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Lost Cause

7 min read

This is a story about predictions...

Recycling

Bookmakers and actuaries are extremely good at predicting the future. The profits of these well-established enterprises depend upon accurate predictions, based upon a vast amount of historical data. Better statistics lead to better predictions, which lead to accurate odds and sustained profitability. If it wasn't possible to predict the future in this way, there wouldn't be a business model for life insurance or gambling.

Unfortunately for individuals, generalised predictions are fairly accurate while individual predictions are not. It is no use asking an actuary when you will die, so that you can plan your life accordingly. The actuary will not be able to tell you whether you'll die of a heart attack age 45, or whether you'll die in your sleep age 95. Those extra 50 years present a considerable problem for the individual, but the actuary does not care, because they spread the risk of having to pay out on life insurance across a large group. On average, the insurer will win. However, none of us can know whether we're going to die prematurely or live unusually long.

It might seem prudent to avoid smoking, drinking and consumption of excessive calories. It might seem prudent to go to the gym every day. It might seem prudent to eat a balanced diet, containing a mixture of fruit and vegetables, full of amino acids, vitamins, minerals, trace elements and other chemical compounds your body needs to repair itself and stay healthy. However, while we can say for certain that smoking and obesity will lead to health complications, none of us can make choices to assure ourselves of a long life.

One day you might just drop dead.

The temptation to use statistical analysis to make predictions for an individual is overwhelming in a world where we have discovered the classical laws of physics. We presume that we are able to predict the future as easily as we can predict the trajectory of a missile. Unfortunately, individuals do not follow simple parabolic curves. While there are statistically significant correlations - good predictors - this does not mean that we can know the future life of a human, after gathering a few crummy data points.

All we have managed to unearth so far about the mysteries of human life is that we can understand risk not destiny. You might have genes which appear to doom you to a certain fate, but those genes are not always expressed in the way which we expect. The sequencing of the human genome has failed to provide the crystal ball that it was promised to deliver, but instead revealed the unimaginable complexity of epigenetics. No clear genes have been found for things such as diabetes and depression. There is no gene which hard-wires our life expectancy into every cell.

Who could have predicted that smoking would be banned in public buildings and the workplace, drinking culture would become diminished, supermarkets would import food from all over the globe, such that strawberries would be on their shelves all year round, and the workplace would become so safe and so sedentary? Who could have predicted that mental health problems would reach such epidemic proportions that the leading cause of death amongst 20 to 40 year old men would be suicide?

Ultimately, the biggest thing affecting my life expectancy appears to be a choice which I'm free to make.

I've never smoked and I quit drinking 4 months ago. I eat a balanced diet and I'm a healthy weight. These things are happy accidents. Every afternoon my anxiety builds to an increasingly intolerable level and every evening I feel suicidal. I live alone and have no friends or family nearby. I have no children, pets or partner.

My life is on a knife-edge.

If you were going to bet on the statistically probable outcome of my life, you'd have lost a lot of money already. I'm afraid to say that I'm an outlier and I have refused to conform to the predictions. I'm a single data point and as such I'm not statistically significant on my own, but the significance of my own life and its outcome is, unsurprisingly, important to me.

It's a hard life being an outlier. Literally, almost everyone is betting against you. It will be harder to get an education, get a job, get a home, borrow money, find a partner, get life insurance, get a pension... all of these things are thwarted by people who believe that they are able to predict my destiny. I'm continuously confronting people who believe I'm a lost cause, and therefore not worth taking a risk on.

We can see that this attempt at prediction becomes a self-fulfilling prophecy. When racial stereotypes become pervasive - for example - then we see that minorities are harshly and unfairly prejudiced, which harms their chance of success and reinforces the correlation between uncorrelated factors. Skin colour should not be a good predictor of socioeconomic outcome, but the data overwhelmingly shows that it is.

From the moment you enter the vast educational system, you are being sifted and sorted in a way which tests you and gathers data on you, in order to attempt to predict your future. Something as random as getting an illness will affect your school attendance data, which will be used against you as a predictor of supposed future failure. You are constantly at risk of flagging yourself as a "disaster waiting to happen" and suffering lifelong prejudice due to the systemic attempts to analyse individuals statistically.

I suppose I now revel in the fact that I'm a living contradiction. My problems with mental health, addiction, alcohol, hospitalisations, psych ward stays, trouble with the police and refusal to be sifted and sorted by the mainstream education system, are not in agreement with the predictions that I should end up bankrupt, in jail and/or dead, having lived a life with no useful contribution to society, and in fact having been a burden. I'm the guy your mother warned you about. I'm the one who isn't supposed to be allowed to freely roam the streets. I'm the one who all the gatekeepers have in mind - I'm the one they want to keep out, but yet I'm very much on the inside.

If those who think they can gaze into the future by studying my data had their way, I wouldn't have a job, a house, any money. The system has tried very hard to railroad me into certain outcomes, because it's what was expected and predicted.

I genuinely don't know whether I'm going to kill myself or if my depression is going to lift and life's going to become pleasant and bearable. I've lived with depression for long enough to know that my choices will have little effect on the outcome. No amount of prescription medication, therapy, yoga and other such things will have the intended effect. It has always been the least expected things in my life which have wrought the most important changes.

If I was betting on myself, I suppose I would bet that I'll die at my own hands. If I was betting on myself, I suppose I would bet that I won't be able to escape the debt trap. If I was betting on myself, I suppose I would bet that I will crumble and break, because that seems like the obvious thing I would do, from looking at the black marks against my name. If I was going to bet according to statistics, I would definitely bet against myself.

However, we know that fundamentally the universe does not obey classical physics, when we study the underlying laws, but instead there is inherent uncertainty. Outcomes are nondeterministic. Knowing my past does not allow anybody to know my future. There is a nonzero probability of every possible outcome, no matter how unlikely it may seem.

My day-to-day life is dominated by a single question - am I going to kill myself? - but despite being the best placed person to answer that, I do not know the answer. Events unfolding are as much a surprise to me as they are to you.

 

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I Felt Something

6 min read

This is a story about flashbacks...

Abandoned shoes

Once upon a time I was in love. Once upon a time I lived in a place where I knew lots of people. Once upon a time I lived somewhere familiar that I called home. Once upon a time I was in the Goldilocks zone: everything was just right.

It often looks as if I start worrying about things too far in advance. I remember I was very anxious about getting another job during the winter of 2016/7. I had money in the bank to pay my rent for many months. I had the financial support of my girlfriend. Really, there was nothing to worry about, but I didn't feel secure.

Nobody could have predicted that I'd get a blood clot in my leg, causing a lot of damage to nerves, blood vessels and muscle, which would trigger my kidneys to fail. Nobody could have predicted the consequent need for dialysis and pain medication.

For sure, I contributed to my own problems, but then the problems multiplied all on their own. It was my fault that I got more sick, didn't get a job and broke up with my girlfriend. Having to leave my home and move to another city was something I already predicted and worried about. Getting into financial difficulties was something I was already losing sleep over. My luck ran out in the end.

There was unimaginable stress and effort required to move from London to Manchester, Manchester to Swansea, Swansea to Cardiff, and stave off bankruptcy. There was an incomprehensible amount of trauma caused by breaking up with the love of my life - even though I instigated it in my madness - and leaving the city which held almost my entire social support network.

Mental health problems, alcoholism and drug abuse added to a toxic mix of moving house, moving city, moving jobs and never putting down any roots. I never felt settled anywhere.

The net result is that I've had to emotionally shut down. The person who I present to prospective employers, prospective landlords and other gatekeepers, is a calm, collected, well-dressed, polite and well-spoken individual, who appears to be handling everything quite well. Without this document, people would be very puzzled and surprised to find that I'd committed suicide. "He looked fine" people would say.

Nobody's really close enough to see the inner anguish and turmoil. Nobody's really close enough to see my mask slip. For sure, I write and publish every day, but my readers are scattered all over the country. At the weekend I saw two close friends, but the previous time I'd seen a close friend had been 5 months ago.

5 months!

Can you imagine that?

Picture yourself pretending like everything is A-OK for 5 straight consecutive months, without a shoulder to cry on and the comfort of opening up to a close friend. Picture yourself being surrounded exclusively by your work colleagues and other people who you need to put on a brave face for, for 5 long months.

My life is very odd. I saw old friends in Portugal, in the gastropub next door to the hotel I lived in, in Prague and near Bristol. I count four occasions when I saw old friends, in the space of a year. That's a staggeringly lonely and isolated existence.

My entire existence revolves around my attempts to avoid gaining a black mark against my name - bankruptcy - and being evicted from the privileged part of society which I'm fortunate enough to be part of. For 5 years I've attempted to muscle my way back into civilised society, while the demands of capitalism have wrestled me to the floor and punched me in the face repeatedly.

My approach to life is very simple: work hard and earn more money that I spend. On paper, it's easy to calculate how long it will take to get myself back in the black. Theoretically, it should be easy for me to restore health, wealth and prosperity to my life.

In reality, I've had to suspend almost everything 'human' about myself and become a robot.

I don't have the time or the money for feelings.

Everything feels very wrong, but conceptually it's right. My feelings tell me that things are painful and unbearable, but on paper I must bear these things, because on paper it's clear what the benefits are. I do not feel any benefits. I very much feel all the horrible unpleasant things. I force myself to live with the intolerable, because it seems logical in theory.

Look around: life seems to be about earning money, paying bills and then dying. I'm making a very passable imitation of those I see around me.

I would desperately like to switch off my feelings, switch off my brain, and just wake up in a year or so when this unpleasantness is over. I'm paid to sit in a chair not saying anything, so it would be very nice if I could be put into a kind of suspended animation, so that I'm unconscious while sitting in that chair. Wake me up when the sitting is finished.

Something unlocked some feelings for the first time in a very long time, and I found myself crying a little bit last night. I cried about breaking up with "the one who got away". It's strange that those tears are almost 2 years overdue. I didn't really cry very much. My feelings are kept very well subdued - the lid is kept on that jar very tight.

I think about the ease with which I could calmly get a sharp knife from the kitchen drawer, walk upstairs to my bathroom, draw a warm bath, immerse myself in the water and open some major blood vessels with the blade. I know how unhesitatingly I would act, once making the decision. I know how little doubt or anxiety would trouble me. I know I wouldn't call anybody or otherwise raise the alarm.

I suppose I could give up the other way. I could allow myself to be ejected from the privileged part of society. I could refuse to partake in the rat race anymore. I could allow my card to be marked and my name to be tarnished. I could let the circling vultures swoop in. I suppose it might actually be more pleasant than the sitting in the chair, quietly doing nothing, just waiting, while in agony.

Regret is the problem.

I cried because I lost the love of my life and it was clearly all my own fault. I cried because I was in the Goldilocks zone but I sabotaged it all. She was just right - not too hot, not too cold - and so were many other things in my life at that time, but I threw it all away.

I don't particularly feel regret, because I don't particularly feel anything. My feelings are all bottled up. There's no time or money for my feelings.

It's been a long time since I cried, but I did cry a little bit last night.

 

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Antipsychiatry

5 min read

This is a story about refusing help...

Pharmacy

If you spend enough time with general practitioners, general psychiatrists, specialist consultant psychiatrists, registered mental nurses, specialty doctors and all the very many other mental health professionals who are part of inpatient and outpatient clinics, community mental health teams, crisis teams and all the other apparatus which is supposed to treat mental health problems, one begins to realise a rather unsettling truth: there aren't very many treatments and they don't work very well.

Psychiatry is a young branch of medicine and it doesn't have a lot to crow about. Since the days of asylums and lobotomies, psychiatry has been dogged by scandals, including the extrapyramidal side effects of medications which have left patients with lifelong irreversible unpleasant problems. The data do not show encouraging outcomes. In fact the outlook is dismal and appears to be worsening as the toxic conditions which create mental health problems, seem to be intensifying. Rates of depression, anxiety, eating disorders, OCD, autistic spectrum disorders, attention deficit and hyperactivity... these are all soaring. Treatments are not effective and vast numbers of people are condemned to suffer with their illnesses AND the side effects of the medications.

I've been lucky enough to have access to private medical care, at times, and even with the very best professionals and medications, there is not a vast difference between what's available from the public healthcare system. It's all pretty crap and it doesn't work very well.

This is not a damning indictment of those who dedicate their lives to trying to treat mental illness, but simply a cold hard rational analysis of the facts.

The conclusion I've reached has been that there's an over-medicalisation of non-medical problems. The bulk of my problems have stemmed from the collapse of my relationships. I got divorced. I am estranged from my family. I've been forced to move to cities where I have no friends - no social support network - in order to work jobs which have been unsuitable for my health. I have the enormous pressure of having to work full-time, to pay rent, bills and service enormous debts, which is unbearable for a person who's having a crisis.

My mental health would be vastly improved if I had a partner, a social support network of local friends, financial and housing security and a job with reduced hours, until this crisis is resolved. Healthy diet, sleep hygiene, exercise, sex, physical affection, sunlight, fresh air, social contact, hobbies and interests... these things are all essential for human wellbeing. None of those things can be prescribed by a doctor.

During the worst days of my addiction and rough sleeping, I noticed that my fellow homeless alcoholics and addicts were not without some routine and social lives. Romantic relationships are not the exclusive preserve of those who live in houses and have jobs. The life of a homeless drug addict might be chaotic to the outside observer, but a less prejudiced analysis reveals no less structure, no less need for comfort, no less humanity. Those who have fallen into habits of addiction and homelessness might find the community of drug addicts, alcoholics and homeless to provide the social support network and sense of community, which they'd struggle to find living anonymously behind a front door.

Does anybody really know I'm here... in this house... in this city? In many ways I have found my contact with hospitals and the police to be of great comfort. I have found the nonjudgemental members of the NHS and police force to be incredibly kind and compassionate people. It's nonsensical, but I've been happy to be hospitalised or arrested. I've been happy to be in a cell or on a hospital ward, with somebody checking on my welfare. Behind my own front door I could be hanging by the neck, dead, and nobody would discover me for days or maybe even weeks.

My problems are mainly attributable to unmet basic needs: hugs, face-to-face conversation and a sense of belonging.

Because of the obvious things which need to be fixed in my life, it seems wrong to seek medical help, when my mood could be radically different if all the broken things were fixed. It might sound like a fun adventure, going to new cities, but the reality is very miserable and lonely. The reality of my present life is that I don't pick up the phone to speak to anybody when I'm feeling dangerously depressed - who would I phone? What would they do? It's not like anybody can nip round to check I'm OK.

Humans are social creatures, but I live on the periphery. I live on the periphery of life itself, always in danger of death or medical emergency. The state of being suicidal should be considered a medical emergency, especially in men of age 20 to 40, where suicide is the biggest cause of death. My perception of the danger is not warped, given my history of suicide attempts and hospitalisations.

There isn't a pill or some psychological therapy which would be effective... especially not when so much of my life is broken. It's not a medical problem. Sure, I have an underlying mood disorder, but the highs and lows of bipolar don't make me as unhappy as my social isolation does.

How I set about fixing things, I have no idea. The task seems insurmountable.

 

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Ignorant Of My Own Stupidity

7 min read

This is a story about benchmarks...

Crossed wires

There's no way for me to really know how much permanent brain damage I've inflicted upon myself. There's no way to know how much cognitive impairment I've caused. There's no way to know how many brain cells I've killed and how much grey matter I've destroyed. Most of the time I feel fine - no change - but sometimes I have a sudden panic that I've lost a lot of my ability to think.

My concentration span is ruined, but I think that's a pretty endemic problem given the ubiquity of smartphones and social media. The reasons for my brain damage are pretty obviously down to neurotoxicity of chemicals I've put into my body, but it's hard to know what I'd be like if I hadn't lived through that period of drug abuse. I feel dumb, but maybe I'd have been made dumb by other stuff anyway, like the steady stream of mind-numbing entertainment which is available over the internet.

I learned some new things in the past 15 months, so my ability to learn doesn't seem totally ruined. I achieved some difficult projects, so my ability to deliver complex pieces of work also seems to be functioning OK. This is a relief - at least my brain is functioning OK in a professional capacity. The demands seem relatively light on my brain - not too taxing - except for the concentration issues and the boredom. The boredom has always been an issue.

I think about the incidence rate of me saying or doing stupid stuff. Sometimes I worry that I'm saying just as much dumb stuff as ever, but then I look at the frequency of the really bad dumb stuff, and I realise that my spectacular own-goals are becoming less and less frequent. When I screw up, it's not as long and protracted and it doesn't cause as much damage.

Of course, I haven't done the data-collection and analysis, but I'm usually right. My hunches are usually correct, because I do collect data as I go along and I regularly compare periods of time using hard numbers.

Still, I can't quite shake the feeling that I've made myself pretty dumb through my abuse of drugs.

I think it's useful that I don't drink caffeinated beverages. I think that caffeine gives me a kind of false sense of security and overconfidence. I'm sure that caffeine is to blame for tipping me into a manic state.

It's kinda useful that I don't drink alcohol. When I quit drinking once in 2015 it was followed by a bad period of mood instability that ultimately cost me a job, financial security and then ultimately resulted in going back to square one. I'm undecided about the role alcohol has in my life, but at the moment I'm glad to be getting my intoxicants in the form of a measured dose, which is not fattening or otherwise damaging to my physical health.

I feel a little stupefied by medication. I feel quite drugged and intoxicated. I have no idea what I'm going to feel like once I finally manage to wean myself off all the pills.

It's very hard to judge where I'm at.

I look at metrics such as my average earnings. The data is very positive.

I look at metrics like my step count. The data is very negative.

I look at things like the tightness of my belt, and things are very positive again. I look at myself in the mirror when I get out of the shower and I can visibly see the improvement. There's no denying the substantial physical change - I'm losing weight and looking healthier.

I combine everything into a generalised view and I can see that this summer is likely to deliver a continued decline, which the step count data robustly supports, as well as my general perception that I've had a couple of terrible years in a row. However, the future is somewhat in my own hands, so I can choose in advance to make plans for the summer which will be something to look forward to. I can plan to succeed, instead of waiting to fail.

I know that having a girlfriend would make life more bearable, but I also know that it has always provoked instability too. I know that breakups have been the catalyst for the most self-destructive behaviour in my life. I find myself wanting some validation that I've done well. I find myself driven by insecurity a little - wanting to reassure myself that I'm still attractive.

I find that my addiction hasn't been cured. I've had thoughts which have resisted suppression, surfacing from my subconscious. I'm experienced enough to know exactly what part of my brain is plotting. I can see all the warning signs. However, I think I've proven that I'm disciplined enough to resist and get through difficulties. It's been too hard to get here - I'm not going to screw things up.

It's difficult to live with so many episodes of boom and bust. There's so many examples to analyse. I can see all the things that have worked very well, and I can see all the things which have been utterly disastrous. It should be good to have so many experiences to draw upon, but it's actually a bit frustrating. Theoretically, I know all the right moves, but linking them together into a dance is not at all easy.

I endlessly analyse everything. I extrapolate. I predict.

My predictions don't make for comfortable reading. I can see that my improvements are only marginal, while the long-term trend is pretty dreadful. I can see that there's a lot of hard work ahead with very little reward. However, I do know that for every year that I'm well more than I'm sick, my situation will improve and my quality of life is much better. For every year that I work more than I don't, my finances improve, which opens the doors to a world of possibilities. Better finances means better living conditions, which means better state of mind, better self-esteem and a whole load of things that I want become easier to get.

I'm not so stupid that I can't see my mistakes and the damage I've done to myself. I'm not so stupid that I can't take premeditated steps to try to change my own future and improve my ultimate outcome. However, I do admit that my intellect has thus far never been something that's stopped me from doing dumb stuff.

I've retreated into my own mind, so it's very hard for me to ask other people whether they can see me improving or declining. My perceptions have been very badly impaired in the past. It's virtually impossible to know whether I'm on the brink of breakthrough or disaster.

It's kind of a make-or-break time. Either the universe gives me everything I want, at long last, or I really have been banging my head against a brick wall all this time. The next few months will determine whether I'm bouncing back or whether I'm doomed.

I've seen a few documentaries about people recovering from traumatic brain injuries, and I see that they can achieve remarkable recovery, but personality change and some impairment seems to always linger. I suppose these things don't matter, in my world where I've successfully re-invented myself. Nobody much remembers who I was and what I was capable of anyway, so perhaps it's helpful that there's no benchmark for me to get depressed about.

 

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Asleep On My Feet

5 min read

This is a story about sleeping pills...

Attic

The existence of this photo is something quite remarkable, even though it's hard to understand if you're not me. This photo captures the end of my attempt to smoothly extricate myself from an acrimonious divorce and pick up my life in London again with little damage. This photo captures the beginning of an astonishingly difficult period of my life - the part that contains all the homelessness and hospitalisations.

I try to compartmentalise everything, and to compare present experiences with past ones to see if I'm repeating patterns of behaviour which are flawed.

One experience which is oddly haunting is that of walking around in a somewhat out-of-body state; tunnel vision. I can hear my mouth talking - I can hear my voice - but it doesn't feel like I'm saying the words... I just hear them. It feels like I'm dreaming.

My brain is recovering from an avalanche of pills I've shoved down my throat in the past fortnight. I'm surprised I haven't suffered seizures or kidney failure, given the cocktail of chemicals I've swallowed.

I forget that I messed up my brain chemistry.

I wonder why I can't concentrate and my anxiety has gone through the roof. I wonder why my perception of time is so warped: The seconds and minutes are dragging along, taking hours and days to pass. My days in the office have been difficult, but my days at home have been no easier. There's no respite from the problems of my mind, my mood, my perceptions - I can't escape my brain.

I forget that I stopped drinking.

I wonder why the days are so long and I seem to have so much more time to do stuff. I wonder why I'm more able to cope. I wonder why I'm not so overwhelmed by things. Then I remember that I'm not shackled to alcohol anymore. I get to Friday and I start thinking that I should get drunk, but then I remember that it doesn't help, but it definitely hinders.

I think about all the detoxes and rehabs and I try to tell myself that £12,000 and 28 days in The Priory - the UK's Betty Ford - isn't enough to 'cure' me then I should go easy on myself. I think that I should allow at least four weeks since any major incident, before deciding that things are broken and won't get better. I think that 6 weeks is better, as a period of recuperation. I think that perhaps 3 months is best of all - 3 months stability and routine is the minimum, before making any big changes.

I always tried to rush things. I got very impatient and I tried to hurry things along. It ended badly.

I got very agitated. I got very angry. Nobody seemed to understand the urgency. Everybody seemed to be getting in my way.

The universe doesn't like to be hurried, it seems.

I think about how many different things I wanted in a short space of time. I wanted to work with my hands. I wanted to not work in an office. I wanted to be my own boss. I wanted to be the CEO of a tech startup. I wanted investors. I wanted to win. Then, I wanted rapid promotions and progression. I wanted to make a notable contribution. I wanted to have a say in everything.

I thought I was going somewhere.

I can look back and laugh at myself, but I must've carried some of that same person from the past into the present, which means I'm laughable today too.

I did learn to keep my mouth shut though, a little bit.

I think it's an interesting story, but I'm biased. I find it interesting that I was held back for years, which was frustrating, but then I squandered many years as an addict, which made absolutely bugger all difference. Instead of screwing up my whole career and future earning potential, my profession just patiently waited to accept me back once I'd got a lot of nonsense out of my system.

What terrifies me is how many years it's been and how similar this feeling is - of being asleep on my feet - to that feeling I had when I thought I was managing to escape my screwed up life and start over again, back in London. It's terrifying to think I haven't progressed at all, except I'm older and I've damaged my body and brain quite a lot.

I thought "OK time to stop now" a long time ago, and then found that I couldn't. The things that I didn't want to happen - like losing all my money and sleeping rough - happened and I landed up having major medical emergencies. I'm smart enough that I made it this far and my story is kinda remarkable, but anything that's vaguely similar to the past gives me a lot of superstitious heebie-jeebies.

This weekend is tougher than I thought it'd be. I'm not as far progressed with my finances as I thought I'd be. I'm not as clean and sober as I'd hoped I would be. There have been setbacks. My journey has been nonlinear.

What's surprising is that the universe has just handed me some major life components. Whether I'm intent on screwing up my entire life or whether I'm trying to achieve something great, pretty much the same outcomes seem to happen. I'm pretty convinced that free-will is an illusion. I don't feel like I'm just observing, but the evidence seems to be that I don't have any control.

Of course, I have too few 'normal' experiences to really benchmark where I'm at. I have too few 'normal' human interactions to gauge whether I've lost my mind or whether I'm OK. I'm completely free from any oversight. I'm untethered.

I don't know what's going on and I'm starting to ramble. I feel very peculiar.

 

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Misuse of Drugs

21 min read

This is a story about fit for purpose...

Prescription medications

Here are a range of prescription medications. Three of them are illegal to possess without a prescription under the Misuse of Drugs Act, because they are scheduled as "class B" and "class C", respectively carrying a 5 year prison sentence, a 2 year prison sentence and an unlimited fine.

So, 3/5ths of the medicines pictured here could see me locked up for somewhere between 2 and 5 years, if I didn't have a prescription.

The medication at the top of the picture is lamotrigine, which treats bipolar depression, as well as epilepsy. It has no abuse potential, but it does carry a high risk of causing a fatal skin rash.

The medication in the middle of the picture is bupropion, which treats addiction to nicotine. It has no abuse potential, but it also carries a high risk of causing seizures, which might be fatal.

The medication in the bottom-left of the picture is pregabalin, which treats neuropathic pain. It is addictive and can be abused. Pregabalin is a "class C" controlled substance, and anybody caught in possession without a prescription, will receive 2 years imprisonment and an unlimited fine.

The medication in the top-right of the picture is methlyphenidate, more commonly known as Ritalin®, which treats Attention-Deficit-Hyperactivity Disorder (ADHD) and Attention-Deficit Disorder (ADD). It is addictive and can be abused. Methlyphenidate is a "class B" controlled substance, and anybody caught in possession without a prescription will be imprisoned for 5 years and receive an unlimited fine.

The medication in the bottom-right of the picture is zopiclone, which treats insomnia and other sleep disorders. It is addictive and can be abused. Zopiclone is a "class C" controlled substance, and anybody caught in possession without a prescription, will receive 2 years imprisonment and an unlimited fine.

So, if I didn't have a prescription for all the medications on this table, I could be facing 9 years in prison and an unlimited fine, should the judge decide that my sentences should run consecutively, not concurrently, due to the gravity of my crime.

Yet, millions of UK citizens receive the medicinal benefits of pregabalin, methylphenidate and zopiclone, and the quality of their lives is greatly improved. These tablets were developed as medicines by pharmaceutical companies, to treat medical problems. Substantial empirical evidence was gathered in many controlled trials, to prove that these medicines were safe and effective at treating the medical problems they have been licensed for.

Indeed, these medicines have unexpected benefits beyond the purpose they were licensed for. Lamotrigine improves sleep quality. Bupropion is a fast-acting non-drowsy antidepressant, which also increase libido and enjoyment of sex. Pregabalin reduces anxiety and aids sleep. Methylphenidate improves concentration, allowing students to study harder and for longer periods. Zopiclone can prophylactically prevent psychosis and mania, by preventing sleep deprivation.

It is very hard to argue that the Misuse of Drugs Act and the Psychoactive Substances Act are successful laws, because the evidence shows that the use of mind-altering substances remains entirely unaltered by legislation which seeks to discourage that behaviour, and harshly penalises those who break the law.

If I approached my GP and asked for zopiclone to help me sleep, methylphenidate to help me concentrate at work, pregabalin (or any benzodiazepine) to treat my anxiety and zopiclone to treat my depression, they would flatly refuse all my requests.

My GP would tell me that zopiclone is too addictive, despite my insomnia ruining my life. My GP would tell me that methyphenidate is too addictive, despite my inability to concentrate impairing my ability to be productive at work. My GP would tell me that pregabalin is not licensed to treat anxiety, and it's too addictive, despite my poor quality of life due to anxiety. My GP would tell me that benzodiazepines are too addictive, despite my life-ruining anxiety. My GP would tell me that bupropion is not licensed to treat depression.

Instead, I would be offered sertraline, which would allegedly treat my depression and reduce my anxiety. Sertraline is very slow to take effect and it has an emotionally-blunting effect, as well as affecting sex drive and ability to orgasm. Sertraline is not an effective treatment for anxiety. Sertraline is not an effective sleep aid. Anybody who has ever tried to quit sertraline will tell you that it is very addictive and the withdrawal side effects are intolerable.

In short, doctors would offer me nothing.

In short, doctors would tell me to go away, even though their medicine cabinets are stuffed full of medicines which have been extensively proven to treat the ailments which ruin my quality of life. The medications exist, but I would be denied a prescription to access those medications.

This much like a man who is dying from a bacterial infection being told that he's not allowed any penicillin, because a small number of people have a penicillin allergy.

Then, there are medications such as diacetylmorphine and ketamine, which are considered essential medicines. Diacetylmorphine, more commonly known as heroin, is scheduled as "class A" which carries a 7 year prison term and an unlimited fine, if possessed without a prescription.

How can we have a Misuse of Drugs Act which puts diacetylmorphine - a medicine routinely prescribed - into the same category as crack cocaine. Crack cocaine is fiendishly addictive and has zero medicinal use. Crack cocaine is so addictive, that it might even be considered to be "instantly addictive" and the vast majority of its users commit acquisitive crimes - muggings, thefts, burglaries - to raise money to pay for their drug addiction. Addiction is a medical condition, not a crime.

How can we have a Misuse of Drugs Act which puts mushrooms into the same category as crack cocaine? In fact the law states that it's magic mushrooms which are a "class A" controlled substance, which implies that the government believes in magic. Is that not utterly terrifying? Is it not utterly terrifying that our lawmakers are so mentally impaired that they would make specific reference in law to a certain type of mushroom which is "magic". Like, are you for real? We actually have laws criminalising magic, in the 21st century.

What would be a fitting punishment for anybody possessing a "magic" mushroom? Perhaps they should be made to climb a beanstalk grown from "magic" beans. Perhaps they should be lashed to a dunking seat and immersed underwater until they drown. Perhaps they should be burnt at the stake. These are the punishments that are most ususal for involvement in "magic".

We also know that behaviours such as sex and gambling can be addictive, but nobody imagines that gambling addicts inject decks of playing cards into their veins. In fact, gambling is widely permitted, advertised and promoted throughout society, despite its addiction potential. We are allowed to have sex, even though there is a risk of contracting sexually-transmitted diseases, and there is addiction potential.

Terrifyingly, the government has now passed an Act of Parliament which criminalises:

Things that cause hallucinations, drowsiness or changes in alertness, perception of time and space, mood or empathy with others

Obviously, eating a big meal might cause you to feel drowsy. Being tired will make you drowsy and less alert. Being tired will affect your mood and make you more 'snappy' with others. It seems pretty obvious that children are a thing that causes drowsiness, changes in alertness, mood and empathy with others. Many mothers get post-natal depression (mood change) and many parents feel a great deal of empathy towards their children. Is the production of children going to carry the 7 year prison sentence, as the law states?

The law helpfully tells us that:

Food [doesn't] count as psychoactive substances.

But, hang on a second... aren't mushrooms food? If I'm a mushroom producer or supplier, am I exempt from the 7 year jail sentence?

Let us imagine that I cross-breed a "magic" mushroom with a regular mushroom, not thought of as "magic" by government lawmakers, I must surely be able to produce a non-magic mushroom, which I can supply as food, even though it might cause hallucinations, changes in perception of time and space and mood. Clearly if I used gene editing, I could produce a mushroom that was not "magic" at all - no witchcraft or wizardry necessary - and this could be bought and sold in the supermarkets as food.

Fundamentally, the Misuse of Drugs Act and the Psychoactive Substances Act are flawed pieces of legislation, which are not protecting citizens of the United Kingdom, reducing crime, reducing antisocial behaviour, saving lives or reducing the burden on public services. In fact, it is categorically clear that the UK's approach to mind-altering substances is a gigantic waste of money, which is also ruining countless lives, by criminalising people with medical conditions.

The fact that we have the word "magic" in our statute books, criminalising mushrooms that are alleged to have "magical" properties, in the 21st century, is quite absurdly ridiculous. The fact that we have put "magic" mushrooms, diacetylmorpine and crack cocaine into the same "class A" schedule, carrying the harshest punishments. Diacetylmorhine is an essential medicine, administed every day by up to 130,000 doctors and countless nurses. Picking "magic" mushrooms to share with my friends is punishable by life imprisonment.

I can understand that crack cocaine is an instantly addictive drug that drives most of its users to commit a very great deal of crime, because they are suffering from an illness. Therefore those who supply crack cocaine are committing a terrible crime, because crack cocaine exists for no other purpose than its abuse, and it's abuse is so devastating that it ruins the life of the sick person and creates very many victims of crime. I can understand why supply of crack cocaine is punishable by life imprisonment.

I cannot understand that "magic" mushrooms, which are not addictive, and its users commit no antisocial nuisance nor cause any burden on the state, and are an incredibly safe thing to eat with no fatalities attributed to their consumption, are seen as the same as crack cocaine in the eyes of the law. Those who supply magic mushrooms are no more guilty than a person who obtains a crate of beer, with which to share with their friends. 

The antisocial behaviour of people intoxicated by alcohol, the addictiveness of alcohol and its adverse health effects, makes suppliers and producers of alcohol culpable for a very serious crime, which deserves harsh punishment, if we follow the logic applied to other mind-altering substances.

To sell packs of cigarettes is possession with intent to supply an addictive harmful substance. The health damage caused by cigarette smoking and the antisocial nature of it, because of the harm caused to passive smokers by second-hand smoke, as well as the unpleasant smell of cigarette smoke, which also harms items of clothing and other property. Cigarette smoking places considerable burden on the state, who must invest significant sums of money into smoking cessation treatments, smoking prevention programs and treat the many smoking-related diseases. Smoking-related diseases shorten lives, cause early death and reduce the productive capacity of those who suffer from cigarette addiction. Cigarettes have a high economic cost to society. Suppliers and producers of cigarettes, cigars and loose tobacco are culpable for a very serious crime, which deserves harsh punishment.

When the esteemed neuropsychopharmacologist Professor David Nutt was adviser to the government on its drug policy, he suggested - based on overwhelming empirical evidence - reclassifying all drugs based upon the health risks they posed, the harms they cause to society, and the economic cost of their use and abuse. He was forced to resign. Drugs are a politcal pawn and the government has no interest in the wellbeing of its citizens, with respect to drug use.

We only need to look at Portugal, which took a scientific data-driven approach to its drug policy and has achieved:

  • 60% increase in uptake of addiction treatment programs
  • 90% drop in the rate of drug-injection related HIV infection
  • 45% decrease in the murder rate
  • Drug-related deaths dropped to 3 per million (in comparison to the EU average of 17.3 per million)

The most [un]surprising thing of all is that drug use remained the same. People like to take drugs. LOTS of people like to take drugs. Alterations to the law do not affect people's desire to take drugs. Drug laws are not a disincentive to drug taking, because drug taking has been a feature of human life since pre-historic times. People want to take drugs, hence why alcohol, cigarette and coffee consumption is ubiquitous and legal.

2.5 million Xanax tablets were purchased on the black market in the UK. At least half a million people in the UK are using MDMA (ecstasy) on regularly, and on a single weekend, a million tablets could be consumed. Almost one million UK citizens are using powder cocaine, and most of them are affluent professionals.

What we can learn from Portugal is that punitive drug laws have no affect on citizen's behaviour. The criminalisation and harsh punishments are not a disincentive to illicit drug purchase and consumption.

Legislation to criminalise the sale of alcohol - prohibition - was tried in the USA from 1920 to 1933, and it was an abysmal failure. Industrial alcohol was deliberately made extremely poisonous in 1927, causing innumerable deaths and making people blind. But people drank it anyway, getting literally "blind drunk". Moonshine was responsible for vast numbers of speakeasy customers being poisoned: 33 people in Manhattan, NY died in just three days, for example.

We can see from all historical evidence, worldwide, that every culture has used mind-altering substances extensively. Coca leaf chewing is common in South America. Tobacco smoking and chewing originated in North America. Betel nuts and areca leaves are chewed all over Asia. Khat leaves are chewed in Africa. Tea leaves a brewed in hot water in China and India. Coffee beans are roasted, ground and brewed in South America. Cannabis has been drunk as Bhang in India for more than 3,000 years, and the Egyptians were smoking cannabis 3,600 years ago. Opium was being consumed 5,400 years ago, by the Mesopotamians. Alcohol wins the top prize though, because it's been brewed for at least 13,000 years - since the goddam stone age.

The invention of distillation apparatus is a relatively recent phenomenon, but we should accept that human desire for intoxicating alcoholic beverages has been unwavering since the discovery of the fermentation process, and the invention of brewing methods. The body of archeological evidence overwhelmingly proves that beer and wine were present in human lives, continuously. Mass production of cheap distilled spirits pose new challenges, but we must remember that society does not adapt to scientific and technological advances with sufficient speed to avoid difficult periods of re-adjustment.

The isolation of psychoactive molecules responsible for psychoactive effects, and the laboratory synthesis of those naturally occurring compounds, has resulted in highly refined and pure chemicals. The investment in high-volume chemical production for industrial and agricultural uses, makes the precursor ingredients for synthesised compounds extremely cheap, and therefore, drug supply can inexpensively meet drug demand, through mass-production. The very poorest people in the world are often able to afford to buy very potent and pure drugs.

In 1804 Friedrich Sertürner isolated the morphine molecule from opium. In 1804 the world's population was 1 billion and the average global income was $3 a day (adjusted for inflation). Today, 3.4 billion people live on approximately $3 a day, which means that there are 340% more people living in poverty on an increasingly overcrowded planet.

We know from animal studies that stress and overcrowding affects behaviour adversely - "the behavioural sink" - and experiments have produced compelling evidence. Animals whose living conditions are intolerable, will prefer water laced with alcohol, cocaine, heroin and other addictive drugs. When the experiment is repeated with better living conditions, such as having other animals to socialise and have sex with, more comfortable bedding, exercise wheels and toys to interact with, then the rats prefer to drink the water without any mind-altering substances.

Findings from experiments with overcrowding in rat colonies found the following disturbing results:

Many female rats were unable to carry pregnancy to full term or to survive delivery of their litters if they did. An even greater number, after successfully giving birth, fell short in their maternal functions. Among the males the behavior disturbances ranged from sexual deviation to cannibalism and from frenetic overactivity to a pathological withdrawal from which individuals would emerge to eat, drink and move about only when other members of the community were asleep.

The animals would crowd together in greatest number in one of the four interconnecting pens in which the colony was maintained. As many as 60 of the 80 rats in each experimental population would assemble in one pen during periods of feeding. Individual rats would rarely eat except in the company of other rats. As a result extreme population densities developed in the pen adopted for eating, leaving the others with sparse populations.

Infant mortality ran as high as 96 percent among the most disoriented groups in the population.

Translated into human terms, we see that the majority of the world's population live in overcrowded cities. We see neglected and abused children taken into foster care. We see high infant mortality rates in the developing world. We see sexual deviancy. We see widespread manic-depressive symptoms and other psychiatric illnesses. We see men living lives of quiet, desperate isolation, withdrawn from the world and spending most of their time in their bedrooms, emerging only to grab a microwave pizza or use the toilet.

One must remember that in the rat overcrowding experiments, there were no drugs or alcohol. The behaviour of the rats was a spontaneous response to their living conditions.

Thus, we must conclude that the problems we see in society are not caused by drugs and alcohol, but the abuse of drugs and alcohol is caused by intolerable living conditions.

In the west, the social problems we have are due to industrialisation and mass-production, which required high-density housing in close proximity to the factories, mills, textile manufacturers and steel works. The social problems were compounded by the service industries building tall office blocks in the business districts of major metropolitan areas. Property developers built high-rise housing blocks in cities which were already densely populated.

Manhatten had a population of 60,000 people in 1800. Today it has a population of 1.7 million people who each earn $378,000 per annum, on average.

Hong Kong Island had a population of about 3,000 people in 1842. Today it has 1.3 million people and a 2-bedroom city centre apartment would cost about $2 million to buy.

Those are the affluent places.

In the developing world, the social problems are due to the purchasing power of "soft" currencies. Only the US dollar, Japanese yen, European euro, Swiss franc, Canadian dollar, Australian dollar, New Zealand dollar and British pound, are considered to be "hard" currencies.

Developing world nations need to build factories, mills, mines, railways, ports, power stations, which can only be paid for in hard currency, along with hospital and a university, fully equipped, staffed. The university needs a library full of books. Almost everthing has to be imported, and the suppliers want to be paid in hard currency.

The developing world nations take out loans from the World Bank, issued in hard currency to buy what they need. The crop harvest, manufactured products and natural resources are exported to buyers who pay with soft currency. Labour is also sold using soft currency .

$1 can purchase 8.3 minutes of labour in the USA. $1 can purchase 36 hours of labour in Ethiopia. The poorest and hungriest Ethiopians get paid 10 Ethiopian birr for 12 hours labour. A day's wage is the same as the cost of the day's food.

$1 is exchanged for 30 Ethiopian birr. The dollar seller can pay 3 Ethiopians their daily wage, after they complete 12 hours labour. The Ethiopian birr seller can purchase $1 of specialist goods, specialist services, or hire a highly-qualified and experienced expert, from the richest nations. $1 could purchase 1 minute of time from a prospecting geologist to survey Ethiopia's stone, ores, minerals, metals and gemstones. When the data is gathered, Ethiopia can then calculate the capital expenditure to purchase land, build processing facilities, buy equipment, and build supply infrastructure. Then they consider the cost the cost of paying for supply chain services. They calculate how soon they can be ready to start exporting. They calculate a sustainable export capacity and work out the anticipated lead time from initial purchase order, legally binding supply contract, agreed.  The operating costs are deducted from the expected income from the exports. It's pretty easy maths:

(Capital expenditure + operational costs + transport costs) - (average raw material market price x quantity of raw material available)

This equation gives three numbers,

1. How much money do we need spend before we see a single dollar

2. How much money will be earned until all the natural resource is gone

3. Proft (if any)

Wheat to make flour with is $0.46 in the US commodities exchange. Coffee beans are $0.94/kg. Orange juice is $1.17/litre. Cotton is $0.71/kg. Raw sugar from sugar cane has by far the lowest market price, of $0.13/kg.

Processing makes little difference: Alcohol made from cane sugar trades at $1.34/litre and refined white sugar trades at $348.

So we can forget growing crops. The US and EU subsidise their farmers by purchasing their harvest, then dumping it in huge silos, or otherwise paying farmers a subsidy for not growing their crop, which is greater than the amount the farmer could expect to earn by selling the harvest. That's economic warfare by the wealthy west on the impoverished developing world nations. The game is rigged.

Then stone, ores, metal, precious metal and gemstones are worth considering.

Iron ore trades at $89/kg. If you invested in heavy machinery and a processing plant: Copper trades at £3/lb, Aluminium at $1/lb. Nickel at $6/lb and Zinc is at $1/kg.

This is because $1 can purchase at least 1kg of flour, which will feed a mother and child for a day. The hungriest poorest people will exchange 12 hours labour . Therefore $1 buys 87 times more labour in the poorest parts of the developing world, than it does in the USA. So $1 is offered in exchange for enough local currency to buy 1kg of flour. It costs 30 Ethiopian birr to buy 1kg of flour,

The densest population on the planet is Tondo - a district in Manila - where you are never more than 2 metres away from another person. I'm 1.83 metres tall, so if I lay down to sleep, I would have 17 centimetres between me and the nearest person That's disturbing.

The developing world population has increased dramatically in the last 200 years, which is a lot of hungry mouths to feed, in countries which might not have clean drinking water, medicine, sanitation systems, and people live with a lot of hunger. See below:

World pop growth

Can you see the trend? Poor nations are getting more populated, which drives down the value of their labour drives down the value of the crops they produce, and drives down the price of the the other commodities they can produce. In a system of global free-market capitalism: A hungry person will work harder for longer, than a well-fed one. A person who lives in a country with high infant mortality rates will have more children that a person with great well-equipped hospitals and doctors, in every city.

It's ludicrous to be criminalising things which would never exist if we paid more for our edible crops. For example, 1kg of opium resin is worth $2,506 if you buy it wholesale directly from the farmers in Afghanistan. That heroin has a market value of $6,600 in the USA.

The drug problem is the inevitable conclusion of exploiting the developing world's labour, crops and raw materials.

I should really have written this as a series of blog posts, but I might is this in a non-fiction book I plan to write if I can convince somebody I like to co-author it with me. Or at least get a literary agent to find me a publisher and give me an editor.

Side note: I started writing this on Saturday and it's now Monday (well, Tuesday, technically) and I've hardly slept. I must publish this now, and proof-read and edit tomorrow.

I hope you find these 4,000 words entertaining.

 

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Bipolar Medications

8 min read

This is a story about tailored medicine...

Different tablets

It's a subject I've written about at length before, but I was writing about my experiences with different mood stabilisers earlier today and I thought I would re-purpose that content for my blog, because I'm tired and I'm stressed, and it seems like a logical thing to do: To take something I wrote earlier and re-use it.

What I've written is in the style of advice given to somebody who's perhaps newly diagnosed as bipolar, or perhaps suspects that they have bipolar disorder. What I've written is from my own personal experiences. What I've written is not meant to be completely authoritative and factually correct, but I'm aware that it's my general writing style to present my opinions in a persuasive manner.

So, without further ado, let's get onto the list of bipolar mood stabilising medications I have known and loved (or hated, more like).

Quetiapine (Seroquel)

Horrible side effects, including weight gain, daytime sleepiness, dry mouth and constipation. When it takes effect, it's so strong that it's very hard to get to bed, or use the toilet in the middle of the night. Cannot be mixed with alcohol - the alcohol makes you feel very unwell.

Overall, this medication feels like being "heavily sedated" and it would be very difficult to carry on a normal life at dosages above 200mg. At dosages of 300mg or more, you'll be sleepy and dopey all the time. At dosages over 400mg, you'll be a shuffling zombie, good for nothing except dribbling in front of daytime TV.

Not compatible with having a job.

Aripiprazole (Abilify)

This medication had a strange side effect, where I lost fine motor control of my lips and seemed to produce excessive amounts of saliva. It was impossible to have a conversation with somebody without spraying them with spit, which was a horribly degrading experience for me.

Aripiprazole is very long-lived in the body, so it can take a week or more to wear off and get back to normal, even after taking this medication for only a couple of days (i.e. if you try it and you get bad side effects immediately, you'll have those side effects for a whole week at least).

Because of its very long half-life, I would have serious reservations about trying this one, except as a last resort.

Lamotrigine (Lamactil)

No side effects at first, but the dosage has to be increased very slowly with this one. Migrane headaches are a very common side effect, which I got, so I decided to stop taking it. The headaches are tolerable, I guess, because this is the medication with the fewest side effects.

Some psychiatrists might not consider lamotrigine to be a mood stabiliser, but in fact more of an antidepressant which is safe for bipolar people to take. It improves sleep quality so I think it's a good choice from amongst the fairly bleak options.

Also a good choice if you plan on attempting to have a normal job and work.

Olanzapine (Zyprexa)

Side effects include weight gain, daytime sleepiness and a general feeling of being drugged, but nowhere near as bad as quetiapine.

Very good at quickly stopping a manic episode, so it could arguably be used only when entering a manic phase, and then stopped a short while later, but this would require discipline.

Not recommended to take on a long-term basis.

Not compatible with having a normal job.

Sodium valproate (Depakote)

Dreadful side effects. Will turn you into a total shuffling, dribbling zombie and eventually you will get an irreversible kind of brain damage, which will cause you to make involuntary facial movements (a bit like a tic).

This is an awful drug, given to paranoid schizophrenics who are very severely sick (paranoia, hearing voices, hallucinations etc).

If you're on this, it's probably forcibly injected into you in a psychiatric institution. The injections last for 3 months. Don't ever let yourself get so unwell that this becomes necessary. Exhaust all the other options first.

Lithium

Very hard to get the dose right, and requires regular blood testing, which is annoying and inconvenient. Very effective and side effects are tolerable if you can get the dose perfect but it might take many years to find exactly the right dose, and it will be very destabilising if you start going too low with your dose - i.e. you might end up triggering manic episodes when you're simply trying to avoid side effects.

Lithium causes irreversible health damage when used long term, and is therefore "life limiting" in a way - it might reduce your lifespan by 5 years or more, which is obviously a high price to pay.

General Comments

Psychiatrists will tell you that you need to commit to a medication for at least 3 months, in order to feel the therapeutic effects and for the side effects to wear off. I have tried all the medications listed above for 3 months or more, and the side effects never wore off. The side effects were intolerable for all the medications, except lamotrigine.

If you take these medications for longer than a few weeks (with the exception of lamotrigine) then you cannot stop taking them abruptly. If you suddenly stop taking these medications, you will have horrible rebound mania and possibly psychosis too (hearing voices etc). However, I have successfully 'weaned' (i.e. tapered) myself off all these medications, without too many problems.

The worst manic episodes I've had have been when stopping quetiapine and olanzapine abruptly. When I've tapered off the medications slowly, my mood has been fine and I've not had any problems. In fact, every time I've stopped taking a medication, I've felt much better, because the side effects are so awful.

I would advise you to consider olanzapine as a treatment for acute episodes of mania... i.e. you should have some ready to take, and when you start to go manic then start taking it to make sure your mania doesn't spiral out of control.

I would also advise you to consider lamotrigine as first or second choice. I believe many busy working professionals with bipolar disorder find lamotrigine to be a good medication, because it has few side effects.

Psychiatrists will probably pressure you to be on a stronger medication, which is likely to be an atypical antipsychotic (quetiapine, aripiprazole, olanzapine, sodium valproate, risperidone, clozapine) but all of these will have very profound side effects, most notably making you feel tired and sleepy, lethargic, foggy-headed, confused, increasing your appetite and reducing your sex drive. It's personal choice, but I find those side effects unacceptable.

Alternatives to Medication

Alternatively, you can use good lifestyle choices to manage bipolar: no alcohol, no caffeine, strict bedtimes, strict work:life balance, exercise, good diet. You will probably need some trusted people around you who can let you know when your speech is becoming more pressured, you're getting irritable, perhaps you're getting a little obsessive about projects, becoming more impulsive and taking more risks... essentially, when you're heading into a manic episode, which could escalate. I find that getting 8 to 10 hours sleep each night, no more and no less, helps me to keep my mood stable. I also find that my manic episodes are much less of a problem since I quit caffeine. Recreational drugs are a terrible terrible idea, and completely incompatible with bipolar, unfortunately, especially the stimulants: legal high powders, speed, coke, crystal meth, meow meow, M-CAT, mephedrone, monkey dust etc. etc.

Stressful life events can be very triggering for mania, as well as the temptation to work hard because of a job change, promotion or exciting project. It takes a lot of careful planning to ensure that stress is kept to a minimum and work:life balance is preserved. If you want to get obsessed with anything, make it exercise and the great outdoors.

In Conclusion

I'm living a functional and complete life, with a full-time job, managing to have good relationships, managing my money, not engaging in risky behaviours or otherwise suffering many problems with my bipolar disorder. I have depressions, which are sometimes bad enough to cause me to take some time off work, but only a few days here and there. I have hypomanic episodes, where I can spend a lot of money and make impulsive decisions. However, considering that I don't take any mood stabilising medications for my bipolar disorder, my mood is remarkably stable and almost everybody would consider me to be successfully managing my condition, without having any particularly adverse effects on my quality of life.

I can highly recommend trying to go medication free, or spending a lot of time trying different medications and tweaking the dosage, because life is so much better when you're not drugged up to the eyeballs with powerful psychiatric chemicals, which radically alter you and your personality, with horrible side effects.

I'm not antipsychiatry per se, but I would advise people to make very well informed decisions and remind your clinicians that it's your body, so it's your rules, and like with every profession, there are people who are brilliant at their jobs and there are people who are not so great. You need to educate yourself so that you know whether you're getting good advice or not. You can't just trust everybody who calls themselves a doctor.

Mental health is complex. Bipolar disorder is complex. People are complex. We are all individuals and we have individual needs and individual unique circumstances. Tailor your solution to meet your needs.

 

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How I Became a Drug Addict Again

6 min read

This is a story about re-relapse...

Syringe

The title of this blog post, the hyphenated nonsensical word "re-relapse" and the image of an oral syringe which I happened to spot lying on the floor of a hospital, are all intended to set the tone of this piece: Everything you think you know about drug addicts is probably wrong, especially when referring to "drug addicts" as a collective group of mostly identical people.

I could easily wander into the territory of blathering on about "we're not all the same, you know" and other such clichés, but instead I thought I'd simply tell you the story of my re-relapse.

I guess how I became a drug addict again is far less interesting and important than why, so I'm actually going to explain some of the who and the what which means my story makes sense, I hope.

Back in November 2018 - less than 3 months ago - I was a drug addict. I also booked some flights to Mexico for my girlfriend and I, so that we could spend Christmas and New Year on the beach. This presented a problem: How does a drug addict go on holiday?

When I went on holiday to Turkey for a week in October 2018, I literally went cold turkey, which I thought was really funny because I had travelled to Turkey for a hot holiday during the cold UK autumn. The irony of it had a kind of poetic deliciousness, which I couldn't resist. Besides, I wasn't that much of a drug addict at the time.

During that week in Turkey, I struggled to sleep at first, without the drugs which I had become addicted to. Then I became incredibly tired and lethargic due to lack of sleep, and I didn't leave my hotel room for 3 days. However, by the end of the holiday I was able to enjoy some sunshine and I was also 'clean' - I was no longer a drug addict.

Now we must ask: If I had managed to get 'clean' and beat my drug addiction, why would I relapse? The answer is quite simple and straightforward really: Because I am using drugs as a coping mechanism for my ordinary day-to-day circumstances.

What about Mexico?

I had planned a 2-week holiday with my girlfriend, to Mexico, which would have been far more enjoyable than the holiday to Turkey, except for the fact that my drug addiction had escalated. I'm not sure what was so particularly awful about November, except that the UK weather was getting even colder and more miserable, but I found it necessary to augment my existing drug addiction with additional substances.

I did not want to travel through two international airports carrying controlled substances, for which I did not have a prescription. In the UK, it's a criminal offence to be in possession of certain medicines, unless you have a prescription. I did not have a prescription. One of the medicines which I needed to transport with me to Mexico via transatlantic flight, in order to maintain my drug addiction, was unfortunately illegal to possess in the UK without a prescription.

What was I going to do?

I procrastinated for a long while, and then with 3 weeks until the scheduled departure of our flight to Mexico, I decided to start reducing my dose a little bit every day. I tapered myself off one of the medications I was addicted to - Xanax - until I was no longer addicted to it, so I was then able to travel without being at risk of prosecution for trafficking narcotics across international borders.

Essentially, I got 'clean' again. Yet again. I've gotten 'clean' so many times.

Oh, did I mention that I also quit drinking?

Yeah. Don't try to quit Xanax in the space of 3 weeks if you're addicted to it. If you're addicted to Xanax, you need to taper down your dose really slowly or else you'll have problems.

I had problems.

I drank 9 pints (5 litres) of very strong beer and I don't remember many of the details, except that I went bat shit crazy and smashed some stuff up. I was pretty much blackout drunk, so my memory is very patchy. I was out of control. I was a mess. The worrying thing is how little of it I remember.

So, I quit drinking soon after I started trying to quit Xanax. Mixing alcohol and Xanax is a bad idea, but drinking alcohol while quitting Xanax is a disastrous idea.

However, quitting alcohol and Xanax, when you're addicted to both... that's hell.

I had 3 weeks where I felt like the world was about to end and life was not worth living. I had 3 weeks where I was absolutely convinced that every conceivable disaster was lurking just around the corner. I had 3 weeks of the most unbearably awful anxiety.

Then I went to Mexico.

Turns out you can just buy Xanax over-the-counter in a pharmacy in Mexico if you smile nicely and pay in cash. Obviously, I was well aware that it's illegal to sell Xanax in Mexico, but I was also well aware that it wasn't illegal for me to buy it or possess it. So, I bought a bottle of Xanax from a Mexican pharmacy, and I resumed my drug addiction. Xanax is branded Tafil in Mexico by the way... if you ever need to get some.

Then, at the end of my holiday in Mexico, which was awesome by the way, I threw the leftover tablets in the bottle into the trash, at the airport.

Since my holiday, my life has continued pretty much as normal. I don't drink - I've managed to remain almost completely sober since I quit alcohol back in December. My life is also normal, insofar as I'm a drug addict.

Every night I take a sleeping pill and a tranquilliser, and I do so because I need sleep and I need to be tranquil. My life circumstances dictate my need for the substances I use.

I imagine that I will become completely 'clean' and 'sober' again one day, but for the time being, I need to endure some pretty horrible life circumstances, and I find that the drugs I'm addicted to are helping me to cope, even though it's commonly thought that all drug addiction is automatically a bad thing.

What I wish for is not to be 'clean' and 'sober' but for the circumstances of my life to be more pleasant and favourable to a life without the 'crutches' of drugs, but what I wish for seems mostly impossible, at the moment. I can't achieve the impossible. I have to work within the limits which I'm constrained by. I have no control over most things in my life, which cause me a great deal of discomfort and unhappiness, but I've found my coping mechanisms which work.

The end.

 

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Perfect Storm

4 min read

This is a story about life at the limits...

Cliffs

I suppose that it's a regular complaint of mine that I'm feeling overwhelmed, and it's a regular boast that I've been through some substantial periods of adversity. I'm also aware that the picture I've selected to accompany today's blog post is not exactly very stormy, but it's the best I could come up with in the circumstances.

I stopped writing for a while, which was because my friend killed himself, and also an enormous project kicked off at work, and also I had plans to get myself across the Atlantic Ocean and back again in one piece... plus all the many other important things to numerous to list. In short, I didn't make the time to write and there were a number of very good reasons why I took a break from writing every day.

Now, my friend's funeral is done, my transatlantic jaunt is done and the enormous project at work isn't going to be finished any time soon, so I must resume my daily writing duties, even on days when I don't feel like writing.

This morning I woke up and I felt terrible. I considered not going to work. I got to the office and several of my colleagues told me that I looked awful and said that I should go home. There was snow forecast and local schools were closing. My colleagues weren't doing anything except staring out of the window and/or talking about stockpiling food. I came home early and worked from my bed.

Unfortunately, I have my 'day job' plus my company to run, plus this website, which I have started to attempt to migrate from one place to another, although all these things are behind the scenes. I also treat my writing a bit like a job, in that I sometimes force myself to write even when I'd much rather be doing something else, or I've got a lot on my plate.

The things that get neglected are my sister and my niece, my friends, all the phone-calls I never answer, all the messages and emails I never reply to, and all the tasks which can be deferred for as long as possible. I need a haircut. My car needs servicing. Today is the final day that personal taxes are due to be paid in the UK, and I was close to the deadline as usual. I need to find a new place to live. I need to renew my car insurance. I need to see if my former friend's mum still has my stuff - the majority of my stuff - still stored in her garage, or whether she's disposed of it, since the fallout with the friend.

I quit drinking back in early December, although I did have a couple of drinks on Christmas Day and New Year's Eve. Quitting drinking helps, actually. I feel fitter, healthier and I've lost some weight. I find my life to be much improved versus the recent period when I was drinking heavily every single day.

Something's gotta give though.

Today it was my health. Sunday, Monday and Tuesday, it was also my health. Every day I take too many sleeping pills and too many tranquillisers.

Eventually, the weather will improve, my finances will improve, my routine will stabilise, I will get the housing security I need, I will have the regular social contact I need, I will get the exercise I need, I will replace my run-down old car with a newer nicer one, I will replace my worn-out clothes, I will pay off my debts and I will get a haircut.

Not today though.

 

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No News is Bad News - Part Two

6 min read

This is a story about radio silence...

Hotel room

On June 20 of this year I attempted to write my life story from 2011 onwards, covering the happiest, most successful period of my life and the pinnacle of my career - doing a tech startup accelerator program in Cambridge with a cohort of incredible people - and the subsequent reasons why I stepped down as CEO, separated from my wife, sold my house and settled my acrimonious divorce.

I wrote 10,000 words in a non-stop brain dump. Once I started I couldn't hold back - the words flooded out onto the page.

It was supposed to be succinct. It was supposed to be a simple set of bullet points.

It turned out to be a lot harder than I thought, to write down even the first part.

Part two has a lot to cover:

  • Homelessness
  • Hospitals
  • Police
  • Drug addiction
  • Psych wards
  • Suicide attempts
  • More banking jobs
  • More IT projects
  • Moving to Manchester
  • Moving to Wales
  • Several relationships and breakups; love and loss
  • Psychosis
  • Self medication
  • Alcohol
  • Depression
  • Anxiety
  • Boredom
  • Financial problems
  • Near-bankruptcy
  • Salvation

I'm not going to write part two in the same way that I wrote part one.

That was 6 months ago. This is now.

A lot can happen in 6 months.

As a quick recap, here are the problems I've been trying to tackle this year:

  • £54,000 of debt
  • Homeless
  • No job
  • No car
  • Single
  • Addicted to prescription drugs: sleeping pills, tranquillisers and painkillers
  • Alcohol abuse
  • Depression, anxiety and bipolar disorder

As if those problems weren't enough, in June I had relapsed onto supercrack. I'd been working but I'd lost my job - through no fault of my own - and I was in no hurry to get another one, because my addiction had returned with a vengeance. I was in a place with no family and only a handful of friends, none of whom were equipped to deal with my clusterfuck of issues. I was more-or-less alone, except for the people who I try to connect with on a daily basis through my blog, Twitter, Facebook and other digital means.

I came up with the title "No News is Bad News" because it's usually true. I came up with that title, because a period of silence on my blog is usually cause for concern. It's usually time to start phoning round the hospitals to see if I've been admitted. It's usually time to start worrying if I'm dead or dying.

Back in June - 6 months ago - the title was very apt, because I hadn't been online for a while. Losing my job had completely destroyed my hopes of dealing with the mountain of issues I was facing. Losing my job had wrecked my plans for recovery.

Today, my world looks very different.

I can't tell you too much - because it's private - but I'm writing from the comfort of my girlfriend's bed. Her bedroom is very pink and girly. She just brought me a plate with a generously buttered thick slice of toast and a glass of orange juice, which I am eating in bed. I'm getting crumbs in the bed and greasy finger-marks on my laptop.

I'm no longer living out of a suitcase in a hotel and eating in the same gastropub every night, sat at a table for one. I'm unofficially co-habiting. We only met a few weeks ago. The relationship is going fast. Too fast some might say.

I kiss my sweetheart good morning and wish her a good day as I depart for work. My journey takes no more than 15 minutes when the traffic is kind to me. I'm finding it easy to get up in the morning. I don't dread lonely evenings in a bland hotel room. I don't dread the unsustainable interminable monotony of miserable days in the office, and miserable evenings spent alone.

I'm going too fast though.

I'm working too hard.

It takes vast quantities of alcohol, sleeping pills and tranquillisers to prevent me from working 12 to 14 hour days. It requires a huge amount of effort to stop myself from working at the weekend. I'm desperate to achieve results as quickly as possible, because the finishing line is within sight.

It could be months before I'm well-and-truly out of the danger zone and enjoying some long-overdue financial security. It's definitely going to be a long time before I get truly settled at home and at work. I need to decide where I'm going to live and what I'm going to do for a job, on a more long-term basis. At some point, my good luck is going to run out and I'll be forced back into living out of a suitcase, maintaining a long-distance relationship, and having to face the anxiety and stress of proving myself in a new organisation, with a new set of work colleagues.

Mania has arrived. There's no doubt about that.

My manic energy has been ploughed into my day job, instead of my new novel. I worry that my work colleagues have noticed that I've completely obsessed by my project. I worry that the undesirable accompanying behaviours - irritability, rapid and pressured speech, arrogance and delusions of grandeur - will become so hard to hide in the office that I might be forced to disclose my bipolar disorder to my colleagues, in the hope that they'll be sympathetic.

My blog has been neglected, along with my friends.

I work too hard. I'm moving 'too fast' in my new relationship - the "L" word has been used and she has given me a key to her place. We're going on holiday together. All my original problems are still there, to some extent. I need to decide where to live, pay off my outstanding debts, drink less, quit the sleeping pills and tranquillisers, get my mania under control.

What else can I tell you?

I can't try to tell you too much all at once, even though I desperately want to. I want to sit down and write 10,000 words without taking a single break. I want to pour my heart out onto the page and tell you everything, but I'm trying to pump the brakes a little bit. I'm trying to be a little bit sensible, even though I'm clearly going too fast.

It feels like the week-long hiatus from blogging was not bad news. Perhaps it's good news? No. It's not good news. I'm not looking after myself. I'm not managing my bipolar very well. I'm allowing myself to become manic, for the purposes of achieving 'great' things at work. It's exciting to be manic after so many months of depression and misery.

It would be a good idea for me to resolve to resume my daily writing, but I'm wary of making unrealistic promises. Today, I'm coming to terms with the fact that my 3rd novel remains unfinished, when I had hoped to have completed it yesterday.

That, ladies and gentlemen, is my present situation in a nutshell.

 

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