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Cold Turkey 2

12 min read

This is a story about sequels...

Leftovers

Two years ago, I was experimenting with my blog. I thought it would be profound to write a public suicide note, record a video and go jump off the Golden Gate Bridge. I thought I would get sacked from my job and illustrate how the stress would push me into acts of extremism. I decided to sleep rough close to the skyscraper I had been working in. I thought I was going to starve myself for 25 days and spend Christmas Day in a tent. I thought I was going to kill myself by going on hunger strike.

For 25 days I wrote an advent calendar type series of blog posts. The whole thing was leading up to the punchline: boxing day. Really, what I was doing was building up to the revelation of the truth: that I'd had problems with addiction. It was a big admission. It took a lot of courage to be honest.

Why did it take me so long to acknowledge my problems with addiction?

Generally, addicts don't get a very favourable hearing. Addicts are amongst the most stigmatised people on the planet. If you're looking for a sympathetic non-judgemental ear, it's probably best if you don't mention any addiction problems you've had until somebody's got to know you.

So, people had to get to know me.

My friends, family and work colleagues knew me. Those people who've gotten to know me have seen that I'm an OK person. I'm not a monster.

But am I a monster?

It's surprising how little it takes for us to question everything we ever knew about a person. Sometimes, there's a revelation about a person that can completely shake our perceptions of them. Suddenly, it's as if a person we knew well is a stranger to us, and not just any stranger: a horrible nasty stranger who's going to rob us and kill our children and eat them. Everybody knows that addicts leave a trail of HIV-infected needles lying around everywhere they go, especially in areas where children play. Everybody knows that addicts enjoy nothing more than random acts of killing. Also, if you discover that somebody's had problems with addiction, you can pretty much forget everything you ever knew about them.

Hang on a second though.

How quickly can you completely re-evaluate an entire person and decide that they're a completely worthless hopeless junkie, who'd rob you without a moment's hesitation in order to score their next fix? How long does it take to write somebody off completely and dismiss everything you ever knew about them? Why are junkies just so damn easy to hate and what happened to the person you used to know?

While there are some very unfortunate people whose morals will be corrupted by their addiction, that's not the case for most addicts. Not every addict is a liar, a cheat, a thief and somebody who would recklessly endanger the lives of your precious children. Not every addict is flakey, unreliable, untrustworthy, unscrupulous and immoral. Not every addict is worthless, hopeless and doomed to forever seek and take drugs. Not every addict is a menace to society, and should be treated like a leper: shunned from work, friends, family and all the other things that give us a functional life. Not every addict should be marginalised and demonised.

Of course, I write with a vested interest. I don't want to be mistreated. I don't want the stigma attached to me.

So, why don't I share my stories of addiction anonymously? Why don't I join Alcoholics Anonymous and Narcotics Anonymous and Cocaine Anonymous and Crystal Meth Anonymous, and while I'm at it Gambling Addicts Anonymous and Sex Addicts Anonymous? Why don't I keep quiet and just pretend like I'm normal? I don't even take drugs.

Nobody thinks that gambling addicts inject packs of cards, so why is it that when you think of me - an addict - you immediately imagine dirty needles? Where did the OK Nick that you used to know go? Why did you eject the pleasant memories you had of me, and replace them with an imagined version of me, where I was mugging grannies for their life savings?

It's necessary for me to concentrate on the prequel to my story, in order to receive a fair hearing. I need to explain that adverse childhood experiences, an abusive relationship, stress, burnout and mental health problems, all created a fertile environment in which to grow a substance abuse problem. I need to explain that my mood instability - bipolar - predisposed me to reckless sensation seeking, such as substance abuse. I need to explain that my motivation was self-medication, not getting high. I sought relief from symptoms, not enjoyment. I was trapped and I needed a way out. I chose the wrong one. I made a mistake.

We might take a quick glance at a situation and utter the words "why don't they just...?". Why don't they just what? Leave their abusive partner? Stop moping around and get out of bed? Stop taking drugs? Move somewhere else? Sort themselves out?

When you're secure and happy, everything looks pretty easy. All people have gotta do is get a house, a job, a sexual partner, friends, hobbies and interests, a loving family, a supportive environment, a healthy lifestyle, coping mechanisms, substantial financial resources and favourable socioeconomic conditions. That's it. That's all. Just get on and do it!

For some, remaining addicted is not about the ongoing want for drugs, it's actually slow suicide.

That last point is worth re-iterating. One of the reasons why some people won't stop taking drugs, is because they don't want to live anymore. They literally don't care if they die. I would say that most addicts are very well aware that their addictions are going to kill them, but they carry on anyway - they're committing suicide, slowly.

Looking at teens and twentysomethings who smoke, we might see that there's a general belief that "it'll never happen to me". In our youth, we tend to believe we're pretty indestructible. By that same token, we might assume that a drug addict believes that they'll be one of the lucky ones, who addiction will spare. I don't think that's the case.

As an addict, it quickly becomes apparent that control has been lost and you're on collision course with health problems and early death. Repeatedly, the addict will have extremely aversive experiences which scream loud and clear that the path of addiction is going to lead to death and destruction. Do you think every lecture about what an addict is doing to themselves falls on deaf ears?

Equally, do you think that addicts just don't care? Do they want to die?

Committing suicide - including addiction - is not about wanting to die. Suicide is driven by hopelessness and inescapable awful feelings. If life only has pain and misery to offer, why wouldn't a person choose early death? If building any kind of liveable tolerable life is an insurmountable task, what hope is there? Who'd want to spend the rest of their life miserable, depressed, anxious and in pain?

It's easy to say "keep putting one foot in front of the other" or "take things one day at a time" because you don't have to live through that misery. It's easy to ask somebody else to tolerate the intolerable, because it's not you who has to suffer: it's them. Eventually, a person can conclude that there aren't going to be any good days, or that the few pleasant times don't outweigh the multitudinous bad times. On balance, one might conclude, life's not worth living.

When you've made that decision that life's not worth living, it's pretty hard to find any reason to not have that next hit of drugs, even when the drugs are killing you.

I write to you today clean, sober and with no intention of obtaining and taking drugs.

However, I think it's highly likely that I will take drugs again, both recreationally and abusively. The number of protective factors - friends, family, work, money - have increased, but my life is still very badly broken. There are innumerable things that predispose me to relapsing onto drugs, and on the flip side there is a huge list of things I've got to fix or get in my life in order to have enough on the other side of the scales to balance things out. I look to the year ahead: what do I have look forward to other than hard work, living out of a suitcase, paying off debts and otherwise scrimping and saving? I'm sorry, but I'm not exactly thrilled by the prospect of living off sandwiches that I've made in a hotel room, spreading the mustard with a shoehorn.

But, perhaps also there's a desperate desire to self-sabotage because life was simpler as an addict. Even the synthetic cannabinoids have enough of an attractive intoxication for addicts to jettison the stress and strain of paying rent and bills, and having to hold down a job, in favour of homelessness. The bureaucratic burden of civilised society is wearisome and ridiculous. The form-filling and pointless makework of bullshit jobs is absurd. It's not just about the drugs - it's also about dropping out.

You'd think that dropping out would be a terrible thing. You'd think that the shame of the loss of status would be unbearable, but it's liberating. You know that you have to work hard to keep up your mortgage or rent payments. You live in constant fear of losing your job, which would quickly lead to eviction. When you become homeless, it's a relief - a thing you feared the most has happened, and it's not as bad as you thought it would be; somehow you manage to cope.

I'm averse to the idea of a miserable dead-end McJob. I'm averse to the idea of spending any more time stressed out of my mind, helping my boss get richer; helping my landlord get richer. I'm averse to the idea that the peanuts that most people get paid, in any way compensates them for giving up the prime years of their lives. I don't see that society is working well for most people. I see that stress, anxiety, depression and other mental health problems are rife. I see that suicide is the biggest killer of the group of people who are our most productive members of society. That's not fair.

So, I need to find a middle way. I need to find a way that's not suicide, not drug addiction, but it's not a miserable dead-end job either. I refuse to get a bullshit job that pays peanuts. I'd rather die.

At the moment, I'm clean from drugs and I'm working a very well paid job. I'm learning stuff. It's stressful, but it's not boring. I'm increasing my value - my employability - as well as doing a good job. It feels fair.

I'm starting 2018 at a considerable disadvantage. I'm deeply in debt. I don't have a girlfriend. I don't rent or own a home. Why bother?

It's been 6 months since I had an addiction. I'm clean. Why would I even write about addiction? I've won, haven't I?

In fact, addiction is always there: a dependable companion. Very little effort is involved in resuming an addiction. Addiction will always be everything you expected it to be. Addiction never disappoints. Conversely, a happy functional life with all the components necessary to make it work, is very very far out of reach; almost unattainable. You might think that because I'm only 6 months away from putting a lot of the pieces in place, that it'd be easy. 6 months is no time at all, right? In fact, 6 months without all the things you take for granted, might as well be a billion years. It's never going to happen. Try getting in a bath filled with ice cubes. Try holding your hand over a naked flame. What you perceive as quick and easy is not quick and easy when you're in pain.

My present situation might look infinitely preferable to my life as an addict, but it's not. Addiction could last me forever - until the day I die - but what I have today is only temporary; it's fake. I can't stay where I am forever. My contract will come to an end and I'll have to find another job. I'll need to rent or buy a place to live. I need to keep moving around: 3 and a half hours on the train, one-way, and moving from hotel to hotel, AirBnB to AirBnB... always moving on. I'm tired, even though it looks like I should be well rested. I'm stressed, even if it looks like things are going in the right direction.

Addiction's there as a one-stop-shop. Addiction means that I can stop pedalling so damn fast. Addiction means relief. Addiction means there's an end in sight. I'd be a liar if I didn't admit that when I'm alone with my thoughts, I don't immediately think that addiction is infinitely preferable to the mountainous task ahead, to merely build a mediocre life of disappointment and depression; boredom and bullshit.

Going cold turkey doesn't prove anything.

 

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Drug of Choice

8 min read

This is a story about cyclical patterns...

Me with pills

In 2014 I was homeless and addicted to drugs. I got myself a job at a bank, got myself a place to live and paid off all my debts. Then, I lost my contract. I went to a shop in Soho and bought two packets of a legal high powder and proceeded to undo all my hard work. Within a matter of weeks, I was back on the supercrack.

In 2015 I was homeless and addicted to drugs. I got myself a job at a bank, got myself a place to live and paid off all my debts. Then, I lost my contract. I went online and bought two packets of legal high powder and two packets of legal benzodiazepine tablets. Within a month, I was back on the supercrack.

In 2016 I had a lovely apartment. I was clean all summer. I went on holiday. I met an amazing girl who I was totally in love with. I wrote my first novel. I had a brilliant Christmas with my girlfriend and her family. Then, I got myself a job at a bank. My left leg swelled up to twice the size of the right leg, both my kidneys failed, I was put on emergency dialysis and I had to be admitted to hospital for a couple of weeks, on a high dependency ward. Then, I lost my contract. Within a fortnight I was back on the supercrack.

In 2017 I had a lovely apartment. I took supercrack. I tried to quit the supercrack. I got depressed. I tricked my doctor into giving me California rocket fuel - a combination of venlafaxine and mirtazepine antidepressants. I went hypomanic and split up with my amazing girlfriend. I bought enough supercrack to last me two years. I went insane with stimulant psychosis and was thoroughly beastly towards my amazing girlfriend. I ran out of money. I moved to Manchester. I got another girlfriend. We broke up. I tried to kill myself. I spent a couple of days with a machine breathing for me in intensive care. I got sectioned and got locked up on a secure psych ward. I moved to Wales. I wrote 42,000 words of my second novel. I got myself a job at a bank. There isn't enough time left in 2017 to get back on the supercrack. I'm worried I'm going to relapse in January. I haven't lost my contract yet.

Fluid in my leg

If we dip into each year a little bit more closely, 2014 was a really dreadful one. I was an inpatient for about 14 weeks. I lived in a bush in Kensington Palace Gardens and slept rough on Hampstead Heath. I was in two rehabs. I lived in a 14-bed hostel dorm, but that was actually one of the highlights. I abused a lot of benzodiazepines and amphetamines, as well as the supercrack. I got in trouble with the police. Twice.

2015 looks tame by comparison. Although I abused stimulants and 'downers', I had a couple of visits to a lovely family in Ireland, who looked after me. Strangely, it was working 12 hour days and working 7 days a week that exhausted me and tipped me into hypomania. I spent a week suicidal on a psych ward then suddenly decided to fly to San Francisco. I went straight to the Golden Gate Bridge, which I had contemplated jumping off. I was sober for 120 consecutive days. I deliberately got my contract terminated, because I had ethical objections to what the bank I was working for was doing. I started blogging.

2016 is unusual - perhaps there is no easy pattern we can spot - because I got myself clean and into work much earlier than I'd managed in previous years. I worked a whole contract - notably not for a bank - without going mad and getting sacked. I got a good reference and my team were really pleased with the way I ran the project. My life was quite stable. However, I was a sneaky bastard. I was using supercrack and benzos in secret, and lying to my amazing girlfriend to cover up my drug abuse.

2017 was off the charts. I've never been so sick. I've never been so close to death. For the first half of the year I had binge after binge after binge. I abused opiates, sleeping pills, tranquillisers, club drugs and stimulants. My drug abuse was definitely going to kill me. I had a physical dependency on benzodiazepines that looked impossible to cure - how was I going to escape from the death trap? I decided I couldn't escape, so I took a massive overdose. The hospital gave me a 50:50 chance of pulling through.

I'm worried that I'm repeating old patterns of behaviour. I always go back to the banks when I need money, because they pay so well and it's the quickest way of digging myself out of debt. I'm living out of a suitcase, moving from AirBnB to AirBnB. It's exhausting and stressful: factors that tipped me into hypomanic insanity back in 2015.

What is unusual is that I'm going into the New Year with a contract in place: I have my job and it's going well. I'm starting 2018 with money on the way, as opposed to the fear of bankruptcy and eviction. I'm going into next year with far fewer stresses than I've had for a very long time. Perhaps it's good that there aren't even any girls in the picture at the moment. Love and sex always have a bit of a destabilising effect on me.

Writing this summary of my hit-and-miss boom-and-bust crazy life, I wonder if I'm doomed to forever repeat the pattern.

One thing that's notably different this year is living with a family. I care about them. I imagine what it'd be like if the kids asked "where's Nick?" and the answer was that I was dead, or as good as dead because I'd relapsed onto supercrack.

This year, I quit supercrack, tramadol, codeine, dihydrocodeine, diazepam (Valium), alprazolam (Xanax), zolpidem (Ambien), zopiclone and pregabalin. I was prescribed venlafaxine, mirtazepine and lamotrogine, but I don't take any of them now. I had 30 consecutive sober days during October. In fact, I was sober from more or less the start of September to early November. My brain has been completely drug-addled at times, but I'm clean as a whistle at the moment - I'm unmedicated and I'm not taking any mind-altering substances. I don't drink caffeinated beverages.

I'd like to tell you that I feel wonderful, but I don't. I have a cold. It's winter. Winter is shit.

You might look at all the times I've tripped up and conclude that I'm bound to trip up again. However, you might look at all the things I've fixed and conclude that I'm pretty good at fixing up my life when it's fucked. All I've got to do is bring together all the different elements: friends and family, work and home, money and rest and relaxation, stability and exercise and hopes and dreams, love and romance and sex. Easy, right?

If you're wondering what my drug of choice is, and thinking that it's supercrack, you're wrong. Look more closely at the picture at the top of this blog post. What's that thing in-between my legs? It's not my male member, it's a wine glass.

Hello wine my old friend

With closer examination of my entire adult life, we can see that alcohol features heavily. In fact my latest job came about as a result of being friends with a lovely guy who's an alcoholic. We spent a week getting pissed, when I was supposed to be finding my feet with the new job. Somehow, I've managed to drink my way through a very successful career. Without booze I'm somewhat out of kilter. Without booze, how would I self-medicate for my mood fluctuations?

Yes, without booze, my bipolar disposition rages out of control. I work too hard. I take everything too seriously. I fly off the handle.

I'm not genuinely suggesting that booze is harmless or the cure of all ills, but it's been such a big component of my adult life that I don't really know how to cope without it. How would I have survived the recent stresses and strains of a 2,500 mile round-trip, to go and gather money from the latest bank I'm working for, without alcohol? How would I square away my deep unhappiness with the work I do, with the need to earn money, if it wasn't for drowning my sorrows? Alcohol might be a terrible solution, but it's the one I've got and I know it works.

Is it lunchtime yet? I'm not an alcoholic, because I don't drink in the morning. I just make sure I lie in bed until it's after midday.

 

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All Your Whales Are Belong To Me

11 min read

This is a story about living out of a suitcase...

Hotel room feast

This is my life now. Spreading mustard and mayonaise onto long-life bread with a shoehorn, placing sweaty pre-cut cheese squares in-between the slices and chowing down on a hotel-room made sandwich, while swigging from a can of strong European lager. This is the life of a business traveller who can't really afford the expenses - I'm faking it until I make it. I'd be sleeping in my car... if I had a car.

It'd be fairly easy to look back on the journey that started with near-certainty that I was going to get sued for non-payment of rent, whilst also being evicted... of course, I had no money. I still don't have any money. I have negative money. I have negative negative LOTS OF DEBT MONEY. When I get paid, things won't be so bad. When I've been paid for a few months, things will look positively rosy. "That wasn't so bad" you'll say. You're wrong. It was bad.

Things are often a lot easier said than done.

A lot of the experiences in my life have been awful at the time, but later on I've been able to laugh about the dire straits I was in. In fact, the only way I've been able to come to terms with some ridiculous stuff I've been through is to tell my hair-raising tales of near-death experiences and destruction to the world. You might think that I glorify events of the past, or wear bad stuff as a badge of honour. That's not true, but what am I supposed to do with all those negative experiences? Am I supposed to walk around with a glum face and tell everybody how terrible I am? Am I only alive to serve as a living reminder to people that they shouldn't make bad choices like I did?

Choices.

Yes. Do you really believe in free will? I imagine that you believe in Santa Claus too. There's no free will. Our choices are always heavily biased. We're cornered and coerced. Would I have gone back to IT consulting for an investment bank in London if I wasn't flat broke? Am I making free will choices, or am I just doing what I've got to do to survive?

Survival.

My version of survival probably looks pretty ridiculous to you. The kind of money that's going to be coming my way soon is pretty obscene - banks pay very well. So, does that mean that I'm not surviving? Am I actually completely fine and dandy? I'm just making a fuss about nothing, right? In fact, if you saw the numbers, you might be angered; you might conclude that I've been fine all along... nothing to worry about and never in any danger.

A friend often challenges me on why I would keep myself on the endangered species list. Why would I continue to advertise my distress? Surely I'm safe and secure now. Well, how long ago was it that I was made homeless, jobless, having some dealings with the police, locked up on a psych ward and facing certain bankruptcy with mountainous debts?

So, I got a job. I worked that job. I did a good job. Money is on the way now. Case closed?

Actually, can you imagine how stressful it was to have to hit the ground running and pretend like I've got my shit together all of a sudden? Just because I'm pretty damn good at acting like I'm a cool customer and I can handle anything that life throws at me, the reality is that my inner monologue goes pretty much like this: "shit! shit! shit! everything's on fire! everything's too hard! it'll never work! everything's ruined and it'll never be fixed! it's too hard! I can't do it!".

Of course, a lot of people find new countries, new cities, new jobs, new work colleagues, new offices, new challenges, new accommodation and the stress of the unfamiliarity of circumstances, to make them very anxious. I'm not the only one who feels stressed and anxious when taken out of my comfort zone. I'm not the first person ever to have butterflies in their tummy about a new job.

Ha ha.

If only it was just a new job. Try plucking homeless unemployed bankrupt drug addicts who are known to the police, up from locked psych wards, giving them a scrub down, putting them in a suit and plonking them at a desk in another country. See how many times that works out for you.

To top it all off, there is the ever-present danger - and there still is - that I'll run out of money before that first payment lands in my bank account. If you think it's just a case of budgeting you're an idiot. You can't budget if the numbers just don't add up - sometimes there just isn't enough money to pay for everything. Sometimes, you can't afford to go to work, because you can't afford to get there. Catch 22.

If you think that I'm not a representative example, you're right. Most people will fall at one of the many hurdles. Most people would find themselves marginalised and excluded and blacklisted and without a hope of ever recovering their poise; hope of ever returning to normal life. You're right. I'm not most people. I'm not special though. I'm not different.

I cashed in one of my "get out of jail free" cards. I don't have any aces left up my sleeve. I've called in pretty much every favour. I had help, of course. People don't survive without help.

Arguably I wasn't a very worthy cause to help. Arguably, I'm arrogant and ungrateful; I credit myself where no credit is due - surely the situation I find myself in today is entirely thanks to other people, and I'm just a passenger... I've been gifted everything I've got from generous people; I haven't worked a day in my life.

To a large extent, I agree that luck and other people's generosity are the main factors in my life. So what? Would you prefer me dead?

Of course, I question my utility; I question the value of my productive output. I'm not rescuing children from burning orphanages after all, am I? Isn't it about time that I built a school in Africa or distributed food and clean water in some war-torn area flooded with refugees? With all my software development expertise, why haven't I created an app that cures cancer, or programmed a supercomputer to find the solution to world hunger? Isn't it about time that I stopped being so pleased with myself and did something to help other people? Isn't it high time that I stopped being so selfish and self-centred?

Easier said than done.

Take a look around. OK so your friend Sharon did a fun run that raised a lot of money for spastics, but she went on and on about it A LOT, going on about how fucking amazing she is for having done that, didn't she? Those 30 minutes that she spent puffing and panting, running around the school sports field hasn't changed anything has it? Did that rock concert that you went to succeed in ending poverty? That's right... you were really philanthropic, by going to see those bands play. How wonderful of you.

So many of us say "I'd like to do more, but I'm struggling myself". It's true, people really are struggling to find the time and the money to get through ordinary life, let alone perform selfless self-sacrificing philanthropic amazing acts of charity. There isn't a culture of helping each other. We mainly eye each other up suspiciously: are our peers getting more money than us? Why does SHE have a bigger house than me? Why are THEY getting a new car this year?

It's pretty easy to take a superficial glance at a person and say "WHY ARE YOU JUST SITTING THERE? GET UP AND DO SOMETHING". We've got all the solutions to other people's problems, haven't we? Isn't it the easiest thing in the world, solving other people's problems? If only people would listen, right?

I am thinking about changing my alarmist "suicide note" blog title to simply read this: addict.

I want people to stigmatise me. I want people to jump to the wrong conclusions. I want everybody who thinks they've got an easy answer to come forward and 'save' me from myself. "Have you tried not taking drugs?" being one amazing suggestion that I'd never thought of before.

I've failed to wean myself off sleeping pills. I've failed to stay off the pregabalin - painkillers - that I worked so hard to quit. I started drinking again, and I've been drinking a whole bottle of wine every night. I'm an addict, even though you might take a lazy glance at my life and conclude that I'm perfectly fine.

As I journey back to Wales for a Christmas break, having completed a nervy few weeks back at work, you could be forgiven for thinking that my life's back on track. Talking to me, you'd think that I've overcome all those obstacles that would normally cause a person to stumble and trip - a mentally ill homeless junkie bankrupt known-to-the-police type person. You'd be forgiven for thinking I'm normal. You'd be forgiven for thinking I'm just like you.

I am normal.

I am an addict.

Surely this is cognitive dissonance. Addicts aren't normal, right? Well, how's about this one: I don't even abuse substances. Why on earth would I label myself as an addict? Surely I've won? Surely I've broken free from everything that threatened to destroy me? Why would I want to publicly wear the most awful label that we can give to a person?

I'm not going to write a world-changing app. If apps had the capacity to change the world for the better, they'd have done it. I'm not going to start a world-changing charity. If charity had the capacity to change the world for the better, it'd have succeeded.

So am I giving up?

Am I putting on my oxygen mask before helping others?

The answer is neither. I'm not doing either of those things. I neither accept that the world's fucked and there's nothing I can do about it, nor do I believe that I have to help myself before helping others. It's true that my situation was unbearable, and it will continue to be unbearable for some time. I'm going through some awful stuff, even if you think my life is blessed and I live a charmed existence.

There's a family in Wales who've helped me. They've seen me during periods when it appears to them like I'm not helping myself. They've torn their hair out with frustration that I've been stubborn at times, when there's been obvious solutions that have been right there, just waiting for me to reach out and grab them. The whole world's problems could be solved overnight if only people would listen, right? Simple. Things are really simple, right?

The asceticism of my life - making my own sandwiches in a hotel room - seems like an obvious solution to a problem to you. No knife to spread the mayonaise on the bread? No worries, here's another solution for you...

However, if you have to actually live with a person while they go through the millions of trials and tribulations in their life, then you start to get a sense that things are not as simple as they appear at first. The case of getting my passport back from a bank in Manchester being a particularly illustrative example.

I'm about to spend Christmas in the bosom of a loving family, living on a gorgeous farm in the Welsh countryside. Of course, things aren't all about me. Christmas is about family; it's about giving, not receiving. How must this family feel though?: they've succeeded. They've nursed me back to health. Money is on the way. I'm back in the saddle, aren't I?

January.

January is my nemesis. Of course, I'm not the only person on planet earth to feel down in January. Of course, we all have winter blues and credit card bills hitting the doormat in January. Great. Let's just see how things go, shall we? I'll be back to living out of a suitcase in January.

 

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Never Don't Not Give Up Not Never No Way

11 min read

This is a story about paralysis...

Suicide Button

I'm never really unsure of what to do. I generally have a very certain idea of what I want to do and how I'm going to do it. I have a really big problem when I can see all the way to the end, and life seems to be a bit of a paint-by-numbers exercise. I really struggle when life is predictable and routine.

I went to see a psychiatrist on Wednesday. I knew what I wanted from the psychiatrist: to see a clinical psychologist. I also knew what the likely outcomes were if I was honest: to have pills thrown at me and put myself at risk of being locked up on a psych ward. It was a situation that was so predictable, that I was able to forecast exactly which medication the psychiatrist would suggest.

Instead of allowing myself to be sectioned and swallowing the prescribed medication, I ran away. I'm currently 1,200 miles away from home and by the time I get back the system will have forgotten all about me. If I really wanted to get what I need - which is some talk therapy - then I'd have played a completely different strategy. Frankly, I can't really afford to be sitting on a therapist's couch - I've nearly run out of money.

So, I find myself away from my friends and my new home, in a strange city, in a new job. It's very stressful. I'm very anxious. However, it's also novel and therefore a little exciting. Even though I've done similar work a million times before, I'm still a little challenged by meeting new people and learning the particular nuances of the organisation I've just joined. There's a little novelty in the experience, even if ultimately I'll realise that it's the same old shit, and I'll be on cruise control until the end of the assignment.

I'm presently thinking about eating pasta from a plastic pot, having poured boiling water over it from a miniature kettle in my hotel room. I will need to stir and eat the pasta with a shoehorn, in the absence of any cutlery. This is the glamorous life I live.

You may wonder whether the stress of homelessness, near-bankruptcy, drug addiction, brushes with the law and general dysfunction in every area of my life, is something that I regret. No. No I don't regret it. Having been an adrenalin-junkie extreme-sports enthusiast all my life, you can't get more of a rush than playing "go for broke" in real life. It seems inevitable that I would push everything to the limit, including taking life-or-death chances.

It is a little hard to see where the reward is, when my life seems mostly miserable. I've had unbearable anxiety and depression for long periods during the last couple of years. However, I'm not rushing to the doctor and begging for a miracle cure. The deeply distressing feelings I'm having are doing very little to change my behaviour. I almost guarantee that I'll find the urge to self-destruct almost irresistible, if I pull through my latest episode of adversity.

Having lived in a bush in a park, it seems rather more preferable to be living in a hotel like I am now. Having nearly run out of money, it seems preferable to have a well-paid job, like I do now. However, I can't make any sense of life when I swing between impending doom and intolerable boredom. What's the point of living if it all ends in misery and disaster? I'm too busy moving from certain destitution to probable financial stability at the moment, to stop and have suicidal thoughts, but I know that the absurdity of the rat-race existence is already something that I'm not able to ignore - I'm completely unable to relax and enjoy trivial distractions.

Existential angst paralyses me. I wake up and I want to go back to sleep, but I can't because I have to go to work. I get to work and I want to walk out, but I can't because I can't lose this job. I should work but I want to scream "THIS IS ALL JUST UTTER BULLSHIT". Everywhere I look, I see needless complexity; makework. Existence itself is just killing time before our eventual death. Why go through the stressful and exhausting bit in the middle? Why not take the short-cut and just commit suicide?

It's strange to write like this, given that I've overcome the incredible stress of getting this job, travelling over a thousand miles and facing my first nervous couple of days in the office. Given that I'll avoid bankruptcy if I just keep turning up and keeping my mouth shut, why would I be writing about suicide? I'm not even suicidal at the moment. I've entered a strange kind of state, where I'm incredibly anxious, but I know that suicide doesn't make sense anymore. I know that I've gone to strange cities, started new jobs and rescued myself from financial ruin enough times. Why am I even writing about death and disaster?

January.

It's been a very, very long time since I had a stable January. Potentially, I'll still have well-paid work in the New Year. Potentially, I don't have to start job hunting and worrying about money during the absolute shittest time of year. Potentially, I start 2018 with prospects rather than worries.

On the flip side, you might say that I'm stuck in a cyclical pattern and that I keep trying the same thing but expecting different results, except you'd be wrong. I'm trying something that's been staggeringly successful, and the circumstances are different each time. One of these days, there's going to be a combination of favourable factors, as opposed to badly-timed clusterfucks.

Money is a 'trigger' for self-sabotage, one might say. Also, finding myself trapped on a rainy miserable island in the middle of winter is also a 'trigger'. My coping strategy in the past was to jet off to Venezuela or Brazil for a couple of weeks. I had a long successful career doing that.

In order to survive, I'm going to have to orchestrate friends, work, money, a place to live, a passion and a girlfriend. You might scream with frustration at your screen, because we're all trying to get that perfect balance, and there's always one area of our life that's not going as well as we'd like it to. Erm, well... you don't know how good you've got it, actually. Try living in a bush in a park with none of the things I listed, then get back to me. This is not a boo-hoo story - I'm just explaining how dysfunctional my life got. If it helps you to say it's all my fault for making bad life choices or whatever, then knock yourself out, but I'm far too busy figuring out whether there's some way I can rediscover a reason to live to worry about shit like that.

I'm just writing now. I'm brain dumping. I'm trying to write without a filter.

It's possible that I got caught in some thought loops before, and I needed to take a break from my usual blogging topics. It's possible that my blog wasn't helping me at all. It's possible that I'd lost perspective, because I'd been doing too much navel gazing. I took a break and now I've come back.

Now, I'm writing mindful of the fact that I have friends who I've been living with in Wales. I'm mindful of the fact that I've got a friend who helped me get this job. I'm mindful of the fact that I can't afford to put a foot wrong. I'm mindful of the precarity of my situation. I'm mindful of the fact that writing is actually pretty exhausting, and I need to devote quite a lot of my energies into doing a good job and impressing the people I'm working with. I'm mindful of the fact that I have repeated the pattern of boom and bust, and it looks pretty obviously cyclical to a casual observer. I'm mindful of the fact that my consistent perseverance in the face of a headwind might look a bloody-minded and stubborn refusal to acknowledge reality. That's not the case.

There's a prescription for an antidepressant waiting for me at my doctor's surgery back in Wales. Given the chance, I would be institutionalised by the mental health services. Instead, I'm pursuing a ridiculously optimistic and hopeful, yet extremely risky strategy, of attempting to avoid medication and the dead-end of financial ruin and the mire of pathetically paid jobs that're just as soul-destroying as the very well paid job I've got. I'm not happy about being unmedicated, but I wouldn't be happy popping pills either. I'm not happy about having to work a bullshit job, but I wouldn't be happy doing a so-called 'fulfilling' one either (there are none).

"What if you're still depressed and anxious in 6 weeks time?" the psychiatrist asked me. "Wouldn't you regret not having started taking medication sooner?" he asked. What happens if I don't give up though? Wouldn't I regret never finding out what happens if I stick to my guns and persevere? What am I going to find out, that nobody else ever would, because it's too hard?

I didn't mean to write so much, but I've uncorked some of the stuff I've been holding back. I've never regretted writing, despite the seemingly dreadful consequences. Writing has been financially disastrous for me, but yet it's got to be a healthier coping strategy than drink or drugs, or even going to the gym excessively, where I'll strain my heart and give myself arthritic joints.

I imagine that I'll meet a nice girl soon enough, and the pleasure of tactile affection will change my mood. I imagine that my lengthy abstinence from mind-altering substances will pay dividends soon. Already, some feeling has returned to my nerve-damaged foot/ankle. I must surely be somewhat more sharp-witted, now that I'm not taking heaps of pills every day. I must surely be on course to return to a more normal life, since kicking my addiction to stimulants.

I'm going to give myself a big pat on the back for reducing my alcohol consumption to a moderate level, breaking my physical benzodiazepine dependence, reducing my sleeping pill habit to almost nothing, getting off powerful prescription painkillers, staying 'clean' from supercrack for 6 months and otherwise living a pretty damn healthy life. It might not seem like I've done very much this year, apart from work three contracts, survive double kidney failure, survive a suicide attempt and survive a bunch of very traumatic events, but I'm damn well going to go ahead and congratulate myself on having spent a couple of days in my new job in what must be the very best mental health that I've enjoyed all year, even if I'm diabolically depressed and anxious.

Thinking about my achievements a little more, I'm going to give myself an imaginary medal for 30 days of not drinking, 30 days of writing a novel and spending more days clean and sober than I've spent intoxicated by medications, drugs and alcohol. Quitting a whole host of highly addictive drugs and medications, while in the throes of depression and anxiety, is something I'm going to go ahead and actually feel really proud of - sorry, not sorry. While I'm at it, I'm going to give myself another imaginary medal for not writing my blog for 30 days too. That was harder than you'd think.

My verbal diarrea is pretty bad, so I'm going to stop now, but I hope you can see that I'm not idle, even if you think I've been unproductive, lazy and self-sabotaging all year. It pisses me off that anybody might think I don't have a work ethic.

I'm not going to give up on my crazy experiment to see how my mental health is affected by my circumstances by just damn well being patient, consistent and relentless. I'm controlling the variables.

 

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Long Case

9 min read

This is a story about medical notes...

Hospital Note

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.

 

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Help the Homeless

5 min read

This is a story about unintended consequences...

Trash strewn in the street

The UK's notorious tabloid rag, The Sun interviewed a grieving father & husband and quoted him as saying "I should never have let the bastard near my family" with reference to a homeless man who had been taken in by his wife. The British press variously reported that the woman - later murdered by the homeless man she'd tried to help - had given "her husband's dinner" to her killer, who also killed her son and badly injured her husband.

Quite unbeknownst to me, this news story had received widespread coverage at exactly the same time as I was taken in by a Good Samaritan - what risk, one wonders, to her children & husband if this is any kind of precedent?

Scanning the column inches for similarities between myself and the perpetrator of the double murder, the newspapers reported mental illness and drug abuse. My Good Samaritan collected me from a secure psychiatric institution on the day when the crescendo of media coverage reached its peak. During the car ride to the family home I explained that I had seen illegal drugs used by my parents on a daily basis, and we agreed that to do that in front of children is not normal, right or proper.

Perhaps my gracious hosts have been hoodwinked. Perhaps I have fabricated a story about my sweet innocence and a set of unfortunate circumstances that have come about through no fault of my own. Given the extraordinary amount that I have written, it seems like a rather elaborate ruse, to write extensively about my chequered past, even when it has clearly caused me more harm than good. Is it not true that I've left my readers in no uncertain doubt about my every misdemeanour?

Further digging through the archives of the internet, I found a newspaper which reported that the aforementioned homeless murderer had been diagnosed with borderline personality disorder (BPD). BPD was casually tossed into the mix by one psychiatrist that I met, as a possible additional diagnosis for my own mental health problems. The only official diagnoses I've received are clinical depression and bipolar disorder, but adjustment disorder also featured in some of my recent paperwork, although this did not appear on my hospital discharge summary.

I'm mindful that further comparison is not at all useful, and I find myself to be extremely stressed about what the kind family who has taken me in, might think about the fact that this matter has been on my mind. When I read the grieving husband's words "I wish my wife had never set eyes on him" I do worry that I never asked my own Good Samaritan "what does your husband think?" but then wouldn't the atmosphere now be a little strange if the reply had been "he's got some reservations"?

I would say that I have never searched my soul for any kind of malice, as extensively as I have done knowing that I would be residing under the same roof as a happy family with several kids. If I had the slightest suspicion that my behaviour could be erratic, then I would not find it conscionable to expose a family to any danger that I might pose.

That said, I'm aware that bonding with the family is taking place. I'm still deeply troubled by almost unbearable levels of anxiety, and suicidal thoughts intrude whenever I consider what the future holds. I'm hopeful that my state of mind will improve when my medication changes are done. I am however mindful that in the worst-case scenario, I do pose a risk to my own life, and although I would put some time & distance between myself and the family, it would be incorrect to say that it would have no effect on them if I were to end my life prematurely.

The question of whether to accept help is as difficult as that of whether to offer assistance to those who are in need. I'm incredibly lucky to not only receive aid, but also to be able to openly discuss the obstacles and difficulties involved.

You may be surprised to learn that these 700 or so words are some of the most carefully chosen I have written, out of over 700,000. I have been shown a great deal of love, care, respect and trust, and this is why the anger, bitterness, rejection and hurt of the past, that usually flows out from me onto these pages, has been replaced with a daunting sense of responsibility towards those who I am now close with.

I'm going to publish now, because it's been agonisingly difficult to write this.

 

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Stroke

5 min read

This is a story about neurotoxicity...

Eye droop

What's happened to the left hand side of my face? My eyelid has drooped; my face is no longer symmetrical. Why do I have a facial tic? Why is my speech slow and slurred? Aren't these all symptoms of cognitive impairment; brain damage?

I decided to read back through some of my blog - I read from February through to June, when I was very unwell. I was surprised that a lot of it was gibberish - I thought that I had written with lucidity, but I had mis-remembered things.

As is so often the case with me, I dice with death and I dodge bullets. I'm still very sick, but I'm getting better. I'm going to make a full recovery. My speech is normal; my face doesn't tic and my eyelid no longer droops. The brain is a remarkable thing, but I do need to stop abusing my body.

A month ago I was livid; I was unbelievably angry. I was fighting for my income, my home and my liberty - I was fighting for my legal rights - and I was spitting venom; I was furious at being abused; mistreated; taken advantage of.

I re-read the lengthy blog post I wrote a month ago, which started OK, but then I got plunged into repetitive thoughts - you can tell that my brain was stuck on a loop and I repeated myself several times. It's surprising that I could express myself fairly well, given the circumstances. I imagine that it took me a long time to compose what I wrote, and I clearly struggled to remember what I'd written at the start, as I reached the end.

It's tempting to edit and airbrush history, but it's much more interesting to maintain a public record of exactly what I was thinking and feeling at a certain point in time. Inadvertently I also capture other details about my state of mind in the way in which I express myself.

I've now been writing for long enough to capture two periods of total abstinence from all mind-altering substances, including alcohol, caffeine and nicotine. I'm a lifelong non-smoker. I stopped drinking caffeinated beverages in 2013. During this particular period of abstinence, I've not drunk any alcohol for 35 consecutive days.

What's the net result of all this?

Me as a kid

Nah, I'm only kidding... that was me when I was twenty years old. However, I'm sure there's been a marked improvement now that all the crap is out of my system.

A few friends spoke to me soon after I arrived on the psych ward. Although I sounded like my old self and I was in good spirits, my recovery was only just beginning - friends who see me and speak to me on a regular basis report that I'm much improved from how I was a month ago.

My hair, my skin, my nails, my teeth, my breath, my sweat and most importantly, my brain - all of these things are completely different, now that I'm not glugging gallons of booze and popping loads of pills.

I cringe with shame a little bit, to think that I made myself very exposed and vulnerable at a time when I was very unwell - the public got a little bit of a behind-the-scenes peek at me when I was extremely poorly. You can go digging in the archives, if it pleases you, or you can take my word for it: there's no surprises and there should be no pleasure in gawping at somebody when they're sick.

If we've not spoken for a while, I highly recommend that you get in contact and we actually speak on the phone - my email is nick@manicgrant.com. You might be very surprised to learn that your friend is in possession of most of his marbles, and not the raving lunatic that you might have guessed I would be, after such a traumatic couple of years.

Recovery selfie

Here's another one for the photo album, taken only seconds ago. My left eye is not yet 100% and I'm still suffering a lot of brain fog and other recovery-related problems - it'll be a month or two before I'm fighting fit. My face still tics when I'm stressed, but it's less pronounced.

I'm struggling with horrible anxiety, depression and confusion; memory problems. None of this is a surprise to me - it's to be expected, given what I've been through and I'm still going through.

I've got no idea what I'm really writing about, or what my purpose is now. Is this still the world's longest suicide note, or am I now campaigning to end the stigmatisation and discrimination that our less fortunate members of society must face: the mentally ill, alcoholics, drug addicts and homeless people... the dregs that nobody wants to touch with a bargepole. I know that I want to be the voice of the voiceless, although I know how clichéd that sounds.

I'm swimming through a fog of confusion, but I know I'm slowly getting better.

 

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If you're Happy and you Know it Shake your Meds

2 min read

This is a story about pill popping...

Chemist prescription

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.

 

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Notes on a Suicide - #WorldMentalHealthDay #WorldSuicidePreventionDay

8 min read

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

Discharge summary

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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Hospital Curtains

6 min read

This is a story about modesty...

Psych ward male dorm

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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