take a chance. Somebody has to be brave and stick to their guns. Somebody has to persevere through the setbacks. Somebody has to keep going when the way ahead looks blocked, to figure out how to overcome the obstacles.

I also love this quote:

"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes up short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat" -- Theodore Roosevelt

I feel gagged. I feel cheated out of the opportunity to demonstrate the best of my abilities; to tap into my creativity and problem solving skills. I feel jealous of those people with inherited wealth, trust funds and other advantages that allow them to dispense with the wearisome world of bullshit jobs, and instead they can flounce around reading interesting things, writing, debating & discussing, composing, painting, drawing, sculpting and generally expressing themselves.

To have those prizes just out of reach, because of the demands of societal conformity, is agonising to the point where it makes me want to give up. I've worked hard enough for long enough that I should be in a different position. I'm left miming the same actions that I've done a thousand times before, in order to keep the money flowing, the rent paid and the food on the table, which is like some kind of psychological torture.

I know it sounds ridiculous, but I knew I would get a contract fairly quickly, and I know that I will be able to run the project really well, very easily. I've seen it all before; done it all before. I can see all the way to the end: no surprises. Because it's all just a means to an end, it makes it that much harder. I've got nothing to prove, and the fact that I'm employed to solve the same old problems in the same old way, time & time again, simply proves that they might as well just give me the money and not bother with the project, if they're not going to listen to the experts who know how to build better systems than these follies; these white elephants.

I've got this easy money contract all lined up. I know what the hell is going on with my kidneys. I've been in hospital enough times with rhabdomyolysis to know when the numbers say I'm fucked, and when the numbers say I've dodged another bullet and I'm fine & dandy. I know when I'm in big trouble and in desperate need of assistance, and I know when my tough little body is patched up and working again.

It's been agonising, to string this client; this consultancy; this agent along, while I've been in limbo: who could have predicted that it'd take nearly 15 hours of dialysis before my kidneys rebooted? Was I ever worried about my life, my health? You're asking the wrong question. You'd have thought that if you pissed absolute jet black liquid and you couldn't feel your foot or your calf, you'd be straight over to A&E, but it doesn't work like that if you're already at the limit of what you can take.

I phoned my client and said I wasn't going to make the 30 minute induction and I was too sick to start work that week. Chances are, that was the end of that: they'd just cancel the contract.

Things in my life are either there to be endured, they're an adventure, something good that's happening, or I've had enough and I'm going to self destruct.

Being in hospital again has been part adventure - I've never had dialysis before - partly something good, in terms of her seeing first hand the shit that I've been through a bunch of times. But there's the actual boring work that has to be endured if I still have a contract by the time I get discharged. There's the self destruct threat, because I've solved all these problems before. Everything's been overcome, so far as I can see. My client will wait until Monday for me to start work, my blood tests are stable and my kidneys are definitely working.

I had no control over whether the client would wait for me to get well. I had no control over when my kidneys would reboot. To discharge myself would have been suicide, so it didn't matter whether I lost the contract or not.

Nobody can see that the recent acute kidney failure is not the root cause of the problem here. Why did I let the problem get so bad? Why am I not afraid of a catastrophic chain of life-changing or life-ending events? My kidneys are working AND the client says I can start work on Monday, but why would I trust my knowledge, experience and the blood test data, and discharge myself, when I could just get another job in a few weeks or months? Why don't I avoid all risk, act like a sensible normal person, and just do everything I'm told?

There's a delicate chain here: I was lucky that my client has waited this long for me to get well, I was lucky that my kidneys recovered quickly, I'm lucky that I have a job that's easy money, I'm lucky that I don't have to suffer more agents and interviews, I'm lucky that I've got a financial lifeline that fixes my cashflow, I'm lucky that this contract keeps me within touching distance of the day when things are stable again, and I have the opportunity to think about doing something rewarding, challenging, creative and everything else I need as the antidote to 20 years of office boredom.

The ticking time bomb exploded, but it was unseen. I couldn't hang on any longer. I couldn't take any more delays and setbacks. My patience for being depressed, stressed and running out of runway, without success at securing a job (that I didn't really want anyway) had expired. I'd been strung along too long. Christmas and New Year slowed everything down and stopped progress, so the agony was drawn out longer than I could take.

Somebody's going to end up not getting what they want.

The doctors want to discharge me with blood tests that show my kidneys are clearing the remaining backlog of toxic crap out of my blood on their own. They want me to have an operation to have a dialysis line put in my jugular vein. They want to do more observation, without dialysis, to know how my kidneys are doing without any assistance.

Her and our friends want me to follow the doctor's advice, and treat my health as if my life hangs by a thread. They care about me. They don't care about my client. They know that there will be other jobs.

I want good quality sleep in my own bed for a couple of nights. I want to try on my ankle splint and get used to getting around on crutches. I want to make a plan for how I'm going to get to work during the tube strike. I want to figure out my medications so I'm not fuzzy-headed and sleepy during the day. I need to not have to start all over again. I need to balance the small risk that my kidneys might take a long time to clear the backlog of creatinine, against the big risk that I can't be out of work any longer, and I can't face starting the job hunt all over again, without depression and stress destroying me.

Yeah, I'm going to feel shit. I was always going to feel shit. I'm going to wish I was more well rested. I'm going to wish things worked out differently. I'm going to wish I could just press the fast forward button and be 6 months further through the year, and everything's gone exactly how I know it's going to go, but I don't have to suffer the boredom, the monotony and the ridiculous deja-vu of solving the same problems in the same way, over and over again.

What's the alternative? I can't cut & run. I can't switch career. I can't chase some stupid pipe dream.

Some people think I'm a know-it-all. Some people think I'm reckless and stupid. Some people think the answer to all my problems is to do the things I've tried before: regular salaried jobs, doctor's advice, safe & sensible behaviour, conformity to the norm.

All I can tell you is, I can make dumb decisions and get myself into deadly situations, but I'm also a bit of an expert in recovering from some very harrowing shit.

It's a bit unfair to ask people who care about me - both loved ones and professionals - to allow me to take what they see as an unnecessary risk, but the flip side is a complex web of psychological risks and consequences that are almost too hard to explain.

If I seem impatient, foolish, arrogant, entitled or somehow like I deserve different treatment and life opportunities to everybody else, all I can say is this: at some point you can't keep trying anymore, you give up and you slip away. At some point, it doesn't seem worth the struggle and the stress, just to line somebody else's pockets and allow them the freedom to pursue their artistic creative ambitions and generally waft around having a lovely time.

If I get what I want, start my job tired and in pain, work for at least 6 months, bored out of my mind and upset that I wasn't well rested and properly prepared; but at least the cashflow hole is plugged, my stress starts to go down, I start to relax about the purse strings, I can show my love and appreciation for the people who I care about and who care about me, I can start to improve my work:life balance and I can start to dream about longer-term ambitions, without torturing myself because things are so far out of reach.

If you think I expect this to happen overnight, you're wrong. I'm forecasting 6 months to stabilise, 6 more months to build up a healthy safety cushion, and another year before I can even dare to dream and start to think about a less soul-destroying life.

As I wrote before, I've got some amazing pieces of the puzzle in place - more love and support than I've ever had in my adult life - but I still can't afford to have other important things slip away for the sake of an acceptably small risk and some short-term pain, discomfort, exhaustion and a bit of extra stress. There is no perfect solution.

There is one thing that nobody can take away from me right at the moment: I'm a penniless writer.

Tags: #writing #art #hospital #career

This is a story about affordable care...

I've been able to roll the dice a few times - following my dreams and chasing my ambitions - because of progressive liberal socialist policies put in place by the Labour government of 1945: most notably, the creation of the National Health Service.

I chose to leave an extremely well remunerated job with an American investment bank, with amazing private medical insurance and a brilliant team of occupational health doctors. That US-style of healthcare certainly gave me access to the very best treatment, whenever I needed it, but it was part of a "golden handcuffs" deal: a job that was so much better than anything I could get anywhere else, that I had to be insane to quit.

Life is a balancing act. You can have loads of money, but no time to spend it. You can have loads of time, but no money. You can have job security, but you'll be bored and constrained. You can have freedom and be your own boss, but you will carry all the risks and responsibilities. You have to choose what works for you.

While one friend has parked his tech startup dreams and has taken a salaried job, another couple of friends have just sold their tech startup. In the space of 6 years, I made myself sick with stress, trying to run my own tech startup; I went back to my old job at the American investment bank and stayed sick until I started rebuilding my life in London as an IT consultant. In the space of those 6 years, my friends had countless sleepless nights and worked relentlessly to build their startups to the point where they were worthy of investment or acquisition. In the space of those 6 years, my friend who originally introduced me to the tech startup ecosystem, built a bunch of cool tech and very gracefully pivoted into a job that really suits him, working for a company he really admires. In the space of those 6 years, my friends from the technology accelerator program we attended in Cambridge, raised millions of pounds of investment and sold their company to a tech giant.

Friends went to Silicon Valley to follow their tech dreams. One friend had to break up with his girlfriend. Another had to move his young children away from the family support network, and live with the risk that the USA would reject him and his family's request for residency. Imagine if I had moved to America. How would I ever afford the medical bills, when things have gone badly wrong? I would have been bankrupted many many times over!

Nobody's keeping a seat warm for me in a cushy job because I went to a posh school and a prestigious university. I have no trust fund or family money behind me. Running out of money has meant homelessness. Starting a business had to be profitable from day one.

There's just no way that I would have been able to pursue the opportunities that I have, without the National Health Service. In theory the UK and US are lands of opportunity, where anybody can start a business and become rich and successful. In practice, it's almost impossible unless you're already quite wealthy. The consequences of failure are just too much to bear, for most people.

My current business is consultancy. If I'm sick, I don't get paid. If I don't have a client, I don't get paid. However, I've calculated that I only need to work a few months of the year to earn the same as as the 'secure' job I gave up. It's a calculated risk. I might end up not being able to pay my tax bill. I might end up not being able to pay my rent. But, when things go well, they go really well. The odds are in my favour: if I can just get two or three contracts in a row, not get sick, maybe have some projects that run longer than expected, then I'll suddenly be way way way ahead of where I would be if I'd just plodded along with the golden handcuffs on.

I sat awkwardly on my leg and it went numb. My foot became swollen. My leg swelled up all the way above my knee. My kidneys shut down. I was admitted to hospital and put on dialysis. I haven't had any income since September. Surely this is why it's best to have a nice 'secure' job?

I've been stressed and depressed about losing a lucrative consultancy contract. I was literally about to start working again when I got sick. Contractually, I have no rights: the company could just award the contract to somebody else. I was going to have to start the search for a client all over again, meaning yet more loss of earnings.

Here I am in hospital. I've been here for a week.

I was seen by a doctor within an hour of arriving at Accident & Emergency. I've had two private rooms with amazing views over central London. I've been seen by top consultants, surgeons, registrars, nurses, phlebotomists, physiotherapists. I've been wheeled around by porters and served meals by catering staff. My bedding has been changed and I've been given clean gowns and towels. Numerous medications have been dispensed. I've had ultrasound scans and my blood has been scrubbed clean and drained of dangerous toxins by dialysis machines. My blood pressure, blood oxygen, pulse and body temperature has been monitored around the clock. Even the amount I drink and piss is meticulously recorded by the staff on the ward.

Nobody has ever asked me for my medical insurance details, credit card or discussed how I plan to pay for all this world-class treatment. Nobody is going to send me a bill when this is over.

As luck would have it, my client has decided they will wait for me to get better, so I can start my contract. Imagine if I wasn't able to take that contract in the first place, because of the risk of getting sick. Imagine if all the profit from my contract got wiped out by a humongous medical bill. How is anybody supposedly 'free' to become rich and successful, if they can't predict when they're going to get sick and how much it's going to cost?

This story is really a re-telling of three stories. The story of the friend who inspired me to follow my startup dreams and who inspired me to write about the importance of the National Health Service for social mobility; the story of the friend who succeeded, after 6 years of sacrifice, blood, sweat and tears, with countless sleepless nights and untold stress; and the story of me, who couldn't handle the chafing of the golden handcuffs, and got unwell because of the combined stress of running a tech startup with an unsupportive partner and unsupportive family.

I'm now lucky enough to have reconnected with old London friends, repaired friendships that were damaged or neglected when I got unwell, made new friends who are incredibly loyal and caring, and I have found an amazing lady who makes me feel loved to bits and completely accepted for who I am. Her family have welcomed me with open arms and most of the get well cards I've been getting have been from her family, along with offers of help to get me back on my feet.

While the welfare state is deeply flawed and it's an impossible task to get the social support that you need, as a single man whose life is imploding, the National Health Service has been the glue between the pooh, holding my shit together and just about keeping me alive. When you add in an amazing girlfriend, her family, loyal and caring friends and the rest of the social fabric that a person needs, you finally stand a chance of getting your life back.

I read with great dismay that the US Affordable Care Act (a.k.a. Obamacare) is being repealed. What the actual fuck, America?

If you wanted a case study for a society that's as close to perfect as you're going to get in an imperfect world, we should look to London. 300 different languages are spoken in London schools. The tower blocks of Canary Wharf sit in a London borough that's 46% Muslim. There are cycle superhighways, driverless trains, an underground railway that moves 5 million people every day. The Metropolitan Police are humble public servants, who protect the vulnerable and take people to hospital, involve social services and mental health crisis teams, rather than flashing their badges and drawing their weapons. The whole city exudes tolerance, inclusion and diversity: it's in London's DNA.

You might mistakenly believe that London is a city for the rich, but it's not: because of the National Health Service. The NHS employs 1.7 million people, and funded properly - like it is in London - it shows that socialism and multiculturalism can be made to work. The last piece of Britain's nationalised socialist infrastructure, not to be wrecked by the greed of capitalism; the NHS is a fly in the ointment for the Tories who want to sell everything off for private profits and damn the lives of British citizens.

I want the railways re-nationalised. I want the energy companies re-nationalised. Most of what comes out of Westminster is good for London but bad for the rest of the UK. What we're seeing is one rule for Londoners and another for everybody else. London gets state-owned public transport where 100% of the profits are re-invested in infrastructure. London has a remarkable set of public services that create jobs as well as keeping the residents well looked after. Socialism for London and capitalism for the rest of the UK... that sucks.

In my week in hospital, I've realised that London truly offers an enticing vision of a near-utopian society, so unlike the ugly one pictured in the dark minds of the populists. London is a European city, connected by train to Paris and Brussels. London is a mercantile centre, where East literally meets West at the Greenwich meridian line: the perfect time zone to deal with both Japan and San Francisco in the same business day. The peaceful co-existence of so many cultures in one crowded city is a modern miracle. I live here because of the immigrants, not in spite of the immigrants. London simply wouldn't function without its chaotic diversity.

Getting used to living in London is hard. The congestion is hard. The clash of cultures is hard. Seeing people who look and act differently is hard. Processing the humbling fact that the world is huge and complex is hard. Realising that you're in the racial minority is hard. Living a small, neat, efficient, considerate, reserved life, where you quietly observe and ask questions, as you discover your fellow Londoners have had incredible journeys, arriving here and building their lives, is hard. It's hard damn work, letting all this chaos and complexity assault your senses.

I don't want private hospitals, private health insurance, medical bills, policemen carrying guns, offensive foreign policy and an economy that offers no hope of escape from the socio-economic background you're born into, except for a tiny handful of sports stars, lottery winners, rappers and criminals. I don't want private prisons stuffed full of black people being used as slaves. I don't want a world of "us" and "them" with torture, pre-emptive strikes, invasion of sovereign nations, regime change and covert ops to destabilise other nations.

In a week in hospital, I've benefitted from everything that's great about Great Britain in the European Union and London's huge immigrant population. Only a tiny handful of the staff who've saved my life were born in Britain. Only a tiny fraction of the medical supplies and equipment were designed, tested and manufactured in the UK. I'm a stone's throw away from mosques where alleged firebrand hate preachers are supposedly plotting against the British people. Whitechapel Market is crowded with women wearing full-face veils, but I'm just another Londoner to them. If there's an exemplary organisation to demonstrate multicultural society working perfectly, doing life-saving work, it's the National Health Service.

Affordable care not only saved my life, but it's keeping my hopes and dreams alive, so I don't have to take a zero-hours contract McJob flipping burgers, just in case I get sick.

Tags: #NHS #hospital

This is a story about treatment for drug addiction...

Having been to four different rehabs, I feel fairly qualified to give a few insights into what happens behind closed doors. Residential rehabs often hide away in leafy suburbs, where there are large houses that can accommodate human trash: dirty junkies and nasty alcoholics.

"Death's too good for 'em! String 'em up!" I hear you say.

Yes, yes, don't worry. We'll get to the idea that an addict will always be an addict, and that we should just write them off as a lost cause.

Boscombe in Dorset - an area of Bournemouth - is where many councils choose to send their difficult members of society, from all over the country. Supposedly, being by the seaside will be good for recovering alcoholics and former drug addicts. There are certainly plenty of rehabs in the area. Even Paul Gascoigne has found himself shuffling around Boscombe's streets, buying bottles of gin from the local off-license.

Ironically, many years after moving to Bournemouth, I became addicted to drugs and found myself in the perfect place to get treatment for my addiction.

Let's talk a little bit about drug addiction.

Having a 'drug habit' is not the same as drug addiction. 'Experimentation' is not the same as addiction. Partying is not the same as addiction. Addiction will rapidly destroy your health, wealth and prospects. Hospitals, police cells and prisons are the institutional stomping grounds of the addict, on their rapid descent into the fires of Hell. If you're successfully hiding your habit from your friends, partner and boss, then addiction hasn't fully taken hold. Addiction is destructive.

What about detox?

You can't really rehabilitate while the drugs and alcohol have got their hooks in you. If you abruptly stop drinking, you might get the shakes, become delirious, have a fit and maybe even die. If you stop taking heroin, you're going to feel sick and in pain. If you stop taking cocaine or amphetamines, you're going to be unbelievably exhausted and depressed, to the point where you're in real danger of killing yourself.

"You should kill yourself if you're a junkie" I hear you say.

What you haven't understood is that drug addiction is slow suicide. Do you think the addict or the alcoholic isn't aware that their body is getting utterly fucked up, and they're going to go to an early grave?

Detox is about breaking the physical addiction that the body has to drugs and/or alcohol. Detox is about suffering the worst of withdrawal, in an environment where substitute drugs can be administered to make the process safe, humane and tolerable. An alcoholic literally risks death if they stopping drinking without Librium. Is it ethical to ask people to die just because you're hung up on ideas like "willpower"?

There's the term "psychological addiction" that needs to stop being used. It's better to think about addiction like this: why did somebody get addicted in the first place?

"Because drugs are fun" I hear you say.

There are shitloads of people who take drugs all the time but they aren't addicts. Every weekend, raves and nightclubs are packed full of people taking Ecstasy (MDMA). Vast quantities of cocaine gets hoovered up by the eager nostrils of young professionals in cities around the world. Every day, a huge proportion of humanity smokes cannabis or drinks alcohol. Why aren't all these people raging addicts and alcoholics?

If you ever feel like quitting, remember why you started.

Most addicts' lives were truly appalling before their addiction took hold. For sure, addiction doesn't improve anybody's life, but it's not like there's any hope of a better life just because an addict quits drugs. The cycle of petty crime, scoring drugs, getting sick, being hospitalised and being locked up... it doesn't look great, does it? But what's the alternative? Flipping burgers and still not having enough money to make ends meet?

So, it's obvious that the rehabilitation process will only be successful if it can return a person to a better life than the one they were trying to escape from with drugs and drink.

The first rehab I attended was in Bournemouth, situated in a grand house at the end of a sweeping driveway, surrounded by mature pine trees, on a road of millionaires' mansions. The place was full of people from Greater London and the surrounding counties, ejected by their councils to make room for more rich middle-class people.

The biggest issue amongst my fellow rehab residents was housing. Boscombe has vast numbers of crappy bedsits that can just about be afforded with housing benefits. London and the South-East has no cheap housing for undesirable members of society. My fellow rehabbers were gleefully pushed away from where they were born and bred - and their families - because they were written off.

A typical day at the Bournemouth rehab would consist of a breakfast of baked beans, white toast and cheap sausages, followed by many rounds of tea, coffee and biscuits, until the 'therapeutic' day began. There were two or three sessions a day, where everybody sat in a big room, slouching on comfy sofas, vaping on e-cigarettes and slurping drinks. It was supposed to be group therapy, but it was basically just listening to heartbreaking tales of people's children being taken into foster care.

Most of the day in Bournemouth rehab was given over to matters of court appearances, housing office appointments, social worker visits and attempts to obtain various forms of welfare benefits. Almost everybody in rehab was in poor physical health, due to a life of drug abuse. Almost everybody in rehab had some underlying mental health disorder.

Those were the dregs of society, but they were warm and welcoming and they accepted me as one of their own. I was warned by staff to leave my iPhone at home and watch my wallet, but I never felt for a single moment as if my peers were going to rob or take advantage of me. I was somewhat appalled by the staff members' low opinion of their service users, but I suppose there's an element of the gamekeepers and the poachers: anybody who's keeping you under lock and key is kind of fair game, because resentment is going to build about the power that staff exercise over people in treatment.

Over the course of the 28-day program, my fellow rehabbers and I would build up special privileges for good behaviour, such as being allowed to go to Alcoholics Anonymous, Narcotics Anonymous or Cocaine Anonymous meetings. Being allowed to go into town, accompanied by a staff member, was the next privilege that accrued. Then, trips to town were permitted when accompanied by a peer who had attained 3 weeks of good behaviour. Finally, you might prove yourself to be trustworthy enough to go into town alone or as a chaperone.

Transgressions could include: not getting up in the morning, not doing your assigned chores, not attending group therapy, being caught with contraband, failing a drugs test and - most serious of all - going somewhere without permission.

Being expelled from rehab for going into town on your own might not sound like a terrible consequence, but almost everybody was there because treatment was mandated by the courts, as part of parole or an attempt to retain contact with children. Being chucked out of rehab could result in going back to prison, or never seeing your children again. The line between treatment and punishment was rather blurry.

My next rehab was 5-star luxury by comparison. You might have heard of it. It was The Priory.

If you're paying £12,000 for a 28 day stay in the countryside, you'd expect it to be pretty nice, wouldn't you? The Priory certainly delivered on making me feel special and cared after... for a high price. Therapists outnumbered patients, the bedrooms were very well appointed and comfortable, the food wasn't bad and there were luxuries like a gym and grounds to take a stroll around. Nobody was made to feel like a prisoner under house arrest.

Unsurprisingly, my fellow Priory rehabbers were rich compared to the Bournemouth lot. There were six-figure salary earning executives and heirs to multimillion-pound fortunes. Alcohol was also the predominant poison, as opposed to heroin.

One girl was so desperate for a drink, that she filled a mug with hand sanitising gel - which contained alcohol - and sweetened it with orange squash.

Therapeutic days were packed full of yoga, mindfulness, art therapy, educational videos, as well as group therapy. Supposedly following the 12-step program we only had enough time to complete the first two steps. AA and 'aftercare' meetings were held in the evenings at The Priory, which we were encouraged to attend, but most of us just watched DVDs in our bedrooms.

In my final week at The Priory, I asked "what next?"

Turns out that 28 days just isn't long enough to turn your life around. 28 days is just about long enough to get over the worst of the drug withdrawal and start thinking about how awesome the drugs are going to feel after a little break and three square meals a day. Aftercare programs are almost as expensive as rehab and last 3+ months: who's got that kind of money and can afford to take that long off work?

Having been through an acrimonious divorce, sold my house, rescued a tiny fraction of my most treasured possessions, boxed my life up, put everything into storage and suffered a horrible family Christmas, I was pretty fucked up by the whole ordeal. I needed to get cleaned up and straightened out again.

The next rehab I booked, I asked for a detox. I didn't want to have to get up in the morning and go to stupid group therapy. I hadn't slept or eaten properly for weeks. I'd been taking benzodiazepines for months and it was possible that I'd developed a physical dependency that could be life-threatening. I needed professional medical care.

The rehab I ended up in was like an alternative therapy spa break. There was a hot tub - called the sex pond - and a vibrating massage table, with whale music playing in the pitch black room. The main thing I was there for was sleep, food and a doctor on hand in case I had a seizure. Reluctantly, I consented to have acupuncture and to do some mindfulness: both of which I fell asleep during.

Most of the staff were kind and caring, but the guy who owned and ran the rehab was a complete egomaniac who clearly wanted his own cult. This idiot tried to force me to attend 'group' therapy, which was basically him giving interminable boring monologues about the time when he went into a Native Indian sweat tent. Believe me, the last thing you want when you're recovering from a near-fatal toxic combo of drugs, is to be a captive audience for some total moron.

While I was at that third rehab, a man was brought in, smashed out of his mind and covered in red wine. He'd been transferred up from the first rehab I'd been in down in Bournemouth. He'd walked out and gone into town to get pissed. Revolving doors.

I had to get away from that place. It wasn't therapy. Fuck knows what it was. Probably just a bit of respite for both family and addict alike.

Finally, I achieved what I wanted: I got back to London. Bullshit family Christmas was over. Divorce and house sale was over. I was free from horrible destructive relationships and nasty people, but I had picked up an addiction and failed to deal with it. My life to that point had been dictated by people who didn't care about my welfare.

I got myself into my fourth and final rehab: a 13 week residential treatment program in Kensington, West London.

Immediately, the place felt right. Rehabs are supposed to be run by former addicts and alcoholics. The guy who I met on my initial assessment had gold teeth and mean tattoos. The guy who ran the place had a massive scar across his face. These were people whose opinion an addict could respect, because they'd been all the way to rock bottom and back again: they'd seen friends die from overdoses and a lot of other rough shit too.

My most important lesson in rehab was how to do time. I had already been heavily institutionalised by working my whole career for massive corporations - with the limits that full-time work and education imposes on your freedom - but I still had lessons to learn about liberty. It helped a great deal that one of my fellow rehabbers was a young lad who'd been in prison twice by the age of 21.

Rehab is literally a kind of house arrest. You can leave anytime you want, but there will be consequences. It was fun to walk up to the gate (pictured above) and put a foot out over the pavement... just stopping short of taking a single step off the property.

It's not too hard to white-knuckle 3 or 4 weeks of abstinence. The first couple of weeks you'll feel awful, but your body is so abused that it's grateful for the sleep and the food. The next week or two are hard, but you know there's light at the end of the tunnel: you'll soon get your fix. You just have to count down the hours, minutes and seconds.

I don't believe you can rehabilitate somebody in just 3 months. So many things get fucked up when you're an addict. You need to get a job and go back to work, pay your bills and any debts that got racked up, repair and replace broken stuff and get a place to live. Everything got fucked up by my addiction: my shoes and clothes were wrecked and everything in my life was in total disarray.

Imagine being a company director through a period of addiction. My accounts and taxes were all messed up, and important paperwork was lost or misplaced.

What about my CV? How could I explain those periods of absence from work?

What about my routine?

Do you realise how much of your life runs itself on autopilot? You pay your rent/mortgage, council tax, electric, gas, water, sewerage, broadband, mobile phone, home insurance, life insurance, car insurance, road tax, MOT, TV license and a zillion other things. You get up every day, have breakfast and go to work. People know and respect you at work and you know how to do your job. You see your friends and socialise. You have your hobbies and you exercise. Do you think you can put all that stuff back together, running smoothly, overnight?

When you're an addict, everybody distances themselves from you. It's obvious that if you even so much as speak to an addict, they're going to steal your newborn baby and sell it to buy crack cocaine. It's obvious that anybody who injects marijuana or sniffs glue is a worthless selfish nasty person who's out to kill you.

Rehabs are necessary because family and friends are judgemental gossips who offer you useless advice like: "have you tried not taking drugs?" or "maybe you should just stop".

Rehab was a holiday from being judged to be an evil failure, morally weak and simply lacking in willpower.

Rehab showed me that I do have the willpower to stop taking drugs whenever I want. Rehab showed me that I'm not weak and I'm not powerless.

By the time I finished my four stays in rehab, I still hadn't run out of money, I had never been arrested, locked up, hospitalised or homeless. I had been nowhere near rock bottom.

I never actually reached rock bottom though. I experienced things that were awful at the time, but I needed to have those experiences.

Stopping drugs is the least of anybody's concerns. Drugs actually help when your life is unbearably shit. Just ask anybody who suffers from depression or anxiety if they'd like to give up their antidepressants or tranquillisers.

Obviously, I'm glad I never got a criminal record or sustained any life-changing injuries, but maybe I needed to come close. Being locked up in a police cell a couple of times and spending weeks in hospital, were not things on my bucket list, but I think they were necessary experiences to complete my adventure.

When the time was right, I got a place to live, a girlfriend and a job. Without those things, life isn't worth living, but equally, those things don't create recovery.

Bullying was relentless and intolerable at school for 11+ consecutive years. Nothing I did was ever right or good enough for my parents. My parents' relationship was appalling - full of verbal abuse and hostility - and I got involved with a girl who physically and mentally abused me, who I stayed with for many years. I got so used to broken, abusive relationships. Do you think that kind of stuff can get healed by 28 days in rehab? Do you think that all my problems came about just because I sniffed a bit of white powder?

You might think I act normally and sound perfectly reasonable, rational and able to string a sentence together, but it's the opinion of the medical professionals who've treated me, that I'm dealing with depression, bipolar and even borderline personality disorder. Clearly, I've had many episodes of mental health issues... including a period of many years before drugs even entered the picture.

This is called dual-diagnosis: the clusterfuck that is both addiction and mental health issues combined. The tail that wags the dog.

I've cherry-picked the best treatment and the most humane and compassionate approach to fixing my addiction and now I've arrived at the situation where - joy of joys - I'm 'just' dealing with depression and anxiety.

I'm itching to press the 'fuck-it button' because life is intolerably stressful, unrewarding and my depression is refusing to lift. What's the solution? Drugs? Been there, done that.

Rehab taught me how to quit drugs cold turkey. Rehab taught me that I'm in control, so long as my life seems worth living.

Addicts and alcoholics are taught on the 12-step program that they're powerless. I'm certainly powerless, but it's over things like whether I get offered a decent job that pays enough money to be able to live. Being powerless to influence the things that really matter to me in life, such as whether I can live with dignity or not, creates incredible stress and anxiety.

I can choose to stop drinking or taking drugs, but why would I, if the alternative is ESA assessments and having my inadequate welfare benefits cut off by somebody who's not even a qualified doctor? Why would I quit, if I have to prostitute my mind and body, to go and work some pointless bullshit job for somebody promoted into a position of incompetence, if I'm 'lucky' enough to be offered a pittance to do the job?

It's so hard to escape the things that drove us to drink & drugs in the first place.

Rehab was important for me to forgive myself for things that weren't even my fault. I didn't make a mistake, getting addicted to drugs: it was a deliberate act and I'd live my life exactly the same if I got to start over from scratch. Rehab was respite from those who wish to scapegoat sick people.

Fundamentally, rehab connected the 'clean' and the 'dirty' world and allowed me to see that they're two sides of the same coin.

Every saint has past and every sinner has a future.

Tags: #addiction #drugs #alcohol

This is a story about compatibility...

Very often, when you're acutely aware that there's something that you need to avoid crashing into, you'll end up staring at it, unable to tear your eyes away. When riding a board or a bike, flying, driving or otherwise in motion, you tend to go in the direction you're looking. If you want to avoid a crash, you should look at a spot away from danger.

Is this the reason why we don't talk about taboo subjects, because we're worried about tempting fate? We turn our back on the ugly truth and try to pretend like everything's OK.

My Christmas stocking included some bath salts.

Clearly, Santa has the same dark sense of humour as me. That's great. I think humour is a fantastic way to exorcise the demons of the past. First comes talking, then understanding and finally you can laugh and joke about a topic that was originally quite painful and difficult to remember. Repressing memories and walking on eggshells is no way to move forward.

If we don't have honest conversations where we can talk about how we really think and feel, then we build up a load of sensitive topics. Secrets and lies lead to paranoia and weak relationships. Keeping schtum about my parents' drug use - when I was a child - was too much of a burden. Writing openly has been liberating and has allowed me to move on from shame and regret, to regain my self-esteem and confidence.

I remember a desperate scramble to cover up my admission to The Priory. My psychiatrist had made a referral to a "private hospital" for treatment of an acute episode of bipolar disorder. All perfectly true, but there was a certain economic use of the truth. What would most people think, if they found out that I was spending weeks in the UK's most notorious treatment specialist for drug & alcohol abuse? They would leap to the wrong conclusions, surely?

It's so bloody exhausting keeping up appearances. One must be aware of how things can be [mis]interpreted and people aren't likely to share their true thoughts and feelings: "better keep him away from the kids if he's mentally ill" or "I bet he's a raging alcoholic behind closed doors if he's been in The Priory".

We're brought up to believe that our reputation is like a balloon: one little prick and it goes pop. We're scared to take time off work, because we'll have gaps on our CV that need to be explained. We're scared to share details of our private lives, lest our employers decide we're unreliable and judge us on preconceived notions. Who wants to work with a madman?

When it comes to dating, the same applies. Who wants to date somebody with flaws; defects? Who wants to take a risk on a ticking time bomb; an unsteady ship? And so, I should have found myself unemployable and undateable. "Take your pills, sit in the corner and shut up" says society.

However, if you ever meet me in a work or social context, you may gain the [false?] impression that I'm pleasant company: a healthy, happy and capable member of society, engaged in productive endeavours. Strangely, you might have the wool pulled over your eyes so much that you actually mistake me for a normal human being.

Surely this is thanks to the excellent medication that I take?

Well, no. I don't take any medication. I don't do therapy. I haven't had a course of electro-convulsive shock treatment. I don't even have a psychiatrist at the moment.

"But you're going to murder everybody if you don't take your pills."

Yes, that's right. I'm your worst nightmare. I'm out there, on the dating scene, luring unsuspecting vulnerable young women into my web. I'm a dangerous fantasist; a con-man. I'm so good at living a lie that I've constructed an elaborate fable that looks, smells, tastes and sounds very much like an authentic real life, but it's all fake. It can't be real. What about the secrets we now know?

If you take your secrets and turn them into jokes, you defuse that ticking time bomb... or at least that's my working hypothesis.

I certainly feel a lot happier knowing that I've met somebody with enough of a good sense of humour to make a joke on Christmas Day about my chequered past. I feel less sensitive, paranoid and insecure than ever before. I feel like I'm myself, and that's OK.

Maybe it's just a getting old thing: the realisation that we're all flawed in some way. We're all human. We all have weaknesses and strengths, and we all have history; baggage even. It seems better to wear my heart on my sleeve than present myself as some whiter than white, holier than thou saint who never put a foot wrong in their life.

I doubt I'll ever unify my professional and private identities, but I certainly don't regret jettisoning the traditional approach to dating. Honesty seems to have been the best policy in this case.

Tags: #dating #sex #bipolar #addiction

This is a story about rambling...

I'm self-censoring. I've written entirely without a filter for well over a year, but now I'm holding back. I'm watching my words. As a wise friend advised me, I'm writing as if my girlfriend's mother was reading this... almost. I'm certainly writing with a certain amount of self-consciousness that I haven't had for the best part of a year.

When I wrote my book, it was easy. I was in the land of fiction, so I could therefore always say "I made that up" if something didn't go down too well. However, my blog has always been a mad blend of 'stream of consciousness' stuff, unflinchingly honest biographical accounts of mental illness, homelessness, addiction, sex, masturbation and all the other gory details that we repress as deeply as we can possibly can. I'm struggling to switch modes.

I'm starting to build up a list of things that I want to write about again, but I'm a bit bored of it to be honest. I've wound myself up and stressed myself out. I've wailed at the moon and yelled at the top of my lungs... and then the world fractured anyway. The bleeding-heart liberals -- who care about social justice, equality, fairness and preventing the regression of the human species into some kind of disgusting bestial form -- have been beaten by the populists, the racists, the bigots, the xenophobes, the sexists, the chauvinists. Basically, the hand-wringing appeals to human decency have reached a cul-de-sac. I'm bored of being reasonable, rational, measured, fair and even-handed.

The other thing that's fun to write about is the stuff that challenges assumptions and prejudice. I like being polite, well-mannered and well spoken enough to lull people into a false sense of security. "It's OK, he's one of us" they say, and then I unleash the punchline: "Ha! Ha! I'm actually a mentally ill homeless bum benefits-scrounger junkie addict unemployed loser". To be honest, it's the kind of joke you can only do once, and then it's not funny anymore.

I know what I've written to date has been horrifically repetitive. I've laboured some of the same points over and over again. I had open wounds. I was hurting. My self esteem, confidence, self-worth: they were all destroyed. I was caught up with ethical conflicts and I wanted to burn bridges that led back to anywhere I shouldn't go. I was bitter and angry. I found a platform to vocalise my side of the story, and put some balance back into the world. I was like a little yapping dog, barking "don't tread on me" as people who sat in idle comfort and security ganged up on me when I was sick and vulnerable. Writing was my megaphone, to shout down a mob of bullies.

I've ended up with a few things worth preserving, by good luck or good judgement. Most of the former rather than the latter, I think. I don't want to screw up a relationship that's going really well. I've started to reconnect with friends and have some stability. I've got a lovely apartment and I've managed to offload a third scrounger twat who thought they were going to live on my dime, not paying rent and bills. I'm well positioned to be able to get another couple of contracts that should bring me the financial security that I deserve.

Deserve??!? So entitled!

Where do you want to draw the line? Am I entitled to oxygen, water, food? What about shelter, warmth? If you think that kids should be grateful to their parents for having sex, you're a special kind of stupid, aren't you?

Oh God, I've really taken this "rambling" thing to heart, haven't I?

I think I understand why people write fiction now. Having a fictional outlet allowed me to deal with a load of shit that was bothering me, while also demanding that I fit it to a narrative. I was able to write with structure and express concepts that I'd written about at length, but it was much more cohesive and coherent than trying to write these [supposedly] single-topic blog posts that often go off-piste.

Anyway, I don't know why I'm yapping on. My writing serves me well as a kind of heartbeat to let my friends know I'm still alive and kicking, but I need to think about why else I'm writing. Am I a social justice crusader? Am I lifting the lid on mental health and addiction treatment? Am I campaigning for housing reform? Am I a fiction writer?

I guess if I get another job I'll be writing because I'm bored as fuck.

Tags: #writing

Contents

Chapter 1: The Caravan

Chapter 2: Invisible Illness

Chapter 3: The Forest

Chapter 4: Prosaic

Chapter 5: The Van

Chapter 6: Into the Unknown

Chapter 7: The Journey

Chapter 8: Infamy

Chapter 9: The Villages

Chapter 10: Waiting Room

Chapter 11: The Shadow People

Chapter 12: Enough Rope

Chapter 13: The Post Offices

Chapter 14: Unsuitable Friends

Chapter 15: The Chase

Chapter 16: Self Inflicted

Chapter 17: The Holiday

Chapter 18: Psychosis, Madness, Insanity and Lunacy

Chapter 19: The Hospitals

Chapter 20: Segmentation

Chapter 21: The Cell

Chapter 22: Wells of Silence

Chapter 23: The Box

Chapter 24: Jailbird

Chapter 25: The Scales

Chapter 26: Descent

Chapter 27: The Syringe

Chapter 28: Anonymity

Chapter 29: The Imposter

Chapter 30: Wish You Were Here

18. Psychosis, Madness, Insanity and Lunacy

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

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

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

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

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

"Did you get the mirtazepine?" asked Lara.

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

"Two medications?"

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

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

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

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

"Did you get a new diagnosis?"

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

"Who are the crisis team?"

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

"Are you still having suicidal thoughts?"

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

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

"Can I have the crisis team number?"

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

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

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

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

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

"Why are you using my name?"

"What do you mean?"

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

"I don't know what you mean"

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

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

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

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

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

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

Two days later, Neil had disappeared.

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

"Have you rung the crisis team?"

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

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

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

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

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

"Yes, Hi"

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

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

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

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

"Yes, Lara"

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

"That's fine."

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

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

Lara noticed that Neil was hovering by the door.

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

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

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

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

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

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

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

"Do you know what day it is today?"

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

"Do you know who the Prime Minister is?"

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

"OK, and where are we?"

"We're in my house"

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

"No"

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

"No"

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

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

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

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

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

"I want to die"

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

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

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

"It's on my bedside table."

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

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

Lara returned with the medication and a drink.

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

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

"Dan, we've got to go."

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

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

The front door closed, Lara returned to the snug.

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

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

Next chapter...

Contents

Chapter 1: The Caravan

Chapter 2: Invisible Illness

Chapter 3: The Forest

Chapter 4: Prosaic

Chapter 5: The Van

Chapter 6: Into the Unknown

Chapter 7: The Journey

Chapter 8: Infamy

Chapter 9: The Villages

Chapter 10: Waiting Room

Chapter 11: The Shadow People

Chapter 12: Enough Rope

Chapter 13: The Post Offices

Chapter 14: Unsuitable Friends

Chapter 15: The Chase

Chapter 16: Self Inflicted

Chapter 17: The Holiday

Chapter 18: Psychosis, Madness, Insanity and Lunacy

Chapter 19: The Hospitals

Chapter 20: Segmentation

Chapter 21: The Cell

Chapter 22: Wells of Silence

Chapter 23: The Box

Chapter 24: Jailbird

Chapter 25: The Scales

Chapter 26: Descent

Chapter 27: The Syringe

Chapter 28: Anonymity

Chapter 29: The Imposter

Chapter 30: Wish You Were Here

6. Into the Unknown

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

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

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

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

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

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

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

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

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

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

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

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

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

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

"Is everything OK, Lara?"

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

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

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

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

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

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

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

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

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

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

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

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

"What was that all about?" Anne asked.

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

"And are you?" Anne asked.

"Not really" said Lara.

Next chapter...

This is a story about being objective...

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

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

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

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

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

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

Defining "happy" has started to get really hard.

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

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

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

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

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

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

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

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

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

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

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

A friend made the following amusing observation:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Tags: #bipolar #depression #mentalhealth #addiction

 This is a story about drug dealers...

The top image shows an official UK prescription. A doctor registered with the GMC prescribed me the medication and a pharmacist registered with the GPHC filled my prescription. The bottom image shows black market prescription drugs for sale on the Dark Web. When you buy from the Dark Web an anonymous vendor will sell you whatever you want, no questions asked.

In order to receive my official prescription, I had to answer 14 yes/no questions. One of the questions was "do you have high blood pressure?". How the hell should I know? The last time I had my blood pressure checked was 11 months ago, and I've gained loads of weight and have been drinking far too much since then.

According to my order tracking, a doctor spent 7 minutes deliberating my 14 answers - 30 seconds per answer - before writing my prescription. I never met this doctor, we never spoke and they never saw my medical records.

Some years ago, with a great deal of arm-twisting from my private psychiatrist, my GP agreed to prescribe me Bupropion for the depressive episodes of my bipolar disorder. In the UK, Bupropion is not licensed for the treatment of depression or bipolar disorder. NICE guidelines do not recommend the use of Bupropion for anything other than as a smoking cessation treatment. Basically, my GP faced being struck off the GMC register if I suffered some horrible medical complications because of an adverse drug reaction.

I've been back in London for 3 years and I've had 2 different GPs since then: one in Camden and one just across the road from where I live. Neither of them has prescribed me a single medication, but the Camden GP took it upon himself to phone me on my mobile in his personal time to see if I was still alive. My GP went out of his way to try and help me.

The average face-to-face GP consultation time in the UK is just under 9 minutes. Imagine having just 9 minutes to establish that somebody is suicidally depressed and then select a psychiatric medication for your patient. The medication could either save them or reduce their quality of life even more. It's not much time, is it?

And so, I became an educated well-informed patient. A doctor I spoke to some years ago said that I would be better off finding a "prescription pad psychiatrist" who would write me a prescription for whatever I wanted. These doctors exist. They're available online, without even having to meet them or speak to them on the telephone, it would seem.

I have no criticism of the ethics of what the doctor and the pharmacist who I obtained my official UK prescription from are doing. It doesn't seem unethical to me.

Interestingly, it cost me £90 for 60x 150mg Bupropion tablets. I could easily buy the exact same medication for less than half that price on the Dark Web. If I was to buy the medication from India, it would cost me less than £6 (plus postage).

On the NHS, a prescription costs £8.40 if you're working and not entitled to welfare benefits.

Basically, you pay for convenience. With the online pharmacy I had a short form to fill in and I got my medication delivered next day. With the Dark Web, I would have had to faff around with Bitcoins, but my medication would also have been delivered next day. With my doctor, I would have had to make an appointment, and there's every chance that they wouldn't have been prepared to take the risk of writing an off-label prescription. With the Indian medication, their postal service is appalling and it takes weeks for a delivery to arrive.

One reason not to order from the Dark Web though, is that you can get anything you want. It's easy to start window shopping. Once you've loaded up your account with some Bitcoins, it's easy to fill up your 'shopping basket' with all kinds of things that you're curious about, or things that you know you really shouldn't be buying because they're bad for you. It's a slippery slope.

One of the reasons why I don't have any drug dealers phone numbers and I've never bought drugs from a drug dealer, is because it's so convenient. I don't believe in the idea of a 'pusher'. People want drugs, plain and simple. The drugs push themselves.

One of the reasons I'm not using internet banking at the moment, is because it makes it too easy for me to buy some Bitcoins, transfer them to a Dark Web marketplace, and have a little jiffy bag containing deadly white powder, hitting my doormat the very next day.

I don't believe prohibition works, but certainly making things a little more inconvenient does offer some protection from temptation. I wouldn't even know where to begin, trying to find a drug dealer, unless I wanted to buy low quality cannabis or terrible quality imitation cocaine from one of the many dealers who hang around by Camden Lock.

Prohibition created legal highs. Prohibition created the Dark Web. Because I'm an IT expert and a sensation seeker, when I read about legal highs in the news I was tempted to give them a go. The rest is history. All of that "moral panic" crap in the media had precisely the opposite effect than intended. A naïve middle-class IT professional working for an investment bank, suddenly became exposed to a world that I would never have become part of, if it wasn't for the fact that prohibition lowered the barrier to entry.

As the legal highs started to get banned, I then took to Internet forums to find out where people who had stockpiled - like me - were supposed to go after we ran out of drugs. That was how I found out about the Dark Web. Yet again, prohibition moved me from a world that was legal, taxed and regulated, towards the dark and murky world of illegal drugs.

One day, in a pit of despair at my spiralling addiction, I decided to order all the drugs. I bought crack, heroin and crystal meth. I didn't even know what to do with them. You can snort heroin and meth, but not crack, as it turns out. How does a middle class homeowner even smoke crack? I didn't even own a cigarette lighter.

A couple weeks later, I had nailed my door shut and put newspaper all over the windows. It's remarkable how quickly a respectable middle-class rich person can turn the house they own into a crack den.

What's also remarkable is how quickly you figure out that you've bought a one way express ticket to an early death, if you have vast sums of money and a reasonable intellect.

One day, I smoked a pipe - I had bought a meth pipe off the Dark Web by this point - that had been filled with heroin, crack and meth. I thought "is this as good as it gets?". The room was bathed with a yellow light, even though it was barely lit. There was a calm serenity. I thought "this ain't even that great" and decided that I'd better stop before I decided that it was great.

It's the strangest thing, flushing rocks of crack and a big bag of heroin down the loo, not because you're addicted and you want to quit, but because you can see how easily you could become addicted.

People think that drug addiction is all about wanting drugs and taking drugs, but it's not that at all. Drug addiction is about identity, routine, habituation, ceremony, lifestyle... things that I even struggle to explain. If you're just locked in a room with a virtually limitless supply of drugs, because the postman keeps bringing your supply and you have lots of money in the bank... you'd think you'd just take drugs and more drugs until you died or ran out of money.

In actual fact, addictions are self-limiting. Given a clean pure supply of drugs, eventually, addiction becomes kinda boring or the downsides start to outweigh the upsides.

I'm lucky, because I'm wealthy and I'm not a total dumbass. I tried so many drugs, and eventually found one that was far better than crack, heroin or crystal methamphetamine, but cost less than £1 a day.

I used to buy a packet of capsules off the Internet for £27. This was a legal high called "NRG-3", which turned out to be MDPV: I've nicknamed it supercrack. The packet contained 20 capsules, and each capsule had 100mg of MDPV in it. I would hide these capsules all over the house, so that I would never have to hunt for very long to get my fix, when the cravings became unbearable.

I would divide the 100mg contents of a capsule into 3 equal piles. Then, I would divide one of the piles into 2 lines. I would snort one of the lines, which would weigh approximately 17mg.

17mg of MDPV is a very strong dose. Basically, it's enough to be bat-shit insane for 24 hours. I would pretty much always end up going back for the second line... so that's 48 hours of insanity, with no sleep. I would go back to work for a rest.

120 days of bat-shit insanity for £27.

Cheap.

Deadly.

You spread 120 days over the weekends, and you've got 2 years worth of hiding a drug habit. If you do anything for 2 years, it becomes an integral part of your life. It's hard to change the habits of a lifetime. Again, you've gotta be smart and spot the changes in your behaviour.

I started cancelling plans, because a 1-day drug binge turned into a whole weekend drug binge.

I started not making any plans, because I was planning on taking drugs all weekend.

How the hell I held down a job during this time, I have no idea.

My psychiatrist and my GP thought I was self-medicating for depression. They thought I was in control. They actually told me "don't stop what you're doing... just try to cut down gradually". My GP signed me off work for 5 weeks, and I thought "great! I can take drugs for 4 weeks and then spend a week recovering".

It's true that my clinical depression and abusive relationship had led me to self medication, but when it became drug experimentation, I lost control over the course of a year. I started with a legal drug called Methylone, which I took every day and it worked to alleviate my depression. Then, when I found NRG-3 during a messy breakup, I was completely hooked.

Less than a month after becoming addicted to NRG-3, I started carrying a letter with me and a £20 note in an envelope. The letter said:

"I am a drug addict. If you have found me with breathing difficulties or unconscious, please put me in a taxi to A&E".

In actual fact, the letter was far more detailed and contained some information that would have been useful for any medical professionals who had the misfortune of trying to look after me... but you get the idea. The penny had dropped. I knew I was in trouble. Self-medication had turned into experimentation, which had unleashed addiction.

For others, there are 3 valuable lessons I learned:

1. Depression, stress, relationship difficulties, money worries, housing worries: these are the things that create a festering swamp. Addiction will take hold, not because of the drugs, but because somebody's life is already awful. If you want to prevent addiction, you need to improve people's lives, not ban drugs.
2. Even though it sounds disingenuous, it does make sense to shop around. Think about all those Oxycontin addicts who haven't yet figured out that heroin is stronger and cheaper. They're going to one day. How much money are they going to 'waste' in the meantime?
3. Addictions are naturally self-limiting. People need to quit on their own terms. There's an oft-quoted line about how addicts and alcoholics "can never get enough of their drug of choice". In actual fact, very few people can actually afford to take as many drugs as they want. Look at the mega wealthy: aren't you surprised that so few of them drop dead from drug abuse?

Alcohol is a dumb choice of drug, because it's so damaging to the liver. In a way, benzos are the smart alternative. GHB/GBL makes you 'drunk' but it doesn't have the same hangover, and it's not so damaging to the body. You can buy 10 litres of "alloy wheel cleaner" from BASF in Germany for about £500. That's equivalent to 7,000 shots of vodka, and it won't give you cirrhosis of the liver.

Cocaine is a dumb drug of choice, because it's so expensive and the adulterants are highly damaging to the mucous membrane in your sinuses, to the point where you might lose your nose. You can buy nitracaine from China in bulk for just a few dollars per gram, and it'll be 99% pure.

Heroin is damn cheap. It's the injecting that causes the problems: collapsed veins, abscesses and dirty needles leading to blood-borne diseases. With an adequate supply of medical grade diamorphine, a heroin addict can live a long, healthy happy life, and will probably "grow out" of their habit in their 40s or 50s.

Crystal meth is cheap anyway. Smoking meth is undoubtably incredibly destructive to teeth and lungs. It sounds crazy to say this, but given an adequate supply, at least crime will go down and the need for prostitution goes away. With higher self-esteem because people are not selling their body to get drugs, surely a large number of addicts are going to stop using eventually?

I'm not saying "legalise all drugs and have your local supermarket stocking crystal meth". Drugs are so widely available and so cheap, we're at the point where prohibition is like a bad joke. Shutting the original Silk Road marketplace on the Dark Web just caused dozens more imitators to spring up and fill its place. You can't legislate to control human nature. It doesn't work. Supply and demand are the only forces that you need to understand.

If you have a loved one who you think is at risk of addiction, or struggling with addiction, you can prevent that journey from even starting by making their life vastly better so that addiction never takes hold. Once an addiction has started, you're not going to be able to cut it short by cutting off their supply of money or forcing them into some rehab program. An addict will simply go around any obstacle. An addict needs to quit on their own terms, when they've had enough.

Perhaps I will never have had enough, because perhaps my life will never improve. Certainly, when you're depressed, stressed, bored shitless by your job, worried about money, isolated and lonely... those things are perfect breeding conditions for addiction to take hold. Why the hell are you being clean & sober, if your clean & sober life is utter bullshit?

This is how I've arrived at the decision to start using drugs again.

Except, I'm being smart... I think. I think I'm smart. Correct me if I'm wrong. Am I smart?

What am I doing differently? Well, nothing really. I'm combining my experience from far too many years of ups, downs and dangerous self-experimentation. However, I have meticulously gathered data. I have documented pages and pages of details on my drug and medication use, and cross-correlated that with my mood diary, earnings, movement data and every other data source that I could harvest.

My conclusion: I need a fast-acting antidepressant that gives me a mood improvement.

So, I decided to prescribe myself Bupropion.

It arrived today.

I took it.

The experiment continues. It's a big relief to finally change something, after 6 painful months of controlling the variables, even though it was causing me untold mental anguish.

Actually, two things changed today, which is a shame, in terms of conducting a decent trial.

Today, I'm unemployed.

Anyway, I need to get another job, and it might just be a little easier, now that I have relented and I'm taking happy pills... let's see, shall we?

Tags: #drugs #addiction #mentalhealth #medication #depression

This is a story about milestones...

There are so many people who either "don't smoke" or call themselves "social smokers". People say "I only smoke when I drink". There are so many people who claim that they are free from drink and drugs, but they're actually popping Xanax, antidepressants, Oxycontin, Solpadeine, Co-codamol (codeine), Vicodin and tranquillisers. There are so many people who sneer at substance abusers, but they drink, smoke and consume lots of tea, coffee and energy drinks, without realising they're dependent on alcohol, nicotine and caffeine, just to cope with normal everyday life.

In 6 months, I got through those 59 tablets - a combination of diazepam and nitrazepam - in an attempt to avoid a nervous breakdown and to survive an extremely stressful situation, where my whole career, solvency, home and life as a respectable member of society, hung in the balance.

If you take benzodiazepines continuously for over 3 months, you have probably become physically addicted. What that means is that you might have a seizure and die, if you were to abruptly stop taking the medication.

I've run out of benzodiazepines today.

I'm not worried about this.

59 tablets, of 2mg to 5mg strength, spread over 180 days, is a piss in the ocean. There's no way that I'm going to have withdrawal symptoms from stopping taking benzodiazepines. I might be a little anxious; I might have a little insomnia; I might feel a bit panicky. However, I'm not going to die.

A couple of years ago I took myself off to rehab. For over 3 months I had been swallowing a little cocktail: 6x 10mg diazepam tablets, 4x 2mg Xanax, 2x 10mg Ambien, 2x 15mg Zopiclone. Maybe it wasn't quite that much. I have no idea. Benzodiazepines cause amnesia. All I can remember is that I used to fill up the palm of my hand with various pills, and swallow them all in one go. Lights out. Wake up 2 days later.

You're in a hell of a mess when you're mixing uppers and downers; stimulants and tranquillisers; but that's what we do every day, when we have our morning coffee and a glass of wine when we get home from work. If you have a strong coffee after a boozy dinner, you're basically having the middle-class equivalent of a speedball (cocaine & heroin, injected).

Obviously, I'm irreverently mocking your self-delusion, when you tell yourself that you're not "hooked" on anything.

I've used alcohol and the occasional tranquilliser tablet, in order to limp through the last 6 months. I haven't been having tea, coffee or other caffeinated drinks.

I've actually tapered off the alcohol and the benzos, to the point where I only drank 2 days in the last 14. I didn't take any benzos all weekend.

The thing is, if you're smart and you're disciplined, addiction is something you can master. It is possible to give up anytime you want. It is possible to become really good at quitting drugs and booze. I'm a fucking expert in abstinence.

Almost like an alarm clock going off, my subconscious revealed that I had simply been waiting for 6 months.

School was absolute shit for me. Getting through the long school days of bullying was awful. Getting through the long terms of bullying was unbearable. Getting through year after year after year of bullying was absolutely dreadful. All I was doing was waiting for the end of school bell, the school holidays, and the day that I could finally leave school and get the fuck away from the bullies.

Family life was absolutely shit for me. I couldn't wait to move out of home, and get away from my arsehole parents. I've loved paying my own rent and bills. I've loved being independent. I do have all the fucking answers. I went out into the world, got a place to live, got a job, and never looked back. Up until then, I'd just been waiting for the day I could finally leave home, and it couldn't come a moment too soon.

So, I spent 17 years, just waiting. I was biding my time. I know how to suffer patiently. I'm an expert in suffering patiently.

Then, I applied my expertise in deferred gratification to the working world. I took shitty entry-level jobs and worked my way up. I stuck with shitty projects, and shitty companies, so that my CV would look good. I stuck with shitty bosses and put up with glass ceilings. I stuck with idiots who couldn't see my potential, and I just suffered because I had a game plan.

I can patiently wait anything out. I've had to spend about 16 weeks with very limited liberty, being treated as an inpatient. That's not including the time I've spent in hospital receiving emergency treatment. In theory, I could have discharged myself, but there would have been consequences. I spent 7 weeks with somebody who'd been in prison twice, and he acknowledges that I have a mindset that suggests I know how to do time.

I mean, Christ, I spent the best part of 5 years working for one damn company, in one damn building, with the same damn people. Day after day, month after month, year after year. I've done 19 bloody years on the IT gravy train, solving the same damn problems again and again and again, and seeing the same damn mistakes time after time.

And so, I wondered to myself, why didn't I have a packet of drugs to tear open, in celebration of the fact that I have so easily completed a 6-month period of abstinence?

What you'll find with many addicts, is that they're liars. When they say that they're abstinent, they're actually lying to themselves and others. I've done "6 months clean" before, but that hasn't counted "the occasional weekend" and one or two "lapses" (note: a lapse is a 'small' relapse). In actual fact, you're still addicted, but you're limping yourself along by hiding your habit, from yourself and others. You start to believe your own lies.

I've arrived at 6 months "clean" and it really is clean. As clean as anybody in the history of anything, ever.

Most people who quit smoking will drink more, have more coffee, eat more. Most people who quit anything, will find some way of compensating. It might be exercise; it might be work. Basically, humans need shit. We're not fucking robots. Humans have always had intoxicating substances. Wine was being made 6,000 years before Jesus Christ was even born... that's over 8,000 years ago!

Anyway, I started looking at websites of awful toxic Chinese "legal" highs. Then I had a look at the Dark Web. The amount of drugs that are available to order over the Internet is just staggering. Prohibition has spectacularly failed. The designer drug industry is enjoying such a boom time, thanks to ridiculous laws that force chemists to get creative. Technology's answer to the eternally insatiable human demand for mind-altering substances has created a whole swathe of online marketplaces stocking every drug under the sun.

There's something for everybody in the cornucopia that has been created by the war on drugs.

My finger hovered over the "Buy Now" button, because I've damn well proven my point. Pick some arbitrary milestone, and I'll hit it, easily. But, what do I have? My life is miserable. All I have ahead of me is stress and loneliness; insecurity and pain; suicidal thoughts and a sense of abandonment. Fairly easy to justify a relapse, isn't it, when you work so hard and you're not getting anywhere.

Then, I thought, what could I do that's slightly more sensible?

With a bit more searching around on the Internet, I found that you can consult a doctor online and have a prescription despatched next day. In the space of 7 minutes, a doctor agreed to prescribe me a fast-acting antidepressant called Wellbutrin. I needed something because I felt certain that I was either going to commit suicide quickly by cutting an artery, or commit suicide slowly by relapsing back into drug abuse.

Wellbutrin is a wonderful medication, because it's fast acting, it doesn't make you drowsy, and it doesn't ruin your sex life. Have you experienced the boredom of patiently fucking somebody who takes an SSRI antidepressant, waiting an absolute age before they possibly cum, but probably won't be able to? Who wants a sex life like that? I don't want my emotions blunted. I don't want 'brain zaps' and uncontrollable crying when I try and stop the damn medication.

Yeah, who knows what the fuck happens next. Tomorrow, I have a 2-month supply of a fast-acting antidepressant that you can't get on the NHS being delivered. Maybe life will look a bit less hopeless when I'm drugged out of my mind, like virtually everybody else I know.

It feels like selling out, but it's nearly killed me having to fight tooth and nail just to have a roof over my head and a job, while also being nearly stone cold sober. I don't have kids to remind me why I get up and go to work. I don't have pets to look after. I literally have no reason for living, except to achieve some arbitrary goals.

I thought, as an added bonus, that I would also be celebrating one year of blogging today, but it turns out that happened a couple of weeks ago. Today is my last day at work, and I've had a couple of leaving dos, which is nice, but I do of course have to go though all the stress and hassle of applying for new jobs, interviewing, making a good first impression etc. etc. How ironic that things seem to have conspired to happen today.

As luck would have it, a colleague has recommended me for another job, which I might end up interviewing for tomorrow and could even be asked to start a new contract as early as Monday. If I do that, I'm damnwell going to need a few happy pills to carry me through, because I had been thinking that I was going to have a minor nervous breakdown.

Anyway, a milestone of sorts. Nice to leave work with a few slaps on the back and "well done"s. Nice to know that I didn't 'cheat' with my 6 months of abstinence from addictive stimulants. Where's my fucking reward? Surely I should feel better than I do, but I'm depressed and anxious. I'm overwhelmed by the task of having to hustle again, to keep the momentum going.

But really, is there momentum, or did I just wait for 6 months, in order to have a well-earned breakdown?

Is that what life is? Just waiting to die, miserable as fuck?

Tags: #depression #suicide #addiction #drugs