Nick Grant

This is a story about assisted dying...

Having spent an extraordinary amount of time thinking and writing about suicide, as well as receiving a massive amount of emails from strangers in crisis, contemplating killing themselves, I don't claim to be exactly the same as a doctor who has specialised in euthanasia, or a crisis counsellor, but it's quite possible that we might have spent the same number of hours contemplating the same subject. My ignorance is not better than anybody's knowledge, but we are, after all, talking about the unknowable. Anybody who claims to know the unknowable is a charlatan.

The original charlatans would have been witch doctors and shamen, I suppose, claiming to have magical powers. Later, with the decline of magic and the rise of organised religion, the charlatans were, and indeed still are, priests. Debatably in modern times, there are [some] doctors who are charlatans. Anybody who says that doctors are scientific and evidence-led, has not met [enough] doctors, and truly understood their role and behaviour in society.

Of course, it's incorrect to say that the practice of witch doctors, shamen and medical doctors can be dismissed as equally groundless. In fact, we can ignore the obvious stuff - surgery, effective treatment for infection, life-support techniques - and look instead at what's common between the voodoo conjurers and your family doctor: neither of them will save your life, or the life of your child[ren], but both enjoy high social status, and we believe that they possess a power which they do not, which perversely can have a positive effect on our superstitious human psychology.

We must, for a minute, acknowledge that it is better to be soothed by a priest, telling us that we don't have to be afraid of death because we are going to heaven, or indeed soothed by a doctor who is telling us that everything is going to be OK because 'medical science'. Neither, in fact, possess the means to ease the burden of mortality, nor any knowledge to transform the human condition, beyond assistance in invoking a person's own capabilities of inducing a delusion: namely that life is anything other than a meaningless, godless existence, which ends with pain and terror.

Most of us will be so frantically pounding on life's treadmill, that we will scarcely have a moment to contemplate mortality, and if we do, it will be in the context of soothing the anxiety of our elderly relatives, and young children. The contemplation of our own individual mortality is a rich-man's hobby, and therefore something which only a very small percentage of the earth's inhabitants will ever have the wealth and privilege to do.

I might be such an idiot that I'm unable to correctly perceive and comprehend the depth and breadth of my own stupidity and ignorance, but, you would be foolish to deny that I have not had a lot more time to consider things than you, given that I have not been spending the majority of my waking hours attempting to shovel baked beans into the face of my grubby progeny.

It's banal and routine to ridicule first-semester philosophy majors, in the North American parlance, for thinking they just solved all philosophical problems at the first attempt. However, once you've figured out that we all end up as worm food, and all of human history and evidence of any human existence, will be obliterated so completely it will be as though humanity never existed, frankly, then at that point, all philosophy starts to look the same; equally absurd and meaningless.

Of course, subscribing to a certain life philosophy, or indeed a collection of different bits of philosophies, can make the difference between bearable or even very pleasurable periods of existence during a short mortal life, versus the unspeakable horror of experiencing the futility and meaninglessness of everything, raw and unfiltered, until you finally, gratefully and gladly expire.

Human inventions, like the wheel, sprung up independently in different times and places. No one human can ever claim to have a monopoly on, for example, a particular philosophical thought, because that thought can be arrived at independently.

To claim that religion and medicine - or at least, doctors who don't practice any medicine, but merely occupy the high-status role, dispensing ostensibly worthless advice - are totally and utterly without value to humanity is entirely wrong: they are valuable. The church keeps a great deal of humanity occupied with futile pursuits, but we must ask ourselves if it's truly futile, if it occupies people when they might otherwise become, like me, preoccupied with their own mortality. Many medical doctors practice a new form of religion, where we worship them and elevate them well beyond their capability to forestall or otherwise arrest our inevitable death, but is their value over-estimated, if our irrational belief in them eases the passage of our lives.

I wish, very often, that I was stupid enough to believe in god, or doctors.

Tags: #suicide

This is a story about alarm clocks...

How many people start the day, jolted from their pleasant slumbers by their alarm clock, repeatedly pressing the snooze button because they want and need more sleep? Is it 50% of the world's population? Is it 75% of the world's population? Is it 95% of the world's population? Certainly, in Europe, North America, New Zealand, Australia - and a bunch of other 'westernised' societies - the figure will be exceedingly high. That's an incredible amount of unnecessary human misery and suffering, in my opinion. Why the hell is society functioning like that, with its most productive members so exhausted?

I do not subscribe to the rat race, insofar as accepting that social jetlag is an inevitable part of the prime years of my life. I do not accept decades of torturous suffering. I refuse to be part of that.

Many years ago, I was unable to get out of bed, one morning. I lay in that bed for weeks, paralysed by depression. But, I don't think it was depression: it was my body's natural reaction to an abhorrent situation. Nobody should have to get up in the morning, against nature. It's unnatural. It's an offence to human existence. It's toxic to human health and wellbeing. No. No way. Not doing it.

But.

It's almost impossible to fight against the established order of society. Even though almost everybody is exhausted and socially jetlagged, because of the rat race, nobody wants to flinch first; nobody wants to be the person who gives up, lest other eager competitors steal their place in the rat race.

In an arms race, eventually, the only outcome is the destruction of human civilisation. This is the point that we've arrived at: life has become uncivilised in the extreme.

So.

What are we going to do about it?

Let me tell you a little bit about my life. I go to bed at the same time every night, and I always fall asleep quickly. Then, I always wake up before I need to wake up. I never set an alarm clock. I'm never woken up unnaturally: I always wake up, doze peacefully a little longer, start thinking about my day, read a little news on my phone, then get up when I'm ready. I'm almost always among the first of my colleagues to start my working day. Sounds too good to be true? Well, yes, certainly this can't be achieved without a little cheating.

How do I cheat?

Well, that's really easy, so I'm not going to beat about the bush. The answer is obvious: sleep medication.

Yes, that's right, sleep medication is the obvious treatment for social jetlag.

Sleep medication.

It's that simple.

There are two problems: firstly, your doctor will not give you any effective sleep medication, because otherwise society would be a happier, better rested, and a less miserable torturous place, and we couldn't possibly have that, could we?!?! Secondly, getting a great night of sleep every night, and waking up naturally every morning feeling refreshed, starting work early without need in alarm clock, is really great so it's hard to want to go back to being tired all the time, and hating every single morning when the alarm goes off. Obviously, you need a virtually unlimited supply of effective sleep medication, to last you until retirement.

Good news though: capitalism plans on continuing to manufacture goods and services, for as long as there's demand. Also good news: while you continue to be useful to capitalism, you will be given tokens which you can exchange for goods and services. More good news: while you have needs and valuable tokens, and capitalism produces goods and services, there will be people willing to facilitate the exchange of those tokens for the goods and services, in exchange for a profit margin. Good news all round: while capitalism demands that you get out of bed unnaturally early in the morning, there will be a plentiful supply of sleep medication, to allow you to cope with the social jetlag.

Of course, when capitalism collapses, I'm going to have some pretty bad insomnia, but maybe that's advantageous. When everybody else is sleeping, overcome by exhaustion, I'll have plenty of extra hours awake to scavenge the looted supermarkets for scraps.

Don't waste your time with your doctor: capitalism has already created efficient markets, where you can procure whatever you need at a highly competitive price.

Tags: #medication #sleep #mentalhealth #depression

This is a story about false advertising...

The subject matter which my website deals with, is either "living with bipolar disorder" or it's "the world's longest suicide note". In fact, it can be both. The two are not mutually exclusive.

However, I don't tend to write very much specifically on the subject of my life with bipolar disorder, because I've always had it and it's so intrinsic to me, that I find it very hard to imagine life without it. Although bipolar has caused me significant problems in my life, those problems were present before my diagnosis, and I've not found it particularly useful, in recent years, to think about my diagnosis at all: I certainly don't seek 'treatment' for the illness, or otherwise involve myself with quacks, and the like.

I suppose I write about bipolar in a tangental way, given that the mental illness does dominate my life. Suicide, for example, would not be such an ever-present danger, were it not for my bipolar disorder. Also, various behaviours, many of which would not be seen particularly as symptoms of mental illness, are driven by my bipolar disorder.

Pictured above are two books which are on my coffee table at the moment. I thought that this accidental juxtaposition served as a brilliant summary of my state of mind. As my mood plummets into depression, I pick up the book about suicide. As my mood soars into mania, I pick up the book about mountain biking.

The mountain biking is a new thing. I used to ride mountain bikes when I was a teenager and as a young man, before graduating on to other more extreme sports. Since approximately 2013, when my life disintegrated during an acrimonious divorce, I haven't done anything which you might call 'sport'... with the possible exception of riding through London traffic on my bike at top speed, which is one of the most extreme 'sports' that you can take part in; one of the activities most likely to kill you.

I'm sorry if you came to my website, hoping to read more about bipolar, but were left feeling disappointed; let down. Most people - from those who write to me at least - tell me that they wish I would provide an idiot-proof step-by-step guide, in minute detail, of exactly how to commit suicide. I am not going to do that. No. Never. No way.

Anyway, despite winter being just around the corner, which always sends my mood nosediving, and other things which aren't right in my life - I'm single, don't have a social life etc - I am extremely keen to go for another ride on my new mountain bike, as soon as my backside has recovered enough, such that I wouldn't ruin this weekend, for the sake of a short midweek ride.

I don't feel manic, but then, I never do. My bank balance probably tells a different story. I spent three times as much on my mountain bike as I did on my car, for example. I have been spending money like crazy, which is usually a sign I'm manic. Also, I am struggling to sleep. Other symptoms too.

Of course, I'm happy to be happy, but I also need to be careful that my mood isn't getting too elevated. I need to be careful, although many would say that spending a ludicrous amount of money on a bike could only be explained by a mental illness.

Tags: #bipolar #bike #suicide

This is a story about treatment and therapy...

I write about my own personal experiences of depression, anxiety, suicidal thoughts, suicidal plans and suicide attempts, because that's what I would want to read if I was in crisis. There's a mountain of material on the web about the symptoms of mental illness, dealing with a crisis, coping with suicidal thoughts, counselling, crisis support, mental health teams, crisis teams, doctors, healers, witch doctors, shamen... and all the rest of it.

It's all been done to death.

So, here's what I'm doing: I write.

I've tried absolutely tons of medications, and all of them have undesirable side-effects, and ultimately didn't bring me a good long-term outcome. I refuse to accept that I simply haven't found the right medication, at the right dose, in the right combinations: personally, I've exhausted that avenue, and found it to be a fruitless exercise. That's not to say that medication won't work for you, and you shouldn't try it, but it didn't work for me.

I tried counselling and behavioural therapies. Nope. Probably OK if you're just 'a bit sad' but if you're reading this then you're probably well beyond being 'a bit sad'. That's not to say you shouldn't try therapy. Everyone's different. However, for me personally, I don't think 45 minutes a week is going to fix all my problems, sorry.

It's important to acknowledge, though, that following the treatment routes which have been resoundingly proven to be ineffective, can be a useful distraction which will eat up a few years of your life. Although I can say with certainty that the long-term outcomes are not attractive, in the short term, there's a lot to be gained from the process of learning about all the different medications and trying them out: it'll keep you busy!

Also, we shouldn't underestimate the power of having a kind non-judgemental person, listening to your traumatic story. Being heard is super important; super healing. Having somebody tell you that you did the best with the hand you were dealt, can be incredibly important, to forgive yourself and start to feel better about being unwell; not so guilty or broken.

I write because it's unlimited free therapy. Instead of only having 45 minutes a week with a therapist, my therapist - the blank page upon which I write - is available 24 x 7 x365, and I can spend as long as I want in a therapy session for free. The free part is not to be underestimated: therapy is really expensive (although it might be money well spent if it works for you). Also, the blank page is the world's best listener: it never interrupts, misunderstands, disagrees, challenges, contradicts, argues or otherwise talks back, which is *perfect* as a therapist.

Given that therapy is pretty much just guided introspection, there's no reason why you can't learn the techniques to explore your own thoughts and feelings, without a guide. Now I'm in the habit of sitting down in front of my blank page every day, I find it really easy to explore whatever's bothering me, or to dig into baggage from the past... whatever I want - it's my time and I'm paying for it!

From personal experience, not professional qualification, I really urge you to write on a regular basis, therapeutically. It's helped more than anything else I've tried, by far.

Of course, we would all love to find an authority figure - a doctor or similar high professional status person - who we can put our faith in to 'cure' us and take care of all our problems, but the reality is that depression and anxiety are modern epidemics, and medicine has failed to provide effective treatment; the problems are getting worse, not better. Ultimately, we are - unfortunately - personally responsible for our safety and wellbeing. Much though I wish there was a magic person in a magic building with magic beans, like a doctor in a hospital with some pills, it's turned out to be a massive disappointment... we're on our own.

Of course you should phone the crisis hotline if you're on the brink of committing suicide. Of course you should go to your doctor and take their advice. Of course you should seek professional help. However, if - like me - you've tried all that and found it to be a dismal disappointment, then I imagine that's why you're here, right now, reading this.

Try writing. It helps.

Tags: #suicide #depression #mentalhealth

This is a story about the control of information...

As is often the case, something I have read or watched has prompted me to write. Today, I felt the urgent need to write about methods of killing yourself. I felt compelled to document every single method of committing suicide, which I could possibly think of.

The reason why I would write this down is that the thing which most often draws visitors to my website is something I wrote about suffocation - asphyxiation - as a means of suicide. People also come who are desperately trying to cure themselves of their problems with mental health, alcoholism and addiction. People visit my website for all kinds of different reasons, but as a source of information on how to kill yourself, my site is one of many millions. Our libraries are full of books which explain in exquisite detail how people have ended their own lives, since we took pen to parchment, or chiselled runes into rock. For those who seek, they will find.

I've noticed a lot of criticism of the owner/operators of forums where suicide is predominantly discussed, and prominent popular indviduals who have large social media followings have been criticised for their participation in the online discussion of suicide which has coalesced around their digital persona.

We have to be very clear about something here: people need and want to talk about suicide. Making it a taboo subject, and ridiculous fantasies about book burning and the modern-day digital equivalent - banning websites - fails to address any of the underlying causes of why people take their own lives.

People don't kill themselves because they're encouraged by others, online. People don't kill themselves because they're able to easily find the information about the methods of suicide. The reasons why people kill themselves are as complex as the individuals who end their lives prematurely, and to point the finger of blame is pointless; futile.

While it might be true that we see 'outbreaks' of suicides which cluster together geographically, almost like a conventional viral, bacterial or parasitic infection, passed from person to person, this does not mean that newspapers, magazines, TV & radio stations and the modern digital equivalents, should never talk about suicides, or the methods. There is no evidence to prove that journalistic guidelines have in any way reduced the likelihood that fellow friends, classmates and other people in the vicinity of a suicide, will commit suicide themselves. We are missing the point: if one person in a particular area of the country, of a certain age, living a certain lifestyle, is compelled to end their life, then why should we be surprised that there are many others who are living on the edge too? It is absolutely untrue that the media and the internet is in any way shape or form responsible for pushing and/or prompting people to end their lives.

We also have to answer the difficult question: is it ethical to force a person to live a miserable and unbearable life? Is it unethical to force a person to endure unending suffering?

A documentary I was watching particularly annoyed me when a so-called expert came onto the program to say that suicidal thoughts are usually fleeting, and quickly pass; they essentially said that depression is temporary - in a particularly dismissive manner - and that we should shut up and put up with it. This made me furious.

People don't end their lives whimsically. Suicides are meticulously planned. The formation of the idea of killing one's self is something that has taken place during years of terrible suffering. I say that it is unethical to act in any kind of way to prevent a suffering person from achieving relief from the terrible torments which they have decided are too unbearable. It's their life at the end of the day. It's selfish to ask them to keep living an intolerable miserable suffering-filled existence... for what reason? So that you don't feel sad? Get over yourself. Get a grip. Have some compassion. Show a little empathy.

I believe strongly that suicides are 100% preventable, and that we should aim for zero suicides - nobody should ever commit suicide. However, the solutions are well beyond the scope of this essay, and ask the reader to think the unthinkable, such as improving people's lives, instead of fobbing them off with cheap anti-depressant tablets and abysmal "behavioural therapy" courses developed and delivered by a group of people with the collective IQ of a slug. The evidence is clear: suicide is the number one killer of men under the age of 50, and the suicide rate in young girls and women is growing faster than ever before. Yet, the approach remains unchanged: ineffective medications and ineffective psychological therapies. Also, the circumstances get worse and worse: youth unemployment soars, personal debt soars, global warming and climate change rages out of control, and the chance of having a fulfilling happy life diminishes by a vast amount every single day.

---

So, you came here for the good stuff, right?

OK, here are all the ways you can kill yourself, separated into some different sections.

Poisonings and Overdoses

Almost every substance which a normal person can obtain will result in a slow and painful death. Anybody can find a poisonous mushroom or plant - such as deadly nightshade or hemlock - which will kill you, but it will be extremely unpleasant. It's possible to purchase a large quantity of paracetamol, for example, which will easily cause fatal liver failure, but this is a particularly slow, painful and unpleasant death.

Deaths by overdose are hard to achieve with so-called 'safe' modern medications. Your doctor is unlikely to prescribe you enough opiates to allow you to kill yourself, unless you stockpile your supply, and slow-release formulas can make it hard to commit suicide using swallowed tablets. Barbiturates, which are the number one choice of doctors who wish to commit suicide, are never prescribed. There are deadly medications, such as warfarin, but to obtain them is almost impossible.

Were you able to obtain a poison such as strychnine or cyanide, your death would be surprisingly slow and painful. Potassium cyanide particularly, would not be a pleasant easy death, unless combined with a large dose of sedative and a painkiller, because it essentially induces a heart attack.

Blood Loss and Other Trauma

The body has developed very advanced mechanisms to cope with severe lacerations, and blood vessels will spasm and contract to contain loss of blood. The arteries are generally well protected by the anatomy which has evolved to keep us alive.

Generally speaking, cutting the jugular vein(s) is a reliable method of suicide, but there are many variables: the blade must be sharp, the aim must be true, and the cut must be made with force and certainty. It's more likely that you will end up with a profusely bleeding laceration than a lethal wound.

Cutting one of the carotid arteries must surely be the most reliable way of killing yourself with a knife or razor blade, but detailed anatomical knowledge and a willingness to undergo immense pain, while conducting this surgery on yourself, makes the task almost impossible.

Plunging a sharp object in-between your ribs and into your heart or one of the biggest blood vessels in your body will kill you very quickly, but the chance of you hitting your target is low.

The Japanese Samurai favour disembowelment as an "honourable death". Do not recommend.

Self-immolation would be incredibly painful, and your death would be caused by suffocation: the flames would consume the oxygen from around your body, and your lungs would be burned so badly they would not function. Definitely do not recommend.

Falls From Height

Yes, these will kill you. There is a well documented case of a man who survived a fall from the Golden Gate Bridge, which is about 67 metres (or 220 feet for those who prefer imperial units). In rock climbing terms, that's about 1 rope length, and there are lots of documented cases of rock climbers who have fallen from the top of a cliff and survived.

This is all about the height, and the surface you're landing on. Maximum height and solid landing surface = more certain death. I would say that 8 storeys or more, landing on concrete, rock or something similar like that, would guarantee 'instant' death. Bear in mind that you would need to jump and also endure the fall, which would both be very traumatic, but it would be a 'quick' death versus a poisoning or overdose, for example.

Hanging

Most people who have hanged themselves have died from asphyxiation, and have suffered an incredibly awful death. Death by hanging has a high success rate, but we should be mindful that the final period of that person's life was unimaginably terrible. To asphyxiate elicits one of our most primal panic responses - the hypercapnic alarm response - and we know that many people who have hanged themselves have taken 30 to 90 minutes before they have finally expired. This is one of the most unpleasant deaths I can imagine.

For a hanging to be a quick death, the neck should be broken or the body should be decapitated - either outcome achieves the desired outcome, which is a quick death. It would be advisable - although I advise nobody to commit suicide, of course - to err on the side of caution, and ensure that the 'drop' is sufficient to break the neck at the very least, and if decapitation occurs, then it's far preferable to the alternative: a lengthy asphyxiation.

Electrocution

Most modern domestic and commercial electrical systems are fitted with systems to prevent electrocution, and as such you would be unlikely to be able to electrocute yourself by, for example, dropping an electrical appliance into the bath-tub while you were in it.

In the interests of a full and frank exploration of all the available suicide options, I must tell you that it's possible to obtain a lethal electrical current by simply removing the cover of your fuse box, where there are live parts which do not have the protections which you have throughout your house or other premises.

Touching a live electrical conductor will hurt, a lot, but it won't kill you. In order to kill yourself by electrocution, you must first grip something which is earthed - such as a copper water pipe or the earth clip for your house, usually marked with green and yellow striped insulation - and then touch the live source of electricity with your OTHER hand. Then, the electrical current will flow across your body, through your chest, and your heart will either be very badly damaged or at least enter ventricular fibrillation, where it is unable to pump blood, causing you to lose consciousness immediately.

It's possible that you might only receive a 'mild' electrocution, leaving you with very bad burns, tissue and nerve damage, but otherwise alive. For this reason, it's probably inadvisable for anybody except a trained electrician to commit suicide using this method.

Asphyxiation, Drowning, Suffocation etc

As I wrote before, the hypercapnic alarm response, which is your body's natural reaction to high carbon dioxide levels in your bloodstream, will cause incredible panic and suffering. As such, drowning yourself by attaching weights to your body and jumping into water, would be a terrible, terrible death. Do not recommend.

To attempt to suffocate yourself, perhaps by putting a plastic bag over your head or other somesuch thing, would result in the elicitation of the hypercapnic alarm response and you would tear the bag off your head, driven by instinct. Your primitive survival instincts would override the neocortical modern brain, which we have unfortunately evolved, leading us to want to commit suicide in the first place.

In order to asphyxiate in the manner which we would all wish to die, which is painlessly and peacefully, the solution is simple: we must breathe a gas which contains no oxygen or carbon dioxide. To breathe the gas from your oven puts your neighbours and firefighters at risk, because a gas explosion will be the likely result. Instead, a bottle of helium can be purchased inexpensively, for the usual purpose of filling baloons. Instead, the helium should be used to provide a steady supply of gas to some kind of 'hood' which you wear. By breathing an inert gas like helium, you will quickly lose consciousness and death will follow within some minutes, as your body and brain are deprived of oxygen.

Other

There are things which might work, but are more likely to cause you incredible pain and injury, such as injecting yourself with a bubble of air.

You could obviously starve or dehydrate yourself to death, but this would be time-consuming and result in a slow and painful death, with much suffering.

For those who live in places where firearms are easily obtained, I don't know why you're even reading this: if I could get hold of a gun I'd already be dead, I'm sure. That's not to say that gun control is preventing my suicide; merely that there are easier ways to kill yourself in a country like the UK, but I foolishly have opted for methods which were unlikely to kill me, such as poison, overdose and cutting veins.

The number of ways to cause your body a traumatic injury are innumerable, but an example might be to turn off the airbag on your car and then drive without a seatbelt at 100mph into a concrete pillar which is supporting a bridge.

---

As you can see, the options are multitudinous and you really don't need me to list them. You already knew almost all this stuff, and if you didn't, it was available on a million websites; it was one single Google search away.

As for the charge that I am encouraging, endorsing, glamourising or enabling suicide in any way whatsoever, you are barking up the wrong tree. Look again at the suffering. Look again at the causes of that suffering. Look again at the options available to the victim of that suffering. If it was possible for a suicidal person to endure any longer, they would. If there was an easy option, like a magic pill from a magic doctor who lives in a magic building, then we would see suicide rates falling not climbing. The medical establishment claims to want to preserve life, and it claims to be empirical and evidence-based, yet all the evidence shows that medicine is failing abysmally to deal with the number one killer of men under the age of 50; the fastest growing cause of death of young girls and women. Medicine can f**k off - it's had plenty of chances to do something about the suicide and mental health epidemic, but instead it has rested on its laurels and dished out useless pills, and allowed intolerable living conditions to grow, flourish and proliferate.

If you think my article is somehow dangerous and irresponsible, I suggest you seek your first recourse with those who claim to be practicing so-called medicine, when all the evidence shows that the medications and treatments prescribed are entirely ineffective, and the mental health epidemic and suicide rate are the number one public health emergency, yet your doctor is doing nothing about it - they have their head buried in the sand.

For those of you who came here looking for information on how to commit suicide, I empathise. I've attempted suicide several times. If you want to talk to somebody who lives with suicidal thoughts on a daily basis and has tried every conventional treatment you can possibly imagine, who won't try to "talk you out of doing anything" or otherwise patronise you, my Twitter DMs are open and my email address is publicly available.

If you're suffering, I'm sad about that. I wish people didn't have to commit suicide, but sometimes they do, because the suffering is too unbearable.

Still thinking about killing yourself? Please read my essay on how to kill yourself.

Want even more? Please read about why I am planning on committing suicide.

Tags: #suicide #depression #medication

This is a story about harm reduction...

I've been sober for 33 consecutive days now. It's not a particularly important number that demonstrates anything of much interest, but I thought I should remind readers of how I'm getting along without alcohol. The plan, which I will easily achieve, is to be teetotal until at least the end of October, under the guise of the "Go Sober for October" sponsored charity event, if anybody asks.

The truth about my sobriety is much more straightforward: alcohol was a source of a great many calories, which were causing me to gain weight, and my liver needed a break from the constant onslaught. My decision to take a break from drinking was motivated by vanity and sensible health considerations, not more interesting and lurid reasons such as a so-called "battle with the demon drink" which I find patently absurd, as a person who's been lucky enough not to be cursed with the misfortune of not being able to control their drinking.

We should, of course, spare a moment for all the alcoholics in the world who are somewhat powerless in the face of their addiction to ethanol. We should be sympathetic and understanding towards those who genuinely have very limited control over their so-called 'free will' to choose between drinking and not drinking. Alcoholics, by definition, have had their decision-making powers almost 100% impaired by the addictive qualities of alcohol, and as such, they would not be able to choose to take a lengthy break from drinking at will.

For those wishing to quit or reduce their drinking, I was in the process of writing my own version of the Alcoholics Anonymous (AA) Twelve Steps. I find abstinence-based so-called 'treatment' of addiction to be a barbaric ritual with very strong evidence to show that not only is it ineffectual, but it's actively unhelpful, unkind and needlessly unpleasant. AA is a cult, with its rituals and other cult qualities, such as the vicious ostricisation of any member who strays too far from the pack, or dares to question its efficacy. While I applaud and and am glad for those who credit AA with their sobriety, I would also remind you that many people credit their good fortune to some form of sky monster (i.e. god or whatever) - human beings are superstitious idiots, and I urge everyone to seek evidence-based treatments, not cult mumbo-jumbo.

So, what is my solution for those who drink too much?

Simple answer: compensation.

We wouldn't say to a person who complains that their diet is too bland, consisting only of gruel and dry bread, that they should instead go without food altogether, would we? The abstinence approach is not only cruel and unkind, it also creates unnecessary and intolerable suffering, which is why so few people are able to use abstinence-based approaches to achieving their goals.

Whether it's dieting to lose weight, quitting gambling, quitting drugs, quitting alcohol, or indeed altering any of our behaviours which are causing us problems, the most important thing to consider is how we are going to compensate for the thing we are giving up or reducing. Without compensation, change is impossible; only suffering will ensue.

When I quit drinking for 121 consecutive days in 2015, I compensated with dietary supplements and other health-conscious changes, which included cutting out gluten and dairy from my diet. In retrospect, that was a really dumb decision. While there was a high placebo value in the changes that I made, there was no other value. I might as well have banged a gong and worshipped a made-up monkey god, asking him to cleanse me of the demon drink - it would have had the same effect. I am neither gluten nor dairy intolerant, so all I did was waste a bunch of money on expensive food products.

This time, I have compensated by using sleeping pills and tranquillisers which mimic the positive effects of alcohol, without the negative ones. I don't get hangovers. I don't have weight gain. I don't have liver damage. However, my anxiety is reduced, my insomnia is cured and my sleep quality is improved. What's not to like?

Of course, I have swapped a nightly glass or two of wine for a tablet or two, which some might see as 'failure' but those people are idiots. I've lost weight, my kidney has had the opportunity to repair itself, plus I have avoided endless amounts of hangxiety and hangovers. Also, the tablets are a damnsight cheaper than alcohol, costing me no more than a couple of pounds every day, which is a fraction of the cost of the alcohol required to achieve the same reduction in anxiety and ability to fall asleep.

We shouldn't underestimate the danger of addictive medications, and I've certainly put off today's problems until tomorrow by using tablets to allow me to achieve a period of sobriety, but I really don't give a shit - I've lost weight and my life has been manageable; my health has improved. I see no downsides. It will be a bit of a bumpy ride when I quit the tablets again, but I have only taken them sporadically during recent weeks, so quitting will be easy enough - I will gently taper the dosage and then I will be free from all mind-altering substances, once again.

I'm one of the most substance-free people you're ever likely to meet. I don't drink (at the moment), don't smoke and I don't drink caffeinated beverages. I'm highly unusual in this regard: you and almost everybody you know, indulges in some kind of mind-altering substance use, even if it's just tea or coffee.

If my life had permitted it, of course I would have been climbing mountains or surfing, or doing some other wholesome outdoor activity, but I've had to work really really hard the past few months, and it's entirely unrealistic to imagine that I would be out in the wilderness charging around like a healthy happy person, when I'm actually incredibly stressed, depressed and anxious, under enormous pressure to deliver a very large complicated project, for a tight deadline. It's a fucking miracle that I'm as healthy as I am, given the pressure I'm under, and the demands placed upon me.

So, shove your yoga, jogging and kale smoothies up your arse. Do whatever it takes to compensate, if you need to stop a particularly unhealthy habit - find something that's less harmful. Harm reduction is better than trying and failing to achieve the impossible. Abstinence is torture and should never be inflicted upon anybody, ever, under any circumstances whatsoever.

Steps Five through Twelve might be a bit rushed, given that there are only 9 days between now and October 31, but I will finish this series, because I think it's important that people who are suffering are given realistic and evidence-based humane alternatives, which will allow them to achieve a better life... not be expected to suffer torture and be doomed to failure, because some twat of a moralising idiot tells them that the only way to get better is through abstinence. Fuck those guys. Do what works.

Tags: #alcohol

This is a story about being deliberately stuck in a rut...

It's fairly common for people charged with healthcare and wellbeing duties to blame the victim. "You don't want to get better, do you?" comes the accusation, when somebody's feeble attempts to help have failed in the face of an intractably difficult set of problems. "You like being depressed, don't you?" comes the victim-blaming response to the failure of a person whose profession is allegedly to help sick people get better.

I read an illuminating article the other day, which shed further light on the mindset which continues to perpetuate medicine and psychology's abysmal failures in the field of mental health. While claiming to practice evidence-based treatment, doctors and psychologists have no basic grasp of the evidence, which clearly shows an epidemic of mental health problems and dreadful outcomes - complete and utter failure, no less. However, in the face of this appalling failure, doctors and psychologists have decided to blame the victims, stating that the patients who don't get better - who are indeed the vast majority - are to blame for their own illness.

The charge, in a nutshell, is that depression and sadness have become a 'comfort zone' for the sufferer, and to attempt to get better would risk disappointment, so instead these untreatable people who are intent on remaining depressed, are competing with each other to see who can be the most depressed and miserable.

What a load of BS.

It's true that I have written endlessly about how depressed and anxious I am. It's true that I've written repeatedly about my certainty that I'm doomed to failure. It's true that I've felt hopeless and helpless; powerless. I've felt like my situation can never be resolved and that my life will never improve.

I've been convinced that my life will never improve.

I've been convinced that my life will never improve so does that mean I've made no attempt to improve it? Does the fact that I spurn medication and therapy indicate that I am intent on remaining depressed and anxious? Is my negative outlook a self-fulfilling prophecy? Am I to blame for my own misery?

Yes, doctors and psychologists would love to blame me for my own depression.

I say that it is them who are the defeatists, responsible for people's depression.

I say that it is those who do not listen and do not care, who only want for quick and easy fixes, who condemn the patients they claim to want to help, to a life of misery and depression. I blame the doctors and the psychologists for the epidemic of mental health problems, because they claim to offer effective evidence-based treatment, but the treatment is ineffective. All the evidence is overwhelming: the treatments on offer DO NOT WORK and often times make the patient's life much worse.

The solutions to the mental health epidemic are as complicated as our busy complex lives, unsurprisingly. The solutions do not come in the form of a pill or a simple cognitive therapy. The solutions are not simple, because the problems are not simple.

The world is addicted to my productivity. The world is addicted to my mental illness. The world does not want me to be well. The world wants me to be sick.

Yes. That's right. The world wants me to be sick.

The rat race is incredibly stressful and is tailor made to create mental health problems. Capitalism is incredibly toxic to mental health. Yet, we cannot discuss these things. Instead we must blame ourselves. Instead we decide it is us who is badly adjusted to society, and therefore it is us who is defective and needs powerful psychiatric medications to 'correct' our faults.

Obviously, when more than 50% of the population is struggling with some kind of mental health problem, then we can see that society is defective, not the individuals.

We ask mothers to leave their children in the hands of strangers, in order to commute long distances and work in offices. We ask fathers to miss out on seeing their kids grow up, because they have to spend so much time away from home, working. Our houses are a crippling financial burden. The lengthy commutes are stressful in rush hour traffic and jostling in crowds on packed trains and busses. We leave the peaceful rural countryside and journey into grey polluted overcrowded concrete centres of commerce, where the noise and the lights and the huge number of people is an assault on our senses.

We aren't supposed to live like this.

We aren't supposed to spend our whole lives fighting so hard; struggling. We weren't built to be so distant from our families and our communities, living lives of quiet desperation in concrete jungles, with so much stress about money. We were never evolved to spend so much time commuting, bored, working bulls**t jobs in offices. It's unnatural. It goes against our fundamental human nature.

We tell ourselves "it's not forever" as we attempt to pay off enough of our mortgages and save enough money into our pension pots to be able to quit the rat race, but the truth is that it is forever - we can never quit the rat race, and that's depressing.

I am making a little progress. I can see some light at the end of the tunnel. My quality of life has improved an immense amount versus a year ago, when things were much more precarious. In a year from now, with a little luck, I might finally be enjoying a little financial security, and therefore be a lot less stressed.

My problems are simple enough, but not simple enough for those who think that there's a pill which can almost instantly cure all my problems. My problems are simple enough for anybody who takes the time to stop and think, but who has the time? Much easier to just suggest that an hour of therapy a week is adequate to solve my rational depression and anxiety about the unbearable unpleasantness of the rat race and the abysmally awful situation which capitalism creates.

I will have no hesitation in ceasing my misery-filled essays, once I have escaped the source of the misery. I am not addicted at all to feeling sad. How preposterous to suggest that I enjoy feeling depressed. How offensive to suggest that I'm to blame for my own unbearable feelings.

I choose not to feel sad, depressed and anxious. I choose happiness. I choose joy. However, these choices are not available to me: it is necessary for me to work long and hard, in intolerable conditions, in order to be able to choose happiness. At least I have an opportunity to achieve financial security, when most people do not.

Of course I would love to solve the world's problems. I can see that society is producing an epidemic of mental health problems - the evidence is overwhelming. I would dearly love to be doing something to improve the human condition, end climate change, end poverty and generally allow people to live happier and more fulfilling lives, but I realise that it's impossible. I assure you that I work extremely hard, attempting to improve my own situation, but it takes a lot of time. I've made extraordinary progress, but there is still a long way to go, and there are regular setbacks.

In some ways I wish that my situation was more hopeless, so that I would feel enabled to do whatever I wanted. I feel as though I am duty-bound to pursue the great opportunity that has been presented to me. I am lucky enough not to held back by black marks against my name, such as a bad credit score, a criminal record, a bankruptcy or other things which condemn so many people to a life of poverty - they will never be afforded the opportunity to earn large sums of money, and therefore to be able to escape poverty by the conventional route. It would be somewhat immoral of me to throw away my good fortune and allow myself to be eaten by the vultures, when I still have the opportunity to work my way out of my intolerable situation, although it's incomprehensibly awful to work your way back up from the bottom, with the constant threat of failure.

I most definitely do not live in the 'comfort zone' of hopeless depression. Instead, I live with the unbearable anxiety and stress of trying and struggling, knowing that all my effort might be wasted, due to a single setback. Yet, I do struggle. I do try. I most definitely am ploughing every ounce of energy that I possess into attempting to escape my dismal plight.

Please stop blaming depressed people for their own depression.

Tags: #depression #capitalism

This is a story about lost causes...

Look at that well-presented man: a professional on his way to work for Barclays at their head office in Canary Wharf as an IT consultant earning £600 a day. Look the attractive Georgian façades of the London townhouses of Camden, where he lives. The major high-street bank he works for has conducted extensive background checks on him and found him to be a fine upstanding member of the community: a model citizen.

Look again.

What you are actually looking at is a homeless man. That's right. This man is no-fixed-abode. This man lives in a hostel with other homeless people. This man was sleeping rough until very recently.

Look at this hostel dorm. It's got brand new beds and clean linen. It's empty. This looks like a pretty nice hostel dorm, doesn't it? Perhaps you wouldn't mind sleeping here. This would be tolerable for a while, perhaps if you were backpacking, wouldn't it?

Look again.

What you are actually looking at is a hostel dorm I stayed in when I was travelling - for leisure purposes - and the people who stay at this hostel are wealthy backpackers. This is not the hostel I stayed in when I was homeless. When I was homeless I stayed in hostel dorms that were full of drug addicts, alcoholics, people with severe mental health problems, thieves, violence, sexual assault, and they were exceptionally dirty and disgusting. The hostels I stayed in when I was homeless were full of everybody's crappy possessions which we carried around with us - we didn't live out of small backpacks, because we were homeless. When you're homeless you carry everything you possibly can: all your possessions. Try to imagine 14 people in a single room along with every single thing that they own. Try to imagine that's where you live - you're not just having a jolly old time doing some backpacking. That's WHERE YOU LIVE and you have to go to work, in the midst of all that chaotic s**t.

That's a nice view isn't it? That's Hampstead Heath. It's a nice place to walk your dog or go for a run. It's a nice place for a picnic. Hampstead Heath is a lovely place to go when the sun's shining. Perhaps you'd like to take a swim in one of the bathing ponds?

Look again.

What you are actually looking at is near the spot where I slept rough, to avoid being robbed, beaten up and/or raped. What you are actually looking at is a place where a homeless person can hide themselves in the undergrowth at night and avoid the perils of sleeping rough. What you are looking at is where I slept for a couple of months. Guess what? It's not always sunny. Sometimes it rains. When it rains you get wet. Very wet. A tent is conspicuous. It's hard to sleep rough, stay dry and avoid becoming a victim of crime when you're so vulnerable. Try to imagine not having a proper bed or any kind of security for you and your stuff - you're totally out in the open, in a remote area.

What's this? Is it a prison cell? I haven't been in a prison cell, but this definitely looks a bit like a prison cell to me. There's a window so that people can look into the room, which clearly has a bed, so this must be a place where I slept. What kind of place has windows in the doors so that people can see in when you're sleeping? That doesn't sound great for privacy, does it?

Look again.

What you are looking at is a room in a secure psychiatric ward. The window is there so that the staff can check you're not attempting to kill yourself. The staff check on you every 15 minutes. At night they sometimes come into your room and shine a torch in your face. You can't have a belt, shoelaces, scissors, razor, cables (e.g. mobile phone) or anything else that you could cut yourself with, or strangle yourself with. You can't lock the door to the shower room or the toilet.

Oh look! There's a view of Hampstead from a tall building. Perhaps we could see the heath from here. This is quite a nice view, except it's kind of in the wrong direction to see any London landmarks. Perhaps this this is the view from an ugly brutalist concrete monstrosity which has now perversely become a desirable place to live as the capital city's property prices have soared.

Look again.

This is the view from the Royal Free Hospital. The emergency services brought me here. I was nearly dead. I was here a long time, while the medical team fought to save my life.

That's a pretty nice room for an NHS hospital. It's a private room. I must have some pretty good private medical insurance. Perhaps I've come to hospital for an elective cosmetic procedure. This certainly doesn't look like the kind of place where a sick patient would be looked after - it's more like the kind of recovery room that somebody with private healthcare would receive.

Look again.

This is the room at The Royal London which was dedicated to my treatment because my kidneys had failed due to a horrific DVT and I was receiving emergency dialysis for many many hours a day. To my left, out of shot, is a dedicated dialysis machine which I was connected to for day after day. I couldn't have dialysis in the main dialysis ward because my blood was so full of potassium that I was at risk of having a cardiac arrest at any moment. My blood was so toxic that many of the measurements were beyond the capability of the equipment to actually measure how toxic my blood was. I was very sick indeed.

Aha! This must be another trick. That pleasant view of a valley filled with low-lying fog, and mountain tops poking out, in pleasant rural surroundings must hide a darker secret. Why don't I just tell you the terrible truth?

Look again.

This is actually a good moment in my life. One of my friends had invited me to stay with his family in Ireland. I was half-dead so the opportunity for some rest and recuperation in rural Ireland was exactly what I needed. I meant to stay only for a short while, but ended up staying longer because I was very poorly and needed looking after, which is exactly what the kind family who took me in did: they nursed me back to health.

Ooooh skyscrapers! We know from the first photograph that I worked in one of those skyscrapers. I also used to live in Canary Wharf and it's actually possible to see my apartment from this picture. I was also working for Lloyds Banking Group at this time, so this must be another good picture, right? Why would I be able to see my apartment and the head office of the bank I was working for though? Where the hell am I?

Look again.

I didn't show you the view out of the window from the private hospital room, did I? This is the view. I didn't really get to see the view much, because I was constantly hooked up to a dialysis machine which was sucking my blood out of me and squirting it back into me, but I did manage to take this photograph. All I can say that's positive about this period of my life is that I didn't die: I was saved [again] by a brilliant NHS medical team.

What now? A hotel room? Not too different from the psych ward room, but with a TV and better lighting. I was living here while working as an IT consultant for HSBC on their number one project, earning £600 a day. Sounds like my life was going pretty well, huh?

Look again.

What have I shown you so far? Homeless people's hostels, sleeping rough, hospitals. I showed you one picture when things were a little better - I was being looked after by my friend and his family - and my life was not in imminent danger. My life is not in peril at this moment, it's true, but I'm clearly staying in a hotel room for a reason. The reason is that I'm homeless. That's the theme of this story: homelessness.

This must be the door to the room that I showed you in the secure psychiatric ward. Somebody's written my name on a little whiteboard strip. That was thoughtful of them. Also, making sure that I'm not killing myself, by checking on me every 15 minutes is pretty damn caring. I'm pretty lucky to have this room all to myself and caring staff members to make sure I stay alive.

Look again.

This is not the same room. This is not the same psychiatric ward. This is not the same hospital. This is not the same city. In the first photograph, I had voluntarily gone to hospital because I couldn't keep myself safe. At the time this photograph was taken I have been sectioned and am being held against my will. At the time the first photograph was taken - in London - I could leave whenever I wanted. At the time this photograph was taken - in Manchester - I cannot leave, which is kind of like being in prison: involuntary internment. I was being held in a psychiatric intensive care unit (PICU) which is where the very most unwell psychiatric patients are held, and this type of unit is highly secure and can only care for 8 patients with a vast number of staff.

Why would I end with this photo?

I was asked to write down in detail where I had been living for the last 5 years of my life, for the purposes of government security vetting, which is a highly invasive process which will rake over every detail of my private life: my divorce, my psychiatric problems, my homelessness, the involvement of the emergency services. The government has access to every single piece of data about me held on every single database, and they are permitted to look at things - like private and confidential medical records - which nobody else is allowed to look at or even ask about, by law.

Why would I publish this?

Do you remember the photograph of the hotel room? That's where I started writing this blog, approximately 4 years ago. I've written 1.2 million words. I've thoroughly documented my life with the kind of candid honesty that the government expect from me when they ask questions like "where have you been living during the last 5 years?". The answer is far more complicated than could be filled in on their forms, so they can read about every detail which doesn't neatly fit into any of their computer systems. I could have asked for extra paper to complete my security vetting forms, but how many pages should I ask for if there are 1.2 million words written down right here and the story is not even fully told?

I chose that final photo because I shouldn't have been alive to take it.

On Saturday 9th September 2017 I attempted to end my life. My suicide attempt should have been successful. Even though I didn't die as quickly as I should have done, and even though the emergency services were able to intervene rapidly, when I believed that nobody knew where I lived or would be able to locate me, I was still having seizures and multiple organ failure. I was unable to breathe on my own. I was very much going to succeed in killing myself, which is exactly what I wanted. I had planned and executed my suicide attempt with precision.

Now, today, I am making an exceptional contribution to one of the government's highest profile projects - the number one project for the particular government organisation who I work for. I have been singled out for special commendation on multiple occasions by very senior government employees. I have worked incredibly hard to make the biggest possible contribution as part of a gigantic team of colleagues. I have busted my balls to go above-and-beyond and exceed all expectations. I have put an enormous amount of effort into delivering valuable skill, expertise, knowledge, effort and energy. I would expect that a significant number of my colleagues would speak very highly of me. In fact, I know that I am held in very high regard.

Also, during the last 5 years, I've slept rough, slept in homeless hostels, slept in hospitals and slept in psych wards. The sum total of the amount of months that I've spent in such places is very significant, but somehow it was hard to articulate this on a security vetting form that's not designed for somebody like me.

Either you believe I'm exceptional or you don't. If you think I'm an exceptional person, you have to decide whether that's a good thing or a bad thing. What cannot be disputed is my contribution to the teams, organisations and wider society, despite the great adversity I've faced.

Here is some of the information that couldn't be captured on a government security vetting form. Judge me however you want - end my career if you must. What you must understand is that I am not afraid, because I have already died a thousand deaths, so I do not fear one more.

Tags: #homeless

This is a story about success and failure...

There was a time, almost exactly a year ago, when I covered my windows with thick paper - so my bedroom was in complete darkness - and I ate baked beans out of a can with a business card as a makeshift spoon. There was nothing particularly wrong with my life at the time. I was earning a fabulous amount of money, my home had amazing panoramic sea views, I had a lovely girlfriend. What could possibly have brought about this rather dire turn of events?

It's important to me to feel like I'm succeeding. It's important to feel like I'm making progress. It's important for me to be able to picture a future that goes beyond the next week or the next month. I need to be able to see a clear pathway to a life that I will find happy and sustainable; fulfilling.

Of course, my path has never been blocked by any insurmountable obstacle. I never doubted for a single moment that my kidneys would start working again when they failed. I never doubt that I'll be able to find well paid work. I never doubt that at some point, eventually, I'll be able to quit the rat race.

The question is: how long will it take to achieve my modest and reasonable desire to feel secure in a happy, sustainable and fulfilling life? How many times will I have to move house, move city? How many times will I have to get a new job? How long until I own my own house again? How long until I have adequate cash reserves to pursue my dreams?

For many people, they already have their answer: they will never escape poverty. For the vast majority of people on the planet, they will be poor for their entire lives, and they will live a miserable, stressful, hand-to-mouth existence.

I'm not most people.

I'm not special or different.

I'm not entitled to any preferential treatment.

I don't deserve to be able to pursue rich-man's hobbies, such as writing, art and indulging academic fetishes.

However, I can tell you how long it will take to be able to free myself from the coercive tyranny of capitalism, and the answer is not "never". I'm fortunate, very fortunate that I do have a route to freedom; a route which most people do not have - they'll never escape the clutches of poverty.

Perhaps my decisions to black out my windows and eat cold beans from a can with an improvised spoon were part of a petulant tantrum; a result of impulsive impatience, in the face of a long and unpleasant waiting game. This is probably the closest approximation to the truth.

If I thought that my quality of life was going to remain below an acceptable minimum for any great length of time, and that the number of years of unpleasantness I was facing were too many for me to bear, I would make decisions... I would make decisions with drastic consequences.

It might seem illogical to you that I would make decisions with terrible consequences, when there are literally billions of people who would kill to trade places with me. However, it also seems illogical to me to make a decision with terrible consequences, such as continuing to tolerate an intolerable life, or worse still, inflicting that intolerable life onto some children knowingly brought into the world in awful circumstances. Surely we have to acknowledge that suicide is an option. Surely we have to acknowledge that contraception and abortions are preferable to miserable deprived hungry children, raised in filth and squalor.

Who am I to decide what the minimum viable quality of life is for somebody else, or the children they spawn? You're right: I can't make that decision for anybody except myself.

As things stand, the quality of my life is pretty exceptional, but there is still an unacceptable level of precarity. There is a greater risk of me falling below the minimum threshold for continued existence, than there is for my peers. I'm lacking vital things, such as a local support network, a supportive family and the willingness to re-endure suffering which I've already experienced beyond the amount I'm prepared to accept.

Of course, it would take a perfect storm, losing my girlfriend, my job, my money, my house and my health, for me to decide that I've had enough. However, I know how easily my flimsy, fragile life can collapse with alarming speed. This is not due to anything specifically weak about myself and my situation, but entirely due to my first-hand experience of calamitous life events.

It's probably true that if something bad happened in my life, I am now in a much more robust position and able to quickly remedy the situation before things collapsed. It's probably true that I'm better prepared than almost anybody to deal with adversity - I have the experience and I've dealt with dreadful things plenty of times. The question is, how much would it take for me to decide I couldn't be bothered to fight anymore?

As it stands, I work very hard to mitigate risks. I think the unthinkable. I anticipate theoretical problems and solve them before they even present themselves in reality. I know where my most vulnerable areas are, I've imagined my reaction, and I've imagined exactly what positive steps I would take in the event of disaster.

I'm quite insecure and anxious, but it's understandable. I don't have the luxury of anybody underwriting my risk. Ultimately, I know that I can fall very, very far. That's my life: a high-wire tightrope walk without a safety net.

Imagine the young trainee doctor I wrote about last year, who killed himself when he thought he was going to be declared unfit to practice medicine. He could have gotten a job at McDonalds. He could have been a beggar. Surely it can't be that bad to be alive, fit and healthy, can it? Surely he should have been happy that he wasn't a starving African child with mutilated genitals? That's not the way it works, I'm afraid. There are people who have terrible lives, but that doesn't mean that other people can't have terrible lives too, even if they are not absolutely terrible. Terribleness is relative to our lived experiences. Terribleness is a function of our very real and tangible hopes and dreams being dashed to pieces on the rocks.

My lived experiences encompass sleeping rough in Kensington Palace Gardens as well as dining nearby on a private terrace overlooking a lush green roof garden with flamingos, and London's skyline providing the backdrop for me proposing marriage with an exorbitantly expensive engagement ring, before clinking glasses with finest champagne. That is an example of the range of my life experiences, from utter failure and destitution to incredible wealth and success. It's impossible to un-experience those things, and to reset the "minimum viable quality of life" to a level of my own choosing.

Could I be poor and happy? Quite possibly, but I very much doubt that I would be happy flipping burgers, getting paid minimum wage on a zero hours contract McJob and giving all my hard-earned money to capitalist leeches for the privilege of being alive.

If you flip burgers and you are happy, then I'm pleased for you. If you're a starving African child with mutilated genitals and you're happy, then I'm pleased for you. Please also recognise that I cannot un-experience what I have experienced in my life and I cannot choose how to feel.

Tags: #capitalism #suicide #career

This is a story about personal responsibility...

I often like to think that I'm 'cured' of bipolar, but the reality is that I can have incredibly functional periods, where it certainly appears to the outside observer as if I'm perfectly healthy. However, the stability of my life - and my mood - is not due to having received treatment, nor is it accident or pure good luck. There are a lot of choices, deliberately made, which keep me functional.

We must accept that whether I'm functional or not, I do experience a mood disorder: bipolar. I can be suicidally depressed but working productively at my desk, with my colleagues blissfully ignorant of my distress and the danger to my life. I can be fighting to control my hypomania with every fibre of my being, desperate to unleash the 'high' episode and experience a period of incredible creativity and productivity, but I know that my colleagues would bear the brunt of my irritability, and their suspicions would be raised by my fast speech and general intensity... I would be told to go home; I would be told I'm working too hard, and I would ignore them, only to subsequently crash.

I'm prone to taking huge risks. I'm prone to depressions that leave me unable to leave my bed or face the world for long periods. I'm prone to hypomanic episodes where I take on ridiculously huge projects, and somehow manage to complete them, but at great expense to my health and stability.

Nobody could say that I don't have to be aware of my bipolar disorder at all times, because it always threatens to plunge me into suicidal depression, or make my hypomanically high - neither state is compatible with a regular 9 to 5 Monday to Friday office job.

Luckily, nobody employs me because I'm a slow and steady guy; nobody employs me because I plod along doing nothing much in particular, keeping a low profile. The reason why I get employed is because I get stuff done. I get a lot of stuff done. I get things done that people say couldn't be done. Then, one day "I can't even" as the kids say. Yep. That's a complete sentence. I can't even finish a sentence properly when I'm having one of those episodes. I become dysfunctional if I don't manage my illness. There's no denying that I'm unwell when I get so sick I can't leave my bed, answer my phone or send an email: I go AWOL.

For years I struggled with the different episodes. I allowed too much of my hypomania to be conspicuously visible in the office. I allowed too much of my depression to overspill from my private life. I was in the office when I shouldn't have been and I wasn't in the office when I should have been. I allowed my mood to dictate my behaviour, as so many of us do, because it's virtually impossible to behave otherwise.

I tried being my own boss, so I could work as hard as I wanted when I was hypomanic, and sleep as much as I needed when I was depressed. Things got worse, not better. I tried tablets. I tried so many tablets. Things got worse. Things got so much worse and I became so dysfunctional that my life fell apart, but nobody believed me. I was sleeping rough in Kensington Palace Gardens - a complete mess - but because I sound posh and intelligent, and I've had a great career, nobody believed that I was losing my battle with my mental illness, and I was incredibly vulnerable. I desperately needed help, but to outside observers, I seemed to have some semblance of the self-reliance I'd always had... everyone assumed that I was as competent and capable as I'd ever been, and that I could take care of myself.

Things got very bad. I was hospitalised several times, both for medical emergencies due to physical health problems which threatened my life, and for the seemingly unending mental health crisis I was suffering. The fact I was alive was taken as evidence of my resourceful nature and self-preservation instincts - my ability to be responsible for myself - but it's pure blind luck that I'm not dead, along with a heck of a lot of skill, effort and energy by a vast number of medical professionals, who've saved my life during various organ failures, seizures and generally near-fatal awfulness which took place in high dependency hospital wards and intensive treatment units.

Today, my life gives few clues about the journey to this point. I have two large scars on my legs and a tattoo behind my ear. The tattoo is something that any observant person might see, as a tiny clue that I've been though some pretty appalling stuff, but the scars are usually hidden beneath my clothes.

The length of time that I've spent working closely with a close-knit group of colleagues, and what we've achieved together as a team, is the basis for the impression that people have of me, along with my general demeanour. I'm lucky enough to have retained my full faculties and suffer no impairment due to the horrors of the past. My colleagues see a competent and capable individual who they have come to depend upon - they trust me and the seek out my opinion. In this sense, you could be forgiven for thinking me 'cured' of bipolar.

I'm hoping that I will stay in my new home city for a long time, and I will build an ever-increasing circle of friends, neighbours and other acquaintances, who see me going about my daily business; who have pleasant normal interactions with me. My existence is clearly no longer full of crises; I'm obviously much more stable than I was, and that stability has proven reasonably reliable.

None of this is an accident. None of this is pure chance.

I don't have any caffeine. I know that alcohol is bad for me, and I avoided it for months, which was very beneficial to my health. I try to sleep as much as possible - 10 or 12 hours a night whenever I can. I keep to a routine... I keep to a REALLY STRICT routine if I can. Mealtimes, when I get up, what I wear, what I eat, writing every day, quiet time before bed, glasses to filter out blue light, dietary supplements... these are some of the things that are working well. I know I need to exercise more and I know I need to get more natural light too. It would be healthy to have regular social contact with people outside work. It would be good if I had a local support network.

My job often bores me, but I put up with it. I'm often too depressed and anxious to get out of bed and go to the office but I force myself. I often find there's not enough time to watch films and documentaries, or do anything other than write, eat and get ready for bed, after work, but I'm trying to do more.

I've gotten tired. Really tired.

Last week was incredibly exhausting. Work was immensely stressful and demanding. Some relationship difficulties cause me to lose a lot of sleep, as well as being very emotionally demanding and stressful. I got a kitten, which has been extremely rewarding and exciting, but also a disruption to my delicate routine and an additional set of responsibilities.

Adrenalin has carried me through the past few weeks and I've managed to skip almost entire nights of sleep on several occasions, seemingly without consequence, but it's all caught up with me.

I haven't been looking after myself.

I've broken my rules.

I've broken the rules which keep me safe, healthy, secure and stable. I've broken the rules which have kept me functional for a very long period of time. I've broken the rules which I invented to end the crises and the dangerous highs and lows. I've broken the rules and I've paid the price.

I'm not sick but I'm not well.

I underestimated the damage it would do to my health, drinking too much and staying up all night. I overestimated my ability to cope with extra stress and big changes. Suddenly I have a girlfriend and a kitten, where previously I had nothing but a big empty house. My life is immensely more pleasant and enjoyable, but it's also suddenly become incredibly fragile. I'm suffering bouts of insecurity and occasional outbursts of frustration that my comfortable stable security and safety margin of spare energy has been exhausted, leaving me irritable and impatient.

It's my responsibility to make sure that I'm getting enough sleep. There aren't enough hours in the day, but I can take some holiday. I've worked non-stop since I got home from Mexico at the start of January. Nobody can work so hard, move house, get a girlfriend, furnish a home and get a kitten, without having a holiday. I've been relentless. I've acted as if I've got limitless energy and a superhuman ability to achieve impossible feats at incredible speed. To all intents and purposes, I've pulled off almost everything, but the cracks are showing - I'm heading for disaster.

Whether I've already gone too far, allowing myself to become too tired and letting myself become unwell, remains to be seen. I was irritable and unpleasant last night, and there might be consequences. Who knows what damage I've done?

I'm going to sleep until lunchtime tomorrow. I'm going to recharge my batteries.

I know that a few extra hours sleep is not enough. I need a whole week of lie-ins. I need a whole week of afternoon naps. I need at least a whole week of being free from the relentless demands which I've faced this year. I desperately need another holiday. I've left it too long, as usual, but I hate going away on my own.

That's another part of the non-pharmaceutical treatment for my bipolar disorder: holidays. I genuinely need holidays for the sake of my health, but when my life was chaotic I would work as hard as I could for as long as I could when I was well, because I felt so much pressure to earn as much money as possible, to support me during episodes of illness. I've come to realise that it's incredibly unhealthy to have 6, 9, 12 and even 18 months without a proper holiday. I need a week away. I need a week of rest and relaxation, and ideally that would be with my girlfriend, if I haven't p*ssed her off and upset her with my unstable mood already.

I wonder if I'll make it - last long enough - to be able to go away on a nice holiday to recharge my batteries. I think that I need to start taking evasive action immediately. I need to be strict with my bedtime. I need to be strict with alcohol. I need to take some mornings off work to catch up on sleep. It might be advisable to take a whole week off and just do nothing for the sake of my health. I know that I've let my health get into a precarious state.

I haven't looked after myself and I need to act.

I could spend a week pottering around my lovely house, with my kitten to keep me company. I think my health would benefit significantly. I need to loosen my grip on my work. I need to relax. I need to rest and recuperate.

Burnout is not good. I'm so sick of burning out. I'm so sick of episodes of mood disorder. I can regain stability, but I need to recognise that I'm not well and I need to act immediately. Yes, I could cling on until the end of July for a holiday with my girlfriend, but there's a huge chance I could get really sick if I try to wait that long. I'm going to have to take some time off work, for health reasons, and it's not the end of the world.

I hope I write again soon that I did the sensible thing, and that I'm getting on top of managing my health. I hope to write that I'm regaining some safety margin, so that I can remain cool, calm and patient, and not be irritable and unpleasant. I hope to write that I'm treating my girlfriend nicely, not being an exhausted wreck, full of insecurity and instability.

I feel super bad that I've mismanaged my illness, but all I can do now is to try to look after myself.

Tags: #bipolar