Tag: medication

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

This is a story about pill popping…

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

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

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

No. No I was not.

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

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

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

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

tags: #mentalhealth #bipolar #medication

11 October 2017
Better Living Through Chemistry

This is a story about decisive weapons….

Would I rather have the pilot of my plane, the driver of my bus, taxi or train, as a completely drug-free ‘clean’ individual, or would I rather that they had taken 5mg of dextroamphetamine before our journey? The answer is the latter, obviously, because they will be more alert, have improved ability to concentrate and faster reaction times.

US fighter jet pilots routinely use ‘go’ pills before a mission, which confer the abilities above, as well as allowing them to fly longer missions with less risk of dangerous sleepiness. Many road accidents are caused by people falling asleep at the wheel. Coffee will only give you a tiny fraction of the benefits of a ‘go’ pill.

Do you find that after a really important day at work, where you had to be at the top of your game, and you were firing on all cylinders; perhaps you had a bunch of coffee to keep you sharp…. do you find that you’re still buzzing when you get home, and you have trouble switching off and going to sleep?

Coffee – especially the super-strong stuff we seem to drink in London and New York – can contain up to 300 to 400mg of caffeine, in for example a Pret-a-Manger strong cappuccino.

The problem with caffeine is that it’s a bit of a crude stimulant with lots of extrapyramidal side effects. That is to say, as you increase the dose of caffeine, most people can’t tolerate the way it makes them feel. Interestingly, intravenously, amphetamine addicts can’t tell the difference between amphetamine and caffeine. Also, most intravenous amphetamine users believe they are being chased by ‘them’ – the police, men in black, shadow people, ninjas, whatever – but these side effects are just part of the fun.

So, the beauty of the ‘go’ pill is that it seems that I get all those desirable effects, with no side effects. You would be completely unable to tell that I was under the influence of 5mg of dextroamphetamine. Recreational use of amphetamines is normally quite obvious to spot: talking too fast, sweating, dilated pupils, restlessness, jerky unnatural movement. No side effects? Well, not quite.

US fighter jet pilots use ‘no-go’ pills at the end of a mission. Having been kept awake and alert for hours, it’s now time to go to sleep or at least chill the fuck out. Sleep can be difficult without a ‘no-go’ pill.

My personal ‘no-go’ cocktail allegedly contains Xanax (alprazolam) and zopiclone, which have hypnotic, sedative, muscle relaxant and anxiolytic properties. To be honest, you could probably get to sleep naturally if you took your ‘go’ pill as soon as you got up, but it’s pretty exhausting spending a full day in a highly alert state.

Isn’t it madness, me taking all these pills? Shouldn’t I just go ‘clean’? Isn’t it best that I’m completely drug-free?

Do you remember when you quit smoking? You chewed a lot of gum, ate a lot more, drank more tea and coffee. Do you remember when the kids were little and life was really stressful? You drank a lot more gin. Do you remember when there was that project with a really tight deadline and you were working really hard; drinking lots of coffee? You were drinking lots of wine in the evenings to relax. Basically, humans will compensate to make sure things remain balanced. If you hurt your foot, you might find your back is aching, because you’ve shifted your body weight to one side, to put less pressure on your injury.

My injury’s a brain injury and the best thing you can do for the brain is to allow it to find its own equilibrium. However, life must go on. My brain’s telling me to go to sleep in a dark room for a month or two, but I need to attend hospital appointments, do the administration for my company, line up my next IT contract, find a new flatmate, move money around and make sure the cash keeps flowing and doesn’t run out.

A bit of dextroamphetamine is an effective antidepressant and helps fight any supercrack cravings. It’s like methadone for a supercrack addict.

I’m on a mission to get back to coffee and wine as my ‘go’ and ‘no-go’ substances. I actually worked really hard to break my caffeine addiction, and now I only drink caffeinated drinks on extremely rare occasions. I’m certainly not habituated into having my morning coffee or cups of tea throughout the day, like the majority of adults are. This is how addiction works: you don’t cure the addiction, you just replace it with something else. There was a time when I loved playing with toy cars. I had hundreds of them, and I played with them all the time. Then, I got a computer, and I loved playing computer games… and the process of swapping one addiction for another continued. I’ll be just fine and dandy with some tasty food, wine to wash it down with, TV and film to distract me and a girl to put my arm around and take to bed for some rumpy-pumpy later on. That ought to just about tick all my boxes.

In the last two weeks, I broke my addiction to two opiates – tramadol & codeine – and I’ve obviously been off the supercrack for the best part of a week now. That’s fairly impressive. Please forgive me for having the occasional G&T, glass of wine and my little ‘go’ and ‘no-go’ pills, just to keep the pedals turning.

I’ve got a torn muscle and ligament, damaged nerve and fractured ulna (bone in my arm) but I spend most of the day with no pain relief at all. It’s only at night that for some reason all these injuries start feeling super painful and I might take a couple of co-codamol.

Interestingly, amongst the opiates, heroin was named because it was thought it would have military applications, making soldiers more heroic. Heroin addicts certainly do seem to be prepared to do almost anything to get their fix and not get junk sick. I guess the idea was perhaps to addict the soldiers, and then deny them their heroin until they had done their mission. I can’t really imagine it’d be a great idea to have a platoon of men who are pretty much just dribbling and half-asleep. The Nazis had the better idea, giving their soldiers crystal meth. The nickname “marching powder” for cocaine is literally what it sounds like: cocaine was given to soldiers so that they could go on longer marches. You might think of the pharmaceutical industry as concerned only with the treatment of disease, but they have profited handsomely from military concoctions.

Adding fluoride to the water supply has made a major impact on the rates of tooth decay. Drug evangelists have touted LSD and MDMA as other candidate chemicals to be added to our drinking water. The idea being that criminal and aggressive behaviour might be replaced with love and empathy, or the ‘sheeple’ might have their consciousness expanded. For clarity: I do not endorse such ideas.

“Go to the doctor” is now a synonym for “go get some pills”. People are extremely disappointed if they don’t come away from a doctor’s appointment with a prescription for some lotion or potion. The reflexive response of people if you ever say you are in pain, is to offer you aspirin, paracetamol, ibuprofen or preparations containing codeine (e.g. co-codamol and Solpadeine). People have looked at me in shock and horror, when I tell them that I don’t take any medication for the incurable mutative virus: the common cold. What part of incurable didn’t you understand?

Many people with mental health issues are asked “did you take your pills today?” or told “maybe you should up your dose” by people with no medical training or expertise, who they simply encounter in their day to day life, such as family members, friends and work colleagues.

We should be mindful that psychopharmacology is only 60 or 70 years old at most, as a fairly advanced field with the accompanying branch of medicine: psychiatry. Before psychiatry, chemists could offer preparations containing opium, cocaine, cannabis; all of which treat symptoms, not underlying issues. We will look back 50 or 100 years from now, and laugh at how primitive our medicine was… especially when it comes to addiction, mental health and the psychoactive compounds.

One final thought: if the majority of us are taking medication for depression, stress and anxiety, are we sick or are we actually victims of a sick society?

Tags: #drugs #addiction #medication #mentalhealth

6 April 2017
Only Smarties Have the Answer

This is a story about a pill for every ill…

There was a young man who swallowed a lie, about how hard work and loyalty to his company would make him successful. It left him exhausted and with depression, that wiggled and jiggled inside his brain. I don’t know why he swallowed the lie. Perhaps he’ll die.

There was a young man who swallowed 150mg of Bupropion – a fast acting antidepressant – to cancel out the depression and exhaustion, that wiggled and jiggled inside his brain. Perhaps he’ll die.

There was a young man who swallowed 5mg of Olanzapine – a mood stabiliser – to cancel out the hypomanic highs that were created by the Bupropion, that was supposed to fix the depression and exhaustion, that wiggled and jiggled inside his brain. Perhaps he’ll die.

There was a young man who swallowed 15mg of Mirtazapine – another antidepressant – because the Bupropion wasn’t working so well any more on its own, to fix the depression and exhaustion, that wiggled and jiggled inside his brain. Perhaps he’ll die.

There was a young man who swallowed 25mg of Lamotrigine, to raise his seizure threshold so he could take more Bupropion, stabilise his mood more and as a third antidepressant, to fix the depression and exhaustion, that wiggled and jiggled inside his brain. Perhaps he’ll die.

There was a young man who swallowed 10mg of Diazepam – an anti-anxiety drug – because by now he was pretty jittery from all the damn drugs, that were supposed to fix his depression and exhaustion, that wiggled and jiggled inside his brain. Perhaps he’ll die.

There was a young man who was going to swallow 2,000mg of potassium cyanide, to end the depression and exhaustion, that wiggled and jiggled inside his brain. Of course he would die.

Top picture, from left to right: Mirtazepine, Olanzapine, Bupropion, Diazepam, Lamotrigine.

Tags: #depression #bipolar #medication #suicide #career

25 October 2016
The Dark Web
This is a story about drug dealers…

The top image shows an official UK prescription. A doctor registered with the GMC prescribed me the medication and a pharmacist registered with the GPHC filled my prescription. The bottom image shows black market prescription drugs for sale on the Dark Web. When you buy from the Dark Web an anonymous vendor will sell you whatever you want, no questions asked.

In order to receive my official prescription, I had to answer 14 yes/no questions. One of the questions was “do you have high blood pressure?”. How the hell should I know? The last time I had my blood pressure checked was 11 months ago, and I’ve gained loads of weight and have been drinking far too much since then.

According to my order tracking, a doctor spent 7 minutes deliberating my 14 answers – 30 seconds per answer – before writing my prescription. I never met this doctor, we never spoke and they never saw my medical records.

Some years ago, with a great deal of arm-twisting from my private psychiatrist, my GP agreed to prescribe me Bupropion for the depressive episodes of my bipolar disorder. In the UK, Bupropion is not licensed for the treatment of depression or bipolar disorder. NICE guidelines do not recommend the use of Bupropion for anything other than as a smoking cessation treatment. Basically, my GP faced being struck off the GMC register if I suffered some horrible medical complications because of an adverse drug reaction.

I’ve been back in London for 3 years and I’ve had 2 different GPs since then: one in Camden and one just across the road from where I live. Neither of them has prescribed me a single medication, but the Camden GP took it upon himself to phone me on my mobile in his personal time to see if I was still alive. My GP went out of his way to try and help me.

The average face-to-face GP consultation time in the UK is just under 9 minutes. Imagine having just 9 minutes to establish that somebody is suicidally depressed and then select a psychiatric medication for your patient. The medication could either save them or reduce their quality of life even more. It’s not much time, is it?

And so, I became an educated well-informed patient. A doctor I spoke to some years ago said that I would be better off finding a “prescription pad psychiatrist” who would write me a prescription for whatever I wanted. These doctors exist. They’re available online, without even having to meet them or speak to them on the telephone, it would seem.

I have no criticism of the ethics of what the doctor and the pharmacist who I obtained my official UK prescription from are doing. It doesn’t seem unethical to me.

Interestingly, it cost me £90 for 60x 150mg Bupropion tablets. I could easily buy the exact same medication for less than half that price on the Dark Web. If I was to buy the medication from India, it would cost me less than £6 (plus postage).

On the NHS, a prescription costs £8.40 if you’re working and not entitled to welfare benefits.

Basically, you pay for convenience. With the online pharmacy I had a short form to fill in and I got my medication delivered next day. With the Dark Web, I would have had to faff around with Bitcoins, but my medication would also have been delivered next day. With my doctor, I would have had to make an appointment, and there’s every chance that they wouldn’t have been prepared to take the risk of writing an off-label prescription. With the Indian medication, their postal service is appalling and it takes weeks for a delivery to arrive.

One reason not to order from the Dark Web though, is that you can get anything you want. It’s easy to start window shopping. Once you’ve loaded up your account with some Bitcoins, it’s easy to fill up your ‘shopping basket’ with all kinds of things that you’re curious about, or things that you know you really shouldn’t be buying because they’re bad for you. It’s a slippery slope.

One of the reasons why I don’t have any drug dealers phone numbers and I’ve never bought drugs from a drug dealer, is because it’s so convenient. I don’t believe in the idea of a ‘pusher’. People want drugs, plain and simple. The drugs push themselves.

One of the reasons I’m not using internet banking at the moment, is because it makes it too easy for me to buy some Bitcoins, transfer them to a Dark Web marketplace, and have a little jiffy bag containing deadly white powder, hitting my doormat the very next day.

I don’t believe prohibition works, but certainly making things a little more inconvenient does offer some protection from temptation. I wouldn’t even know where to begin, trying to find a drug dealer, unless I wanted to buy low quality cannabis or terrible quality imitation cocaine from one of the many dealers who hang around by Camden Lock.

Prohibition created legal highs. Prohibition created the Dark Web. Because I’m an IT expert and a sensation seeker, when I read about legal highs in the news I was tempted to give them a go. The rest is history. All of that “moral panic” crap in the media had precisely the opposite effect than intended. A naïve middle-class IT professional working for an investment bank, suddenly became exposed to a world that I would never have become part of, if it wasn’t for the fact that prohibition lowered the barrier to entry.

As the legal highs started to get banned, I then took to Internet forums to find out where people who had stockpiled – like me – were supposed to go after we ran out of drugs. That was how I found out about the Dark Web. Yet again, prohibition moved me from a world that was legal, taxed and regulated, towards the dark and murky world of illegal drugs.

One day, in a pit of despair at my spiralling addiction, I decided to order all the drugs. I bought crack, heroin and crystal meth. I didn’t even know what to do with them. You can snort heroin and meth, but not crack, as it turns out. How does a middle class homeowner even smoke crack? I didn’t even own a cigarette lighter.

A couple weeks later, I had nailed my door shut and put newspaper all over the windows. It’s remarkable how quickly a respectable middle-class rich person can turn the house they own into a crack den.

What’s also remarkable is how quickly you figure out that you’ve bought a one way express ticket to an early death, if you have vast sums of money and a reasonable intellect.

One day, I smoked a pipe – I had bought a meth pipe off the Dark Web by this point – that had been filled with heroin, crack and meth. I thought “is this as good as it gets?”. The room was bathed with a yellow light, even though it was barely lit. There was a calm serenity. I thought “this ain’t even that great” and decided that I’d better stop before I decided that it was great.

It’s the strangest thing, flushing rocks of crack and a big bag of heroin down the loo, not because you’re addicted and you want to quit, but because you can see how easily you could become addicted.

People think that drug addiction is all about wanting drugs and taking drugs, but it’s not that at all. Drug addiction is about identity, routine, habituation, ceremony, lifestyle… things that I even struggle to explain. If you’re just locked in a room with a virtually limitless supply of drugs, because the postman keeps bringing your supply and you have lots of money in the bank… you’d think you’d just take drugs and more drugs until you died or ran out of money.

In actual fact, addictions are self-limiting. Given a clean pure supply of drugs, eventually, addiction becomes kinda boring or the downsides start to outweigh the upsides.

I’m lucky, because I’m wealthy and I’m not a total dumbass. I tried so many drugs, and eventually found one that was far better than crack, heroin or crystal methamphetamine, but cost less than £1 a day.

I used to buy a packet of capsules off the Internet for £27. This was a legal high called “NRG-3”, which turned out to be MDPV: I’ve nicknamed it supercrack. The packet contained 20 capsules, and each capsule had 100mg of MDPV in it. I would hide these capsules all over the house, so that I would never have to hunt for very long to get my fix, when the cravings became unbearable.

I would divide the 100mg contents of a capsule into 3 equal piles. Then, I would divide one of the piles into 2 lines. I would snort one of the lines, which would weigh approximately 17mg.

17mg of MDPV is a very strong dose. Basically, it’s enough to be bat-shit insane for 24 hours. I would pretty much always end up going back for the second line… so that’s 48 hours of insanity, with no sleep. I would go back to work for a rest.

120 days of bat-shit insanity for £27.

Cheap.

Deadly.

You spread 120 days over the weekends, and you’ve got 2 years worth of hiding a drug habit. If you do anything for 2 years, it becomes an integral part of your life. It’s hard to change the habits of a lifetime. Again, you’ve gotta be smart and spot the changes in your behaviour.

I started cancelling plans, because a 1-day drug binge turned into a whole weekend drug binge.

I started not making any plans, because I was planning on taking drugs all weekend.

How the hell I held down a job during this time, I have no idea.

My psychiatrist and my GP thought I was self-medicating for depression. They thought I was in control. They actually told me “don’t stop what you’re doing… just try to cut down gradually”. My GP signed me off work for 5 weeks, and I thought “great! I can take drugs for 4 weeks and then spend a week recovering”.

It’s true that my clinical depression and abusive relationship had led me to self medication, but when it became drug experimentation, I lost control over the course of a year. I started with a legal drug called Methylone, which I took every day and it worked to alleviate my depression. Then, when I found NRG-3 during a messy breakup, I was completely hooked.

Less than a month after becoming addicted to NRG-3, I started carrying a letter with me and a £20 note in an envelope. The letter said:

“I am a drug addict. If you have found me with breathing difficulties or unconscious, please put me in a taxi to A&E”.

In actual fact, the letter was far more detailed and contained some information that would have been useful for any medical professionals who had the misfortune of trying to look after me… but you get the idea. The penny had dropped. I knew I was in trouble. Self-medication had turned into experimentation, which had unleashed addiction.

For others, there are 3 valuable lessons I learned:
1. Depression, stress, relationship difficulties, money worries, housing worries: these are the things that create a festering swamp. Addiction will take hold, not because of the drugs, but because somebody’s life is already awful. If you want to prevent addiction, you need to improve people’s lives, not ban drugs.
2. Even though it sounds disingenuous, it does make sense to shop around. Think about all those Oxycontin addicts who haven’t yet figured out that heroin is stronger and cheaper. They’re going to one day. How much money are they going to ‘waste’ in the meantime?
3. Addictions are naturally self-limiting. People need to quit on their own terms. There’s an oft-quoted line about how addicts and alcoholics “can never get enough of their drug of choice”. In actual fact, very few people can actually afford to take as many drugs as they want. Look at the mega wealthy: aren’t you surprised that so few of them drop dead from drug abuse?
Alcohol is a dumb choice of drug, because it’s so damaging to the liver. In a way, benzos are the smart alternative. GHB/GBL makes you ‘drunk’ but it doesn’t have the same hangover, and it’s not so damaging to the body. You can buy 10 litres of “alloy wheel cleaner” from BASF in Germany for about £500. That’s equivalent to 7,000 shots of vodka, and it won’t give you cirrhosis of the liver.

Cocaine is a dumb drug of choice, because it’s so expensive and the adulterants are highly damaging to the mucous membrane in your sinuses, to the point where you might lose your nose. You can buy nitracaine from China in bulk for just a few dollars per gram, and it’ll be 99% pure.

Heroin is damn cheap. It’s the injecting that causes the problems: collapsed veins, abscesses and dirty needles leading to blood-borne diseases. With an adequate supply of medical grade diamorphine, a heroin addict can live a long, healthy happy life, and will probably “grow out” of their habit in their 40s or 50s.

Crystal meth is cheap anyway. Smoking meth is undoubtably incredibly destructive to teeth and lungs. It sounds crazy to say this, but given an adequate supply, at least crime will go down and the need for prostitution goes away. With higher self-esteem because people are not selling their body to get drugs, surely a large number of addicts are going to stop using eventually?

I’m not saying “legalise all drugs and have your local supermarket stocking crystal meth”. Drugs are so widely available and so cheap, we’re at the point where prohibition is like a bad joke. Shutting the original Silk Road marketplace on the Dark Web just caused dozens more imitators to spring up and fill its place. You can’t legislate to control human nature. It doesn’t work. Supply and demand are the only forces that you need to understand.

If you have a loved one who you think is at risk of addiction, or struggling with addiction, you can prevent that journey from even starting by making their life vastly better so that addiction never takes hold. Once an addiction has started, you’re not going to be able to cut it short by cutting off their supply of money or forcing them into some rehab program. An addict will simply go around any obstacle. An addict needs to quit on their own terms, when they’ve had enough.

Perhaps I will never have had enough, because perhaps my life will never improve. Certainly, when you’re depressed, stressed, bored shitless by your job, worried about money, isolated and lonely… those things are perfect breeding conditions for addiction to take hold. Why the hell are you being clean & sober, if your clean & sober life is utter bullshit?

This is how I’ve arrived at the decision to start using drugs again.

Except, I’m being smart… I think. I think I’m smart. Correct me if I’m wrong. Am I smart?

What am I doing differently? Well, nothing really. I’m combining my experience from far too many years of ups, downs and dangerous self-experimentation. However, I have meticulously gathered data. I have documented pages and pages of details on my drug and medication use, and cross-correlated that with my mood diary, earnings, movement data and every other data source that I could harvest.

My conclusion: I need a fast-acting antidepressant that gives me a mood improvement.

So, I decided to prescribe myself Bupropion.

It arrived today.

I took it.

The experiment continues. It’s a big relief to finally change something, after 6 painful months of controlling the variables, even though it was causing me untold mental anguish.

Actually, two things changed today, which is a shame, in terms of conducting a decent trial.

Today, I’m unemployed.

Anyway, I need to get another job, and it might just be a little easier, now that I have relented and I’m taking happy pills… let’s see, shall we?

Tags: #drugs #addiction #mentalhealth #medication #depression
22 September 2016
Right to Die

This is a story about euthanasia…

I need to cover what I’m about to write with a hefty preamble, full of caveats and other disclaimers, because there are so many considerations with this issue, but it’s an issue I need to tackle.

Firstly, let’s consider this: nobody really wants to die.

For people who are in pain and other kinds of physical discomfort, or are otherwise afflicted by diseases, injuries or genetic problems that mean their quality of life is terrible, or certainly going to end up terrible: these people do not want to die. Those people would dearly love for a cure or some kind of relief from their symptoms that doesn’t come with intolerable side effects.

Clearly people who want to prematurely end their lives in a dignified manner, have exhausted all treatment options, and their future looks bleak: pain, discomfort, infirmity, senility and disability.

Alzheimers and other kinds of incurable degenerative brain diseases carry the added worry that the sufferer will no longer be of a sound and rational mind when the illness reaches its late stages, and they will burden their carers, while perhaps not even being able to recognise their loved ones any more.

Let’s also consider this: some people have hope, while others do not.

Yes, there’s always a chance of a miracle cure. Yes, there’s always a 1-in-a-trillion shot that God might personally intervene to remove the horrible afflictions that he originally cursed you with.

Most people love life and can’t bear the thought of being torn from the arms of their loved ones. Most people cry out in fear, when they think they’re about to die. Most people fight to survive.

There are people who have gone through many bouts of surgery, chemotherapy, radiotherapy, transplants and who take bucketloads of medications with horrible side effects, and generally battle through awful sickness and pain, holding out hope that their ailments will be at least treated well enough to prolong their lives a little longer.

Some people might spend a long time on a transplant list, barely surviving, while oxygen and dialysis just about preserve them while they wait for a donor match. An agonising race against time happens: will a donor arrive before the illness kills the poor helpless person who can only sit and wait?

I feel like I should use softer language, to cushion the blows for every person who’s lost a child, parent, friend, partner, relative. Death is painful, and all the more so knowing that a person had so much more life left in them. Death can be so cruel. People so deserving of more life can be snatched away, while others who are seemingly careless with the gift of life can seem so selfish and ungrateful for their good fortune to have been spared by the gods.

And it’s the ungrateful ones I want to talk about.

What do you do with the alcoholic who ‘wants’ to drink themself to death? What do you do with a suicidal person?

The footballer George Best famously received a liver transplant, and then proceeded to court controversy when he was caught drinking again. Instead of demonstrating his gratitude for his stay of execution, by becoming teetotal, he was clearly the same person – ungrateful for life some might say – as he was before he received an organ donation.

What do you do with somebody who is determined to kill themself? Do you put them in a straightjacket and keep them in a padded cell indefinitely, just so that they can die of old age in an asylum?

It might be the case that a suicidal person is in perfectly good physical health and does not abuse drugs or alcohol, but they are nonetheless determined to end their own life prematurely.

There’s a general belief that telling people that their lifestyle is much akin to suicide, will curtail their health-damaging behaviour. Doctors mostly seem to take the route of saying “if you keep drinking, you’re going to die young” to alcoholics. While most people would think that this would shock somebody into cutting down their drinking, in fact there’s little evidence that it has any affect at all.

Similarly, telling suicidal people “you’ve got so much to live for” and “it’s just your depression telling you lies” and other statements that make perfect sense to people who are not suicidal, is also ineffective. The only thing that has proven somewhat effective – as far as short 12-week studies paid for by pharmaceutical companies can tell – is psychoactive medication.

Smoking causes many preventable diseases, and is a big killer, but yet people still choose to smoke even though it’s expensive, makes you smell and stains your teeth. You would have thought that the large “SMOKING KILLS” health warnings on packets would cause people to stop smoking immediately, but no.

You know what one of the most effective smoking cessation treatments is? It’s the antidepressant called Wellbutrin (marketed as stop-smoking drug Zyban and generically known as Bupropion).

Why would an antidepressant be a good treatment for smokers? Well, let’s consider two things: firstly, people smoke because they’re missing something. Take smoking away, and a smoker’s life is now incomplete. Removing nicotine and the habit/ceremony of smoking leaves a void in that person’s life. Also, you’ve got to be fairly depressed to do something that’s clearly a threat to your health, and possibly your life.

Wellbutrin is a fast-acting antidepressant, unlike anything we can get on the NHS. Instead of making people feel sleepy and emotionally numbed, Wellbutrin has been proven to offer a number of improvements in the lives of patients, including their sex lives. Wellbutrin is France’s most popular antidepressant.

What do you really want from an antidepressant, other than to relieve your symptoms of depression now when you’re feeling it? Being told that a medication might take 6 to 8 weeks to become effective, and then having to suffer your symptoms that whole time while you’re waiting is no use at all! Some depressions will lift naturally after a month or two anyway.

But what goes up must come down. After some weeks or months taking Wellbutrin, many patients experience panic attacks and insomnia. Plus there’s the obvious problem of having to stop taking the medication at some point, and suffering the comedown (sorry, I mean withdrawal syndrome).

Yes, the difference between ‘drugs of abuse’ and ‘prescribed psychoactive medications’ is precisely zero. Every medication that has an upside also has a downside. Addiction and habituation with prescription medications is just as much of a problem as with street drugs. The only difference is medical oversight and quality control.

And so, I arrive at the situation where I’m perfectly well aware that I can get short-term relief for the symptoms of my depression, in the form of a pill from my doctor. However, I’m equally aware that to go down that road is to have a lifetime dependence on medication for my sense of wellbeing. Basically, do I want to be a medically sanctioned drug addict? None of the stigma, but all of the same behaviours.

You’re right, I wouldn’t have to lie, cheat or steal to feed my habit. I can wander into my pharmacist, and get my uppers over the counter, and carry on like I’m a fine upstanding member of the community. Did you know that even heroin addicts are completely functional members of society, when they can get a clean high quality supply of the opiates they need? When doctors in the UK used to prescribe heroin, there were none of the antisocial problems that we instinctively associate with drug abuse today.

Of course, I’m not advocating drug abuse, but then I’m also pointing out that the flaws that afflict a smoker, a drinker, a junkie and even a depressed person… they’re all rooted in the same psychological need to cure an invisible illness.

Pretty soon, I will have spent a year where over 75% of the time I was using no psychoactive substances at all, except for alcohol. A period of 115 consecutive days – 32% of the year – I was completely teetotal. For the whole year I had no tea, coffee, cola, energy drinks, or caffeine containing headache pills (more common than you think). I’m completely unmedicated.

How do I feel? Awful.

It seems to me like I have a choice: suicidal depression, or drugs (i.e. medication, coffee & alcohol etc.)

I know that a scientific study with one participant tells us nothing, but equally I’m not a group, I’m me. You can’t dismiss my individual findings, that are true for me. I’ve gathered the data during a 20 year career, and I’ve come to the conclusion that my life is unliveable in its current form.

When you are conducting a scientific study, you have to control the variables. Thankfully, I’m an ideal test subject for this.

Since the age of 17, I’ve been a very well paid software engineer. For sure, during the first couple of years it took me a while to get my salary up to a decent level, but since the age of 19 I’ve never had to worry about money. Also, I’ve done pretty much the same thing for all my career: sitting at a desk, tapping on a keyboard, making software.

I’ve had the same running crisis my whole career. When I was 19, I was bored so I applied to university and was offered places at some very prestigious institutions to study psychopharmacology. I decided to stick with the money, and keep selling my soul to the highest bidder.

When I was 28, depression had crushed me to the point I was on my knees and unable to turn up and do the same office bullshit anymore. I retrained as an electrician and started my own company.

As a self-employed tradesman, I loved what I did, but I was grossly underpaid for the level of responsibility I had. Ordinary members of the public think that tradesmen are out to rip them off. In reality tradesmen are highly trained professionals whose job it is to stop houses burning down and families being electrocuted or poisoned by carbon monoxide.

The freedom of not having a boss, not having a 9 to 5, Monday to Friday routine, and not having to sit in the same damn chair at the same damn desk, pushing the same damn 102 keys on the same goddam keyboard… all of those things are just as great as they sound. However, getting paid peanuts to do dangerous dirty work is also not great either.

And so, I returned to what I’m experienced and qualified to do.

I earn staggering amounts of cash for moving my mouse around and looking busy at a desk. However, I used to earn £470 per day when I was 20 years old, doing computer programming for Lloyds TSB back in the year 2000. My job is exactly the same today, doing the same damn computer code for HSBC, JPMorgan, Barclays or any other damn bank.

But maybe the problem’s banking? Nope. I’ve written computer code for nuclear submarines, torpedos, school computer networks, trains, parking ticket machines, busses, security guards, shop assistants and just about every other weird and wonderful industry you can think of. I’ve written in dozens of programming languages, for dozens of operating systems, on dozens of form factors. It’s all the fucking same binary 1s and 0s and boolean algebra under the covers. All code is made from the same nuts and bolts. It’s fucking boring.

And so, I can be a miserable exploited worker on a low wage, doing something I take pride in but knowing that I’m undervalued. I can be an overpaid and underworked software developer / scrum master / development manager / IT director. I can be a stressed out startup founder working my arse off to line the pockets of the venture capitalists who are going to get filthy rich at the expense of my health. I can be a destitute bum, a tramp, a hobo. Which would YOU choose?

I particularly object to the idea that I have to drug myself up, just to fit in with the bullshit jobs economy. I object to having to be high on antidepressants just to be able to cope with the same bunch of fucktards making the same fucking mistakes I’ve seen a million times over, in the job that I’ve mastered and brings in obscene amounts of cash. I object to having to be high on anxiety medication, to cope with the insecurity faced by the underpaid and undervalued front-line members of society who build your houses, look after you in hospital, grow your food and perform every other truly useful function that we need.

Even to work in civil engineering would frustrate the hell out of me. Crossrail, the multi billion dollar project improve London’s cross-capital transportation, is rather pointless because it will be at full capacity on the day it opens, because London is already packed full of idle fucktards like me, clogging up the world with pointless makework jobs. Do we really need any more offices and office workers? Do we really need any more service sector jobs? Do we really need such a bloated financial services sector, with its equally parasitic support industries of corporate law and accounting? It’s all such utter bullshit.

And so, I’m damned if I do and I’m damned if I don’t.

In my 20 years of full time work, I’ve become worn down with it all. I’m exhausted. I’ve tried a number of things, and I find that bullshit prevails everywhere I look. My heart is broken by all the bullshit that trumps everything else.

I’m exhausted, and I’m depressed and I’m suicidal.

Yes, I know some people are grateful for their lives and what little quality of life they can squeeze out of their existence. Yes, I know that I have good physical health and I’m reasonably young still. Yes, I know that there’d a queue that stretches around the planet, of people who would love to have my job.

So, if I choose to reject all that and end my life because I feel like I have no quality of life, is that morally wrong?

You can’t even level the accusation of me that I don’t know suffering, and I don’t know poverty. I’ve lived homeless in a park, destitute, penniless and surviving on charitable food donations. I’ve woken up in hospital numerous times in pain and discomfort. I’ve had numerous scrapes with death. Shouldn’t all that stuff make me grateful to be alive? Guess what? You have absolutely no idea. Guess what else, I have a very good idea, because it’s already all happened to me.

I wasn’t born with a silver spoon in my mouth. I went to state comprehensive schools. I wasn’t gifted jobs by any friend or family member. I had no head start in life. It’s true that I have no obvious disability or disadvantage either, unless you count a couple of drug addict alcoholic parents, but I still had other family members, teachers and friends who were nice to me. It’s not a fucking competition. The point is that the variables are controlled. I neither had advantage nor disadvantage, but yet I arrived at this point, here, now, today.

It’s not like we can say this is just a short-term crisis. Like this will fucking blow over.

It’s not going to blow over. For 20 fucking years it’s been the same. The same shit, different day.

Yes, there were times that were actually pretty good, but guess what… they weren’t sustainable. I liked living in a hostel with a bunch of other homeless people. I liked not having a job and being a bum. I liked having no responsibilities. Who wouldn’t? But that’s not real life. We don’t get to have a freebie just because ‘real’ life is killing us. It still cost £120 a week for my bunk bed in a dormitory that slept 15 people, with one fucking bathroom between us all. My current rent is only £240 a week and for that I get a double bedroom, an ensuite bathroom, a kitchen, a dining room, a dual-aspect lounge with panoramic views over London and a balcony overlooking the river Thames.

I should be happy, but I’m not. Happiness is not a choice, no matter what you read on some bullshit Internet meme inspirational quote.

All the right pieces are in place. My doctors are chuffed to bits that I don’t drink, smoke, abuse drugs or in any way engage in health damaging behaviours. My blood pressure is amazing. My cholesterol is low. My eyesight, hearing, teeth, joints… all of it is perfect.

And yet, my mental health is in ruins. I’m so depressed. I’m so suicidal.

I’m doing everything right, and yet everything feels so wrong.

Of course I feel guilty for feeling like this. What the fuck am I supposed to do though?

Honestly, I feel like I want to spend the next 30 days convincing people that the most humane thing is to let me end my life. Honestly, despite the things that should be really great in my life, nothing feels great. Nothing feels good or nice. Nothing works. Nothing is working.

There’s still the possibility of just running away and absenting myself from all responsibility, but then when I’m dirty and sick from a life of destitution… when I die then, will anybody understand? A tramp, a bum, a hobo, a junkie, an alkie… these people are all too easily dismissed by society.

What happens when highly paid banking IT consultants start dying? Well if they’re white middle class thirtysomething men… not much. Who cares? Probably just a selfish socialite, having a tantrum because they can’t do whatever they want, one newspaper article basically said, in the wake of one death.

What the fuck is anybody supposed to do about this fucked up life that we’re supposed to live?

I really don’t feel like I can live this bullshit rat race anymore, and the alternative is a long slow death, shunned by society and marginalised.

In the long run, we’re all fucking dead anyway.

Apologies if I’m triggering raw and painful feelings about your beloved family member or friend who is busily fighting for survival, or who lost their battle. I really don’t mean things disrespectfully, but I can’t lie anymore. I feel this stuff and it’s undeniable.

Call me narcissistic needy spoilt white middle class brat if you like, if it’ll make you feel better. It certainly won’t make me feel any worse, but isn’t that so terribly melodramatic and attention seeking?

Can you understand, how exhausting it is, having to justify your feelings and apologise for wanting to be dead the whole fucking time?

It’s a one-way ticket and for sure it needs careful thought, but aren’t we being a bit unfair, shutting down the conversation by guilt-tripping people into hiding their feelings? Perhaps suicide is a smart choice for people who feel that they have no quality of life.

Tags: #suicide #depression #mentalhealth #addiction #alcohol #drugs #medication #nhs #hospital

22 August 2016