This is a story about missed connections...

Like many people, I have a large collection of digital photos. My library starts in 2005, when a group of friends and I pooled our holiday snaps from a trip to Venezuela. Travel photography is the main thing that featured until my life started getting erratic. I have an increasingly random muddle of photos and screenshots, like a breadcrumb trail leading back to saner and more stable times.

2008 was the beginning of a much more exciting life than I had led before. I quit my investment banking career, developed some iPhone apps, retrained as an electrician, called off my wedding and went back to IT consultancy work. Having lived under the dark storm-cloud of an abusive relationship for far too long, I finally decided I'd had enough and broke up with my fiancée. I made a new group of friends and rebooted my life - as a prescription for depression, that shock treatment worked perfectly.

Fast-forward to 2011 and I knew that my relationship - back together with the girl who my friends call "the poison dwarf" - was destroying my world and ruining my happiness. I spent 3 amazing months in Cambridge and I'd fallen in love with somebody else, but I was too loyal; too faithful; too committed to give up on a failing relationship and go for what I really wanted.

In 2012 I capitulated and tried to follow doctor's orders - I started taking medication - and went back to the life I hated. I returned to the investment bank I'd previously worked for and tried to pretend like I was OK with that. I even got married to "the poison dwarf". I tried my very hardest to put on the boring grey suit and pretend like I was able to work doing the 9 to 5 office routine that I'd done for years and years, but my heart was broken.

I guess I never really got over the fact that I hadn't followed my dreams; followed my heart.

2013 brought the inevitable divorce, which necessitated selling my house and figuring out what to do with all my worldly possessions. In short, I didn't want anything to do with my toxic old life: the place and the things and the pain of everything getting ripped to shreds was just too much to bear. I wanted the whole lot to burn to the ground so I could start over. I wanted a fresh start.

I tried to court that girl from Cambridge who I'd fallen in love with - she liked me too and things were going well. It looked like I was going to break free from the gravity that tried to pull me back into a black hole. Despite me telling "the poison dwarf" that she could take as much as she wanted, she tried to destroy me. She just needed to leave me alone to get on with my new life, but she made the process of divorce into an unbelievably horrible disaster. Despite my attempts to make things quick and painless and give her a big cash settlement, she sabotaged my every effort.

In the midst of the acrimonious divorce, I tried to get away from the worsening British weather and get some rest and relaxation before Christmas. I was going to go to Florida and do some skydiving, and then I was going to go to San Francisco to see my friends in the Bay Area. The house should have been sold; the cash should have been in the bank - it wasn't, because "the poison dwarf" had screwed up the easy house sale that I'd worked so hard to make happen.

I was too sick to take my flight to America.

I think of 2014 as my annus horribilis given that I spent about 11 weeks receiving inpatient treatment, essentially for the problems caused by getting screwed over as a vulnerable person, by my ex-wife. She'd demanded a quick divorce and I'd said "take whatever you want" but then she made it unspeakably awful. After a rotten birthday where I found myself well and truly homeless, I repeated my magic trick of 2008: I got myself back into IT consultancy and made a load of new friends; I flew off to Tenerife with my new girlfriend and went kitesurfing. From the depths of despair and near destruction, I rose up and rebuilt myself.

What happened in 2015, 2016 and 2017, combined a winning formula of highly paid IT consultancy work and my ability to make new friends and rebuild my life, with the sensation-seeking desire to maintain a novel lifestyle: if nothing else, my life has been very exciting for the past few years.

Whereas most people live in fear of tarnishing their professional reputation and losing everything they own and hold dear, I found those things became incredibly cumbersome when I was unwell. To maintain appearances and pretend like everything is just fine, is immensely energy-draining. It's almost driven me insane, worrying about what former work colleagues and bosses think about me; what people know about my chequered past. Far, far, far more than the abuse my body has suffered, and the mental health problems I've been through, the biggest problem in my life has been worrying about people finding out the very things that I've catalogued on the pages of this blog, quite publicly.

We are now approaching a third San Francisco flight that has been booked, but there is a great deal of uncertainty regarding whether I will be going or not. I dearly wish to see an old schoolfriend who was pivotal in raising the alarm on social media, to the fact that I was in the process of killing myself - in essence, he was the last person I spoke to while still alive, telling him that I was sorry I wouldn't be seeing him in November [because I'd be dead].

It fucking horrifies me that the managing director of the company who I was working for at the time - who booked my flights out to San Francisco - was in the process of attempting to terminate my employment while I was on life support in intensive care... because he'd read this on Twitter!

Given that I've stubbornly refused to die, I feel like taking the trip to San Francisco in defiance of the arsehole who didn't care whether I lived or died. That gobsmackingly awful human being deserves to have to see me alive and well, taking a trans-Atlantic flight to go and see an old friend who actually cared about my life.

I feel like I might be calling on you - my social media friends - to help me raise Hell to show that vulnerable people shouldn't get screwed over by unscrupulous arseholes.

So, this is my call to action: I'd like to speak to you and I'd like your support in turning up the heat on people who put personal profit ahead of human lives. I've been wondering what to do with myself, and this feels like an important point; this feels like something symbolic.

Whether it's my ex-wife who literally said "I'd rather be a widow than a divorcee" or my ex-boss who literally fired me for being dead, I want to stand up to these fucking arseholes.

Tags: #career

This is a story about medical notes...

My ex-wife - a biochemist by way of undergraduate degree - once screamed at me in an incoherent rage because I had innocently asked her "how big is a protein?" having wondered how many nanometers across, the average protein molecule measured. The sheer audacity of me asking such a question enraged her, perhaps because free thinking is expressly forbidden in an academic world which promotes rote-learning of facts and examinations graded to a marking scheme, ahead of learning.

(The answer, by the way, is roughly 3 nanometres in radius).

When I attempt to answer a difficult question, I sometimes pause and chuckle. "What is consciousness?" came one question. Although I was desperate to talk about weakly interacting subatomic particles, General Relativity and nuclear fusion, I somehow managed to constrain myself to a meaningless analogy, while keeping quiet about my "mind's eye" which could picture every piece of information that captured my entire existence, smeared out in a infinitely thin sphere at the event horizon of a singularity, across all meaningful spacetime for the entire universe that I will ever perceive, which would have been rather a mouthful to express.

Just as one may cram for an exam the night before, I've attempted to only ever amass the prerequisite knowledge that may be considered the minimum viable to navigate whatever situations I have had to endure to reach my goals. Education has never seemed like an end in and of itself, given that our understanding of the fundmental nature of reality is evolving, and the Standard Model of particle physics is rather long in the tooth. Although I find it quite delightful that there are quarks named strange, charm and beauty in the particle zoo, I would find it rather frustrating to dedicate years of my life, obtaining a degree and writing a thesis using tools which may soon look as clunky and outdated as Newton's inverse-square law of gravity.

The mathematicians will mock physics as simply being applied mathematics. The physicists will mock chemistry as simply being applied physics. The chemists will mock biology as simply being applied chemistry, and so on.

Computers are now capable of solving equations and modelling real-world phenomena, potentially making algebra and calculus into dying arts, along with handwriting and long-division. The Fractal Geometry of Nature has revealed that cold rational calculating machines can produce simulations that imitate reality, through repeating patterns. Massive computational power does not only aid human discovery of hidden algebraic equations.

Amid much fanfare, computer software is touted as potentiating new drug discovery by simulating molecular binding, protein folding, rapid gene sequencing and personalised medicine. However, we seem to have forgotten that half the planet is impoverished & hungry, and vast numbers of those who are fortunate enough to live in advanced, wealthy & technologically advanced societies, are suffering from an epidemic of anxiety, depression and other mental health issues that is bad enough to drive vast numbers of men in the prime of their life to commit suicide: the biggest killer of males under the age of 45 in the UK - more than road traffic accidents, drug-related deaths, physical disease, murder, accidents and all the other causes of death.

One should consider that I took leave of my senses in 2008, but since that time I have only managed to attract two clinical diagnoses - convenient medical short-hand - although I have acquired a third which is perhaps the bluntest instrument of the three, and much more of a pejorative than a diagnosis.

"Substance abuse" is a catch-all term which serves me well when I haven't the time & energy to go into detail. Given humanity's long history of self-intoxication, some physicians would consider themselves to be well-versed in the matter. Even the most insulated amongst us, will have struggled to escape contact with a drunk in our lives. We quickly forget, of course, that psychiatry is an extremely young discipline. The isolation, refinement and synthesis of molecules which can short-circuit brain mechanisms, is something that dates back only 70 or 80 years, along with the branch of medicine chiefly concerned with treatment of matters of the mind.

The brain: the most complicated organ in the human body - estimated to have up to a quadrillion neuronal synapses - is often considered only in terms of its vital function as central nervous system, insofar as the same fatty grey matter helps other species to fuck, fight, flee and feed. This does not, however, tell us much about human consciousness, and even less still about pathological thought.

I once sat down and hand-wrote 12 pages of notes, from memory, of every General Practice doctor, psychiatrist and hospital, which I had attended during a 7 year period. Although I kept things as brief as I could, with names, dates and locations, as well as diagnoses and medications, there was a great deal to write. I'm not a complete hypochondriac - there were important notes about my episodes of depression and hypomania, where my mental health had caused me to become significantly dysfunctional.

Perhaps your mind is now skipping ahead - as mine often does - and you're attempting to finish my sentences. Presumably, you're trying to guess the punchline of the joke. I assume you've already got more than enough information to diagnose and treat me.

I'm second-guessing myself here, and I'm struck by the egotism and "navel gazing" of the very act of being sufficiently appraised of my own medical history that I should remember such a level of detail. Who the hell am I to take an interest in my own diagnosis and treatment? Where's my certificate, framed on the wall? Where's the photo of me wearing a mortar board & gown, and clutching a scroll of parchment with a red ribbon tied around it?

When I think about where I should spend my precious time and effort, I'm not motivated by the prospect of being an understudy to a failure. While psychiatry continues to produce dismal outcomes for humanity, in terms of the epidemic of mental health problems, addiction and general societal collapse under the weight of stress and burnout, I'm reluctant to follow in the path of those who are not succeeding in improving the human condition. It should however be noted that I do not for a single moment, criticise the well-meaning intent of those in the healthcare professions, nor do I mean to discredit the lifesaving work that takes place every single day.

The idea of using myself as a case study seems quite ridiculous, but one must consider that it would be unethical to - for example - risk a person's life when there is a treatment available that has been proven to be more effective than placebo.

With a sample size of one, perhaps nothing useful can be gleaned from my first-hand experiences, but I have attempted to corroborate my findings with other evidence wherever possible. I have deliberately avoided areas where another data point would make no difference: what use would it be if I too experienced anorgasmia as a result of SSRI medication, for example?

A great deal of our knowledge regarding the anatomy of the human brain has been gleaned from unethical experiments on unconsenting psychiatric patients - lobotomies, testing of medications and induced seizures. Animal studies have been gratuitously gruesome, with a great deal of unnecessary suffering inflicted upon primates. I'm not an anti-vivisection nutcase, but there must be very tangible goals to justify the means of obtaining the results.

To bathe a brain in psychoactive molecules that will cross the blood-brain barrier, is barbaric when we consider that the theoretical reasons why drugs have the effect that they do - the theories have so often been disproven. The 'chemical imbalance' theory that said that depressed brains had lower levels of serotonin, and that SSRIs would increase levels of synaptic serotonin, has been conclusively disproven, yet it is still a widely-circulated myth.

The much-vaunted sequencing of the human genome looks like a ridiculous white elephant of a project, when we consider that epigenetic gene expression had been discovered to allow genetically identical animals to exhibit completely different physical characteristics, depending on the environment that they have been exposed to.

In a collapsing global economy, education is one of the few sectors that's not feeling the pinch, and good solid science is getting drowned out in a sea of noise: pointless research. There are already excellent animal models which demonstrate that overpopulation and otherwise horrible living conditions, will produce a "behavioural sink" and addiction, in individuals who would otherwise lead happy healthy lives.

It has seemed fairly obvious to me from the start, that my mental health problems have stemmed from the ethical objections I had to the conduct of financial services organisations, and the role of global capitalism in ruining billions of human lives, in pursuit of unrestrained, unregulated and immoral profits, to the exclusion of any and all consideration of long-term consequences. In short: my problems should not be medicalised. I'm having a sane reaction to an insane world.

While this essay goes well beyond the "answer A, B or C" multiple-choice options on the prescriptive menu that is on offer, I feel that this does not invalidate the points I am making.

To have invested heavily in a mainstream education, would be to risk becoming incoherent with rage whenever somebody was so impertinent as to ask a thoughtful question - questions that spring into a mind that's unconstrained by the narrow status quo viewpoint, rote-learned while kowtowing to those with the necessary credentials to approve clones of themselves.

This is not "my ignorance is as good as your knowledge" anti-intellectualism, but instead a suggestion that we don't need so many people who've all read exactly the same books and sat more-or-less exactly the same tests. Moving towards intellectual homogeny is as dangerous as book burning, in my opinion.

In conclusion: this is a convoluted way of saying that you're unqualified to judge me, although you're possibly technically correct if you say that my problems are mostly of my own making.

Tags: #mentalhealth #suicide #addiction

This is a story about pill popping...

If you're unfortunate enough to find yourself on a psych ward, you might be surprised to discover that you don't have a choice about whether you take your medication or not - you can be treated against your will. That's worth repeating one last time: you can't refuse your treatment.

At the moment, I'm effectively unmedicated. I'm taking pregabalin for neuropathic pain, but I'm reducing my dose by 50mg every 4 days, so I will stop taking it altogether in just 12 days time. I'm taking zopiclone for insomnia, but I will halve the dose in 7 days time and stop taking it altogether in 21 days time. Meanwhile, I've been taking a tiny dose of lamotrogine - just 25mg - which is too little for it to have any effect.

But, presumably I was on some heavy medications while I was in hospital?

No. No I was not.

Since the 9th of September 2017, I've stopped drinking altogether - I'm teetotal - and I've stopped abusing benzodiazepines (Xanax and Valium). I've also not taken anything other than pregabalin and zopiclone. It was less than 3 weeks ago that I started taking a tiny dose of lamotrogine, which is not capable of controlling any mood disorder that might be troubling me.

I must admit that I rather toyed with the poor psychiatrists who saw me. I casually dropped olanzapine and sodium valproate into conversation, and their faces lit up like a Christmas tree. My fellow patients were acutely unwell, and injections of Depakote - colloquially known as "depo" - were dished out to anybody who exhibited troublesome behaviour. It's a sad sight to see somebody who's just had their injection, shuffling along the corridor like a zombie.

Although strictly speaking this is not supposed to happen, I dictated the medication I wanted. My notes from my psychiatrist in London had not travelled up to the North of England with me, and my new doctor (General Pracititioner) knew nothing about me. The clinical team had to take my word as gospel.

I'm now wondering whether to be compliant with the medication that I decided I wanted, or not.

tags: #mentalhealth #bipolar #medication

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

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.

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

This is a story about modesty...

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.

Tags: #hospital #nhs #mentalhealth

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

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.

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.

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.

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.

Tags: #hospital #mentalhealth #nhs

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

It all looks rather counter-productive to me.

Tags: #addiction #hospital #mentalhealth #nhs

This is a story about being observant...

Where do blue tablets actually come from? Well, presumably they are pooped out by blue fish, like the ones that can be seen swimming here on the pavement and road. Can you see them - the little blue fishies?

With our Sherlock Holmes deerstalker hat on, puffing from our pipe, we might deduce from the proximity of a large hospital and the lack of water, that these are not actually fish. What could they be?

An electroencephalogram (EEG) is a graph of what's going on in our head, quite literally. En kephalé means "in head" in Greek, and the gram bit means "written down". Electro should be relatively self-explanatory.

Were these fish involved in seeing what was going on inside somebody's head? No, I don't think so.

An electrocardiogram (ECG) is a graph of our heartbeat, as denoted by the cardio part.

In order to know what our heart's doing, we are all very familiar with the stethoscope, but there's a more accurate test that doesn't depend on human hearing. The muscles that pump the 4 chambers of the heart never stop unless you go into cardiac arrest or otherwise die. Muscles give off tiny electrical impulses, and these can be measured with highly sensitive equipment - an ECG machine.

So what about these fish? Well, it looks like they're the little sticky electrodes that are put on each of your ankles, arms and across your chest around your heart. When you are hooked up to an ECG machine, you've got a stack of cables attached to you.

One of my fellow patients at the hospital was in such a big hurry to get rid of these stickers, after having the health of their heart measured, that they tore them off and discarded them onto the floor, quite possibly in a fit of rage at having been cared for by one of the finest healthcare systems in the world. It's quite understandable that having received lifesaving treatment that's free at the point of use, this individual should have ripped these electrodes off their body and tossed them onto the road and pavement - that'll teach society a lesson, now that a street sweeper will have to come along and clean up this trash!

We might note that there are only 4 stickers, and we can presume that these are the ones from the person's wrists and ankles, which would have been most conspicuous. Perhaps it wasn't until the person explored their body later, that they found 4 more on their chest - one of which was lurking around on their left hand side and might not even have been discovered until a later date.

Debate rages in the United Kingdom, about whether we should have penalties to discourage people from treating the National Health Service disrespectfully. We could charge people for a no-show to a General Practice (GP) or outpatient appointment. We could charge people for any visit to Accident & Emergency for trivial matters that could have been treated at a minor injuries clinic, or perhaps did not require medical attention at all.

There is evidence that we are starting to allow a two-tier society to emerge where none is supposed to exist. Doctors' waiting rooms have plush leather seats for 'VIP' patients - who are paying for private consultations - while the NHS patients sit on hard wooden chairs. For an operation, paying to go private might mean skipping waiting times, even though it will be the same surgical team, in the same hospital, with the same equipment and in the same operating theatre. Although it's not supposed to happen, surely some of the waiting times are because private patients are queue-jumping?

Those at the bottom struggle with zero-hours contract minimum wage jobs, with the purchasing power of their pay packet decreasing every month, due to inflation. Things are not a lot better on the next rung of the ladder - an NHS Clinical Support Worker's salary tops out at around £15,000. That's £259 a week. Ouch. My rent in London was £480 a week. The wealth disparity is disgusting, isn't it?

While the cost of housing and the cost of energy - electricity and gas - is skyrocketing with double-digit percentage increases, wages barely increase at all. One only needs to look at the use of food banks, to see that the little people are struggling - people who clean your toilet, scrub your floor, wipe your bum, cook your food, stack your shelves and scatter rose petals along the privileged path that you walk. But, these spoiled brats still vote for a ruling elite who care nothing for the wails of distress that are now becoming a deafening scream of pain.

The bulk of the BBC was moved up to Manchester a few years ago, and it's been quite evident that it's had an effect on the mindset of the people who work for the broadcaster. In London, the homelessness problem is inconspicuous in wealthy districts, but in Manchester - where homelessness has soared 1,100% in just 7 years - the problem is inescapable. The BBC has shown a number of documentaries which accurately reflect exactly what I have seen and experienced: there are vast numbers of people in dire need of assistance.

Who wants a McJob that doesn't even pay enough to be able to rent a room in a shit apartment, and have any life at all? Does it surprise you that people are smoking strong synthetic cannabinoids which allow them to escape the stress and hopelessness of a hideous reality that nobody in Government seems to want to address.

There's a crisis that's going on all around us. Pull back the covers and human tragedy is unfolding underneath.

This is not a "wake up sheeple!" alarmist or sensationalistic think-piece, but in actual fact an unfliching and painfully truthful account - I bear testament to what I've seen - of the shocking disparity between London and the South-East, where our wealth is concentrated, and the rest of the United Kingdom where things are very grim indeed.

We talk about the 'Westminster Bubble' and I can attest first hand what it's like. At the beginning of this year I was at the grand headquarters building of Her Majesty's Revenue Collectors (HMRC) and it had been refurbished to an incredibly high standard. I was taken to an extremely grand room, which was capacious enough to hold at least 50, maybe even 100 people, but only had me and the two people interviewing me. Otherwise this space was left empty and unused, so far as I could see - perhaps a metaphor for all the empty homes that have been bought by foreign investors in London.

Meanwhile, it was barely two years ago that I was in social housing apartment (council flat) in London, which was in such a poor state of repair that there was literally 2 inches of water that one had to paddle through, in order to use the toilet or a terrible shower that barely worked. It's quite clear where our tax money is going - tax breaks for millionaires, not houses for nurses.

Bursaries for nursing have now been removed, so our nurses will emerge with the best part of £60,000 of debt when they qualify, which will further reduce their take-home pay. The interest on a student loan of that magnitude is more than 12% of our nurses' starting salary of £22,000, which means they will sink deeper and deeper into debt each year.

Who will mop up your sick, piss, vomit, blood, mucous, pooh, give you a sponge-bath in bed, say soothing things and give you painkillers when you cry out in agony, come running when you press the call button and generally make you as comfortable as possible when you're unwell?

As comrade Corbyn said: a millionaire in their mansion is going to need an ambulance if they have a heart attack, just like anybody else.

Tags: #nhs #hospital #politics

This is a story about winning a prize...

This week's big climber in the UK top 40 is a new single from the National Health Service. This band has been churning out smash hits since 1948 and is loved by tens of millions of fans. Here on Top of the Pops tonight, you'll see a live performance from this sensational act. Keep watching to find out what the UK's number one hit single is, at the end of the show.

Here on this page are the dry words of a deranged individual. How will you choose to interpret them?

Language is a rather crude and imprecise tool to fully express ourselves. Ambiguity creeps in and the thoughts and feelings of the author are not communicated with high fidelity - each reader will arrive at a different impression from the text.

As a software engineer who's been building systems for some of the world's biggest companies for over 20 years, I could easily copy Uber's dastardly tactics of diverting any web requests from a certain region of the country - e.g. a specific city in the North of England - in order to display a different page.

Most of my readers are using smartphones or tablets. Readers who are using Windows XP and Internet Explorer are quite unusual, and it's easy to flag up those anomalies - they stand out in the data that I gather about my visitors.

It's not hard for tech companies and technologists to present something that has been customised and tailored for each visitor. You might think that you'd see the same Google search results as somebody else, for example, given the same search terms, but Google works very hard to identify individuals, even in their anonymised dataset.

Traditional print-media widely reports that we are living in social media bubbles, where we are fed things that we like, because we're more likely to share that content and spread it 'virally'. What is less well reported is how wedded we are to the walled gardens that we live in - Facebook, Twitter, Instagram, Snapchat et. al.

How long are you going to keep reading for? There's nearly 700,000 words here. Are you gonna read it all?

The best defence against anybody who would seek to jump to the wrong conclusions and make silly assumptions, is to present more data than can be reasonably processed - information overload - such that the farcical nature of reducing the complexities of life to some pathetic synopsis, are exposed as pure stupidity.

Of course, we would all love to feel that we understand all the laws of the universe. I've fried my mind with stacks of books and papers on theoretical physics, attempting to understand the fundamental nature of reality itself. Emotionally, I don't want to admit defeat, but digging deeper only seems to reveal even more unfathomable weirdness. Some of the quarks are called strange, charm and beauty. I love that.

Are you bored yet?

Can you not see that my intention is to create a maze of complexity that's impenetrable? It's not possible to know my mind. Even for me, I struggle to understand fully why I say and do the things I do. If it's hard for me, it's going to be impossible for you to dissect or categorise me; to judge me and to simplify me into something that can be captured by written language on a sheet of paper. What are you going to write in your report or your email?

There's mockery and disdain here, but if you dig a little deeper I hope you see that I don't have disrespect for anybody whose intention is to help and support me, and I have no intention of damaging my own treatment and recovery, nor anybody else's, nor cause any difficulty for the hard-working staff of the National Health Service and the ancillary support services.

Today, I'm a free man - an informal patient - but that puts me in an additionally vulnerable situation. I could be discharged from the hospital without a discharge plan - no place to live and no income. I'm sure some pen-pusher somewhere sees the opportunity for a quick win - am I just a statistic on a monthly report?

It upsets me that front-line staff have been cut, while middle managers have plenty of time on their hands to justify their pointless existence. The managers have survived the cull, the pay freeze and the excessive demands placed on the over-stretched people who actually do the damn job. Police, NHS workers, teachers - to name but a few - are getting a bum rap.

The first thing that I'm excited about doing with my newfound freedom is going to a protest at Tory cuts and austerity, to co-incide with the start of the Conservative Party conference, in a certain Northern city. The establishment are coming to me, and I will thumb my nose at them and boo them. A friend suggested that I could throw eggs and if I got in trouble with the police, they'd probably just bring me back to hospital on a section 136... put that in your damn report.

"Risk to the community - possibly going to throw eggs at Theresa May, to protest against cuts to front-line services and damage to the NHS, as well as undue stress on the police and other workers who care for and protect our most vulnerable members of society".

Tags: #hospital #politics #nhs #police #socialmedia

This is a story about customer service...

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.

Tags: #hospital #mentalhealth #drugs #addiction