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I write every day about living with bipolar disorder, also known as manic depression. I've written and published more than 1.3 million words

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nick@manicgrant.com

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I Nearly Died on #WorldSuicidePreventionDay

5 min read

This is a story about a life or death situation...

Golden Gate Bridge suicide

I have no memory of this day, one year ago, because I was unconscious in a coma on life support in the ITU critical care ward of a hospital. My prognosis was not good. I was having a lot of seizures. My kidneys had failed. I was in a bad way.

I've written extensively about the very many aspects surrounding my suicide attempt, so I shan't repeat myself. For anybody who hasn't read about it, the various bits and pieces are here:

  • Surviving Suicide talks about what it was like to regain consciousness in intensive care after days in a coma.
  • Suicide Attempt: One-Year Anniversary talks about my reflections on the final moments which tipped me over the edge, and how I came to be saved by my Twitter followers raising the alarm to the emergency services.
  • The Closest I've Come to Suicide was written only hours before my actual suicide attempt, and gives a chilling insight into my fragile state of mind and shows that my life was balanced on a knife-edge

There's a lot more I've written under the hashtag, which collects together all my blog posts on the topic in reverse-chronological order. All in all I've written more than a million words on this blog, with a very great deal of it talking about the things which were driving my depression and suicidal thoughts, and detailing some of my plans, which included a trip to the Golden Gate Bridge.

In the 3 years that I've been writing every day about the challenges I've faced, which very nearly claimed my life, I've been on a secure psych ward twice, I've tried multiple antidepressants and mood stabilisers, seen many psychiatrists and received care in the community with crisis teams and home treatment teams. I'm very well appraised of the full gamut of mental health services which are available in the UK. I know exactly how people slip through the net and wind up dead through suicide.

One of the reasons I started writing was that I was inspired by a campaign called RUOK? which made me start thinking about technology solutions to allow us to easily check up on friends we're worried about. I developed a quick website and Twitter bot which would allow anybody to anonymously ping somebody who was at risk of suicide, and raise the alarm if they'd gone silent - like a heartbeat check. Through developing this idea, I decided that I myself needed some kind of heartbeat-like thing to alert concerned friends if I was in trouble. If I stop writing regularly, I have a huge amount of people who'd notice and talk to each other to check on my welfare. It was through my Twitter followers that the emergency services were brought to my door just in time to save my life, one year ago.

The irony of dying on was not lost on me. That I was saved is quite miraculous, but a testament to the ability of social media supporters to make a real and tangible positive difference in the lives of people suffering with depression and struggling with suicidal thoughts.

Only a couple of weeks ago I was feeling very low and I sent out a tweet which said I hated my life, and the response was so incredibly awesome and supportive that it completely changed my mood. I had been feeling very isolated, lonely and uncared for; unloved. The unexpected flood of messages I received at that low ebb was exactly what I needed.

It's important to note that I didn't phone any crisis services or friends when I attempted suicide. It's crucial to understand that many of those who successfully commit suicide aren't crying for help or otherwise seeking attention. I had every intention of dying, not being saved by anybody or talked out of it. This is why it's so important that we look out for each other, especially living in a day and age when we're highly connected online but increasingly isolated and lonely in our local communities.

If we're looking to prevent suicides, it's worth encouraging those who are struggling with suicidal thoughts to connect via social media, where hopefully there will be caring and supportive people to spot a suicide attempt and alert the emergency services, or otherwise intervene. One of my Twitter followers responded within seconds, sending me his telephone number and the telephone number of the Samaritans, but I thought it was too late as I'd already swallowed what should have been a fatal overdose. That rapid response saved my life.

We might become resigned to the idea that somebody intent on killing themselves is going to find a way, but I'm living proof that even a very well-planned pre-meditated suicide attempt, executed relatively flawlessly, can still be a salvageable situation if the alarm is raised quickly enough. When we're attuned to the suffering of people we care about, we can sometimes catch suicide attempts in the nick of time, and save lives - that's what happened to me, thanks to concerned followers around the world.

There is hope that we can prevent suicides.

 

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Notes on a Suicide - #WorldMentalHealthDay #WorldSuicidePreventionDay

8 min read

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

Discharge summary

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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#WorldSuicidePreventionDay

6 min read

This is a story about tiny fractions...

Crisis Call

Today is World Suicide Prevention Day. In theory, I'm 1/365th safer today than I am the rest of the year. By my calculations, 0.27% of the time, we are trying to prevent suicide. The other 99.73% of the time, we are not trying to prevent suicide.

There are various ways that we try and make suicidal people feel responsible, selfish and guilt tripped. "Nobody is responsible for your life except you" is something I often hear. This is plainly wrong.

Individualism has led to the collapse of local communities. Individualism has led to silent commuter trains, with everybody listening to their own music through their headphones. Individualism has led to unpleasant levels of competition, where we trample each other for the few jobs. We lie, cheat and steal, because we are all rodents in the rat race.

If we took collective responsibility for our suffering, then we could collectively bargain to improve our situation. With the power of the collective things can improve. As individuals, we are divided and ruled over by cruel elites who care nothing about the mental health epidemic and soaring suicide rates.

Suicide is everywhere.

Suicide is in our schools, where there is enormous pressure to achieve academically. Our exam grades will govern our future so we no longer have a childhood. Bullying is rampant, and it destroys the quality of life of children and drives them to self harm and suicide. Bullying is not getting better. Bullying is getting worse. Bullying was terrible when I was a kid, and unbearable. It must be unspeakably awful now. No wonder self harm, depression and anxiety affect so many children in school.

Suicide is in our workplace, where our jobs are insecure and hidden inflation means that our wages are shrinking in real terms. The steady increase in suicide rates, since the 2008 financial crisis, has now reached the point where it's the biggest killer of men under the age of 45 - 'breadwinners' in the prime of their life.

Suicide is in our homes, where thinking "at least I'm not a starving African" doesn't actually put food on the table and a roof over your head. Bills, debts, rent/mortgage and the many things that we need to live in Western society, are not going away with a few people saying "chin up" and "it can't be that bad... other people have it worse". We've been putting a brave face on everything for years, and some people reach breaking point.

To say that suicide is a selfish act is dumb. To say that suicide is running away from your responsibilities is dumb. To say that suicide is dumping a load of pain onto other people is dumb. In actual fact, a suicidal person has almost definitely been struggling with overwhelmingly awful and painfully intolerable feelings, for longer than you can even imagine. To ask them to continue to prop up the status quo any longer is selfish.

When a person reaches the point where they're attempting suicide, they've exhausted all avenues. When a person attempts suicide, they have taken responsibility for their own life. A person attempting suicide has tried everything that they have the means to change. They're out of ideas. They're out of energy. They've gone as far as they're able to go... on their own.

To make accusations that suicide is running away from problems, selfish, is why suicidal people feel so isolated and alone. Taking your own life is not something you do, surrounded by loving friends and family. Attempting suicide is done when you're all alone. Suicide is just you, and death.

You'd be surprised how people step back when you reach the point of considering the end of your own life. People don't want to be near you. People don't see you anymore. People shun you, like you're a leper, like you're a ticking time bomb.

You'd be surprised at how many days I've spent in hospital, all alone, no visitors. That hurts. That sends a message.

It's easy to put something on social media saying "you'd be missed if you died" but, seriously, how much does that really reconcile with that person's experiences? If you say you'd miss them, then when was the last time you actually took the time to see them? When was the last time you actually took advantage of the fact they're still alive?

It's a binary thing: people are either alive, or they're dead. There's no use saying "we didn't know what to do" when somebody's dead. There's a spectacular lack of discussion and action around improving the lives of people who are suicidal. Instead, there is an endless stream of trite platitudes, that you've heard over and over again.

Believe me, I've got plenty of perspective. All that "it isn't so bad" bullshit, and the "other people have it worse" bullying is the reason why we arrived at this state where suicide is the biggest killer of men under 45. Suicide kills 3 times as many men as it does women. Believe me when I say that I want to go to Africa and distribute food and clean water. Believe me when I say I want to pull Syrian children out of the rubble.

Aren't you all just being total dicks though, if you expect our most suicidally depressed people to be the ones acting charitably? Why should the mentally ill be doing good work, while everybody else just keeps making bombs to drop on Syria, and working jobs that economically enslave the developing world?

I've got plenty of perspective, and what I see is a selfish society. What I see is collective insanity, where we are working bullshit jobs. We're working jobs that actually destroy lives. What I see is a bunch of people whose mental health and will to live are being badly damaged, and a bunch more people who want things to stay the same or get even worse.

How bad does it have to get? Does it have to be your son or daughter who takes their own life before you get it?

 

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