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Notes on a Suicide - #WorldMentalHealthDay #WorldSuicidePreventionDay

8 min read

This is a story about slipping through the safety net...

Discharge summary

Exactly one month ago was World Suicide Prevention Day and exactly one month ago I was in a critical condition, on life support in intensive care. I was given a 50/50 chance of living or dying, following an overdose the night before. It seems sickeningly ironic that if the emergency services had reached me just a little bit later, I wouldn't be writing this. If I didn't live in the United Kingdom, where we have the best healthcare system in the world, I would probably not be writing this.

It was 9 years ago that I first sought help for my mental health. "Have you heard of fluoxetine?" asked my doctor, within 30 seconds of me explaining my symptoms: suicidal thoughts, low mood, low energy and an inability to get out of bed and go to work like normal. I was disappointed to be offered patent-expired generic medication, without a moment's hesitation. I walked away empty handed.

Clinical depression was where I started my mental health journey. Having the label "clinical" made a huge difference. To add that word - clinical - onto how I was feeling, was necessary to defend myself from anybody who might say "just snap out of it" or "pull yourself together". In my case, having a label was desirable - it wasn't an excuse; it was a diagnosis.

Every time I've gone to my doctor, I've been hoping to receive some counselling, but instead I got referred into psychiatric services as an outpatient in 2010. I was referred for Cognitive-Behavioural Therapy (CBT) treatment, but by the time I was assessed, my mood disorder had been diagnosed as type II bipolar disorder. The assessment concluded that my mood disorder was too severe to be treated with CBT. I was left with no psychological treatment. "What am I supposed to do?" I asked. "Go back to your doctor" came the reply. It was a devastating disappointment.

By 2011 I was so unwell that I was assessed under the Mental Health Act, to see if I needed to be detained in hospital - what is colloquially referred to as a "section". I begged to be hospitalised as I was suicidal. I repeatedly said the classic cliché that so many people will say when they are desperate for help: "I'm going to kill myself". Community Mental Health Teams (CMHTs), crisis teams and home treatment teams must hear those words so often.

With a shortage of psychiatric beds, there's a huge reluctance to "section" anybody. At the time of my first section assessment, my girlfriend and my dad were present, so the assessment concluded that I could be kept safe at home. In fact, I sawed a hole in the back of my shed, climbed over a neighbour's fence and ran away. The police were called to look for me because I was a danger to myself.

Soon after that, I was seen by a private psychiatrist, referred and admitted for 4 weeks of inpatient treatment at a private hospital. The cost was over £12,000.

There was some debate with my medical insurance company as to whether my bipolar disorder was acute or chronic. The insurance company said it was a chronic condition, and therefore not covered by the policy. The consultant whose care I was under, managed to argue - over the course of a couple of nail-biting weeks - that my presentation was acute.

Having to resort to the private sector; having disputes with an insurance company - none of this was conducive to getting better. In fact, having to find my own psychiatrist, get approval from the insurance company to even speak to the doctor and then having the stress of thinking that I might need to spend £12,000 of my dwindling savings, was an awful ordeal when I was clearly very unwell.

At the end of 2012 I got married and 8 months later I separated from my wife. She didn't care about the incredible stress that divorce and selling our house would put me under. I moved to London to live with supportive friends while my life was ripped to pieces. I lost my job.

By 2014, I completely slipped through the safety net. I took an overdose and lay dying of multiple organ failure on the floor. I managed to phone a friend who got me to hospital. After a week, the hospital discharged me to a hotel. I had two weeks to organise my own accommodation because no bed on a psychiatric ward could be found for me. My muscles were horribly damaged by the overdose and I was in agony. With a bundle of documents to prove that I was a priority case for emergency housing, I visited the local council housing department. The officer I saw promptly disappeared on holiday, abandoning my case. I became homeless.

After living in cheap backpackers' hostel, I reached my two week limit, which is a rule that most hostels have. I then started living in a bush in Kensington Palace Gardens. When it became apparent that living in a bush was not a long-term solution, I stumbled into nearby Paddington - St Mary's Hospital - and presented myself at Accident & Emergency. 12 hours later, I was given two weeks respite in a "crisis house". I tracked down the housing officer who I'd spoken to before. At the end of two weeks, I received a one-line email: I wasn't eligible for any help from the local council. Why? What now?

I was homeless on Hampstead Heath. It was very beautiful, but it was still summer. What was I supposed to do when the weather turned bad?

How had this situation come to be? I'd been a highly functional, productive and fine upstanding member of society: I'd had a successful career, paid taxes all my working life, bought a house, gotten married and done all the things we're supposed to do. What the heck was I doing homeless and abandoned by the state when I was obviously a vulnerable adult? My doctor had written a letter saying I was a vulnerable adult, and my psychiatrist had done the same. These letters had been presented to the local council housing officer, but yet it had made no difference. What have you got to do to get help in this country?

Eventually, I came to be living in the North of England, in an apartment which was a perk of a job I'd taken out of desperation. The apartment was miserable, dark and dingy, and I was terribly lonely. On the 9th of September 2017, I took a massive overdose, which I had researched on the internet to make sure it was likely to be fatal. I regained consciousness after having been in a coma, in hospital, on the 11th of September 2017 - I had completely missed World Suicide Prevention Day. A machine was breathing for me and I was put back to sleep. I didn't leave the intensive care and high dependency wards until the 12th of September 2017.

On the 13th of September 2017, I found myself discharged from hospital and left to flounder all on my own. I didn't want to go back to the apartment where I'd tried to kill myself. I've not been back there. I'll never go back there.

I was sectioned - a section 136 - after being taken to hospital by police. I had to make a massive public nuisance of myself in order to get help. The hospital upgraded me to a section 2, which meant I was going to be kept on a psychiatric ward for up to 28 days. Why now? I'd had two near-fatal overdoses, which had hospitalised me in a critically ill condition, but yet I hadn't been considered enough of a risk to myself to receive inpatient psychiatric treatment. Why did it take so long to finally get the treatment I'd been begging to get for 6 years?

The psychiatric ward discharged me from my section after 12 days, and another week later I was discharged from hospital - a good samaritan has taken me into their home. Again I wonder why no temporary housing was forthcoming, given the fact I am so vulnerable - I lost my job and my apartment due to mental health discrimination. I'm being victimised again & again.

I'm in a safe place now, but my food & accommodation comes from a charitable family who have taken pity on me, after reading my story on my blog - we clearly don't have a system that works for the whole of society. We can't all turn to Twitter every time we're having a mental health crisis.

My Twitter followers brought the emergency services to my door, saving my life. Through my blogging and social media presence, a stranger read about my desperate plight, and kindly offered to take me into the family home.

Today, I feel OK, but why have I been subjected to such a horrific ordeal? I very nearly succeeded in ending my own life, because no help was forthcoming when I really needed it - we're locking the stable door after the horse has bolted.

Using myself as a case study, the safeguards we have in place to prevent suicides are woefully inadequate. My first-hand experience of NHS mental health services, is that they're desperately underfunded and overstretched.

There will be so many tragic preventable deaths if we allow the current situation to persist.

 

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Hospital Curtains

6 min read

This is a story about modesty...

Psych ward male dorm

It took 12 days to be "discharged" from my section - that is to say, to be allowed to leave the secure psychiatric ward whenever I wanted. However, it took 21 days before I was actually discharged from hospital: no vulnerable adult can leave hospital without a discharge plan, although I could have discharged myself against the advice of the healthcare professionals who were taking care of me, because I was a free man.

I'd been assessed to see whether I needed to be detained under the Mental Health Act at least 5 times. 6th time lucky.

When you find out for the first time in your adult life, that you're about to be detained against your will, I would've thought that everybody would have a similar reaction: "oh my god, I'm now trapped somewhere I might not want to be, and I don't have any say in the matter" which is distressing.

It's not so much that I didn't want to be in hospital; it's that I couldn't leave even if I wanted to. Although I wanted to be in hospital - because I knew I was very sick and in a dreadful situation - there was still a moment where I thought "oh shit what have I done?".

To calmly accept your plight is not something that would be anybody's natural reaction. Under such stress and shock, it's hard to recognise immediately that any attempt to fight against the system will lead to further difficulties. I was least surprised out of anybody that I got sectioned, having been the one who actually phoned the police to come and get me. Of course, escape is not hard if you're determined enough. I was conflicted - I was safe, but the price I paid was my detention: I lost my liberty.

Running away from a psych ward will result in the police being called to look for you. Britain's most dangerous psychiatric patients are kept in facilities which are far more secure than anything I experienced. I could have escaped easily and the police wouldn't have tried very hard to find me - I was a danger to myself but not others.

Our natural reaction to detention is to panic and start yelling for anyone who can possibly get you out - a solicitor, a social worker, a family member - and to start demanding your rights. There's a process that's got to chew you up before it can spit you out, and once you've just started the rollercoaster ride there's no getting off until the end - scream if you want to go faster.

Despite my messed up state, I knew that I had the right to appeal my 'section' with a tribunal supposed to happen within 7 days. I knew that my dad had the right to request my release, with a decision having to be made within 72 hours. I didn't have much hope that my dad would be helpful, so I requested an appeal.

It's so damn hard to get any treatment for mental health problems, beyond some cheap patent-expired generic medications or a computer-based Cognitive-Behavioural Therapy (CBT) thing. Inpatient hospital treatment, paid for by the NHS, is only given to very unwell people or exceptionally stubborn & determined people. However, when you have been admitted to hospital once as an inpatient under a section, you might struggle to ever escape the revolving doors.

Many of my fellow patients had the same story - they were released from hospital, stopped taking their medication, went mad and were brought back into hospital, where they were forced to start taking medication again... eventually being released and starting the whole process again.

Note, when I say "forced to start taking medication" I literally mean that they were held down by a whole gang of hospital staff members and forcibly injected against their will.

It would be stupid to argue that psychiatric medication is entirely unhelpful. However, one should be mindful that a perfectly sane person who had been taking powerful antipsychotic medication, would experience extremely powerful withdrawal symptoms if they stopped. Antipsychotic withdrawal symptoms are indistinguishable from the spontaneous psychosis that occurs in a person with a mental illness - how can one distinguish between a madman and somebody who's experiencing the perturbations of a brain that's readjusting to medication-free homeostasis?

As we move towards a world where the majority of us suffer near-debilitating levels of anxiety and depression, and psychiatric medications are dished out like candy from general doctors who have no specialist training in the treatment of mental health problems, are we diagnosing disease when we should be looking at what a person's life circumstances are like?

Ironically, I was diagnosed with adjustment disorder, which is to say that I simply couldn't cope with stressful life events - a clinical label for an intolerable clusterfuck of dreadful stuff which could happen to anybody. There isn't a pill for adjustment disorder, yet, although a bottle or two of wine each night is often chosen as self-medication.

The stress of living with 20+ mentally ill men in a locked psych ward is something that most people would not adjust to particularly easily. The 4 walls of my home were replaced with a curtain, which was opened every 15 minutes by a nurse or a support worker to observe what I was doing.

I think psych wards are necessary and I'd rather have the apparatus that treats mental health problems, than not have it at all. This is not an essay that criticises mental health treatment or the hardworking professionals who care for people with mental health problems. I write merely to reflect on my journey through the mental health system, which finally ejected me yesterday. I'm coming to terms with the fact that I was discharged from hospital, and today is the first time in weeks where I have woken up somewhere I can leave without having to ask permission.

Yes, I think that sums up yet another Earth-shattering overnight change to my life: I've gone from a flimsy curtain and a locked door, to 4 solid walls and I'm free.

 

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A Tale of Ten Beds

7 min read

This is a story about how nothing really mattress...

Double bed

This is the last double bed I slept in, 27 days ago. That's my brand new bedding with brand new pillows and a brand new duvet. I moved to Manchester with nothing more than my laptop and a bag of clothes. New life - clean slate. This is the apartment where I tried to kill myself. It was a miserable place and I'm glad I never slept there again.

I woke up on Saturday 9th September, and I was miserable. I wrote a blog post in this bed, about how miserable I was and how close I was to committing suicide. It was prescient.

The next bed I lay upon was owned by a guy who I had become friends with through my girlfriend. My girlfriend at the time was of no fixed abode - sofa surfing with a guy who she met on a dating website. I'd travelled to this friend's apartment to see my girlfriend. We lay kissing and cuddling on our friend's bed. Then, we broke up.

Coming home to my miserable apartment, I didn't get into bed - I took a massive overdose and lay on the bathroom floor in the dark, waiting to die. The next bed I laid upon was in the Accident & Emergency department of the nearest hospital.

I'm presuming - because I was unconscious - that I stayed on the same hospital bed, as I was transferred from A&E resus to the Intensive Treatment Unit (ITU) and then to a High Dependency ward. I was on life support. I was having seizures. I don't remember any of this.

I vaguely remember having to scramble across onto a different bed, to move me out of the High Dependency ward and onto a general ward. I remember this because there was a bag of my piss sloshing around that had to be moved too, and there was a tube coming out of my penis, which I had to be careful not to entangle with anything. The tube that was going up my dick yanked my male member around - it wasn't a comfortable experience.

From hospital I was thrown in a police cell. There was a 'bed' made of concrete painted with light blue paint - the same glossy paint that adorned the floor and walls of the cell. To slightly soften the hard concrete, there was a thin blue foam mat, which was wipe-clean. I did not sleep.

Driven home by the two police who had interviewed me - at 2am in the morning - I finally got back home at 3:30am. My sleep medication was nowhere to be found and I'd had a traumatic day - sleep was impossible. I lay awake on my bed, waiting until the earliest possible moment I could go to the office and try to find a work colleague - I was in a desperate situation and I needed help from somebody friendly and sympathetic to my plight: alone in a strange city with no friends or family; no smartphone, laptop, debit card, credit cards, cash or driving license.

After a second dreadful day I was pretty fucked up, as one might expect of somebody abandoned in such shitty circumstances. As sleep deprivation reached the 40+ hour mark, I ended up back at the same hospital's Accident & Emergency department that I had been in 5 days earlier.

Another day, another hospital bed. This one I came round face down on, with my wrists handcuffed behind my back, after having received an intramuscular injection of 4mg of lorazepam. It was approximately 3am in the morning - now 6 days after my original hospital admission.

Sectioned first under a 136 (up to 72 hours) and then upgraded to a section 2 (up to 28 days) I was then taken to a secure psychiatric facility with airlock-type doors, to stop anybody escaping. I was given a private room that was quite nicely appointed, with a writing desk and an ensuite wet-room.

Psychiatric intensive care

Having blearily come round in the early hours of the Tuesday morning, it was now Thursday night. I finally had a single bed in a comparatively peaceful environment in which to collapse and sleep, mercifully with the assistance of some zopiclone to calm my jangled nerves and soothe me into my slumbers.

Gone were the bleeps and hisses of the machines that were keeping people alive, on the Psychiatric Intensive Care Unit (PICU), replaced with the sound of alarms, slamming doors, shouting and running in corridors, as my fellow patients were restrained by staff. I found it somewhat comforting, to know that my crisis was no longer at its peak.

After 8 days on the PICU, I was transferred to an acute psych ward. It was terrifying.

With me in hospital I had two Apple iPhones, two Apple Macbooks, a Nintendo Switch and £1,150 in £50 notes. It's not really recommended to have that amount of valuables on your person, in amongst some very poor and deprived people. The wealth disparity was vulgar.

My guardian angel facilitated the return of my surplus iPhone and Macbook - Apple were excellent and refunded me with no quibbles.

I begun life on the new ward in a private bedroom, but I didn't have an ensuite shower and the TV blasted right next door for 19 hours a day, at full volume. At first, I was too tired to care and I could sleep through the dawn chorus of utter bullshit television a million decibels, but then it started to keep me awake, leaving me less than 5 hours of shut-eye per night.

Psych ward TV torture chamber

Then, the dreaded dormitory. Dorms are a mixed bag - very dependent on the luck of the draw, in terms of your fellow occupants. Security is a massive concern, as nothing more than a privacy curtain separated my personal possessions from anybody who'd care to have a look through my bags. Snoring can be a pain in the arse, with one person able to keep everybody else awake listening to their noisy slumbers. Thankfully, my dorm buddies weren't too bad.

This morning I woke up to "second; minute; hour; power; shower" repeated over and over, as a poetic dorm buddy wrote a new rap. That was 5:15am. It was still dark. He was pretty loud. He's sleeping now - snoring.

Today, I'm bustin' out of the psych ward. Watch out, general public of the United Kingdom - I'm going to be moving among you again as a free man.

Psych ward dorm

This is my current bed. I'm lying on it as I type this. I don't know what the bed or the room I'm sleeping in tonight looks like - I've never set foot in the house I'm going to travel to this afternoon. It's a leap in the dark, as is my wont.

Some of my few remaining worldly possessions are here with me in Manchester and some are in London. I'm surprised that I haven't lost more of my valuables. I can't quite bring myself to do the maths, to figure how much money I've lost on this crazy jaunt to the North of England. What does it matter? I'm alive and about to be accepted into the fold of a kind family who are taking me in - the IT consultant who lost his mind in a city where he didn't have any friends or family. It's unlikely that I'd have ended up homeless, but I wasn't relishing the prospect of being chucked off the psych ward and into a dreadful bed & breakfast, in some shitty suburb.

The very definition of "my" home and "my" bed has been smashed to smithereens. Tonight will be the tenth bed I've lain upon in less than 28 days, including several hospital beds and the concrete slab that passes for a bed in a police cell.

Distress flares were fired off and a good samaritan is coming to rescue me from a fairly dire situation.

Tonight, I sleep in a normal house for the first time in what feels like a very long time.

 

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Blue Tablet

6 min read

This is a story about customer service...

Bedside table

Amongst a small group of my friends, we have all found that a medication called pregabalin - marketed as Lyrica in the UK - has been useful to us, but also has adverse side effects and is difficult to stop taking. Pregabalin is quite good at combatting anxiety and improving sleep, which are obviously the desirable effects: most of us have stress in our lives, and struggle to get enough high-quality sleep. Personally, pregabalin is an effective treatment for the phantom limb pain I feel, due to damaged nerves - I can't feel my left foot. Pregabalin is far better than the opiate painkillers, which left me sweating and nauseous at times. However, stopping taking pregabalin leaves me feeling anxious and gives me insomnia - what goes up must come down.

Soon pregabalin - "the new Valium" - will be scheduled as a class C controlled substance, which makes it much harder to obtain a prescription, and possession without a prescription could be punished with a criminal conviction.

Here on the psych ward, a man screams for a "blue tablet". Perhaps more blatantly obvious as an addiction, another man attempts to wheedle more Subutex (buprenorphine) out of the staff - he's been droning on about having his dose restored from 8mg to 16mg, because he is being weaned off the synthetic opiate he is addicted to. I can hear this guy, who is obviously no stranger to our prison system, chopping and snorting drugs his room. The man who screams for a "blue tablet" is actually asking for a 10mg diazepam pill - blue in colour - which is Valium. Our screaming friend decides he wants to leave hospital, and the staff tell him he can't leave because he's going to take heroin. "It's my body! I do what I want!" he screams. Then, he starts getting abusive.

Early on in my hospital detention under section 2 of the Mental Health Act, I ask a nurse if she can nip to the shop to get me a 4-pack of beer. We lock eyes for what seems like an eternity. I maintain a completely straight face. Then, we both snigger and she regains her composure. She jokes that we should have a big piss-up on the ward. With a different nurse, I tell her with a straight face that they have forgotten my methadone and she immediately unlocks the cabinet containing the opiates that are so coveted by some patients here... I hastily tell her that I was joking, but she still continues to search my medication chart. Do I look like a junkie? I certainly don't have track marks on my arms or other identifying features of an injecting drugs user, such as abscess scars.

A doctor comes to take my blood. She doesn't shut my bedroom door. Three men, who I know were heroin users, peer into my room and I feel bad that I didn't ask the doctor to close the door or get up and close it myself - surely the sight of a needle going into a vein is going to be a terrible trigger. There's good evidence that addicts' brain reward pathways are activated when they see drugs and drug paraphernalia for just 33 milliseconds, which is less than the 40 milliseconds that a single frame of cinema film is shown for.

Having been detoxed from my physical dependency on benzodiazepines and alcohol, I find that I crave nothing more than a few drinks in the evening - some wine or some beer - to take the edge off the stress and anxiety of my situation and help me relax during what is a fairly dreadful clusterfuck of issues with employment, housing, accommodation and my health. However, I don't want to sabotage my treatment and recovery.

I'm incredibly grateful to the NHS, for accidentally detoxing me while they were treating my deadly deliberate overdose - my suicide attempt. Being physically dependent on a medication is to be shackled to it - to stop taking it would cause seizures and potentially death. There wasn't a 'buzz' that I was chasing with booze & benzos. I was using mind-altering substances to soothe my jangled nerves: self medication.

Am I glorifying drug taking, or making light of serious matters? Don't be so ridiculous.

An epidemic of illicit opiate use sweeps across the United States, with the number of overdose deaths and addicted babies born, skyrocketing in the past few years. An epidemic of mental health issues has pushed the services that are there to support those who become unwell, to breaking point. Only a wilfully ignorant person would turn a blind eye to what's happening all around us.

Carfentanil - a synthetic opioid - is so powerful that an aerosol of it could be sprayed in a packed metropolitan area and cause hundreds of people to die from respiratory arrest. This drug is being sold as an adulterant in bags of heroin, in the United States today. In the UK, carfentanil's less potent - but still deadly - chemical cousin, fentanyl, is quite common now in batches of street heroin. If you're worried about terrorism and weapons of mass destruction, these things have already arrived on the shores of the US and UK, in the form of incredibly deadly chemicals that are available for sale to anybody with the money.

My fellow patients are unrelenting. There's been a 2-day nonstop assault on the staff, as the patients attempt to get a tiny amount more synthetic opiate out of the doctor. There's not much else to do on the ward, and whatever medications the doctor has decided to write on their chart will remain fixed for a whole week. I guess they've got nothing to lose apart from their 30 minutes of escorted leave from the ward. One patient has done a runner, sensing that the doctor's decision has not gone the way he would prefer.

"You've not done anything wrong. You can come back and you won't be in any trouble" a stressed looking nurse is saying down the telephone, to the patient who has gone AWOL. Meanwhile, a patient takes breaks between harassing the staff for 8mg more Subutex, in order to chop and snort lines of white powder in his room - presumably he has a plentiful supply of his own drugs, which he wishes to supplement with a legal prescription.

I try to calmly await my section tribunal, despite the chaos outside my bedroom door.

It should be noted, that the quality of care does not vary with one's behaviour - the staff are supremely professional - but good manners are declared as the number one thing that every staff member wants, on a notice board that tells the patients a little more about the team of people who look after us.

Good manners cost nothing.

 

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#FoodPorn

5 min read

This is a story about peaks and troughs...

Bacon barm

I'm in the middle of a warzone. "I WANT TO GO HOME" yell multiple angry men, who are considered unsafe to be out in the community. It's all kicking off on the psych ward, because today is ward round with the doctors. Today is the culmination of a week of waiting and hoping; hoping that today will be the day that the consultant decides to grant some liberty to the men who are detained here - the top doctor is all powerful.

Ward round is supposed to be 10 minutes per patient, but I'm a psychiatric anomaly - completely unmedicated, yet compliant, articulate and reasonable. The staff - nurses and support workers - report that I have been polite and well mannered. It's rare that a middle class person winds up on an NHS psych ward - my fellow patients are all victims of poverty, and their mental health conditions make them most unmanageable indeed.

Having moved from an 8-bed Psychiatric Intensive Care Unit (PICU) to this ward that sleeps 20+ men, the intensity of what's going on around me is much greater, even if there isn't the sound of struggling patients being dragged down the corridor to a padded and soundproofed isolation booth. At least on the PICU I could lock my bedroom door and feel a little safe. Of course, the staff opened a little peep hole every 15 minutes to check I was still breathing, but it was a much less stressful environment.

The world's most terrible shower was one of my big disappointments, as I repeatedly pressed a push-button to get a pathetic dribble of water that could barely wash away the soap from my hair. At least the water was warm, I thought. Then, a nurse knocked on the door and offered to make me a bacon & egg barm (roll) and I was pleasantly surprised. Returning to my bedroom, I was greeted with the delicious sight of the lovely breakfast snack pictured above.

A lot of people have presupposed that the food is terrible on the psych ward, but it's actually very decent. Through my turbulent journey of the last few years, I've eaten a lot of hospital food. When you're on a general NHS ward, you actually get a spectacular choice of meals, plus kosher and halal options too, which I can highly recommend.

Beans on toast

Because my ward round time overran, I missed lunch. I asked if the staff were making any trips to the local shop - my permission to leave the ward has been cancelled due to the fact that I'm a suicide risk - and if they could get me a sandwich.

Despite the commotion, somehow a kind nurse managed to make me beans on toast with scrambled eggs. I was actually more disturbed by the disruption of the routine than I thought I would be. The amount of stuff that's happening all one one day is insane. The clamour for the doctor's attention is just as bad as you'd think it would be, given that everybody's been locked up all week and only this one guy has the power to allow anybody off the secure ward.

These two meals - breakfast roll and beans on toast - are unlikely to be in line with the NHS's ambitions to reduce salt, sugar, fat and other unhealthy things from patients' diet. Salt sachets are liberally sprinkled onto all the regular food we get, replacing the salt that would usually be added by the chef - the net salt consumption must surely be the same. There was something delicious about these beans, in their sweet tomato sauce on white bread. The carbohydrate content of this meal must have been huge, even though it was virtually fat-free except for a light coating of margarine on the toast.

The fluctuations in blood sugar and medications are very pronounced. From 10pm to 9am, no medications are dispensed, but they are dished out throughout the day. From midnight to 6am, the smokers are not allowed to cluster around the doorway that leads to the tiny outdoor area surrounded by high fences, in order to get their nicotine fix. Tea and coffee is decaffeinated, but I quit drinking hot drinks quite a few years ago. The fluctuation in the importance of days of the week, is all fixated around Tuesdays, when ward round happens. The tension in the air is palpable - patients want their freedom.

Being a non-smoker, the passing of time is marked by food and sleep for me. Masturbating in the world's shittest shower is not something I've even brought myself to do, yet, although the sexual needs of the 20+ men on this ward can't be magicked away with medication. There's clearly an undercurrent of sexual tension, which reveals itself in inappropriate ways... however, can we view the natural urges of these men - myself included - as wicked and wrong, when they are simply part of our biological make-up?

Three hot meals a day. None are particularly photogenic, but I devour every last bite. The pleasure of eating is one human thing that can't be denied to us, despite the dining not being haute cuisine. I'm grateful for the safety of this NHS psych ward, and the food I receive at taxpayers' expense.

My ensuite bathroom has no shower, but at least I don't have to share a toilet to dispose of the digested remains of what I shovel into the hole in my face. I barely chew, but mealtimes are the three happy moments in my day, which is otherwise just spent waiting... waiting.

 

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Two Weeks Ago I was Dead

9 min read

This is a story about the comeback kid...

Hospital property record

Here's quite an interesting document, to me anyway - it says that I was transferred to a Northern city hospital's intensive care unit (ITU) on Sunday 10th September and all I had were the clothes on my back. The date of my original admission to hospital - Saturday 9th September 2017 - is shown quite clearly in the top left, under my name.

The reason why this document is interesting to me, is that I started having seizures at some point after arriving in hospital. I was already well into a fatal tramadol and codeine overdose when the emergency services got to me. I'm pretty sure I remember the hospital telling me that they'd make me as comfortable as possible but I was probably going to die, or words to that effect.

I've been through all my paperwork and I can't find my hospital discharge summary. I suspect that it may have gone wayward during the insane events of the Wednesday & Thursday following my fatal overdose. I will be obtaining another copy as soon as I can. Any documents I can lay my hands on are useful for me, because seizures, coma and unconsciousness are not particularly conducive to remembering the events of my hospitalisation very well.

What must be self-evident is that I was very sick indeed, to have been in intensive care.

Anybody who's followed my story knows about my plans. One only needs to go back to a blog post on August 10th to see one of the actual boxes of legally prescribed medication that constituted part of my fatal overdose.

I use those words fatal overdose quite deliberately. I had calculated the dose that would be fatal, doubled it and then chucked in another shitload of prescription opiates for good measure. I wasn't messing around. This wasn't a cry for help. This wasn't some attention seeking bullshit. This was a very real, calculated, pre-planned and meticulously executed suicide - following the precise steps that I had outlined earlier in the day.

It might surprise you to learn that I set an alarm on my phone, so that I wouldn't tweet or otherwise let on that I was in the process of killing myself, before I was beyond the point of no return. Who does that? Certainly not somebody who has any intention of going on living, I would've thought. Would you be brave enough to take a fatal overdose and gamble that you might get saved by social media? Seems like a pretty dumb publicity stunt or way of getting attention - in all probability you'd just wind up dead.

I remember when I was in the Emergency Department of the hospital, trying desperately to get a drink of water - I was fully aware that having more fluids in me would allow more of the deadly medications to be absorbed into my bloodstream, accelerating my death. The hospital were wise to my suicidal intent and they knew that they could ignore my requests to not be treated, as soon as I fell unconscious or started having seizures. The anaesthetists must have stepped in at some point and put me into a medically induced coma.

Imagine waking up in a hospital gown, with a tube coming out of your piss hole, sellotaped to your leg. Imagine waking up and not being able to speak, because there's a tube down your throat. Imagine waking up and all you can see all around you are machines that are either pumping stuff into you or taking stuff out - loads of screens and loads of digital readouts. I had more input and output ports than a Personal Computer (PC) from the 1990s.

I've written about this before, but I need to write about it again, because I'm trying to process what happened to me with only the scant information that's available. Between the hospital and the police, they pretty much conspired to keep my friends, family and work colleagues completely in the dark about whether I'd lived or died and what the hell was going on. I wasn't really conscious until Tuesday 12th of September 2017 - that's quite a long time to be in limbo land. On the Tuesday, I was vaguely aware that my sister and my work colleagues wanted to speak to me, and I wanted to speak to them, but I wasn't allowed to. What utter bullshit.

The police have since phoned the company that I was working for, and told them in no uncertain terms that I was in hospital and not at all able to communicate with them to let them know I was going to be off work on the Monday & Tuesday. However, the company has severed all contact with me and has been avoiding the office since Wednesday 13th September 2017. What on earth could they be so afraid of, that they daren't answer the phone or go to the office? What on earth are they thinking? I have no idea, because they won't return my calls or reply to my emails.

Over that Wednesday & Thursday following my fatal overdose, everything collapsed around my ears. Without a phone, wallet, cash, laptop or any of the other things most of us take for granted every single day, I was lost in a city that was nearly completely alien to me, with not a single person to turn to. It was highly distressing. It was exhausting and stressful, to go from place to place, replacing whatever I could.

The Apple Store in the nearby shopping centre became the centre of my world, having been impolitely muscled out of my office with rather flimsy excuses. I dug my heels in, because something fishy was going on and I wanted people to come clean - what the fuck was going on? Why was I being treated so unprofessionally? It was a horrible experience, and not something I should have been put through, given my recent discharge from hospital.

I received a phonecall saying I had an email with some letters from a solicitor, from the company I was working for. How was I supposed to read this email, without my laptop or smartphone? Nobody from the company would speak to me properly. I did not receive even the bare minimum professional courtesy that should be extended to somebody who'd been a valued member of the team for some time.

Because the matter is now being handled by legal professionals, due to the complete refusal of the company to treat me with the common decency that any human being might expect - let alone adhere to contract and UK laws - I can't really go into any more detail. I'll be sure to share the details of any court proceedings so that this blasted company can't get away with their inexcusable misbehaviour.

Of course, the pages of this blog document my darkest secrets in unflinching detail, but this is therapy for me and I do not mix my professional and my social media identities in a way that might besmirch or sully the reputation of a company that is trading ethically and within the law. There are a lot of Nick Grants out there in the world, and I'm just one of many. In fact, this whole blog could have been created by somebody who maliciously intended to impersonate me, for nefarious purposes, couldn't it? Have you been careful to check who actually controls my Twitter, Facebook and blog? Is there anywhere that there is a direct reference to who and what I actually do for a day job, that could justify the mistreatment I've suffered?

One should remember that this blog has been the best thing I ever did, in terms of being able to stabilise my life and recover my poise after homelessness, addiction, alcoholism, financial problems and a whole world of pain, absolutely tore me to shreds. Should I hang my head in shame and hide in the shadows? Should I keep my mouth shut, and pretend that nothing bad ever happened to me?

There's absolutely no way you're gonna shut me up without killing me. I'm loud and I'm proud. It's more important that I write my story in unflinching detail, than cowering in fear and attempting to cover up what's happened to me. What have I got to be ashamed of? I've worked damn hard to get my shit together after it was blown to bits, so I'm damn well going to write about it.

Of course, culturally we only allow those who are already successful to share their stories of their life struggles, that challenge the status quo and our preconceptions. Paul Gascoigne and George Best have done a lot to bring the ethical debates surrounding alcohol abuse into the public consciousness, for example. Ronnie O'Sullivan and Stephen Fry have candidly shared their experiences of cocaine addiction, but yet we still revere them as great people... why is this? If you've been reading carefully, you'll know that I'm teetotal and I'm not on any drugs, except for pregabalin (for nerve damage) and zopiclone (because it's bloody hard to sleep on a noisy psychiatric ward of a hospital) which are both legally prescribed to me.

It seems I've taken a battering, because of foolish assumptions that have been made about me. Just about the only correct assumption that you could've made, is that I should probably be dead, after having ingested such a massive overdose and had plenty of time for it to take effect before the emergency services got me to hospital.

I really can't get myself into the mindset, where I would mistreat somebody who'd been hospitalised and was very sick. Please, somebody explain to me what have I done wrong, apart from what I've already very publicly admitted to? Is it right to crucify me; to punish me beyond the punishment that I've already suffered? Do you not think it was awful, what I've been through? Why would you put the boot in and kick me when I'm down? I don't understand why the shit continues to be rained down upon my head.

Does somebody want to explain to me how it's at all ethical, that I came to find myself homeless, unemployed and isolated in a city I'd never set foot in two months ago, after I took all the risks and put in so much effort to try and make a go of things?

Answers on a postcard to Nick Grant, Planet Earth.

 

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Prince of Wales

17 min read

This is a story about being hounded to death...

Another hospital

One week ago, I was shovelling pills into my mouth, washed down with pints of white wine. The LD50 is the lethal dose that will kill 50% of the test subjects. Lethal doses are normally calculated in milligrams per kilogram of body weight. Tramadol is quite a reliable way to kill yourself, with plenty of examples of successful suicides in the literature, for anybody who wishes to trawl the medical journals.

Most opiates will cause respiratory arrest. Tramadol seems to kill more often through serotonin syndrome, according to what I read in advance of my suicide attempt. I can tell you exactly what it feels like, to reach your wits end, decide to end your life, and follow through with the necessary steps. I can tell you exactly what it feels like, during the periods of consciousness, as you die.

Once I had downed all the capsules and their gelatin shells had started to dissolve, I started to become quite intoxicated, thanks in no small part to the wine I used to wash my legally prescribed pain medication - tramadol - down my throat. Of course, I had stockpiled the capsules, which is not what my doctor had anticipated I would do, when they wrote the prescription, but I was getting a box each visit to the pharmacist, with each box containing plenty to end my life.

I decided to send out some final Tweets, when I believed I was beyond the point of no return. I have no idea whether I inadvertantly saved my own life or not, by alerting my social media contacts to the fact that I was on my way to meet my maker.

Discussion of what pushed me over the edge is not really warranted here, suffice to say that I simply had nothing in reserve when my fragile embryonic new life in this Northern city started to crumble. I had given 100% to my new job, my new girlfriend and my new friends. I had no safety net, when the slender threads that supported me, snapped suddenly.

Firstly, it should be noted that it takes quite a long time for your stomach and large intestine to process enough capsules for you to start to experience the onset of a fatal overdose. I had imagined that 40 minutes would be plenty for the first wave of powerful tramadol to hit me, and to make me unconscious or at least delerious and incoherent. I was wrong - I was able to send out several Tweets that actually seem to make sense now - one week later - as well as being gramatically OK and without spelling mistakes.

Secondly, it should be noted that the ideal scenario of falling asleep and not waking up, did not happen at all. I did get waves of soporific effect from both the alcohol and the tramadol, but I imagine that the adrenalin of knowing I was on my way to the grave kept me mostly conscious. My eyelids would get heavy and my head would drop, but my body fought to stay alive and I kept jerking awake.

Thirdly, I have horrible snatches of memory. I can remember exactly what it was like to fill my mouth with capsules, and gulp them down with wine from a pint glass. I remember how agonisingly long it took to empty out all the packets into the box, which I used as a kind of cup, from which to tip a load of tramadol into my mouth before swallowing it. I can remember the emergency services battering their way into the bathroom, where I had slumped in the dark, waiting to die. I can remember telling them where all the empty pill packets were.

I can remember telling somebody - was it somebody at the hospital? - who my doctor was and exactly what overdose I had taken. I can remember the very worst moment, when the hospital told me that death was likely to be slow and painful, not the unconscious affair I had imagined.

I can remember when I started to have seizures. I can remember begging the hospital not to treat me with activated charcoal; not to pump my stomach; not to resuscitate me if I went into cardiac arrest. I can remember coming round after 12+ hours under sedation, breathing with a ventilator. I had a tube coming out of my nose, one down my throat and one up my dick - I had been intubated, catheterised and had several canulas installed, including an arterial one that was measuring my blood pressure. It felt like I had snot running down my face, but it was just a tube that was being used to put stuff into my stomach to neutralise the deadly chemicals.

I can remember a nurse or a doctor came and asked me a question, and I tried to reply but I couldn't. Every time I tried to speak, my lungs pushed air against the ventilator, and I would be left momentairily be gasping for air until I allowed the machine to breathe for me again.

I can remember a different nurse or doctor reassured me that I would be able to speak once the tube had been pulled out of my throat, where it was impeding my vocal chords. I was so relieved, because it was deeply distressing to lose my ability to talk and have moments where I couldn't breathe.

I can remember being asked how I felt about the fact I had survived an overdose that should have been fatal. I felt terrible about telling the hard-working intensive-care nurse or doctor that nothing had changed... in fact things were worse than ever, as I imagined that the overdose would have caused horrific organ damage. I expressed in no uncertain terms that I still wanted to die.

I can remember drifting in and out of consciousness. From Saturday night to Tuesday morning, I had no idea whether I was in A&E resus, intensive care or the high dependency unit. I can vaguely recall being told, but the memories seem all out of sequence, and dreamlike - quite unreal.

I can remember being wheeled into a general hospital ward at some point on Tuesday, and then wheeled off to my own private room. I can remember slowly regaining some mental capacity. I can remember a visit from a psychiatrist, where I again expressed my distress with my situation and fear that I would not be able to guarantee my own safety - what had improved since I had tried to end my own life? Nothing. In fact, my situation had worstened: I had no idea what kind of state my apartment would be in when I got home - my wallet, keys, phone and other personal effects had gone missing. It seemed unthinkable that I would have to face potentially being locked out of my apartment, with no money or credit cards on me, and no means of contacting anybody.

When I did finally make it back home, things were worse than I had even imagined. My laptop and digital camera had been stolen. Every single prescribed medication had been stripped from my shelves and drawers and cupboards. There was one single solitary pregabalin capsule, almost left mockingly on my bedroom floor which lay in disgraceful mess. I need pregabalin for nerve damage in my left ankle/foot... as a non-opiod painkiller. I desperately needed some of the zopiclone that I had stockpiled, in order to sleep after such a horrific ordeal. These are not dangerous medications, ironically. I had moved myself off the tramadol, because it was not desirable to use it as a long-term painkiller. I had stockpiles of zopiclone, because it was useful for these very eventualities. The home treatment team had thrown bucketloads at me, because sleep is so important for good mental health. Where was all my prescription medication?

There was no sign of my mobile phone anywhere, and without my wallet and laptop, I was completely stuffed in terms of being able to get a message to anybody. From Saturday night until around 3 or 4am on Wednesday morning, I had been completely cut off from the world... mostly unconscious, and without access to telephone, email or social media.

Wednesday daytime, the way I was treated at the office - where I went to store the few valuables that had not been stolen - was extremely odd; if not downright rude and unpleasant. It was most unsettling indeed to be treated so oddly at my place of work, especially after surviving a suicide attempt and having suffered a burgulary. I was also fighting off panic attacks and pain, because my legally prescribed medications had been stolen too.

After a quite baffling experience at the office, where I was ushered out of the door as if I was an interloper, the CEO of the company I had been doing consultancy work for, spoke to me to say that he would be very happy to see me for a beer, but that I could spend the rest of the week sorting out everything that now dauntingly lay ahead of me: repairing the damage from the break-in and replacing the stolen items. Life is profoundly difficult without your credit and debit cards, mobile phone and laptop.

I managed to get an emergency prescription for 7 days of pregabalin and zopicline, so that I could restabilise my medication regimen. I managed to get enough cash out from the bank to replace my laptop, but not my smartphone or pay for repairs to my flat. I was starting to be overwhelmed with the enormity of the task that was expected of me: for a suicide survivor to carry on with their life as if nothing had happened. My home felt violated and insecure. There was something weird going on at work. It was deeply unsettling.

Gladly, I was re-admitted to hospital at Accident & Emergency, because I was driven into crisis by the horrendous near-death experience, only to then find that my two most valuable and prized possessions - my smartphone and laptop - had been stolen, and my flat had been ransacked; my front door and bathroom door were smashed up; the place had been turned upside down.

The fact that I was discharged from hospital and ended up back at my trashed apartment at 3 or 4am on Wednesday morning is something that should never have come to pass. What the fuck are you doing discharging a suicidal person in crisis, into a situation where they've got more on their plate than they can handle? How the fuck am I going to go back to life as normal, without my smartphone, laptop or a secure home to keep myself and my possessions in? How the fuck am I going to get through life without the pain medication for my nerve damage, and sleep medication for the horrendously stressful circumstances.

Being re-admitted to hospital - first the Accident & Emergency department, and then psychiatric hospital - was inevitable, and essential for my safety and wellbeing.

I could have bounced back, but the strange experience at the office and the amount of things I had to sort out due to theft or loss, was simply too much for somebody as sick as I was then.

I managed to get a replacement debit card for my business bank account, and make some cash withdrawals using my passport, but after replacing my mobile phone and laptop I had very little money left; I was exhausted stressed and in no mood to return to my home that not only felt violated, but also not a secure place to keep myself and my valuables.

My very worst fear was realised: that of finding myself completely alone in this Northern city with nobody to turn to for support. Without a smartphone, I felt completely cut off from social media. By some strange co-incidence, my work colleagues were both out of town. This was the perfect storm. This was exactly what I never wanted to ever happen - to be isolated and alone.

I thought about throwing myself off a high building, or under a bus. In the end, I finally made it back to where I should have been allowed to stay: the safety of hospital. Surviving a suicide attempt is a big deal, and then to have shit to deal with at work and home, was horrendous.

My memory about how I arrived back in hospital is just as fucked up as you'd expect of somebody who's been through a near-death experience and survived, but only barely. I'm not sure what's real and what's dream. I feel like I died all over again. I have these strange memories of trying to replace my mobile phone, laptop and get enough cash out of the bank to replace my iPhone too. I can remember waking up on a hospital trolley and re-orienting myself with reality... there were lots of things that I could vaguely remember, but they seemed to be from a different life. Had I died and had my heart restarted? Certainly, there was a period where I was sure I was dreaming. Perhaps I was still having seizures, because of the unbelievable disturbance to the stability of my life, including the regularity with which I was able to take my medications and soothe my jangled nerves with alcohol.

I write to you now, in stone cold sobriety. My alcohol consumption has been practically zero for a whole week... cut at a rate that would easily cause problems, especially considering that all the other medications that I have been prescribed have been very irregularly given to me too. Rebound insomnia from suddenly stopping zopiclone would be expected. Suddenly stopping pregabalin will have terrible consequences, as with any of the GABA agonists. I'm surprised I haven't had MORE seizures or perhaps even been killed by the sudden withdrawal of medications that I had become physically dependent on, as well as alcohol. You can't just suddenly stop drinking and taking the pills that I had been prescribed - you have to taper down gently.

In a way, I'm in a good situation now that I'm off all the alcohol and most of the meds that I had become dependent on. My sleep is terrible, I'm in a lot of pain, and I'm overwhelmed by anxiety and a general sense of unease, but it's good to not be drinking so much and having to take pills just to stay calm through some incredibly stressful events.

My housing, employment and general situation is dreadful. I'm being royally dicked over by everybody who has sensed that I'm in a vulnerable state. It's an abosoute disgrace, how people have tried to put the boot in and deal the final death blow to me, when I was already bruised and bloodied and at death's door.

I'm in psych hospital until Monday at least, which is a blessed relief. I have a room with a door that hasn't been kicked in and has a fairly sturdy lock, with which to protect my valuables. I get three hot meals a day and there's plenty of hot water. There are loads of mental health professionals on hand if I was feeling suicidal again.

Sadly, I am having to turn to the law to defend me from mental health discrimination, illegal eviction, and hopefully recover my valuables that were lost or stolen due to negligence. At least I am in a safe place from which to defend myself. Justice will prevail.

I think it's outrageous that I was ever declared fit and well enough to be let out of hospital, especially given the ransacked shithole I had to go back home to, and the mistreatment I received at work. However, I am also sympathetic towards the police, who have a difficult job to do, as well as to the fact that I have received a substantial amount of hospital care, to save my life.

There's a fairly simple ethical guiding principle here though: don't fuck with vulnerable people. I'm pretty mad that I'm the one with the stolen iPhone, MacBook, the battered and bruised body, the missing medications and having faced some terrible stress, on top of the situation that was already so horribly desperate that it drove me to try to end my own life. Nobody is coming to me and offering me compensation of any kind, despite my phone and laptop being supposedly covered under a company insurance policy.

I have a fully functioning conscience - a moral compass - and I am trying to set matters straight that I am responsible for. Even in the midst of what might have been the final hour or two that I walked upon this Earth, I still had concern for rectifying certain things, and I still do. I'm being treated like shit, but I don't feel that entitles me to treat others like shit. I'm in a horrible situation, but I'll do what I can from where I can... although I do expect to be treated fairly and in accordance with the contractual obligations, housing obligations and obligations to not be discriminated against because of my mental health crisis. The door swings both ways, and I take my ethical conduct very seriously.

Sadly, the law and solicitors of various flavours are being involved, which means I can do little until they're back at work again on Monday. I need to proceed through the official channels, seeing as I'm being beaten with a legal stick. I'm outraged that my housing and income is under threat, simply because the opportunistic shits that I've been doing some work for have sensed an opportunity to try and scam me.

I wish everybody would just do the right thing, or offer to rectify things when they have made a mistake.

Anyway, as you can tell, I'm feeling quite sorry for myself, given the shitshow of my life. My guardian angel has arrived in the nick of time to help me stay afloat, but I'm still battered, bruised, organ damaged, hospitalised, under threat of illegal eviction, my client is in breach of contract with unpaid invoices, my employment offer has been withdrawn due to mental health discrimination, and the dreadful ordeal on Tues/Weds with being released from hospital too early, has pretty much fucked any chance of recovering my delicate poise. Everything was so fucking fragile, and it burned down in the blink of an eye.

Fundamentally, where is my girlfriend, my friends - my support network - as well as my work colleagues, income, housing and all the other pieces of the puzzle that make a liveable life? All I can see are circling vultures, greedily eyeing me up as a piece of carrion.

At least we have a decent legal system here in the UK and justice will prevail eventually. Nobody can get away with acting unethically and abusing vulnerable people. I'm safe in hospital. I can defend myself from here.

Finally... I got my replacement laptop working and I'm back online.

Without the structure of being able to capture images and compose my thoughts on the pages of this blog, I've been rather cut adrift. Without my social media contacts, I've felt totally isolated and that nobody knows what I'm going through, although my guardian angel has bridged the gap very well, so I must give a great deal of thanks to her.

Nobody knows just how close to the edge you are until it's too late. What an absolute shitshow.

 

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The Closest I've Come to Suicide

6 min read

This is a story about the straw that broke the camel's back...

Skullface

You'd think that the closest I ever came to finishing this suicide note - and ending my life - would have been the time both my kidneys failed and an old ankle injury made it almost impossible to work. I also lost one of the best IT contracts I've ever had and became hooked on legally prescribed pain medication, which pretty much scuppered my ability to get another contract. I was running out of money fast, but struck down with physical and psychological problems - depression - I could barely function.

My girlfriend at the time was exhausted after spending weeks in hospital with me, while the survival of my kidneys was in doubt. She came to all my outpatient appointments. She helped me hobble around and get my prescriptions for my pain. Then, I dumped her. She was exhausted and she'd just been to Cornwall - Land's End - to meet her new nephew. I had a crisis while she was away and in her state of tiredness, she couldn't think straight. In the state I was in, I needed her help, but to me she didn't seem to care - that was my warped perception, at least. I immediately broke up with her, because what seemed like life or death to me didn't seem to matter to her due to compassion fatigue and physical tiredness. To my messed up mind it seemed as if she didn't care about me, when I desperately needed her help.

Having no girlfriend, no job, no money, bad health and a ridiculously expensive riverside apartment to keep up the rent & bills payments on, losing a loan that had been promised to me by my girlfriend, further compounded a dreadful situation.

I sold a lot of my most precious things, even though I knew that the money would barely cover a month's rent. Being a high earner, most welfare benefits were inaccesible to me and to have a black mark on my credit score would preclude me from ever working in banking again.

I became hopeless, resigned to a fate of eviction, bailiffs, debt collection agencies and destitution. The best option was to spend 28 days in hospital, said my psychiatrist - at least I would be safer there.

My trigger finger was itchy, but I knew that if I could beg a sofa or spare bed to sleep on, I would at least avoid another period of homelessness. One of my Twitter followers offered her spare bedroom and things briefly looked up, but then she changed her mind. One old friend offered to put me up in a bed & breakfast for 2 weeks, which would have been welcome respite. An old schoolfriend said if I was desperate I could couch-surf in his 1-bedroom apartment, where he has a 4-year-old daughter. Three offers, which gave me a momentary boost, but at the same time, it's somewhat depressing that of all the people I know on Facebook and Twitter who have generously proportioned houses, nobody else even offered to let me pitch my tent in their back garden... my experience of dealing with the local council and government benefits system means that you're just plain wrong if you think all those taxes you pay mean you won't end up sleeping rough, if life doesn't treat you well.

I always had a plan - 336 tramadol tablets - that would virtually assure me a swift and painless death, but I always felt a few steps removed from actually following through with it.

I'm so exhausted and unwell at the moment, in a stressful (but rewarding) job that it took hardly anything to push me over the edge to the most suicidal I've ever been. Losing my new local girlfriend and the accompanying social group, would be too much to bear, when I haven't the energy to grieve the loss and to pick myself up again.

There was no doubt in my mind about what the plan was. I could visualise the steps. It took every ounce of effort and willpower to overcome the urge to simply empty the 336 capsules into a small glass, add some other opiates that would cause respiratory arrest, and them simply get drunk until I passed out... probably less than 60 minutes, and I'd have departed from this world.

It might seem rash; an overreaction, but the rollercoaster ride I've been on has left me without a single percent of spare capacity. Even something minorly inconvenient or unexpectedly going wrong, can cause a seemingly disproportionate reaction.

I wasn't scared. I wasn't hesitant. It would have been done, and that would have been that. Call it a strength if you like - I can take bold fearless actions, even if they would certainly cause my life to be ended.

The scary thing is just how quickly I would have acted, having started the process. Less than an hour, to be a cold white corpse with purple lips and rigor mortis setting in. "Will I feel differently in an hour?" I asked myself, hypothetically supposing that I delay my deadly potion in order to see if my mood changed.

Luckily, I acted positively and pursued a more favourable resolution to what was almost certainly going to be a breakup. She said she wasn't going to pick up the phone or reply to my messages, which would perversely have only accelerated the commencement of my death ritual.

While it looks like a sudden thing to do over a very trivial trigger, things have to be seen in the wider context. I know how depressed and lonely I was before I met this girl and her friends. I know that the effort involved in courting her almost cost me my sanity, stability and job. I know how hard things have been at times during the umpteen years I've been diagnosed with clinical depression. At some point, you're so sick of a miserable life, that you'll gladly welcome the end of the suffering.

I felt a little bad about leaving the project I was working on unfinished, but I'd done the hardest bits, so most of it that was left to do was copy & paste.

I didn't feel any sadness or guilt, for depriving friends and family of the living version of me. Less than 1% of the people I'm in contact with, offered any kind of assistance when I was in a crisis. Basically, I mean fuck all to anybody, no matter what they say.

I'm sleep deprived and my brain chemistry just isn't right at the moment, but still, I know when it's time to go - you get sick of all the bullshit of living, Being alive is over-rated. It's been mostly suffering for me (boo hoo! get the violins out).

So, that was the time I nearly killed myself, deliberately... a close shave.

 

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Suicidal Intent: Part 2

5 min read

This is a story about irreversible decisions....

Tramadol capsules

Nearly 400,000 people killed or injured themselves using a gun, in the United States in 2016. That's 1 one 1,000 Americans, who them will shoot themselves each year.

In the United Kingdom, the only way for me to get a gun is to buy one on the dark web. For me to possess a firearm without a license and keep such a weapon without a locked gun cabinet, contravenes many British laws. In short, deadly weapons are outlawed in the United Kingdom and to 'bear arms' could see me imprisoned.

For £8.40 I obtained 112 tramadol capsules, which are contained in the brightly coloured box pictured above. The aggregate weight of the deadly opiate within this box is 5.6 grams. An overdose of tramadol is considered to be anything above 0.4 grams. Therefore, this box contains 14 times the maximum 'safe' dose. Death would be a certainty, if I was to swallow little more than a couple of mouthfuls of this medication.

Perhaps, you are thinking, that I procured this deadly substance through the dark web. In fact, I had been prescribed this pain relief treatment by my doctor, and I had collected three of these boxes quite legally and within my rights as a British citizen.

For £25, I had stockpiled enough pills to end my own life several times over.

In a deal I struck with my psychiatrist, I surrendered two out of three of the boxes that I was entitled to possess. My general practitioner (GP) had authorised a pharmacist to dispense this controlled substance to me... little did they know that I had already weaned myself off these addictive opiates and had amassed a total of 336 capsules, which contained approximately 17 grams of tramadol in total.

For many citizens of the USA, they consider it an inalienable right to own guns. Equally, I reserve the right to end my own life peacefully, painlessly and without undue suffering.

In the UK, people throw themselves under trains or hang themselves. If you are kiled on the railway, the driver of that locomotive will have to live with the recollection of seeing you hurl yourself onto the tracks; somebody will have to collect your body parts, put them into a body bag and take them to a hospital morgue. If you hang yourself, somebody will find your lifeless body suspended by whatever cord you chose to make a noose out of... they will have to cut your lifeless corpse down, and there will be clear evidence that your final moments of life were not at all pleasant for your body: your bowels and bladder may well have been involuntarily emptied and the ligature to your neck will have caused significant trauma.

The smallest amount of blood, semen, faeces or urine, seems to spread out far more than any other substance. A person who has chosen to evacuate the contents of their veins and arteries will be as white as a sheet, and there will be a shocking contrast with the dark red life-giving substance - their blood - that has been deliberately emptied from their body. 

Does it not seem better that if one has to deal with a cadaver, that it should be less physically mutilated? Does it not seem humane that people should die with the most peaceful expression that's possible in the circumstances?

What should I say about the sudden darkness that descended on me yesterday? There's little point in offering fake reassurances that everything's OK. The truth of the matter is that I live life with daily precarity, and with only a few bare bones of a social skeleton around me - seemingly inconsequential events lead to a disproportionate response. "It's not the end end of the world" somebody might say, and they're right, but when you're already close to the tipping point, it doesn't take much for it to be the end of your life.

I've done a zillion things impulsively in my life. None of those rash decisions have led me up a dead-end alleyway, yet.

There's something tantalisingly alluring about swallowing a couple of handfuls of pills and then slipping peacefully into unconsciousness. Even if I was to have seizures before I finally gave up the ghost, I would be completely unaware of my body's struggle to keep itself alive. How wonderful, to have the option to end the suffering on a whim.

To think that I'm being flippant or making light of the final decision that I'd ever make is not true.

One of the reasons I quit drinking a couple of years ago - for 120 consecutive days - is that I was afraid of acting impulsively while intoxicated. It's one thing to wake up with a hangover, thinking "why the fuck did I say/do those things?" but it's quite something else to not wake up at all.

I live with a toxic combination of a high-stress job, financial pressures and limited social support. Beyond Facebook and Twitter. I've retreated into a world of technology. The few close friends that I have are hand-picked because they're loyal and sympathetic towards my circumstances, which - I assure you - are not a result of free-will choices or preplanning. To have a seemingly minor setback might cause irrational behaviour, but so fucking what? Please show me the contract that my brain has signed up to, saying that it will always think rational things.

This blog was supposed to be a short and sweet message of reassurance, after a 'cry for help' yesterday. It was not nice wandering around the city centre for a few hours, hoping that the awful imperative to hurt myself, would pass harmlessly.

 

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Spread Thin

9 min read

This is a story about succession planning...

Beef bovril

The British have always liked hot drinks.

Coffee shops were terribly trendy in the late 1600s, having been launched in Oxford before springing up across London, where ships that brought the crop of beans to English shores found many willing patrons for the roasted, ground and brewed end product.

Tea symbolises imperial Great Britain. The Indian town of Darjeeling - formerly part of the British Empire - is synonymous with the tender leaves that citizens of the United Kingdom douse with boiling water, infusing bitter plant alkaloids into the hot liquid. "Put the kettle on" are four words that will be said in millions of homes this evening, despite the stimulating effects of caffeine.

Cocoa beans have given rise to hot chocolate, also known as drinking chocolate. Even a small UK food & drink shop will offer all manner of flavourings for hot water. Nestled in amongst the other things that my fellow Brits would categorise as 'hot drinks' I found something that I think of as a powerfully concentrated and flavoured spread, ideally enjoyed on toasted slices of bread - a jar of Bovril beef extract.

The flavour of Bovril is closer to Marmite and Vegemite - or any other brand of yeast extract - than it is to beef, in my opinion. How exactly they "extract" Bovril from a cow is something that I don't really want to think about. I suppose it's a macroscopic version of what they do with microscopic yeast - microorganisms are just the same as cattle really... eating, shitting, reproducing and not doing much else.

In this Bovril-drinking Northern city, conspicuous by their absence are people with skin tones darker than my own and women wearing headscarves. I formerly lived in a region where the population is 46% Muslim. Surprisingly, the Bengali shopkeepers have no issue with selling pork and alcohol to those who are not forbidden - for religious reasons - from eating swine flesh and imbibing the intoxicating liquor created from fermented fruits and grains.

In this unfamiliar part of Northern England, there are innumerable drinking establishments in my local vicinity, as well a vast number of hot food outlets where a bacon or sausage "bap" can be procured as a traditional breakfast snack.

India - before she was partitioned in 1947 - was a nation where Muslims would respect the holiness of cows in the Hindu culture, and reciprocally the Hindus would respect the Muslim rejection of pigs as unclean animals, and alcohol as an addictive intoxicant that places a heavy burden on any society that permits its consumption.

Modern global society still holds strong religious views on the treatment of domesticated animals and the brewing and consumption of alcohol. When we examine the historical evidence using the scientific method, we can see that cows and pigs would not exist today as we know them, without human intervention spanning many more thousands of years than even the oldest religion. Furthermore, we can see that humanity has been intent on its own intoxication throughout the history of civilisation. The Mayans were chewing coca leaves at least 3,400 years before Islam had its golden age, and vastly predates Hinduism and Judaism. Ergo, we must conclude that excluding beef, pork, alcohol and other things from our diet and habits of consumption is a relatively recent 'fad'.

The Chinese are the biggest per capita consumers of pork, while America and the developed nations hoover up vast quantities of refined coca leaves in the form of white powder cocaine and rocks of freebase cocaine, known as crack. Opium, morphine and diamorphine (heroin) are endemic worldwide. Caffeinated beverages - hot or cold - are guzzled by the globe. Alcohol is cheaper than bottled mineral water from desirable brands like Evian or Perrier. Yet, only in the North of England - so far as I know - do people consume a hot drink made from Bovril.

I hate being spread thin. I'm adaptable and I can be sent all over the globe to work with people who observe different cultural traditions. I am relatively worldly-wise enough to not commit a faux-pas, such as eating food before sundown in front of those observing the Ramadan period of fasting. I can pretty much figure out whatever you want me to do, if you're paying me enough and you're not open to persuasion that your ideas are probably terrible in their original unmodified form.

Why have a dog and bark yourself?

Now I find myself juggling the essential task of finding a doctor who will keep me supplied with the medications that I have become physically dependent on, while also settling in a new home in an unfamiliar city. I must also meet the demands placed upon me in the pursuit of enough money to eat, service my debts and give myself more security and freedom of choice.

I'm withdrawing from Xanax (alprazolam), Valium (diazepam), Ambien (zolpidem), zopiclone and Lyrica (pregablin). All of these drugs work in a very similar way - mimicking the brain's own 'brakes' and calming neural activity. These medications cause a chemical called GABA to be released in the brain, block the brain from recycling any unused GABA, or imitate the 'signature' of GABA itself. The overall effect is tranquillising, stress relieving and aids sleep, but the withdrawal is quite the opposite. In fact, the abrupt withdrawal from any or all of the medications listed can cause life-threatening seizures.

I must juggle social drinking - alcohol is a mandatory social lubricant in most UK culture - with the need to use alcohol as a form of self-medication for the stress I'm under. I also use alcohol as a substitute for the powerful psychotropic medications that my body has become dependent on, like heroin addicts kick their habit using methadone. Alcoholics can break free from physical dependence using benzodiazepines such as Librium (chlordiazepoxide). I'm doing it the other way round, because I know I can stop drinking - I plan on doing so in October, when I will use the excuse that I'm going teetotal to raise money for charity (a.k.a. Stoptober) - as I have done successfully before.

How I ended up with so much on my plate is not really my intended subject of this lengthy diatribe, but in my dark and difficult moments, I am facing a clusterfuck of competing demands on my time and energy, while also dealing with panic attacks and a general feeling of uneasiness and discontent; a false perception of threat, danger and imminent disaster.

My perceptions are not completely warped. Earlier this year, both my kidneys completely failed. Very recently I narrowly escaped homelessness, bankruptcy, destitution and destruction. Unpleasant feelings are a harbinger of a genuine medical emergency - I am detoxing myself without the supervision of a doctor or nurse, while also working full time.

I've skippered yachts and kept my crew safe in stormy weather; I've led groups safely up and down dangerous mountains covered with snow and ice; I've become blasé about near-death experiences, because I've now had so many. I don't think I'm exaggerating or being hyperbolic when I say that I'm facing my life's toughest challenge so far.

The demands placed upon me in my day job seem unreasonable at the moment, but I was desperate for fast cash. I was drowning and I was thrown a lifeline - beggars can't be choosers.

Friends who have submitted themselves to the mercy of the state seem to have suffered greatly from the trials and tribulations of dealing with compassion fatigued bureaucrats. A great many nurses and doctors have told me that I'm 'entitled' to live at the expense of the government - i.e. my fellow citizens - because of the taxes I have paid in my life, and because my mental illness disqualifies me from being 'fit for work'. To put work as my priority, ahead of treatment is something that none of my doctors want, but equally there's a long queue of people who would prefer to sit at home smoking cannabis and playing on their Playstations, rather than flipping burgers or scrubbing toilets for the minimum wage.

Like concentrated beef extract, I'm intense; I'm focussed; I can achieve a lot very quickly. The terrifying truth is that the world applauds anybody who exhibits bipolar behaviours... what happened to all those 'overnight successes' and 'one-hit wonders'? They spent all their money on fast cars, beautiful women, drugs & alcohol, and the rest they just wasted, is the oft-repeated quote.

Once you've figured out a winning formula, all you can do is teach others to follow in your footsteps. If you can train an army of mini-mes to do the grunt work - the heavy lifting - then life becomes more sustainable. Only a fool repeats the same behaviour, expecting different results.

And so, I desperately need to find my successor - somebody to fill my shoes and shoulder some of the burden, allowing me to recover and stabilise, rather than being trapped in a cycle of just repeating things that I've done before a thousand times.

It's hard to find somebody who's willing to do a shitty job, and it's hard to find somebody who's able to navigate their way through the piles of shit and find the better way of doing things. I might be that diamond in the rough, but that doesn't mean it's a great idea to get me scrubbing toilets or flipping burgers, even though I will do if you ask me, pay me and I'm desperate enough.

Having a desperation-driven economy, with most of us spread thinly - stressed out and always on the brink of breakdown and ruin - is a terrible, terrible thing to do to people.

Hunger will drive ingenuity and industriousness, but it's not a sustainable strategy, no matter how much Bovril you have to eat and/or drink.

 

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