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 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 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 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

This is a story about insecure housing...

She said she wanted to be a widow. She marked my suicide note with red pen, filling it with abusive language. I didn't feel safe in the house with her - she would rage and kick and punch the door I'd put between us to protect myself. I was afraid to use the toilet or otherwise leave the room I'd barricaded myself in for my own protection. I wasn't eating. I wasn't afraid without good reason - she'd battered my face not once, not twice, but three times. She'd had her three strikes and I'd had to go to work saying "I walked into a door". I'd had to make excuses for her violence to her parents... to explain away my black eyes, my broken nose.

The abuse had caused me to start self-harming. Later, I started smashing stuff up. We had blazing rows, but, it was always me who ended up locked in the spare bedroom, afraid for my own safety. It was her who got stronger and stronger, while I got weaker and weaker; sicker and sicker; more and more afraid; more and more isolated. I was suicidally depressed and I was trapped. How was I going to escape this abusive relationship? Where would I go? I'd lost so many friends because of her. I'd lost my identity. I'd lost my self-confidence.

She said she'd rather that I died rather than go into hospital. I needed to go to hospital. I was suicidally depressed, but she said if I did go into hospital she'd divorce me. I said that it was life or death... that my suicidal thoughts were so bad I couldn't keep myself safe. She said she'd rather be a widow.

My friends in London took me in. They tried to keep me safe during an incredibly acrimonious divorce. They supported me. They cared for me. I stayed in their spare bedroom until the house was sold and the divorce had been through the courts.

Then I tried to kill myself.

I moved out of my friends' house and I immediately tried to kill myself.

I couldn't kill myself while I was living under their roof - it wasn't right, because they'd helped me so much. They'd helped me escape my ex-wife, but I'd lost my house and what little self-esteem I had. I'd nearly lost my new business. I nearly lost everything. I had just about enough money and energy left to move out, but then I tried to kill myself because I was jobless and sick, living in a shitty shared apartment in a crappy part of London. I was all alone.

Things got worse. The hospital discharged me into a hotel. I said I didn't want to go back to that town where my ex-wife lived. There couldn't have been anything worse psychologically than being forced to go back to that town where she lived. The hospital took pity on me. They discharged me to a hotel. I had 2 weeks to sort out my life.

Inevitably, I became homeless. It was impossible. I was sick. How was I supposed to navigate the complex bureaucratic nightmare that is the UK housing system? I was refused a hostel bed. I was refused supported accommodation. I was told I could get housing benefit, but no landlord will take somebody who pays their rent with "DSS". Housing benefit doesn't pay enough to rent a place in London anyway. What was I supposed to do?

I ended up sleeping rough in Kensington Palace Gardens, and later Hampstead Heath. I bought a tent and made camp in dense undergrowth far away from the main paths. I used all my expeditionary experience to hide myself and sleep under the stars.

I lived in hostels. The hostels brought me into contact with a social group. Socialising made me feel better about myself  - people liked me; I was popular. My self-esteem started to improve.

I rented a little room in a student apartment. It was cheap, for London. They were nice kids, but they were messy students - they were trashing the place. They were partying all the time. It was hard for a thirty-something man with a full-time job at a bank to mix those lifestyles. It was hard when I left the homeless community. It was hard when I transitioned from being homeless to re-entering civilised society. There was a culture clash. I lost most of my friends.

I went back to living in a hostel.

I rented an amazing apartment on the River Thames with panoramic views over London. It wasn't my idea. A friend thought it'd be a good idea to spend a hefty portion of my monthly income on a super-luxury apartment. "You deserve it" he said. Seemed like a good idea at the time. He wanted to live there rent-free, of course. Other parasites came, wanting to live there rent-free too. I found it hard to turn them down, because I'd been homeless. I was a soft touch. I was taken advantage of. I'm owed thousands and thousands of pounds in unpaid rent and bills.

I spent the best part of 2 years living in the same amazing apartment. It was stable, but it wasn't. I had to have an incredibly well-paid job to pay for the rent. It was well beyond my means when I wasn't working. When I was well enough to work, it was a nice reward for my efforts, but the pressure to maintain the lifestyle wasn't sustainable. I got into debt, just so that I could have a place to live and not end up back on the streets. Moving is stressful. I didn't want to have to move again. I had the threat of financial ruin hanging over me the whole time.

I took a contract in Manchester because it came with a relocation allowance - an apartment. I never wanted to live or work in Manchester, but I was desperate. Out of sheer desperation - I was almost broke - I accepted the job and relocated. I didn't know anyone in Manchester. I tried to kill myself.

Of course I tried to kill myself. It was all too much to bear.

I ended up in hospital in Manchester. Of course I ended up in hospital again. I'm so vulnerable; my life is so fragile. I needed that safety; that security.

A stranger contacted me via email to say they'd read my blog. Did I want to live with them in Wales, they asked. At the time, I was living on a psych ward in a dormitory. Of course I wanted a bit of peace and quiet; a change from the insanity of the psych ward. Of course I wanted a stepping stone to a better life... the revolving doors of the institutions and welfare benefits have little to offer, except for days spent dribbling while watching daytime TV, doped up to the eyeballs on incredibly strong psychiatric medications.

I rented another apartment.

The stress peaked and I wanted to kill myself. I thought that the local job was going to fall through, I thought that the apartment was going to fall through, there was conflict with some people. Everything was falling to pieces. The stress was too much to handle. I was going to kill myself.

The stress peaked and now I'm lying on my sofa writing this, in my own place. I've got my own roof over my head, which is affordable. I've got the things that most people take for granted: money, a place to live, a partner, a job, a car. I've still got stuff that'll take time to fix, but it's so much easier when your living arrangements are acceptable, rather than impossible. Living in a hostel is OK when you're unemployed and single, but I've tried working a 'straight' job while living in a 14-bed hostel dorm, and it's impossible... trust me on that one.

You might think I'm spoiled and privileged. You might think that it's unfair that things are working out OK for me, when there are so many people who have things so much worse than me. Vulnerability is vulnerability though, and I've been so close to death so many times. How many times have I been in hospital, in the Intensive Treatment Unit (ITU) or high-dependency wards? How many times have I been on the brink of bankruptcy? How many nights have I slept rough? How long have I lived in hostels? Do you begrudge me my recovery?

There's more work ahead. I still need to dig myself out of a hole. I'm not out of the woods yet. I ran up debts just staying alive, which I need to repay. I need my income, to allow me to pay down my debts and build up a financial cushion in case I get sick again. I've got bipolar disorder, which means depression, mania and hypomania can all cause major problems in my life - there's no cure for this, and it can be really destructive when I have an episode. I need to stay well, but I don't have any choice in the matter.

So much of my precious stuff was lost, stolen, broken or has otherwise disappeared, during my lengthy escape from that abusive relationship. It's caused so much damage to my life, getting away from my ex and that horrible situation. I jumped out of the frying pan and into the fire. Yes, it's true that at times in London I felt like I was making some progress, but there was too much pressure on me... too much pressure to maintain an unsustainable lifestyle.

Here in Wales life seems simpler; easier. There's less traffic, less crowding, less congestion, less pollution, fewer people, less competition, less crime, less noise... it's just a lot calmer. I feel like I'm calming down.

I can see the sea from my apartment. I can see the sea.

I used to own a house by the seaside.

I'm happy by the seaside.

Now, I'm starting to get my life back. I live by the seaside again. I'm not far from the beach. I can see the sea.

This is the journey I've been on. From domestic violence - domestic abuse - to domestic bliss. I'm a lot happier now I'm not having to barricade myself behind doors to protect myself.

Tags: #homeless #divorce #relationships

This is a story about pseudonyms...

I've moved house. I now live at the following address:

Mr Nick "Manic" Grant
Number One
Wales
United Kingdom

Send me a letter. I'm sure it'll get delivered. Pay me a visit sometime. Search for my address on Google Maps to see where I live.

The man who has nothing has nothing to lose.

I got used to the anonymity of London; the urban solitude; the crowds. I got used to my life being completely destroyed. I was always closer to death and destitution than I was to recovery and happiness, so I didn't care about my privacy. In fact I really did care about my privacy: specifically I didn't want to have any privacy, because I wanted the world to know all the reasons why my life was falling to pieces. I wanted witnesses. I wanted people to understand why I was dying or dead.

Things are different now.

When I recovered in London and got off the streets and back into civilised society, I still wasn't part of a community. In fact, I lost the community that I belonged to. I used to be a member of the homeless community, but then I got a nice apartment and I was no longer homeless. Twice I got myself off the streets and into a place of my own. Twice I dug myself out of a deep hole and sorted myself out... perhaps even three times. Each time everything fell to pieces.

I leapt at the chance to move to Manchester because I was homeless and bankrupt. I found a kind of community in Manchester... a community of addicts. That wasn't good.

When I was offered the chance to move to Wales, I was homeless and running out of money fast, and I was a patient on a locked hospital psych ward. In Wales I have found a community. It's a small place. People know each other. There are fewer degrees of separation. There isn't the anonymity of a giant city with millions of inhabitants. London has 9 or 10 million people. Manchester has the best part of 3 million people. That's more than the entire population of Wales.

I've made numerous assumptions about people's ability to make connections. I've assumed that by not mentioning names, places, dates etc. then I've managed to obfuscate anything that would allow anybody to be identified. I've assumed that nobody would have any idea who I'm talking about - or ever be able to discover who I'm talking about - when I write "my friends" or "my girlfriend" for example. I've steered clear of using the initial of the first or last name, or anything else that might be vaguely identifying.

Having lived out my life publicly on the pages of this blog for the best part of 3 years, I'm quite used to having visitors from all over the world reading my stuff. It's quite normal for me to tell the entire world all the gory details of my murky past and dodgy deeds. I'm pretty transparent; an open book.

Somebody from where I work has found my blog. I've upset some people who are very important to me, inadvertently, by writing something that I have subsequently deleted. To refer to these events is a risk. Those people will be able to identify themselves even if nobody else would ever be able to discover who I'm talking about. I guess my work colleague - for example - is thinking "how the hell?" and feeling a little spied on. My justification for writing whatever the hell I want has always been that you chose to come here and read all about me, which kinda means I'm allowed to know that you've been reading. If you have an opinion about me, I'll have an opinion about you... and I might share that opinion, although anonymised so only you know who I'm talking about.

Upon reflection, I've got too much to lose. I like my friends, my girlfriend, my job, my apartment. My life is going OK and we're coming into spring. My mood is improving. The future looks really great. Things are going really well now that I've overcome a whole heap of super-duper stressful stuff. Upon reflection, I'm no longer the man who has nothing, who has nothing to lose.

When I was down on my luck, I had no responsibilities because I couldn't handle any responsibilities. I didn't owe anybody anything, because I didn't have anything. I'd lost everything, which liberated me. I'm no longer liberated. I have to act responsibly.

I need to treat friends with respect. I need to treat my girlfriend with respect. I need to treat the local community with respect. I need to treat my colleagues with respect. I need to treat my profession with respect. My conduct needs to completely change from the kind of conduct that was appropriate for a destitute homeless guy with mental health problems, into conduct more befitting of the fine upstanding member of society that I'm now supposed to exemplify.

It's a transition period. I need to move from the old world to the new paradigm, where my life is improving and I've got lots of good things that I want to hang onto. I'm bound by the Official Secrets Act, as if to remind me that my old life of writing whatever the hell I wanted is now over.

I'm not sure how I'm going to use my blog as a healthy coping mechanism anymore, but I've just been through one of the most ridiculously stressful periods of my life, and it literally nearly killed me - I'm not being hyperbolic. I hope that I'm naturally not going to need to write "cry for help" or "angry rant" type pieces to dissipate the negative emotions and avoid killing myself. I hope that one day this might change from being a suicide note to something else. I have hope. I'm working towards a brighter, happier future.

There are going to be bumps in the road, I'm sure, but I really don't want to piss off my friends, girlfriend or work colleagues. Obviously, I have those people in my life and it might be unavoidable to mention them using those anonymised monikers, but I'm not going to be writing about them if you know what I mean. It'd be nice if can hang onto some of the good things I've gained in my life. It'd be nice if I can start to grow my group of friends rather than continuing the destructive patterns.

I doubt I'm going to write under a pen name; a pseudonym. I'm loud and I'm proud. This is the journey I've been on and I'm good at what I do. Why should I hide? Why should I be anonymous?

However, I appreciate that most other people are at completely the opposite end of the privacy/openness spectrum from me, and don't appreciate even the tiniest little things being splurged all over the pages of the internet, no matter how anonymised they are. Though I can't fully relate, I can respect those wishes and attempt to change my wicked ways. Sorry.

Tags: #writing #socialmedia #homeless #wales

This is a story about seeing things through a blue filter...

Three years ago I rented a lovely apartment by the River Thames. It was very stressful going through the process of getting off the streets, out of the hostel and into a place of my own, but I did it. Soon after moving in, I realised that the whole ordeal had taken me to the brink of a nervous breakdown. I had myself admitted to hospital - a psych ward - because I was afraid that I was going to commit suicide. The London apartment completely over-stretched me financially, necessitating a big money contract to pay the rent, although as a proportion of my income it was very affordable.

I'm attempting to rent somewhere new. The cost is only a fraction of what my rent was in London, but I'm earning the same amount of money as I was in London. The cost of living is so much less in Wales. I've managed to earn enough money to pay lots of rent up-front if I really needed to, so I'm in a much stronger position than I was in London. It's still stressful though.

What am I going to do if everything goes to plan? I'll have nothing to complain about.

Perhaps I seem like a broken record, complaining about my lot in life when I'm very lucky, fortunate and blessed. It must seem to you like I lead a charmed existence. It must seem to you like everything goes my way and I get everything I want. It must seem to you like I worry and complain about nothing.

I complained about my cashflow; my finances. I complained about living out of a suitcase. I complained about being bored, isolated and lonely; not working with a team of people. I complained about having to go through a security clearance vetting process. Now I'm complaining about the tenancy application process. It seems like I just love complaining.

I don't love complaining. I need the things that you take for granted: friends, a partner, money, a job, a car, a home. I complain when I'm missing something essential from my life. I complain when something's not right and it's unbearable; intolerable. It's true that I had a job and I complained about it... that's because I didn't have any work to do or anybody to talk to, which was horrible. I don't complain without good reason.

For three consecutive years it appears like I managed to get everything I ever wanted and needed, but then I screwed it all up and threw it all away. Only a year ago I apparently had it all, only to then self-sabotage. Maybe I don't really want to sort my life out?

The amount of time and effort involved in repairing my life is quite staggering. It's not easy to come back from the brink of irreparable disaster. It's not easy to come back from the dead. The kind of self-resurrection process that I've made appear quite easy and routine is not easy at all. The kinds of 'everyday' stress and anxiety that you think that you face in life - such as starting a new job or moving house - are actually incredibly rare occurrences that cause you a great deal of distress. Imagine having all the most stressful experiences in your life condensed into a time period of approximately a month - that would surely be too much stress to handle, wouldn't it?

Yes I'm a broken record and I'll probably keep repeating myself until I have a signed tenancy agreement and a bunch of apartment keys in my hand, or my [current] worst fear is realised and I'm marginalised; destined to remain homeless.

Yes, other people experience stressful events in their lives too. Good for them. I'm not looking for reasons to be negative. I don't think that I'm not going through the same kind of job-hunting and apartment-renting processes that other people have experienced in their lives. It's just that things are a little more life-or-death for me because I've been through hell to get where I've got and I'm exhausted; I'm at the limit of the shit that I can take.

Sorry for repeating myself.

Tags: #apartment

This is a story about three snapshots in time...

Here's a picture of what my life looks like tonight. That pile contains almost everything that I need each week. In a single holdall, I can transport my work clothes, my regular clothes, a few toiletries and a handful of other things that I use regularly. I live out of this bag. This is my mobile life.

This is what my life looked like 6 months ago. Here are my bags in the psychiatric intensive care unit (PICU) where I was locked up for a week. I was discharged from my section at tribunal after 12 days. I stayed in the psychiatric hospital for about 3 weeks in total, most of it voluntarily. Note: it's the same black holdall as pictured at the top.

This is what I managed to reduce my life to so that I could leave my apartment in London, when I was forced to take a job in Manchester because I was close to destitution. This is everything that I took with me when I left the city I've lived in for most of my adult life - in fact longer than anywhere I've lived in my entire life - to go to a city I'd never visited before and a flat I'd never set foot inside.

Most people take a stable home for granted. Most people have friends or relatives who they could live with if they fell on hard times. Most people find moving house to be one of the most stressful things they ever do, and they don't do it very often.

I was no fixed abode. I slept rough and I slept in hostels. I slept in dorms with up to 13 other farting, snoring people, making noise around-the-clock. I've been either on the streets or on the verge of being back on the street for longer than I care to remember. I've either been homeless or had the threat of homelessness hanging over me for an unbearable amount of time.

I viewed an apartment this evening. That's the view from the lounge. Yes, it's really soon to be thinking about renting my own apartment, but I've been on a hell of a long journey. I was born in Wales. I've come home to Wales. I want to live here. I want to put down roots. I want to stop moving from place to place. I want to stop living out of a suitcase. I want to feel like I have a place I can call home that's mine.

I'm incredibly grateful to my friends for letting me live with them. Taking in a mentally ill homeless junkie alcoholic thief beggar bankrupt loser murderer baby-eater was a brave thing to do. It was so kind and generous of my friends to risking having a horrible monster like me in their family home. It shouldn't be understated how much of a big risk it is to take in a homeless person and give them a chance to get back on their feet. My friends have nursed me back to health.

The journey isn't over. I need to keep all the plates spinning. I need to continue to maintain my friendships, keep doing a good job at work, keep developing my fledgling romance, keep my car running and the money flowing... it's not easy. Theoretically, I have enough money to pay 12 months rent. In practice, cashflow is going to be really tight. It's going to be super stressful going through all the hassle of renting a place to live... like, how do I explain that I haven't got a reference from a previous landlord? Perhaps I can show them the excellent feedback that I've got on my AirBnB profile from all those different places I stayed in London during the last few months.

Oh my god it'll be so good to finally unpack. It'll be so good to have my own place. It'll be so good if I can get a bunch of the pieces of the puzzle all in place at the same time.

Tags: #homeless

This is a story about past performance as a guarantee of future performance...

In the space of a few photos - arranged chronologically in my album - we jump from my wedding, a Formula 1 racing circuit, skydiving and dawn breaking over London, photographed from Primrose Hill. These were the only things that seemed worthy of a photograph, sandwiched in-between my honeymoon and my separation from my wife. My niece was born in this period, but I keep my special photos in a different place from my everyday snaps - I photograph a lot of random things for my visual diary.

I was chatting to a friend and former colleague and he asked me if I'd "dealt with any of [my] demons?". I wonder what he meant. When we started working together I was nearly bankrupt, living in a hostel (i.e. homeless) addicted to drugs and having mental health problems. Yes, I suppose I've dealt with a few demons. I don't want to make excuses for past mistakes, or assume that everything's going to be plain sailing again in future, but that job we did together where I was working six and a bit days a week, 12 to 14 hours a day, and trying to get myself clean and off the streets.... it was a challenge.

There was that time that I moved to a city I'd never visited before, moved into a flat I'd never set foot in before and started work on an incredibly ambitious project, with no team supporting me. I had a tiny hiccup - also known as a medical emergency that left me in a coma in intensive care - which caused me to lose two days at work, and that was the end of that, even though I'd delivered 85% of the project.

A guy rang me up, asked me if I could do a piece of work for him. I said it would take me 6 weeks. He asked if it could be done in 3 weeks. I said it could, but the end result would be rubbish. I've been working on that project for 12 weeks and the result is great... in fact, I finished 6 weeks ago and I've been killing time ever since, because there isn't anything left to do but the guy wants to retain my services. This guy STILL wants to retain my services. One very happy client. I'm not good at being bored though.

Wherever I've gone, I've delivered value; I've improved things; I've earned my money. Wherever I've gone, I've made stuff work, on time, exceeding expectations. Wherever I've gone, it's been of substantial net benefit to my client. However, the mileage has varied.

During that period when I didn't take many photographs, I spoke to my boss. He'd rung me up to congratulate me on a really important piece of work that I'd done, and tell me that I was getting a special commendation award and a hefty extra unexpected bonus in my pay packet. Ironically, I was just about to go into hospital for a month-long stay. I knew I was sick. It was bizarre to be having this conversation, knowing that I was in the middle of a crisis.

Some people are steady Eddies. Some people will be consistently mediocre. Some people will never disappoint you, because they inspire such abysmally low expectations. I've never really had much interest in steadily and slowly plodding my way towards low quality, late, over-budget and depressingly below-average outcomes for projects that ultimately end in failure. Fail fast.

We're very afraid of failure in the corporate world. Nobody fails, in fact, we just succeed in unplanned ways: "think about all the lessons we can learn from this project" we say, as we realise that it's a pile of stinking crap that's never going to fly. It's not really in my DNA to be part of that culture.

Failure is a huge part of who I am. Failure to get to work on time. Failure to get through an entire year without having a single sick day. Failure to be content to just take my wages and ignore problems; not try to improve things; not to try to make things into a success. I fail. I can get sick. I can drink too much coffee and start shooting my mouth off - become overconfident, arrogant and deluded due to lack of sleep and too many stimulants - and I can become depressed and unable to get out of bed. Sue me. I get shit done. There's my consistency: when there's a deadline, I consistently meet it. I consistently deliver on time and on budget. I'm highly INconsistent when it comes to when I'm going to turn up in the office, or even IF I'm going to turn up in the office for a few days.

With this do-what-the-fuck-I-want kind of attitude, I've had a string of successful projects and happy bosses and clients, but it occasionally causes resentment amongst the morning-lark steady-Eddies whose only virtuous attribute is that they're always there at their desks on time, despite the fact they're fucking useless at their jobs. In fact, this statement is unfair. An organisation needs a mix of steady Eddies and sprint'n'coasts. I don't really sprint and coast... it's more like work my bollocks off and burn out a little bit, but it gets stuff done.

It's difficult for me, because there will always be some bosses who will gleefully receive the fruits of the labour from those incredibly productive periods, and then think that it's 'normal' and sustainable. When it becomes expected to work at a super high level of intensity, there's no gratitude for the incredible cost of such a feat, and there's no allowance for the fact that for every up there must be a down - people have to be given time to recover after exerting themselves.

I really don't think that there's a 'slow and steady' way to achieve some things. Fast is the only way to go, and the faster the better. The sooner you see something that's real and tangible and working, the sooner you know whether it works the way you expected it to or not. There's no value at all in something that's only half-built. I'd rather have people say "I wish it did this AS WELL" rather than "I wish it worked". Even if people say "that's not what I expected" at least they've got something that they can use, or can serve as a prototype.

A lot of managers don't really know what they want when they're recruiting. They'll hire a lot of folks who are very good at playing buzzword bingo, answering interview questions and keeping a low profile in organisations so they can keep getting paid - but those aren't exactly great qualities for getting projects delivered.

The precarity of my situation should have pushed me towards meek compliance - perhaps I too should have learned to keep my mouth shut, cover my arse and spin jobs out so that they last as long as possible. Perhaps I too should have learned the fine art of looking busy and coping with the soul-destroying nature of pointless work and projects that are doomed to failure. Perhaps I need to stop caring so much. Not my circus, not my monkeys, right? Not my money, so I shouldn't care, right?

I feel terrible imposter syndrome, because I've had a turbulent few years. I feel terrible imposter syndrome because it wasn't very long ago that I had a pretty horrendously insurmountable heap of problems. I feel terrible imposter syndrome because my past performance is no guarantee of future performance, despite a 20+ year career where my achievements completely eclipse and nullify any of the very few hiccups, none of which has meant that there hasn't still been a successful project outcome.

I don't know how to characterise myself. In the corporate world, nobody talks about any difficulties they've faced - everything is given a positive spin. In the corporate world, gaps in your CV and things like that are severely career-hampering blemishes; black marks. I think it's a huge strength, that I've made positive contributions to important projects, despite having to deal with some incredibly difficult things in my personal life at the same time. If the corporate world could wrap its tiny mind around it, I'd love to give the background context to my employment history.

Thus, mileage can vary. If you hire somebody who's never had a problem in their life, assuming that their spotless record is going to remain so forever, you might be disappointed if they ever face any difficulties, because they're probably not the kind of person who's ever had to deal with challenging circumstances. You might hire somebody because they've never had a mental health problem, but anybody can get depressed. A person who's experiencing problems for the first time in their life is going to be less able to cope and communicate and manage effectively, than the person who's been functioning with those kind of problems in their life for years and years. Every set of circumstances is different. Every set of pressures is different. Every time is different.

I just keep rolling the dice. As long as I'm allowed to keep rolling the dice, I'm winning more than I'm losing.

Tags: #career #mentalhealth #bipolar #depression

This is a story about quality of life...

You would have thought that rock bottom would come when you're sleeping rough, arrested by the police, thrown into a cell, you've spent all your money on drugs, you've got a physical dependency, you end up hospitalised or locked on a psych ward. You would have thought that losing your job, your apartment and tarnishing your otherwise squeaky clean CV, credit score and other things that are important to give you access to well-paid respectable work, would be the most crushing blow. In fact it's the lead-up to the point where you lose everything that's far worse. Once you're cut adrift and tossed by the wind and the waves, then you might as well just relax and go with the flow.

I woke up this morning, having been awake since 3am, worrying about the tricky transition between two contracts that are worth six figures, annually. It's a nice problem to have, right, to have two companies offering to pay you big fat wads of cash for your time and expertise, but the reality is somewhat more complicated.

I've drained my business bank account, because I've needed to buy plane tickets, book hotel rooms, train tickets and AirBnB rooms. I've been working for three months, but I'm still waiting to be paid - these are the commercial challenges I face. You've got to speculate to accumulate.

I have borrowing facilities available to me, but a substantial portion of my income is wasted on interest, paying for the money which I've needed for cashflow. Cashflow is tight when you're only managing to work 12 weeks a year, because you've been so unwell. I was hospitalised with DVT and both my kidneys had failed. I was hospitalised after a massive overdose - a suicide attempt. I was hospitalised and sectioned for mental health reasons, for my own protection. These are considerable obstacles to earning money, despite the fact that I discharged myself from hospital against medical advice, so that I could struggle into the office and not lose my job... but I lost it anyway. After my suicide attempt I struggled into the office, but I lost my job anyway.

I'm struggling into the office every day. I'm working Tuesday to Friday, for 4 hours each afternoon. My colleagues look at me like I'm taking the piss, as I saunter in at lunchtime and leave soon after 5pm. I travel across the country on a Tuesday morning, and I travel back the other way on a Friday evening - over 3 hours each way, which some people might scoff at. I know that there are many people who do long commutes, but I doubt many of them do them in the same year they were hospitalised as many times as I've been, due to medical emergencies.

This is my rock bottom - I'm only able to work about 16 hours a week, but it's killing me. I woke up this morning and I'm properly physically sick. If it hadn't been for the fact that I had to check out of my AirBnB, I would have stayed in bed. You'd have stayed in bed too, if you felt like I do. This is rock bottom - struggling along and barely managing to survive, even if you think that my situation is not very desperate.

I'm quite qualified to tell you what's desperate and what's not, because I've slept rough on the streets; I've lived in 14-bed hostel dorms and psych ward dorms. It's not a competition. Either you accept that I know what rock bottom looks like, or you don't.

What you can't see - because you only look at the good bits - is how quickly my life could unravel. I've got no safety net; I've got no cushion. My life hangs by a few slender threads. Of course I accept that I've had a run of good luck, such that I haven't ended up bankrupt and sleeping rough again. Of course I accept that I've had a run of good luck that there are still opportunities available to me; there's still a slim chance that I might rescue myself from my desperate situation.

There's an infantile attitude that I have to constantly suffer, like life is simple and all I need to do is get a job stacking shelves in a supermarket. You don't understand how real life works. You're not acknowledging reality. In reality we can't just abandon all responsibility and pretend like it's not psychologically destructive to lose hope; to have our dreams shattered. Loss of status and having a black mark against your name is a big deal. Being chased by debt collectors and bailiffs is a big deal. Having court summonses and court judgements and being sued into oblivion is a big deal. Getting fines and charges and all the other things that get slapped onto a poor person whose life is imploding, is a big deal. Real life... REAL LIFE involves earning as much money as you can, so that you don't have to take a calculator with you to the supermarket and ration out the value-price beans. Your infantile fantasies that we can just abandon everything that society holds dear - bank accounts and credit checks - and instantly switch our lives to be free and easy... this is complete and utter horse shit.

The reality of life is that there's a great deal of precarity. It might not look like it, but I've worked very hard to get myself back on my feet and I'm still a long way off. It might not look like it, but I couldn't have put in any more effort; I couldn't have handled any more stress - it's enough to give the most stable and secure person that you know a massive nervous breakdown. Eventually, we all reach our breaking point. We can't tolerate mental torture forever.

I've got my 3+ hour train journey, then a night in one place, a night in another, a night somewhere else, then it's back on the train, back to my job, time to check into yet another AirBnB I've never set foot in before. I need to buy two birthday presents, get a haircut. I need to do some washing. None of this is beyond the wit of man, but I'm so mentally and physically sick that I need to spend at least a week in bed, but I can't. I've got to keep the plates spinning.

Yes there are parents out there who are stressed out of their minds. Yes there are starving Africans. Fuck the fuck off. You think I've only got nice problems to have? You think my life is rainbows and puppy dogs and candy floss? Fuck the fuck off.

This is my rock bottom, because I want to throw everything away. It's too much effort. It's too much stress. It's causing too much anxiety. It's too exhausting. You think what I do is easy? If it's so fucking easy why isn't everyone doing it? If it's so easy, why aren't more people bouncing back from divorce, losing their home, drug addiction, alcoholism, bankruptcy, trouble with the police, mental health problems, suicide attempts, physical health problems and all the other things that bury people? Why aren't more people pulling themselves up by their bootstraps and getting themselves back on their feet?

It feels like I'm really close to a breakthrough, and that's what makes it so hard. All the time I'm thinking "it's only another 6 weeks, 3 months, 6 months... until I'm all fixed up and back to health, wealth and prosperity". It seems like it's no time at all, but that's because you're an idiot. You just don't understand how the shortest possible time can feel like an eternity, when you're in agony; when you're in such distress.

So close but yet so far.

Tags: #career #addiction #alcohol #homeless #drugs #suicide #hospital