This is a story about primary care...

Primum non nocere is in and of itself a non sequitur because the use of Latin and other languages of classical antiquity is primarily intended to deter the hoi polloi from becoming educated. The number of doctors who are able to train, qualify and practice, is something that is tightly controlled in order to maintain high salaries - artificial scarcity - as opposed to allowing the unrestricted proliferation of medical knowledge which might improve the health of the nation.

Those who profess the Hippocratic Oath might be able to stay true to the vow they have sworn if they practice the treatment of acute illness in a hospital - dealing with curable disease and injury - but in the treatment of chronic illness in the community, as General Practitioners (GPs), can we say the same?

If we look at a few obvious statistics, we can see that medicine is failing. Average life expectancies have started to fall and chronic illness has seen a dramatic rise. There is an epidemic of mental health problems, and suicide is the biggest killer of men under the age of 45.

Of course, one might say that the root causes of these conditions are non-medical.

It occurred to me that a significant piece of the NHS has already been privatised, in that many general practice surgeries are owned and operated as private profit-making enterprises. This seemed to present a significant conflict of interest, so I decided to conduct an experiment.

I asked a GP a simple question: when you're treating a patient, do you think about their healthcare needs, or do you think about other things? The reply was shocking.

"It's not about [the patient] it's about everybody else"

I'd had my suspicions for a while - gathering plenty of evidence - that those who profess to do no harm might actually have been corrupted into serving other purposes; into betraying their profession and failing in their duty of care. This was the final confirmation that my worst fears were realised, and there are powerful actors within the healthcare system who place other things above the health of their patients.

By co-opting doctors into the capitalist profit-driven sector of the economy, and by co-opting them into the welfare system, we are asking doctors to choose between their luxury cars, the private school fees for their children, and other trimmings associated with their high social status, versus increased taxes to pay for the welfare state. By placing the most vulnerable people in society in front of the doctors, when seeking incapacity benefit, the government is pitting one group against another.

If the study of economics has taught us anything, it's that people respond to financial incentives. While a GP might argue that they're saving valuable taxpayer money, which might be spent on the NHS, by denying incapacity benefit to a vulnerable member of society, one must also admit that the GP acts in rational self-interest. Less money spent supporting society's most vulnerable means a lower tax burden and more money in the pockets of the profiteers, which include GPs who are partners in their practice.

The first principle of do no harm forbids a doctor from weeding out malingerers based on their best guess. To cut off somebody's incapacity benefit is definitely harmful, and there is no diagnostic test which could decide with a high degree of accuracy who is the malingerer and who is genuinely unable to work. If the doctor in question truly cares about their patients, they would have no option but to choose the option which gives most benefit and inflicts least harm.

We see so many suicides because patients are fobbed off with inferior treatment options, because it's a cheaper alternative to give somebody pills than to give them psychological therapy. While I understand that being cost-conscious might be seen as being pragmatic, it again violates the principle of do no harm. To fob a desperate and vulnerable person off with ineffective medication, when better treatment options are available, is tantamount to negligence. If a doctor has a consultation with a man under the age of 45, they must surely be well aware that suicide is the thing that is most likely to cause their death, and they should therefore treat it as a serious threat to their life. To call people's bluff and knowingly prescribe ineffective treatment is obviously the reason why suicide rates are so scandalously high.

I imagine that some doctors - although egotistical and in love with themselves - have a tiny piece of them that wants to make a difference and save lives. I think that exhaustion and the pressures that are felt by ordinary people are imposing themselves on doctors now, who are struggling to send their children to the best private schools (boo hoo) and are feeling compassion fatigued because of burnout. If we can relieve the pressure on GPs, they may become more willing and able to work in support of their patients' needs, as opposed to "everybody else" (read: being the government's job police).

I strongly believe that we have an urgent need to change primary care, so that it becomes not-for-profit, and patient healthcare can become the primary objective. Perhaps profits are not the primary motivator, but money has a corrupting influence which can be clearly seen when you speak to a GP who is/was a partner of a practice. Co-opting healthcare professionals into the job of coercing vulnerable people into bullshit McJobs, where they are exploited by the capitalists, has absolutely nothing to do with healthcare and is most certainly harmful.

I've witnessed first-hand how this care for "everybody else" - instead of patients - has become shorthand for the compassionless, sympathy-lacking, bullying, hectoring and suicide-inducing grotesquely twisted vision of so-called medicine, inflicted on society's most vulnerable people.

If you want to be the job police, and you think that suicides are an acceptable price to pay, so you can feel superior and send your kids to private school, perhaps medicine is not for you.

Tags: #nhs

This is a story about being functional...

In every supermarket, corner shop, convenience store, licensed café, restaurant and in vast numbers of bars, pubs, clubs and other establishments where people gather to spend money and socialise, there is always alcohol on sale. Alcohol is ubiquitous. It's always possible to get cheap booze quickly, wherever you are - you're never further than a short walk and a couple of quid away from intoxication.

The weather in the UK is pretty miserable. We get hardly any snow, and there's only a couple of mountains that have a ski lift - it's quicker and easier for me to fly to France, Austria, Switzerland or Italy, than it is for me to drive all the way to Scotland, where the mountains aren't very high and the snow's really poor. The pleasant months of weather in the UK are May through to September, and the rest of the time it's grey and overcast; drizzly and thoroughly miserable. Our summers are often plagued by rain, although the weather is at least pleasantly warm by British standards, but don't forget your brolly even in August. It's enough to drive anybody to drink.

Our little island is quite overcrowded. The industrial revolution led us to abandon our rural lifestyle and move to the cities, seeking our fortune. Our cramped towns and cities have rows and rows of terraced worker cottages, which are too small to comfortably accomodate a family. As our social fabric disintegrated in the 1960s and 1970s, we built brutalist concrete monstrosities, very similar to Soviet-era blocks, which could house vast numbers of people who serve no useful economic purpose in the age of robotics, technology, automation, IT and the boom of the service industries. The vast majority of Britons are struggling to just-about-manage on god-awful estates, some of which were built by councils as social housing, and others were built by a handful of massive property developers. Estates comprise huge numbers of cheap and nasty houses built on the outskirts of dismal towns, which were already struggling to provide the necessary infrastructure to educate, transport, entertain and look after the health of local residents. We have not scaled well.

Overcrowding has reached such problematic levels, that cities such as London, Bristol and Manchester have no-go areas, where drugs, guns, knives and prostitution are the backbone of their black-market economies. In those areas predominantly populated by people who are considered economically redundant, there is little hope of escaping poverty, except by selling drugs or selling your body. Gangs compete for their turf, and violence is rife.

Meanwhile, we have seen the rise and rise of the bullshit job. While the economically redundant are given a pitiful state handout and left to rot on their council estates, the 'cream of the crop' will be able to study at university and obtain the necessary academic credentials to get a job that's completely unrelated to their field of study, which will mostly involve pointless boring meetings, Excel spreadsheets and a ridiculous volume of emails about absolutely nothing. The service industries produce nothing - no real value to the economy, no productive output - but they account for 85% or more of the so-called economy. Paper gets shuffled around in increasingly elaborate ways of obfuscating the fact that nothing of any importance is being done. Our smartest people are very busy doing nothing... and the smarter ones quickly figure this out and become quite disillusioned with the whole sham.

All of these things contributes to a toxic environment which makes people depressed, demotivated, stressed, anxious, but horribly trapped by their mortgages, car loan repayments. Despite stress and exhaustion, there persists a futile and flawed belief that if we only work hard enough, we'll be able to elevate ourselves from our dismal situation and build a better life for us and our family. When the workers eventually realise that life in the UK is a massive con, and we're going to be stuck in our dead-end job that we hate until the day we die - and our children are going to struggle just as much, if not more - then we need vast quantities of antidepressants, anxiety pills, tranquillisers, sedatives - and alcohol - in order to allow us to ignore the horrible situation and carry on functioning. Our nation is packed full of functional addicts.

Alcohol is used because of its ubiquity. It's self-medication that's available on every street corner. The proportion of the average family budget that gets spent on alcohol, versus food, is quite staggering - alcohol is the glue between the pooh... the only thing that's allowing people to carry on being functional in such a toxic environment; under such a hostile conditions.

Alcohol is the cause of so much obesity, as well as the other health-damage that accompanies its chronic consumption. If we really cared about people's health, we wouldn't bully and hector them to give up their crutches, but we would instead improve the quality of people's lives. If we make the world a less depressing and stressful place, we'll see alcohol consumption levels naturally drop.

I hate that I have to drink, just to get through the working week. I hate that I'm using a really fattening and health-damaging drug to salve my stress, and to help me to cope, but it's freely and readily available without having to see a condescending, patronising and unhelpful doctor, who has no sympathy and compassion for the day-to-day struggles of the proletariat. Doctors enjoy a position of high social status and an income that is many times greater than the average wage - they have no idea what life's like in the real world, for ordinary people - and while my overall experience with doctors has been a mostly positive one, the elites completely fail to grasp the awfulness of life for ordinary people, and fail to sympathise with the plight of the just-about-managing struggling masses.

Our doctors are trained in acute medicine - disease and injury - and are not succeeding at treating the chronic conditions that arise from the current economic climate, which is so toxic to mental health. Instead of lecturing, hectoring and bullying people because they use alcohol, cigarettes, coffee and drugs to be able to cope, our medical community needs to recognise that people are driven to use substances because of their intolerable living conditions. The mental health epidemic and scandalous suicide rates are all the proof we need that the model of medicine which dished out bucketloads of antibiotics is not succeeding in saving lives, when it dishes out bucketloads of antidepressants - clearly it's not working and suicide and mental health problems are the number one public health issue we're facing.

Having access to a fast-acting drug which can help when the stress levels become unbearable - when life becomes unliveable - is vitally important for a society that wishes to treat its people with some degree of sympathy and compassion for their plight... people need something to ease their suffering.

I think alcohol is a terrible drug, and I pity those who have become addicted to it, but it's plain to see the reasons why people drink too much, and it's not that they've got 'addictive personalities' or they lack willpower - it's that their lives are fucking shit and they've got to find a way to cope.

I wish I could quit alcohol, but how would I cope without it?

Tags: #alcohol #addiction

This is a story about motivation...

In a godless universe with no afterlife, if you're not fulfilling the will of your genes and reproducing, what's the point in being alive? We all die and we're all forgotten; everything is meaningless. Entropy will destroy everything that's structured, ordered and regular - we are being systematically destroyed; in the blink of an eye it will be as if we never even existed... all of human history, all civilisations, all buildings, all scientific knowledge, all great men and women, all works of art... it will all be gone.

Replication; reproduction is the force that fights against entropy. While entropy seeks to return everything to a jumbled and unordered chaotic mess, molecules that are mathematically probable to exist turn into more complex hydrocarbons, acids, proteins and all the other building blocks in the primordial soup, from which emerged the first self-replicating entities. Replication is as inevitable as the force that destroys everything that is ordered and regular, and returns it to disorder and chaos. Replication is the yin to entropy's yang.

The fact that you are conscious today, and not at some earlier point in history, is proof that you're the only consciousness in the cosmos. When you die, the universe dies with you too. You are the sole observer of events from your frame of reference, which means that your universe is unique to you. There are lots of other universes that are similar, but you cannot be conscious of those where you are dead, because your consciousness has ceased to exist, or never existed in them - you can only be conscious when you are alive. It's inevitable that there would be many other self-replicating entities in your universe with you, in close proximity, because of the spectacularly improbability of all the circumstances being right to create a consciousness - of course there'd be billions of very similar entities, with all very similar experiences, and all similarly 'conscious'... but your consciousness is unique in your universe, and your universe will end when you do.

If you're fulfilling the will of your genes, you are not conscious, you are merely one of the hundreds of billions of human animals that lived and died before you - unthinking fucking baby-making machines, making yet more beasts which will fuck and make more babies... and so on. You're just a disposable bundle of chemicals that has been used to replicate your genes. You're spent. You're trash. You're a husk; a shell.

In a godless universe with no afterlife, there's no point in anything, so you might as well do whatever you want. It could be a good excuse to live a hedonistic pleasure and sensation-seeking life that will maximise the amount of euphoria that you feel. However, you might sadly discover that you're immortal and find that your morals are completely corrupted. If you believe that the reason for living is to maximise your pleasure, what's to stop you raping and killing, just for fun? What's to stop you from raping the earth for your own pleasure? What's to stop you using and abusing the whole human race, and leaving the surface of the earth scorched and barren, plundered for every single drop of pleasure that you could possibly extract?

Thus, we arrive at a vision of hell: a planet made uninhabitable by an all-powerful immortal overlord who believes in nothing except their own pleasure, and damn the long-term consequences. It's pretty easy to see the evidence for that all around us.

Is there a middle ground?

I like to think that one day I'll be able to quit the rat race and become an artist. You might say that I'm already an artist, because I'm a writer, but the bulk of my time and effort is diverted into very mundane bullshit. My day job exhausts me. The need to pay rent and bills and service debts is a huge stress and a strain; a distraction. I'm completely unable to immerse myself in art, because of the arduous job of simply keeping a roof over my head and putting food on the table.

I've worked very hard during my 21+ year full-time career, and although I've been able to pursue a period of hedonism up to the point where it nearly killed me, I've not been able to ever pursue something I really love and am passionate about. It seems like the opportunity to indulge my passion for art might never be realised - it's somewhat unattainable.

I work, always with the slim hope that through hard work I'll be able to dig myself out of the hole and be able to then follow my dreams, but the realisation of that hope is eternally just out of reach. Hard work just isn't paying off. It doesn't matter how hard I work, and how long I work for... I can never reach my goal.

Why bother? Why bother with the early mornings and the dreadful boredom? Why put up with the stress and the anxiety and the slog of it all? Why put in the effort? Where's it getting me? Where's the payoff?

If life is about the hedonistic pursuit of pleasure, I can do that today and not have to work a single day more. I can end the struggle and return to my hedonistic life. Why bother struggling any more?

However, if life is about following your dream, and ideally pursuing some aesthetic abstract thing, like art, then I don't think I'll ever get there. I think being an artist would be perfect, because it's a change from the relentless pursuit of things that simply consume and exhaust resources, like procreation and hedonism, growth and conquest, business and capitalism, war, slavery and all the other things that inflict untold human misery.

I feel like I should be more comfortable than I am; more able to be an artist; more free.

Why go on? Why struggle anymore?

I'm not sure if I want to kill myself, or if I just need 2 weeks lying on a beach in a hot country.

Tags: #art #suicide #physics

This is a story about neuroplasticity...

Who even am I any more? Am I the same person my friends knew 5 years ago, 10 years ago, 15 years ago? Have I changed beyond all recognition?

I suppose change is not important if you're happy with who you are in the present day. I wonder about who I've become. I'm very isolated and I'm so fixated on earning enough money to dig myself out of the hole I got in, that I'm not really making a lot of time for socialising or reconnecting with old friends. I don't speak to anybody on the phone. I don't speak to anybody via email. I only speak to a tiny handful of people via text message. I've got no local social network. There's hardly anybody I'm in regular contact with.

I had a very clear plan for a long time - get out of an abusive relationship, move to London and resume my career in The City. Moving, selling the house and divorce were horribly sabotaged by my ex and made unbearably awful, which derailed me. I ended up stuck in a never-ending nightmare cycle of getting sick, ending up in hospital, recovering, starting to get my life together, and then it all falling to pieces over and over again. I had one good shot at escaping from her, but she ruined it; she ruined me; she ruined my chance.

I woke up in hospital all on my own far more times than I care to remember. I was cut adrift. Nobody came to see me.

Then, a little over a year ago, one of my lovely ex-girlfriends organised a load of support for me when I was in hospital. I had LOTS of visitors and brilliant messages of support. That was amazing. That made such a big difference. That was a turning point.

Recovery is non-linear, and getting my life back on track back in London was impossibly hard. I needed to leave London, which meant a breakup with the aforementioned lovely ex-girlfriend. Nothing about that breakup was done right by me. Nothing about the situation was good. It was a big fat mess. Things got worse before they got better. Things got A LOT worse.

Between the seizures and the coma, I think that my latest suicide attempt reset my brain. I think all those seizures were like a kind of intensive Electro-Convulsive Therapy (ECT) for me. My life certainly started to improve versus the destructive cycle I had been caught in while living in London. When I tried to kill myself, I was hopelessly trapped. My suicide attempt broke me free from something I could never have escaped otherwise.

It's strange: two breakups and a suicide attempt led me to a better life, inadvertently. Through that destruction has come new life and more prosperity; hope.

I'm completing my 21st consecutive month without a proper holiday, and I'm exhausted and stressed, but I get up every morning and I go to work. Whatever's going on with my mental health, I'm very functional. I'm in a healthy happy relationship. I'm getting on well with my colleagues. I'm staying on top of my adult responsibilities - paying my rent & bills, keeping my car road legal, washing, cleaning, laundry, shopping, cooking and all the other stuff that caused me unbearable anxiety and difficulties last year.

I might be somebody completely different, but I'm still somebody. My personality might have completely changed, but I'm still me... just not the me I was in the past. If my work colleagues like me and my girlfriend likes me, and I'm a functional member of society, then what's the problem with me?

I'm paranoid that mental health problems are going to rear their ugly head, but it's been almost 8 months without incident. I don't want to get complacent, but that's a long time to be unmedicated as well as dealing with the horrendous stress of losing your home, losing your job, almost going bankrupt, moving house, moving city, starting two new jobs and everything else to boot. Looking at the evidence, I'd say that I'm one of the most mentally strong and stable people you're ever likely to meet, as opposed to an emotionally unstable lunatic, which you might wrongly presume from some of the stuff that happened before.

I think the lesson is that the brain is a homeostatic organ that's evolved to rapidly adapt to the ever-changing environment. If you trap me in to dreadful circumstances, I'm going to have a dreadful reaction - that's logical and reasonable; that's rational... a sane reaction to an insane world.

I do have my PTSD flashbacks - described as "Tourette's-like" by a close friend - and I do have to be extremely careful with my sleep, diet, stress levels and myriad other things, but my mental health problems are a risk not my destiny.

If I can just keep plodding through life, things will improve. Time is the biggest healer, giving my brain time to adapt.

Tags: #mentalhealth #ptsd #suicide #homeless #career

This is a story about victim playing...

Apparently the world is full of attention-seeking malingerers who aren't really sick, but who in fact choose to be depressed and miserable, and to self-harm and attempt suicide, because it's a lifestyle choice. Apparently everybody knows exactly what they're doing all the time and we all have complete free will - our hand is never forced, we're never coerced or pressured into doing things we don't want to do, and we can choose how we want to feel. If we want to be happy, we can just choose to be happy.

Those who are suffering aren't really suffering - they're victim-playing; they're attempting to get sympathy, so they can bunk off school or work. Thankfully though, there are some clever people out there who can see straight through you and understand everything about you in an instant. Thankfully there are clever people who are qualified to immediately judge you, and to declare you fit and well, except you're just too damn bloody minded to snap out of your silly pointless melancholy.

Those clever people who declare that you're so definitely faking it are so clever and infallible that they're prepared to risk your life. They'll call your bluff. They don't care if you die. It's more important that you're unmasked for what you really are - a self pitying attention seeking malingering poser - than you staying alive.

This situation, where those clever people call your bluff, is clearly working very well, because suicide is the biggest killer of men under the age of 45. If somebody commits suicide, clearly they were telling the truth, but if they don't immediately kill themselves that then proves that the clever person is really clever and can carry on killing people.

It's a bit like the witch-hunts. If a woman floats, she's a witch, and if she drowns she wasn't a witch. It's a flawless system.

I do often wonder - as I'm programmed to do by society - whether I'm feeling too sorry for myself; whether I whinge and moan too much. I'm certainly not wedded to depression as part of my identity and I wouldn't be sorry to see it go. I can see my part in my problems, in as much as I had ability to make other choices. You really don't understand the pressures and biases and other factors that influence a person's decision making, if you think that life is all about free will and making the right choices.

Yes, it is nice to have a reason for why life is shit. Yes, it's nice to have a diagnosis that says that there's a very good reason why life is harder than it should be. These things aren't excuses, they're explanations. Yes, it's comforting to know that there are very good reasons why I'm predisposed towards certain negative feelings and behaviours, and it's not because I'm lazy, stupid, immoral, bloody-minded, evil or of bad character. Yes, it's useful to think of myself as a victim of circumstances and a victim of disease, rather than some evil bastard who deliberately makes bad choices and is depressed and suicidal out of spite.

If I'm victim playing, fine, whatever - put me down as a victim player. If I'm self-pitying and saying "poor me" far too often, fine, whatever - put me down as an attention seeking poser.

I have some choice in the matter of what happens in my life, but mostly I don't. Most of what happens to all of us is dictated by fate - when we were born, where we were born, the socioeconomic circumstances we were born into, the people we came into contact with, the things that happened to us that were completely outside of our control. Even my choice of what to eat for dinner is heavily influenced by my upbringing and everything else that's going on in my life - I might crave salt or sugar, because my body needs it because of the activity I've been doing. How much do you want to blame the victims?

If you get your kicks from fat-shaming, then you're the kind of person who probably enjoys victim-blaming the suicidal too. You're the kind of person who'd rather see people die, than show them any sympathy. You're a bluff caller. You're a gambler with people's lives. You probably think of yourself as very clever.

Do you think it's worth it, to have suicide being the biggest killer of men under the age of 45, just so that you can feel big and clever?

Tags: #suicide #depression #mentalhealth

This is a story about relentless monotony...

I fell asleep at my desk today. I haven't had any time off since November. I spent November writing a novel, so I guess I haven't had any time off since October. I was in hospital in October and I moved house, so I guess I haven't had any time off since September. I was in hospital in September and I tried to commit suicide and I lost my job and I was evicted, so I guess I haven't had any time off since July. I moved house and started a new job in July, so I guess I haven't had any time off since June. I was selling loads of my stuff, trying not to go bankrupt, while also trying to get a job in June, so I guess I haven't had any time off since May. I was quitting supercrack, having an episode of medication-induced mania from California rocket fuel and breaking up with my girlfriend in May, so I guess I haven't had any time off since April. I was a drug addict in April. This is what I was doing back in April.

Here I am looking at the dark web a little over a year ago. I'm probably not buying anything that would be illegal because I already had enough supercrack to last me 2 years. The fact I'm wearing clothes and sitting in my lounge, taking recognisably normal-ish photographs suggests that a little over a year ago, things were going OK.

Oh no I spoke to soon. This night-vision photograph indicates that I was going bat-shit insane while high on supercrack. I took this photograph only a couple of days after the one before, where I was sat in the lounge browsing the dark web. This photograph was taken about a year ago.

What the hell is THAT? Well, it's pretty obvious that I've barricaded myself in my bedroom. This photograph was taken one year and one day ago. This photograph perfectly illustrates my subconscious fears of privacy invasion - that people are going to burst in on me, shame me and violently attack me. I don't come across as very paranoid in day-to-day life, but I'm very traumatised, and this is my reaction that that trauma: I barricade myself in to protect myself from my parents and ex-wife. It's bat-shit insane, of course, but this is my underlying psychology.

Looks like I was eating some food. I'd probably barricaded myself in my bedroom for days. I'd probably not slept for days. My life was a horrific mess a year ago. I had a virtually unlimited supply of supercrack and my addiction was raging out of control. Clearly I was paranoid because of drugs and sleep deprivation, but what was the seed of that paranoia? I wonder if it could have anything to do with having the rug pulled out from under my feet - being muscled out of my own home; being horrifically injured in my own home; being punched in the face or suffering a horrific injury to my leg, at the hands of my ex-wife and parents. I wonder if it could have anything to do with them. I was trapped in a corner for so very long, with no means of escaping my tormentors, who were demonstrably vile, violent and abusive. Fuck them. That kind of trauma has a lasting effect.

My paranoia reached such ridiculous levels that I barricaded the door to my ensuite bathroom using my laundry bins and some clothes storage boxes. Clearly I just wanted to be left alone. Clearly I didn't feel safe. Yes, it's paranoia that's come about because of drug abuse and sleep deprivation, but there's got to be a seed too. Nobody gets this paranoid unless they have their ex-wife kicking doors in and screaming abuse at the top of her lungs. Nobody gets this paranoid unless they have their parents humiliating them and bursting in on them, and dragging them out of their own home. There's a seed for paranoia. There's always a seed.

Something to help me sleep (zopiclone) and something to help me cope and function (dexamfetamine). You can't end a horrific addiction instantly. There's no cold turkey when you're in as deep as I was. I was too dependent. To attempt to suddenly quit overnight would have caused me unbearable withdrawal symptoms and would have required me to be hospitalised. This is what I prescribed myself - two medications for harm reduction. Two medications that I used to wean myself off the dangerous and highly addictive supercrack.

I flushed that big bag of supercrack a year ago. There was enough to last me a couple of years, easily. I can't remember when exactly I flushed it, because my life was chaotic, but the evidence suggests that it was at this point I decided to get clean, using substitute prescribing.

Things didn't go smoothly, but it's very difficult to deal with a major addiction as well as mental health problems and all the practical problems that came about because my life had disintegrated. I needed to get money, get a job, get an apartment I could afford. I needed to move house, move city. I needed to get a new girlfriend and a new group of friends. I had a false start in Manchester, but I tried again in Wales... I'm trying again in Wales.

Maybe you think my life is easy and everything is sorted out, because I earned bit of money, which I spent renting an apartment and buying a car so that I can get to my new job. Maybe you think my life is easy because I get up and go to work every day, and I'm doing a good job and my bosses are impressed with me. Maybe you think my life is easy because I've 'bounced back' from losing two apartments, running out of money three times and being hospitalised twice. Maybe you think my life is easy, because I've made it look so easy, quitting supercrack, Valium, Xanax, tramadol, codeine, dihydrocodiene, pregabalin, zopiclone and zolpidem, which are all highly addictive. Maybe you think my life is easy, because I've gone 7 months unmedicated and I haven't had a single mental health episode that's caused me to commit suicide or do something else drastic to fuck up my life. Maybe you think my life is easy because my finances are improving and I've got a girlfriend. Maybe you think none of what I went through in the last year was very hard. Maybe you think none of what I've been through in the last year has caused any lasting damage.

I'm in my 5th consecutive month of full-time work without a holiday. I'm working my bollocks off. All I do is work work work, because I'm running as fast as I can to get myself into a position where my housing is secure - nobody can evict me - and I'm financially secure. I constantly have to ignore my physical and mental health, because I so desperately need to get myself into a position where I can collapse in a heap and have a minor nervous breakdown.

Yes, I can do stuff like this - I can save myself; I can come back to life; I can return from the brink of destitution and make it look very easy.

It's not easy.

Tags: #homeless #addiction #drugs #bipolar #mentalhealth #suicide

This is a story about keeping up appearances...

I have a tattoo that I can't cover up, which tells the world that I've had problems with suicide attempts, self-harm, depression, bipolar, alcoholism and substance abuse. I have a blog which puts me on page 2 of Google if you search for my name. I have a Twitter account that has the most followers out of anybody who shares my name. I'm hardly being shy and retiring about my dark past. I'm hardly keeping my skeletons in the cupboard.

One of my work colleagues has already found my blog - by Google'ing me - and has visited a few times. I can see that he uses the WiFi at work and I can see that he uses his Apple iPhone Plus. That's happened waaaay too soon.

An old friend who I know from the kitesurfing community recommended me for the job. He's friends with another colleague on Facebook. I don't use Facebook much, but when I do, it's usually because I'm having suicidal thoughts and it's a cry for help. If my friend commented on something I put on Facebook, my other work colleague might see it.

It's a small world, so that's why it's a good idea to be open and transparent. Nothing to hide, nothing to fear.

Of course, people who suffer from mental health problems - including addiction - are heavily stigmatised. If I didn't think I was able to do my job highly effectively, with an excellent level of professionalism and reliability, then I'd be slightly more reluctant to publish the inner-workings of my mind, and make my struggles a matter of public record.

I take my readers on a journey on me, and some of them will become sympathetic towards me and my story. Generally, if you read forwards and follow along with me, you'll gain a positive view, but if you read backwards then you'll dislike me and imagine that I enjoy the benefit of hindsight, which I don't.

It was particularly telling, the difference in reactions to my attempted suicide last September. My colleague who had followed my progress on my blog was sympathetic and caring. My colleague who read back through my blog, starting from the point where I believed I was going to die, was so unsympathetic that he sacked me and evicted me from my home, because I was on a life-support system and therefore unable to phone and say that I was going to be out of the office for a couple of days. He literally didn't care that I was in a coma with a tube down my throat and a machine breathing for me. That's the difference that it makes, reading my blog backwards versus reading it forwards - it can make a person not care that I'm dying, or it can elicit a sympathetic response to my plight.

For the avoidance of any doubt, I'm through the worst of my suicidal moments, now that the stress levels in my life are subsiding. Naturally, being homeless, close to bankruptcy, jobless, friendless, single, new to an area and generally having nothing and nobody is pretty damn awful for a person's mental health. In the space of 6 months I've made some friends, got a girlfriend, earned some money, bought a car, rented an apartment, got a local job and gotten myself a bit more settled, although I'm still a long way off having security and stability.

What might annoy my colleagues is thinking they've got a bargain - that I'm an expert in my field and I've got talent and experience - when in actual fact they've got a homeless bankrupt junkie alcoholic with mental health problems who never even knew how to switch a computer on until yesterday. Surely I could have been bought for minimum wage, because I'm desperate and vulnerable? This was certainly the case with the guy who didn't care that I was on life support - he felt ripped off, when he discovered the truth about me, even though I had nearly completed the first phase of the project I'd been working on, and the results had been fantastic.

I think really horrible people are few and far between. I think unethical exploitative bosses are few and far between. I really don't think it's going to be a problem that my real identity doesn't quite marry up with corporate expectations. I'm always well presented at work. Nobody would be any the wiser about my dark past, except for the aforementioned tattoo, of course.

I'm mentioning the tattoo and putting up a picture of myself without my infallible disguise quite deliberately, of course. Of course I know what I'm doing. I'm not exactly unhappy about anybody knowing about who I am, because I find it too exhausting to wear the corporate mask and pretend I'm perfect. It's not nice to have to live a lie and cover up any struggles I might have in my personal life.

It's been nearly 8 months since I had any problems with my mental health. I don't take any drugs or medications. I drink in moderation. I'm not suicidal. I'm not self-harming. I'm delivering high-quality work to the satisfaction of my bosses. My finances are improving. I've got my own place. I've got my little car. I've got my girlfriend. I've got my friends. Things aren't perfect, but they're improving and they'll continue to improve as long as I'm allowed to keep working and earning money.

It's a big gamble to keep this big digital presence alive. I obviously can't write about anything that would be unprofessional, breach my code-of-conduct, bring my profession into disrepute, breach confidentiality or any any way shape or form be considered unacceptable behaviour, but to delete my blog and my Twitter and Facebook account and expunge myself from the internet would be a considerable loss to me, and would be likely to negatively affect my ability to cope and function.

I hope that if my colleague(s) continue to read this, they can see it for what it is - my healthy coping mechanism, and something I need, because it brings me great comfort and a lot of care and support.

So far, I only know for definite that one work colleague is reading my blog. I hope to make friends at work. I need friends. I don't see it as a bad thing that somebody's reading.

I don't want the secret identity thing. I don't want the double-life thing. I've got nothing to hide; nothing to be ashamed of.

Tags: #writing #socialmedia

This is a story about crossing a line...

To say I'm not sorry, I'm unremorseful, I don't live with regrets and I've never made a mistake, would be completely untrue. My life is fairly simple - work, eat, sleep - so I have a lot of time to think about things. I'm always prepared to consider the possibility that I've overstepped the mark; that I've gone too far.

The level of isolation I live with is something that 99% of people would find intolerable. Humans are sociable creatures. I'm quite a sociable guy, but my life completely collapsed and I haven't rebuilt it yet. I started a new job a little over a month ago and I'm starting to build a good relationship with my colleagues, but it's early days and I have to tread carefully because I really need the job and I don't really want everyone to know that I've been really unwell. I only moved to the area a little over 6 months ago, and I've spent half that time working in London, so I've not had much opportunity to make new friends yet.

I wake up, I drive to work and I think about what I'm going to write. My job's pretty easy, so I spent lots of time at work thinking about what I'm going to write. I get home and I write. I then spend a lot of time thinking about what I've just written. I often think that what I've just written doesn't accurately reflect how I'm feeling because I feel differently after writing. On reflection, I often feel like I've gone too far - I've been too passive-aggressive and critical; I've been a little negative and cynical. However, if I let my frustrations build up I'd explode or be driven mad.

You probably don't realise just how much you use your support network every day, because you take those people for granted. If you're feeling upset about something, you can pick up the phone or talk to somebody face-to-face. I often don't have that. At work I put on my corporate mask and pretend like everything's perfect in my personal life. With people who I rely upon for my money and my accommodation, I have to present a fake front, because my life depends on it. I'm very rarely able to be myself, and when I am able to finally talk with people who I can be honest and open with, they tend to be my social media contacts, because of my isolated life.

I have a girlfriend and she's great, but I can't have a dependency on one single person - that's too much pressure. My girlfriend suggests seeing a therapist, but that's expensive and you can only talk to them for an hour a week... provided you even like and respect them, of course. Finding a good therapist is a hard enough challenge in and of itself.

If you imagine the amount of traumatic experiences I've had in the past few years - a horrendous leg injury, suicide attempt, kidney failure, police, sleeping rough, crisis house, hostel, police, lost job, evicted, hostel, police, psych ward, DVT, kidney failure, dialysis, homeless and virtually bankrupt, suicide attempt, police, psych ward - then I hope you realise that an hour of week of speaking to a therapist isn't really going to cut the mustard... hence the blog.

I arrive at the point I'm at today, heavily traumatised.

You can't see the trauma, but I know it's there because I keep getting invasive thoughts that stab me like a knife in the guts.

The shit I've been through doesn't give me an excuse to be shitty to people and not be sorry when I upset people. The shit I've been through doesn't give me an excuse to say and do whatever the fuck I want. But, I've only got a limited amount of patience for anybody who makes my life any harder than it needs to be. I've only got a limited amount of patience for anybody who thinks they've got quick fixes and easy solutions. I can only humour people for so long.

Dealing with this post-traumatic stress is taking a long time. There's a lot of shit to work through. There's a lot of stuff I'm getting over. I only just managed to get myself into secure housing and start a job that I can tolerate. My finances are still shitty and I'm only just getting to the point where I'm a couple of weeks away from a cash injection I desperately need. There's been a mountain of practical stuff to sort out, on top of the psychological damage; the trauma.

Frankly, I'm surprised that I'm not more vindictive and nasty, because I've been through a right load of shit and I'm still deeply traumatised. It's true that people have been hurt who don't deserve it, but it's not true that I'm not sorry... in 99% of the cases, I'm sorry when somebody got hurt by me lashing out.

I don't really have anybody who regularly provides some kind of checks & balance on my behaviour. Most of us talk to our friends and family and then our initial anger and indignation dissipates... we feel like we're being unreasonable, when we voice our frustrations to our trusted confidantes. My blog is my trusted confidante, because my life collapsed and I'm dealing with a clusterfuck of post-traumatic stress.

Yes, my blog is public, but I also avoid using names or other things that might identify people. Yes, my blog is public, but how else am I supposed to get the support that I need, when I'm in such a dangerously low and precarious situation? Yes you might feel personally attacked, but are you absolutely certain that it's you I'm talking about? If you think it's you, is that because you've got a guilty conscience?

So, sorry I'm not sorry. But I also am sorry too, in those cases where I overstepped the mark; where I was unnecessarily unkind.

Tags: #writing #ptsd

This is a story about having a chip on my shoulder...

Seemingly out of nowhere a huge grudge has reared its ugly head. It felt like I'd been biting my tongue for a long time, and sadly it seems like I'd been unable to forgive and forget a big list of transgressions. I don't know why I've been carrying this unhelpful baggage around. I don't know why my own less-than-perfect behaviour doesn't cancel out the occasions which have upset me. I don't know why I haven't been able to resolve problems amicably. However, I blew up; I got mad. A huge tsunami of anger hit me and I've raged about all the stuff that's been bothering me for a long time, which I'd bottled up.

Every time I censor my blog, it's a huge mistake.

My blog is where I come to write, as a coping mechanism for some awful stuff that I've been through. My blog is a healthy coping mechanism, when so many others would resort to drugs & alcohol, or perhaps be driven mad by the torment of their suffering. My blog has been miraculously therapeutic at getting me through so many episodes of relapse, hospitalisation, homelessness, lost jobs, near-bankruptcy and other financial distress, and very difficult struggles with drink, drugs and mental health problems. I depend on my blog. To be denied the opportunity to write freely has dire consequences.

It was a huge mistake to censor my blog.

I took down a blog post as a goodwill gesture. It was a mistake. There was nothing in the blog post that was offensive or in any way problematic.

I had days of hell where I had absolutely no idea what was wrong with what I'd written. I had days of hell where there was an impending confrontation linked to somebody who had quite routinely tormented me and had been very aggressive. I thought things got resolved, but my Twitter was later examined with a fine-tooth comb and the unpleasant and extremely stressful confrontation - far worse than I had been expecting or prepared for - was completely pointless because the goodwill gesture achieved nothing. In fact, deleting my blog post and then being unable to write because I had no idea what was problematic with it, was incredibly disruptive and ultimately futile; pointless.

Unintentionally, the dam burst and I wrote about all the things that had been bothering me, but I wrote in a way that was stoked up by the unpleasant nasty confrontation and the censorship of my blog. It was a stressful and confusing situation, and ultimately it was utterly pointless - I should never have censored my blog or attempted reconciliation. As a result, things have come out with a lot more anger than I'd have liked. Things have come out a lot more forcefully than I'd have liked.

I can totally understand why I was Tweeting so desperately, having gone through 4 sleepless nights and had nothing to go on except an abusive phonecall... plus all the other unpleasant stuff that had gone before, of course. What had gone before could perhaps have been shrugged off as "a clash of personalities" but ended up crystallising into the firm belief that I didn't want anything more to do with a person who'd caused me a great deal of distress. I don't want to make things personal. I don't want to take someone to pieces and destroy them on social media and on my blog. What you have to understand is that this blog is my coping mechanism - this is where I come when I'm hurting, to work stuff out.

I'd like to stop being bitter, angry and vindictive, but I know that this fire's gonna burn for far longer than I want. I really want a clean break; a fresh start. I really want to move on. I want to forget all about the whole dismal episode.

I may end up re-writing the original blog post that I deleted, and publishing it in its edited form, as some kind of closure.

Publish or perish.

You have to understand that's why I write: because it's a life-or-death situation.

Tags: #writing #socialmedia #suicide

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

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

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

All the psychiatrists agree: I have bipolar disorder.

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

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

I did not ask for a fourteenth opinion.

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

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

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

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

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

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

Finally, we must consider loss of status.

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

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

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

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

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

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

So...

I have bipolar disorder. That's it.

Tags: #bipolar