This is a story about nerve damage...

As you can see from the picture above, I had a very bad injury to my left leg. What you might not know is that the massive lesion to my leg healed perfectly. Some nerves were severed when a piece of mirror glass guillotined its way through my shin, but the nerves managed to regrow. The severed tendons and muscle was sewn back together and my leg had completely recovered.

Then I got DVT (deep-vein thrombosis).

The first I knew about the DVT was that my ankle looked a bit swollen and my foot went numb. It was the fact I hadn't needed to urinate for several days which prompted me to go to hospital. On the day I decided to go to hospital, my foot, ankle, leg and knee were swelling at an alarming rate. By the time I was examined in Accident & Emergency, my left leg was almost fully twice as large as the right leg.

My weight soared from around 80kg (176 pounds or 12½ stone) to 95kg (209 pounds or 15 stone) which is a heck of a lot of weight gain for 5 or 6 days. It took many many sessions of dialysis to get that fluid out of me, while the hospital anxiously waited for my kidneys to start working again.

Unfortunately, the blood clot/thrombosis and other complications caused nerve damage. Presumably the blood vessels which had been surgically repaired and the nerves which had managed to re-grow and re-attach themselves, were quite fragile versus normal physiology. My foot went numb.

To be more accurate, my foot was left numb after many months of excruciating pain.

I had a nerve condition study and an MRI scan, but there was still a lot of swelling and other damage, making it unclear whether a surgical intervention might ever return the feeling to my foot. My main concern at the time was pain management, because it was too painful to walk any great distance, and pain kept me awake at night very badly. I was taking the maximum dose of tramadol AND codeine, plus supplementing prescribed painkillers with dihyrocodiene and other opiate medications, which I bought on the black market. I was briefly a very heavily dependent opioid painkiller user.

Opiates have weird side-effects. I couldn't tell whether the nausea, itching, constipation, cramps, sweating, diarrhoea, and intense anxiousness about maintaining my supply of opiate painkilllers, was a result of their effects or the effect of withdrawal. All I knew was that I would have periods where I felt incredibly rubbish, and then periods where things were more bearable, despite dosing myself regularly throughout the day.

The thing which made the greatest difference - other than a loving, caring, attentive and wonderful girlfriend - was a topical ointment containing diclofenac, which is a NSAID (non-steroidal anti-inflamatory drug). Because of the earlier complications with my kidneys, many medications were contraindicated. Perhaps I shouldn't have used the diclofenac gel, because it's not very kidney-friendly, but it was the only thing which gave me any reliable relief.

It's possible that most of my pain was related to opiate withdrawal and strange interactions between the tramadol, codeine and dhydrocodeine, which I should not have been combining, but I did so out of desperation for pain relief. It's possible that in my desperation for pain relief, I actually made things worse. Perhaps tramadol alone would have been more effective.

Eventually, I decided that I hated all the effects of the opiates, so I decided to go cold turkey. I had been heavily opiate dependent, for a period of several months, so I was expecting to experience pure hell quitting the opiates. Certainly a lot of noise has been made about the addictiveness of OxyContin, Vicodin and other painkillers which have been implicated in the opiod addiction epidemic sweeping the United States, declared a nationwide public health emergency by President Obama on October 26th 2017.

Back in July 2017, I tried to walk from my apartment to my local Chinese takeaway in flip flops - a distance of about 500 metres. I could not walk more than ten paces without the flip flop coming off my left foot, because it was so numb and my toes were somewhat 'clawed' such that I couldn't hold the flip flop on my foot or tell when it was slipping off.

For almost all of 2017 I was taking a neuropathic painkiller called pregabalin - marketed as Lyrica - which I found to be quite effective. However, it occurred to me that this painkiller might have been preventing the natural nerve re-growth which had successfully healed my severed nerves once before. After 9 months with no improvement to the numbness in my foot, I was becoming quite depressed about the prospect of never regaining any feeling in my foot, and consequently never being able to wear flip-flops again, without tying them onto my foot as pictured above.

I like wearing flip flops. They're an important part of my beach bum seaside-dwelling kitesurfer identity.

I decided to stop taking pregabalin.

If anybody tells you that pregabalin is not addictive, they're just plain wrong.

Pregabalin quite recently became a scheduled drug in the UK, making it illegal to possess without a prescription. Pregabalin affects the GABA system of the brain, just like alcohol, Valium, Xanax and GHB/GBL, which are all considered to have a high abuse potential, so naturally pregabalin is no different.

Of all the drugs I've quit and medications I've withdrawn from, pregabalin is one of the worst. Because of its tranquilising and sedating effects, the rebound when withdrawing creates a state of insomnia, anxiety and induces the general sensation that the world is about to end, which lasts for months.

I quit pregabalin under the supervision of doctors, tapering the dosage down gradually, but it was a pretty aggressive schedule, which was chosen by me. I wanted to quit pregabalin as quickly as possible, because I wanted to find out if it would help my nerves re-grow and allow me to wear flip flops again, or indeed be able to feel a kitesurf board underneath my feet.

Pleasingly, I can report that I put on a pair of newly-purchased flip flops tonight, and I was able to walk around without the left one falling off.

My left foot feels different from the right one, but I do have some sensation restored and I don't have the aches and pains which troubled me during a lot of 2017.

It might seem like a minor point, but it's actually something that has disproportionate imporance in my life: To be able to wear flip flops again is a big deal.

Life is better in flip flops.

Tags: #accident #injury #dvt #hospital #kitesurfing #beach #summer #sun #holiday

This is a story about shame...

The holes in my wall tell a story. I picked up a massive wardrobe and moved it to block the entrance to my bedroom in an attempt to barricade myself in, because I wanted privacy so badly; I so desperately wanted the certainty of knowing that nobody would barge in on me unexpectedly. In fact, I spent the best part of two days and nights without sleep, attempting to secure my bedroom against would-be perverts hoping to barge in and catch a glimpse of me in my nest of shame.

Obviously, it's somewhat of a self-fulfilling prophecy. When somebody spends a couple of days dismantling beds, bookcases, chests of drawers and heaving heavy pieces of furniture into their barricade, it's pretty noisy and the work is exhausting. As a person gets more physically tired and sleep deprived, they gey clumsy and they make mistakes, such as toppling a massive heavy thing with sharp corners into a wall, gouging out plaster and leaving an ugly hole.

My body is covered with battle scars from my efforts to keep my shame private. I have an enormous scar on my left calf and another one on my right thigh. I have a broken nose from where I was balancing a piece of furniture above my head in an attempt to cover a window.

My paranoia stems from my childhood, when I was constantly bullied, at home and at school. Nobody respected my privacy or my right to live a dignified life. My paranoia stems from an abusive relationship, where I was punched in the face, screamed at and generally verbally abused, and regularly had to put a door in-between my ex and I, which she would spend hours aggressively kicking while I was trapped in a room with no toilet, food drink, or exit other than to face the violent abusive woman on the other side of the door. My paranoia stems from not having a space of my own where I can lock the door and feel confident that I'm the only one with the key; feeling like I have no right to privacy and that I can expect somebody to barge in at any moment. Being a guest in somebody's home is not the same as having your own safe space. Being a prisoner in your own home is truly traumatic.

I built myself a summerhouse in 2009 and then insulated and carpeted it in 2013. I finally had my own miniature house with a front door I could lock, although it had no running water or toilet. I improvised a water supply using the garden hose and locked myself in there until my ex-wife moved out. I would have starved to death if she hadn't, but I didn't care... I wanted to escape from that abusive relationship.

I could have had a clean break, but my ex-wife put me through hell with the divorce. I arranged a quick and easy house sale, which would have allowed us both to get on with our lives, but she sabotaged me at every opportunity. She ruined my chance of escape and recovery. She sabotaged my efforts to rebuild my life.

London is not a good place to be sick and poor.

London is not a good place to be paranoid.

London is not private.

However, at least London is anonymous. I completely lost my mind on the streets of London and nobody paid me the blindest bit of attention. Nobody would remember my face. I'm never going to see anybody who remembers me when I was insane, penniless, homeless, destitute and in a very shameful sorry state indeed. London was the perfect place to recover from the trauma, without getting paranoid about my neighbours witnessing what should be a private affair.

Privacy is important when you're struggling. Privacy is important when your life is filled with shame.

Invasion of privacy sows the seeds of paranoia, leading to psychosis and schizophrenia. Human interest is a powerful force, which is the reason why fly-on-the wall documentaries and reality TV shows are so enthralling, and why we love to read people's blogs, diaries and journals. It's impossible to tear your eyes away from the spectacle of somebody struggling. People will line up like it's a fucking spectator sport, watching somebody suffer and not doing the slightest thing to intervene or otherwise fucking off and minding their own business. People know when they're being watched. Knowing that you're being watched makes everything a million times worse. "Why don't they do something or just fuck off?" you think to yourself, and soon it's all you can think about; the audience is spellbound and they'll literally spend hours watching and talking amongst themselves: "ooh it's awful isn't it?" and "yes I know. it's been going on for ages" ... but they never get bored.

I've recovered a remarkable amount since those dark days of 2013/4. In fact, I've made a miraculous recovery, but it's very far from complete.

I've gone from owning my own home and a summerhouse, to now renting an apartment. I've gone from financial security to mountainous debts. I've gone from having every right to privacy, to the situation where I have to show my bank statements to letting agents and allow my landlord to come into my home. Instead of being my own boss, I have to submit myself to security vetting and allow people to pore over the details of my private life. I've been poked, prodded and generally put into a goldfish bowl to be gawped at by numerous doctors, consultants, psychiatrists, social workers and a whole heap of wannabe amateur psychiatrists, who think they've got me all figured out, but who fail to recognise that it's grossly insulting and patronising for them to take a lazy glance and think they know me.

Things are very difficult.

I've had so many years and months of shame and swallowing my pride, and it fucking sucks.

I've had so many people judge me who I really didn't invite to pass judgement, and who really have no place, prying into my private affairs. I'm doing a good job of living a normal life within society's rules. I don't deserve to have people sitting in judgement of who I am, what I am, and whether my thoughts, feelings, actions, intentions, character and other attributes of me and my personality, are somehow acceptable to the self-appointed nosy busybodies.

Where is my space where I can feel safe? Where can I be free from the tyranny of the judgement of puffed-up pompous twats who think they know best and they have a right to barge in on me in my private shame; to embarrass me.

That's why I work so damn hard. I'm trying to earn enough to buy a place which is mine and nobody has the right to come barging into. I'm trying to get my little slice of privacy and free myself of the tyranny of having to kowtow to other people's judgement... most often other people's inferior judgement.

Please, give me some space. Have I not always used it wisely? Have I not proven myself to be very capable of doing amazing things, when given the space; the trust?

I have my shame, which I'm attempting to de-fuse by making everything about myself as public as possible, but it's a slow process. I feel like I'm only halfway there.

I have my flaws. I have things I want to keep private.

I need dignity.

Tags: #privacy #paranoia #divorce #house #debt #apartment #injury #hospital #london

This is a story about early retirement...

I was pretty pleased with my life's achievements by the time I hit the age of 30. I'd earned a lot of money and been able to enjoy a lavish lifestyle, and I had plenty of material possessions as status symbols to attest to my accomplishments. My income vastly exceeded my expenditure and I'd amassed enough savings and assets to be able to support myself without a job for many years, without having to tighten my belt or live frugally.

I decided to quit the rat race and be my own boss. I retrained as an electrician and set myself up in business as a one-man operation: just me and my van... and my customers. Turns out that you always have a boss, whether you're a salaried employee or the founder and CEO of your own company. There's always somebody who you're dependent on for your money, like investors and customers who have to be kept happy. Perhaps only trust fund brats are truly free from the tyranny of having to kowtow to anybody, but even they have to kiss the ass of the trustees if they want to get their hands on more cash than their already more-than-ample unearned lifelong income.

My subsequent attempt to use my software smarts to earn money while I slept didn't turn out much better than my attempt to become a traditional tradesman. Realising that customers were harder to extract money from than I'd anticipated, and that I was going to end up giving away a substantial amount of equity and control to investors, I burned out and became very depressed about life.

I tend to win more than I lose when software's involved and my most recent attempt at earning money in my sleep was quite successful, when I bought Bitcoin miners which I kept in my summer house. I also ploughed every pound and penny that I could beg, borrow or steal and I bought Bitcoins, which then appreciated in value a hundredfold or more. Sadly, I needed to liquidate my assets to settle an acrimonious divorce, hence why I'm not [yet] a multimillionaire... well, and also to be honest I didn't think the value of Bitcoin was going to go much beyond $5,000 but that's another story.

To be fully retired and spend my days wandering around National Trust stately homes - or whatever it is that retired folk do - I think would be quite torturous and tedious. I was dragged around enough stately homes as a child, with my pushy parents mistakenly believing that educational leisure experiences would be somehow beneficial to me and my future.

Software is the gift that keeps on giving and I've worked an average of 3 months per year, during the last 4 or 5 years. That's pretty close to semi-retired. The remaining 9 months of each year have been spent sleeping rough, living in hostel dorms, in and out of hospital, locked up on psych wards or otherwise generally living a life which most people would not consider to contain much rest and relaxation.

I'm pretty exhausted to be honest.

I'm 39 years old and I'm knackered.

During the last 9 years I've done all the things which my parents told me not to. I've followed my dreams and I've ended up in a few nightmares too, but I've finally been able to experience life. I was a very well-behaved boy and young man: I was the well-mannered sensible child who did all the right things and was achieving all the things that grannies and aunties like to hear about when your parents phone or write to brag. There's a lot of snobbery in my family and I felt duty-bound to comply with very boring, rigid and old-fashioned ideas of success. I'd spent my life up to the age of 30 living somebody else's idea of how I should live my life. Then, I rebelled.

I really rebelled.

It took me a while, but I caught up. At the age of 32 I had been a straight-laced boring conformist who'd never stepped out of line and had never experienced life, in all its its horror as well as its beauty. By the time I reached my 35th birthday I was pretty much ready to start gently pressing the brake pedal. Now I'm only a year away from turning 40 I've got both feet on the brakes and I've pulled the handbrake too.

I don't think you can really say you've lived until you've been arrested, thrown in the back of a paddy waggon, locked in a police cell, sectioned, locked up on a psych ward, been hospitalised, been in critical care / intensive care, been on a high dependency ward, had organ failure, had dialysis, had a horrific injury requiring general anaesthetic and major surgery, become homeless, slept rough, lived in a hostel dorm, run out of money, been physically addicted to drugs and all the other things which came about when I decided to abandon all caution and just do whatever the f**k I wanted for a few years.

I really made up for lost time, but I don't regret any of it. If I have any regrets, it's only that I listened to my parents and I behaved myself and I was sensible. I wish I followed my dreams earlier. I wish I did what I wanted sooner, rather than attempting to please my parents and gain their approval, which turned out to be impossible anyway.

To continue my life in the way I had been living it until a year ago would be quite disgraceful. There's no dignity in being 40+ years old and doing the kind of crazy s**t that I've been doing during a lot of my thirties... in fact I think it's a real shame to see people who haven't been able to stop the madness when they've reached an age where they should supposedly know better.

In light of the fact that I only have a year until my 40th birthday, I am now semi-retired. I have almost fully retired from my life of crime, drugs and insanity. Now, my life consists of a cushy government job which requires very little thought or effort and gives me a lot of disposable income and leisure time. Life is a lot less exhausting without the police cells and the hospital beds.

Over the coming months I'm going to complete my 1-million word writing project, pay off all my debts, replenish my savings and write a new chapter in my life: the comfortable semi-retired existence of a highly paid consultant doing government work; the return of some of the lavishness of the lifestyle I used to enjoy when I was a much younger man.

I am a little sad to say goodbye to the version of me who could say and do whatever he wanted, but the consequences almost killed me on numerous occasions and my luck was going to run out sooner rather than later.

39 isn't the usual age where people start a laid-back life of semi-retirement, but I think it's appropriate in my case to dial back the insanity from 11 to a much more reasonable 3 or 4.

I hope the previous 12 months I'm writing about this time next year are much more becoming of a gentleman celebrating his 40th birthday. I'm pleased that I've got a year to get things sorted in my life, so I don't feel like a total failure.

Happy birthday to me. 39 today.

Tags: #career

This is a story about unnecessary packaging...

I've had a stressful morning. I had to package my Macbook carefully so that it could be safely sent away to be repaired. I had to locate the original packaging for my Virgin broadband router and box it up so it could be sent back to them, even though it's defective junk. I then had to find a UPS parcel drop-off point and a Collect+ drop off point to drop off the respective parcels. This required a trip to purchase bubble wrap, a suitable sized box and packing tape, as well as two more trips to two different drop-off places.

While I was out dealing with those chores, I also had to purchase a piece of carry-on luggage and some flip-flops. The flip flops were sold to me in a box. I don't know why flip flops need a box - just a simple cardboard clip to keep the left and the right flip-flop together is more than sufficient.

Anyway, I'm home now. I have located my passport. I have located some leftover Euros I had from the last holiday I took... 22 months ago. I opened the box containing my new flip-flops and lo and behold, there was a discrepancy in the number of flip flops present in the box - 50% of the required number of flip-flops were missing.

Do I drive back into town, park my car, walk to the shop and explain the situation in the hope that they admit their mistake and remedy it without quibble? Do I just purchase a second pair of flip-flops and then open and check inside the box before i leave the store? Do I just abandon the whole ill-fated exercise, and buy a pair at the tiny departure airport, where the shops will probably be closed? Do I take time out from the one single whole day I get to spend with my friend, without either of us having to worry about airport arrivals/departures, hotel check ins/out and all the rest of that crap, just to go looking for some suitable summer footwear?

I don't know why this is making me upset, because I don't even know if the nerve damage to my left foot/ankle is so bad that I can even wear a flip-flop on that foot. The last time I tried, I didn't have enough sensation and motor control to keep a flip-flop on my foot.

Also, my flight's delayed - French air traffic controllers on strike or something. My flight barely enters French airspace, but whatever... everyone should have the right to go on strike for better pay and conditions.

My 'holiday' is really just a day spent with a friend who I hardly ever get to see, then we both fly home on Monday. I have another week to go before my current gig comes to an end, so I need to make sure I take the money while it's there on offer.

"Have you got any holidays planned?" asked a person I spoke to on Friday, which is code for "we want you to work solidly until you drop dead". We'll have to see how badly they want me, because I really need a holiday - a proper holiday.

It seems churlish to complain, but I've had a month of hell. Breakup, losing my local job, getting sick, holiday plans pretty much cancelled, the stress of finding a new gig, the prospect of going back to London, the never-ending pressure to generate vast sums of cash to dig myself out of the hole... the hole I can never quite escape from. FML.

What was supposed to be a romantic beach holiday with my [ex]girlfriend has now turned into a very brief weekend meetup of two old friends. It'd have been far easier for us to meet in London, as he was there yesterday. He's travelled London -> Prague -> Lisbon -> Faro -> Lisbon -> Prague, and I'm travelling Wales -> Bristol -> Faro -> Bristol -> Wales. Our carbon footprint is criminal.

Hopefully I'll be in a better mood when I wake up in Faro tomorrow and I can hang out with my old friend for the whole day, free from commitments and responsibilities... I can put up with sweaty feet.

Tags: #holiday #summershoes #injury #friends #startuplife #startups

This is a story about it being all in your mind...

Uncontrollable shaking, jaw chattering, nausea, insomnia, restlessness, chest pains, elevated body temperature and sweatiness, breathlessness, diarrhoea and stomach cramps - it sounds like I'm physically sick, but I'm not. I genuinely believe that there's no physical reason why I'm experiencing all these symptoms. It's all in my head.

My symptoms are not due to disease, medication, drugs, alcohol, injury or any tangible physical thing. A medical examination - purely physical - would conclude that I'm in good health.

Why do I feel so damn awful then?

It's been months since I stopped taking the addictive sleeping tablets. It's been months since I stopped taking the addictive painkillers. It's been well over 6 months since I stopped taking the addictive sedatives and tranquillisers. It's been about a year since I stopped taking the stimulant I was addicted to. It's been over a year since I stopped taking opiates for the pain in my ankle. I'm completely clean and I recently had 5 days of sobriety, to prove that I hadn't become alcohol dependent and give my liver a break from the booze.

From what we understand of addiction, there are physical addictions, which we treat with substitute prescribing because the physical symptoms are too awful for addicts to withstand, and there are psychological addictions, which are just a lack of willpower and an indication of moral deficiency and bad character. We understand that psychological addictions are easy to deal with - just quit cold turkey and get over it.

It upsets me that I've done all the hard work of getting off at least 8 addictive substances, with 7 of them considered to be physically addictive, but the 8th still has a psychological hold on me, somehow... 1 year later. That's not supposed to happen. In the textbook, once you quit drugs your life becomes amazing and brilliant and perfect and you never look back. Certainly, the textbook will tell you that physical addictions are real addictions, and psychological addictions are not real addictions at all - they're all in the mind.

So why is it that I'm so sick?

If it's all in my head, why do I feel so nauseous?

If it's all in my head, why is my body shaking uncontrollably?

If it's all in my head, why are my symptoms so manifestly physical that other people can notice them?

Addicts are taught to hate themselves. We're told that we're bad people; that our problems are all our own fault. We're told that we have bad character; we're weak; we lack the moral fibre to buck our ideas up and behave properly. We're told that we're worthless scum... worse than worthless, in fact - a menace to society and death's too good for us.

How can it be then, that I've done all the right things and proven my worth to society; I've proven that I can white-knuckle my way through cold turkey and get clean from not just 1 addictive substance but 8. I've done all the right things, but there's still very a real and tangible physical manifestation of my addiction, which isn't supposed to exist because any residual addiction that I still have is psychological apparently.

It upsets me that I've done all the hard work and proven that I've got incredible willpower, yet this psychological problem with physical manifestation still plagues me.

With my bipolar disorder, I have to be very careful to manage my stress levels, make sure I get enough sleep, have a good routine, eat well and generally look after myself, but I still suffer bouts of depression and episodes of mania. I have to be very careful to not get carried away when the early warning signs of mania and the triggers are present. I have to struggle an incredible amount to hide the fact that I regularly have debilitating depression and suicidal thoughts.

With addiction, we're told that there aren't any tablets to treat it, unless it's a physical addiction. My kind of addiction has supposedly been cured, because I've used the only treatment option that's available: willpower. For over a year, I've managed to control my addiction to my substance of choice, by simply willing my addiction to go away.

It seems a little remarkable to me that I've managed to rebuild a lot of my life and I appear to be a very functional fine upstanding member of society, but yet I'm sick enough to cause concern to my nearest and dearest. How can I be so sick when I've been doing all the right things? How can I be so sick when I haven't done anything wrong? I've followed the textbook to the letter, but reality does not correlate with the wishful thinking you find in the textbooks.

In a perfect world, I'd disappear for a month and go lie a beach in a hot country. In a perfect world, my income would be secure. In a perfect world, I wouldn't have Damocles' sword dangling over me all the time. In a perfect world, I'd put my health first and society's expectations and the unbearable pressures on me second.

This is not a perfect world. I'm trying to build a glider while falling off a cliff.

Tags: #addiction

This is a story about primary care...

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Tags: #nhs

This is a story about being functional...

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

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

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

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

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

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

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

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

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

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

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

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

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

Tags: #alcohol #addiction

This is a story about 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 crossing a line...

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Tags: #writing #ptsd

This is a story about the most depressing day of the year...

I had a game plan for this week. I thought everything was going to be OK. I woke up and I felt awful. Then, I started feeling progressively more awful.

Past performance is not a guide to future performance. Just because I had an OK day on Friday, doesn't mean that I'm going to have an OK week this week. Just because I can appear to be functional at times, doesn't mean that I'm cured of depression and other debilitating mental illness. Just because I did my job doesn't mean I'm going to be able to crank out day after day of great performance at work. Most of the time my life sucks.

Of course, a lot of people's lives suck. A lot of us are stressed and exhausted and overwhelmed. A lot of us have almost intolerable levels of anxiety and other mental ailments that make our heads feel like they're going to implode. A lot of us say to ourselves "I can't do it; I can't go on; I can't cope"... but we do.

Just because we're appearing to cope doesn't mean that we really are coping. Some of us are building up to a breakdown of some sort. Some of us are pushing ourselves to the limit and beyond in an unsustainable way that's going to end in disaster.

I do a lot of whinging, don't I?

Of course I don't think I'm unique. Of course I don't think that my problems are worse than anybody else's. Of course I don't think that issues are insurmountable. Of course other people have survived worse. Of course I'm aware that my perceptions are warped by depression and anxiety, such that everything seems to be broken and disastrous and intolerably unbearably awful. But none of that matters - the fact is that one day you wake up and you just can't go on. One day, no amount of bullying and coercion will get you out of bed.

I used to stroke my cat and talk to him. I used to potter round my garden and talk to my plants. I used to talk to my significant other. Now, I talk to myself. I'm alone with my thoughts around-the-clock.

My job is incredibly isolating. I have no real reason to talk to anybody. I'm expected to be plugged into the Matrix, quietly making software. I'm expected to be some kind of robotic software-making machine, sitting silently in a corner churning out software systems, with zero human interaction required.

My home life is 5/7ths isolating, sitting alone in hotel rooms trying to connect with the world via the internet. London's not an unfriendly place, but locals definitely think you're a bit strange if you try to start a conversation with them. I suppose I could go looking for groups of gregarious tourists who'd be happy to chat to somebody who knows this city well, but it's exhausting doing all that getting-to-know-you stuff. It's exhausting to work all day and then have to carry on working just as hard - if not harder - to put myself out there and meet people.

So, here I am, in yet another room I'd never set foot in before. The noises are all different. The light is different. The bed is different. The bathroom is different. At night, different things wake me up. My body and brain are on high alert in this alien environment. I'll get used to it, but it's exhausting staying somewhere new every week.

I should have been at work today. Work is a known quantity. I know exactly what work I've got to do. I know roughly how I'm going to do my work. Nobody else is going to do anything - it's all down to me. My work will still be there, exactly how I left it. It's a job I've been doing for over 20 years, so there are no surprises. The familiarity makes it exhausting somehow - I get anxious about solving problems I've solved a million times before. I get anxious, because I know exactly how it makes me feel.

I hit the wall today. I couldn't get up. I gave up.

It's not like I had the flu or arterial bleeding gushing from a gaping wound. It's not like I had a legitimate excuse for not going to work, I just felt really shitty.

How can I explain it to you, that I really felt like I couldn't get up and face the day? How can I explain that although I was able to get up and buy myself something to eat at 3pm in the afternoon, I couldn't leap out of bed and dash off to the office at 8am? How is it possible to reconcile the fact that if I could be bothered to breathe, then surely it would have been possible to go and do 8 hours work?

I feel run down but I don't feel sick. I don't have nausea, vomiting, diarrhoea, pain, swelling, tenderness, bleeding, bruising or any other physical symptoms to speak of. I feel exhausted, but I haven't recently run a marathon or climbed a mountain. I feel sad but I haven't recently lost a loved one. I feel anxious but I'm not trapped in a cage with a tiger. In theory, I shouldn't be feeling anything other than tip-top, ready and raring to go to work.

I don't know what to say, other than that I feel guilty about feeling like this. I feel guilty that I haven't gone to work when so many other people have done today. I feel guilty that I've spent time in bed when I haven't got any obvious physical symptoms of illness.

When I've felt like this before, I've been tested for thyroid problems and even AIDS. I've been subjected to a barrage of tests on my kidneys, liver and blood. I've been poked and prodded for any possible physical reason why I'd feel tired and unable to leap out of bed and enthusiastically rush to my desk in my office. No physical illness has ever been discovered. I'm not physically sick. I must be making it up. People in Africa wouldn't lie in bed like I do.

I sometimes wonder if we're supposed to get up when it's still dark, in the middle of the wettest and coldest months of the year, in order to go to jobs that are soul-destroying.

I wonder if one day, somebody's going to be brave enough to say "actually, you're having a sane reaction to an insane world" and give me a prescription for exemption from the bullshit of the rat race. It's surely grossly unhealthy to experience as much unhappiness as I do. It must be damaging to be as stressed as I am. It must be enough to make me sick, to be so isolated and lonely.

I walk down the road, or I sit at my desk, and I chatter away to myself. I write this blog because I need somebody to chat to. I have no regular healthy human contact. Everything shifts around me constantly. New places; new people. I assume that everything's all transient; temporary. What's the point in getting attached to anything or anybody? What's the point in feeling settled and contented - my whole world gets smashed to smithereens all the time anyway, so what's the point of anything? What's the point of life?

There's this massive gash; an open wound. I've got a staggeringly terrible injury, but nobody seems to acknowledge it. It's like I'm walking around with my arm hanging off and blood pissing out onto the ground, and everybody's just ignoring it. "It's just a scratch. You'll be fine. Just go to work like everybody else. You don't see other people making such a fuss, do you?"

But, I am making a fuss. I'm bunking off work, which always pisses people off ("lazy scrounger parasite" etc) and I'm lying in bed, which also pisses people off ("layabout idle waste-of-space" etc). What's my excuse? Because I don't feel very well? Not good enough. What possible reason could I have for not feeling very well? What's my excuse?

I've got antidepressants, but I don't take them. I've never taken antidepressants.

"Well, there's your problem"

Erm, yeah... if you say so. But what causes depression?

"Chemical imbalance"

Right. So what causes the "chemical imbalance"?

"I dunno. Genes or something"

Ok, but did you know that two genetically identical mice can end up looking completely different depending on environmental cues that cause different epigenetic expression of genes? That is to say, two mice with identical DNA won't always end up being identical individuals. Even with identical DNA, the environment can influence identical twins to become non-identical in appearance.

You're right, I don't live in Africa. I don't live in a warzone. My life's just peachy. What could I possibly have in my environment that would induce anxiety and depression in me?

In the last year, what's the ratio of traumatic events versus consistent things you have in your life? Did you stay in the same home? Did you stay in the same job? Did you stay in the same area of the country? How many kids do you have? Did you have the same partner? How many family members do you see and speak to on a regular basis? How many times were you hospitalised? How many times were you arrested? How many times did you think you were going to go bankrupt? How many times were you homeless? How many times did you think you were going to die?

It's not a competition and I'm not trying to elicit sympathy.

I'm exhausted and depressed and anxious, and I don't really know why, but it's not because I don't take antidepressants.

Tags: #depression