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The world's longest suicide note

I write about life with bipolar disorder (a.k.a. manic depression)

All opinions are my own

twitter.com/ManicGrant

nick@manicgrant.com

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Rehabilitation

12 min read

This is a story about civilised society...

Lots of pills

What is rock bottom? My life doesn't seem to obey the rules - the first time I was forced to sleep rough because of my drug addiction and chaotic lifestyle, I had about £50,000 in the bank. Of course I could have stayed in a very fine hotel, but the culture clash between me in my dishevelled state, the hotel staff and the other guests was going to create a lot of friction. The first time I ran out of money I owned my own home. The first time I had depression so bad that I wanted to kill myself, I seeming had it all: friends, girlfriend, good job, money in the bank, nice house, boat, cars etc. etc.

Rock bottom seemed to begin shortly after I landed a lucrative contract with Lloyds Banking Group, when I sat on my leg which caused circulation problems, resulting in a blood clot and Deep-Vein Thrombosis (DVT) which then caused kidney failure and landed me in hospital on dialysis. It wouldn't have been so bad, but the DVT caused nerve damage and the pain was excruciating, so I was taking the maximum dose of tramadol, which is an opiate painkiller.

I started to get closer to rock bottom moments when I desperately sought relief from the pain - I obtained codeine and dihydrocodeine tablets on the Dark Web, as well as some extra tramadol. I was in too much pain and discomfort to work. The ludicrous amount of opiate painkillers I was taking left me a dribbling mess at the office. When I lost the job which I had fought so hard to keep, it destroyed me. I started swallowing a chemical cocktail which I'm very surprised didn't kill me.

The problem with opiate painkillers is that they cause very unpleasant physical symptoms. When you take opiate painkillers they make you sleepy and constipated, and when you withdraw you get diarrhoea, aching, sweating and a whole host of other flu-like symptoms. It's thoroughly unpleasant and withdrawal brings back the original pain twice as bad.

I had started taking a neuropathic painkiller called pregabalin - marketed as Lyrica - which isn't an opiate. I was also taking sleeping pills: zolpidem - marketed as Ambien - and zopiclone.. These are what you might call downers as they all have a sedating, tranquillising and soporific effect. The list of downers doesn't end there. I had started to use increasing amounts of diazepam - Valium - and alprazolam - Xanax - which have similar effects to the pregabalin, zolpidem and zopiclone.

So, to recap, I was taking on a daily basis: tramadol, codeine, dihydrocodeine, pregabalin, zolpidem, zopiclone, alprazolam and diazepam... and that's just the pills.

You can't function if you're as doped up to the eyeballs as I was, so I was also drinking strong coffee, Red Bull energy drinks, taking dexedrine and occasionally dabbling with crystal meth in an attempt to bring myself out of my stupefied state of drugged intoxication.

Somehow, I managed to get off the opiate painkillers. I went cold turkey and it was unpleasant, but after a week or so things started to improve. Life on opiates is a horrible merry-go-round of repeatedly having to take a dose every two or three hours to stave off the nasty withdrawal symptoms. I feel very glad that I was able to kick them to the kerb without too much difficulty.

Getting off all the other pills proved much more difficult. You can't just stop taking benzodiazepines - like Valium and Xanax - because you'll have a seizure if you've been taking them for a long time at high doses. Benzos are far more physically addictive than opiates - you can die if you suddenly go cold turkey.

During this extended period of unpleasantness, I broke up with the love of my life in a moment of spectacular stupidity and drug-induced insanity. To my ever-lasting shame, I continued my non-stop blogging and oversharing on Twitter and Facebook, broadcasting my idiocy to all my friends as well as on the public internet. That was - in retrospect - definitely rock bottom, but I was too messed up to see it at the time.

My super-expensive London apartment was burning through my cash and available credit at very high speed, and it became apparent that I was going to get into rent arrears if I didn't take drastic action. All my worldly possessions had to be boxed up and put into storage, and I didn't have enough money left to be able to afford to rent anywhere cheaper in London. I was forced to leave my home and my home city, in search of the first financially viable opportunity, which arose in Manchester.

You'd think that being effectively bankrupt and homeless would be rock bottom, but no, I still think that my rock bottom had been spread over an extended period when my life truly started falling apart. It started with the blood clot and the DVT in my leg/ankle and reached its peak when I broke up with my wonderful lovely amazing ex. It's very hard to pinpoint a single moment of rock-bottomness, because there was a chain-reaction of events which unfolded like a slow-motion car crash. Unlike a car crash, however, I was dimly aware of the disasterous decisions that I was making and should have been more in control.

I'm not an idiot, so of course I knew that I shouldn't risk becoming addicted to opiate painkillers. I'm no fool, so of course I knew that all the sleeping tablets, tranquillisers and sedatives were addictive and I was becoming dependent on them. When I relapsed back into fully-blown supercrack addiction the consequences were obvious: the sleep deprivation and the stimulant psychosis is enough to send anybody insane.

There was never a moment that was so utterly awful that I would call it rock bottom. In fact, the moment when I decided that I need to take evasive action and attempt to avert total disaster, was not a moment at all. I had known for a long while that the money I had managed to accumulate would only allow me to survive for a finite amount of time, and that my expensive London lifestyle was burning through cash at an astonishing rate. I knew exactly how long I could remain as a jobless junkie, before I became bankrupt, destitute and homeless. The only surprise to me is how lucky I am that total disaster was averted at all.

When I left London for Manchester I carried a horrible addiction with me. Benzodiazepines are insidious as they creep their way into your life, literally lulling you into a state of tranquility. Quitting benzodiazepines is not only extremely dangerous, but almost indescribably unpleasant as well - peaceful, tranquil and anxiety-free existence is replaced by incredible anxiousness, stress, worry, nervous tension, insomnia, restlessness and a general sense of all-pervasive and inescapable unease.

I ended up in a shitty apartment, being paid less than half what I'm worth, with an incredibly stressful and demanding job, in a city where I have no friends or family. I had a couple of "rebound" flings with girls, which had seemed promising at first but then ended miserably. Perhaps this was my rock bottom, because this was when I made my most premeditated and calculated attempt to kill myself.

I don't think I tried to kill myself because I was at rock bottom. There have been times in my life when I've been in much worse situations. I could see that there was no way I was going to be able to quit all the addictive benzodiazepines and make new friends and woo a new girlfriend and deliver my project at work and get back on my feet financially. I had a fleeting moment where I lost hope and I was so heavily doped up that it was a lot easier to kill myself. I was so full of medication that I quite calmly poured myself several pints of white wine, which I used to wash down about 400 tablets and capsules, most of which were very powerful and deadly opiate painkillers.

I should have died. I certainly didn't have better than 50/50 odds.

After they told me in hospital that I was going to survive, soon followed the moment which would seem most like rock bottom to a casual observer. I quickly had even more problems than when I had attempted suicide. I lost my job and my apartment and found myself not only homeless, jobless and virtually penniless, but also sectioned and locked up on a psych ward in a part of the country miles away from any friends or family. However, I'd suffered days of seizures while in hospital and had been through an incredibly rapid benzo detox. I was at least free from the shackles of my benzodiazepine addiction at last. It would have been impossible for me to detox on my own and without intensive medical assistance.

Having to sell my house due to my divorce was incredibly traumatic and destabilising, but I was glad to be rid of my horrible ex-wife. Becoming homeless in London and getting in trouble with the police was traumatic and I thought I'd never be able to recover from the shame of being arrested and locked up in a cell, but the police are kind and they helped me - they didn't want to ruin my life [or me to ruin it myself]. Sleeping rough and living in a hostel was an adventure and I made lots of new friends. Becoming a poly-drug abuser - addicted to a whole heap of medications - going insane and breaking up with the love of my life was incredibly tragic and I feel very guilty about what I put her through, as well as being heartbroken myself... however, I needed to escape the high cost of living in London and reduce the enormous financial pressure I was under. For every downside I see an upside. For every moment that was thoroughly awful at the time, I can look back and see that none of those moments were bad enough to be called rock bottom.

My life today could be characterised conventionally as 'desirable' by most ordinary people's standards. I have a large amount of so-called disposable income - although I use every spare penny to rapidly repay my debts - and I'm quickly returning to a position of financial stability. I have a lovely apartment with sea views, which is far more spacious than I need. I have a very well paid respectable job and I work with smart people. My commute is not too far. I enjoy a great deal of comfort and luxury, which belies my troubled past. I've never had to compromise on my lifestyle - although I've come within a whisker of bankruptcy on very many occasions, I've never had to economise or alter my habits of consumption.

On the flip side, I've lost contact with many friends and I have no local support network to speak of. I live a very solitary reclusive existence, where I spend 99% of my leisure time alone, reading, writing, watching documentaries and films. I'm unfit and I drink too much. I'm bored and unchallenged most of the time at work, and I'm depressed and anxious a lot. The tiniest things can inflict an incredible amount of stress, causing sudden and breathtakingly powerful suicide and self-harm impulses.

By anybody's measure I'm rehabilitated. In the last year I've worked for 4 different organisations and delivered 4 big projects successfully. I've earned a lot of money. I've got my own home. I've got money in the bank. I've got a car. I'm getting up and going to work and my colleagues have absolutely no idea what I've been through, and they would never suspect a thing. I'm quite a convincingly 'normal' productive member of civilised society. I've even managed to sail through background checks and security clearance, and found myself in positions of responsibility, which one would not normally imagine being given to an ex-homeless, ex-junkie, near-bankrupt person with mental health problems, who's known to the police.

If you believe that people can be rehabilitated - that deep down there's always some good in a person no matter how many bad things there are in their past - then I think that I could be a poster-boy for that idealistic belief. I hope that my story indicates that it's worth giving people a second chance; allowing them to pick up the pieces of their broken lives and to be rehabilitated without prejudice and stigma.

Of course, I still have the potential to f**k up spectacularly, but on the whole my net contribution to society must surely be a positive one. I am trying my very hardest to see if I can at least break-even.

Am I rehabilitated? Inside I feel very broken and that happiness and contentment are still an extremely long way away, but to all outside observers and by all objective measures I represent a great success: the proof that a person can re-enter civilised society and make a valuable contribution, provided they are given the chance.

Am I rehabilitated? I leave it to the reader, who is far better informed than most, to decide.

 

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How to Become Irreverent

14 min read

This is a story about the values you raise your children with...

Church window

It seems like I have had the sentimental attachment most of us feel towards everything we revere in society systematically thrashed out of me. If you pick one thing that summons feelings of safety, security, comfort, respect for authority and faith in the divine/spiritual, then I will tell you how exactly how I came to question everything: every institution, everything sacred, every tradition, every profession, people who are normally considered beyond reproach and ultimately even existence and its purpose.

Starting with my birth, I'm literally a bastard. I was born outside of wedlock. My parents never married and always planned to remain unmarried, such that I took my mother's surname instead of my father's. Ironically, my mother had once been married, and I have the surname of her ex-husband instead of her maiden name. Confused? Imagine trying to explain that to your fellow pre-schoolers when you're 3 years old. I didn't really understand it at the time, but I understood that I was different; unusual.

My schools would often address letters intended for my parents to Mr & Mrs Grant, and my father would always tell me that I was the only Mr Grant in the house and therefore the letter was addressed to me. My mother would tell me that she was no longer Mrs Grant and she was Ms Grant. "Why not Miss?" I would ask, and she would explain that she had been married, and Miss was only used by women who hadn't been married. If anybody telephoned the house and asked to speak to Mr Grant, my father would hand the receiver to me and say "it's for you", which it never was, of course.

I understood that there was divorce and some of my school-friends were raised by a single parent, or a step-parent. My peers would often ask if my father was my step-father, to which I would reply "no". Nobody could understand how I came to have a different surname from my biological father, or entertain the notion that I could have been given my mother's surname, not my father's.

At some point, a fairly clear question formed in my mind: "why aren't my parents married?". 

The reasons why people get married had become quite clear in my mind, for the very simple reason that I had endured years and years of people's reactions that suggested that not getting married was very atypical behaviour. Nobody wants to feel unusual; freakish. Nobody likes to feel odd.

When I posed my question - "why aren't you married?" - to my parents, they replied with their own question: "why should we get married?". I had a pretty easy answer for them, as I've explained: because that's what everybody else does. "Do you want to be like everybody else?" my parents asked. "Yes" I replied.

[I just burst into uncontrollable sobbing. If it wasn't what you experienced, I don't think you can begin to understand what it's like to spend your entire childhood as the freakish weirdo; the odd one out... the one who's different from everybody else]

Having covered marriage there is a natural segue into the topic of religion, and the origins of my atheism.

For a number of formative and important childhood years I lived in an attractive terraced house in an area called Jericho, on one of the most desirable roads in central Oxford. These houses are the most expensive in the world, far exceeding real estate prices in London, San Francisco and Hong Kong, in terms of their affordability. However, these £1.5 million houses were bought by the first wave of gentrifiers, when academics and young professionals with families started to move into slummy areas because they couldn't afford family homes in the more desirable parts of the city.

When your immediate neighbours include an MP, a barrister, a heart surgeon, a City banker and a number of promenant Oxford dons and professors, their children were raised in an environment which was knowledge-rich and encouraged the exploration afforded by a curious rational mind; critical thinking. Nobody went to church. My friends, whose father was a consultant at Oxford John Radcliffe Hospital, went to Quaker "friends meetings" occasionally, but my peer group - the sons and daughters of the intellectual elite - had little place for God and church in their lives.

We should rewind a little bit, back to the village our family lived in before we moved to central Oxford. If one were to imagine the most quintessentially English picturesque Cotswolds village, with the manor house, the village green, the workers' cottages, the post office and village shop, the village pub, the village school, one should not forget the church and its graveyard. The church's presence and influence is not to be underestimated. My religious indoctrination began as soon as I started school, with the vicar regularly present. Village social events are very often church-linked, like harvest festival, and of course everybody who grew up in such an idyllic village wants to get married in that particular church, have their children baptised there and be buried in that graveyard.

Essentially, the church's opportunity to exploit a child's vulnerable immature mind were scuppered by my father. For everything that the church had a comforting but incorrect explanation for, my dad cited a lack of evidence and instilled in me the skepticism which gradually became integral to my developing personality: "show me the evidence".

When we moved to the centre of a city whose university is globally recognised for its academic excellence, I never encountered another simple-minded fool who had been persuaded to believe in Gods and other aspects of religion, which are so obviously irreconcilable with the pursuit of knowledge. Religion encourages ignorance but I had been raised to question everything and remain skeptical until I had seen convincing proof. "What are atoms made of?" I remember asking one of my friends who lived on my street. "Quarks" he replied. We were perhaps only 5 or 6 years old - the product of a childhood immersed in academic culture, as opposed to the sentimental and traditional.

The disturbing and unpleasant consequences of an irreverent life can impose themselves on a child at a worryingly young age. I've already been uncontrollably sobbing about just one thing - the tradition and sanctity of the institution of marriage - and I haven't even mentioned how a child deals with the concept of mortality and threat of death without the comfort of religion.

A US Air Force pilot who drank at the village pub which my parents later bought and now live in, drunkenly boasted about the ability of the United States to wipe humanity off the face of the earth. I was definitely no older than 4 years old. With my friend with whom I had discussed subatomic particles, we talked about the temperatures which could be reached near ground zero of a fission or fusion nuclear bomb, and how the radiated 'heat' (electromagnetic radiation) had instantly vaporised human beings in Hiroshima and Nagasaki, with only their shadows left behind, permanently etched into the walls of buildings.

If you believe you live in a Godless world with no afterlife you naturally want to know what everything's made of if God didn't make it; you want to know why it's here. How did it get here? Why is it here? You start to pick everything to pieces by iteratively asking what each thing is made of: humans are made of cells, and cells are made of molecules, and molecules are made of atoms, and atoms are made of quarks and leptons... and you can in fact keep asking the question. There's good proof that the electron is not a fundamental particle, as had originally been thought.

When your schoolmates are smart-arse little shits, because their parents are brilliant academics, teachers and school loses its awe and authority. If you're being taught science that's almost 100 years old, and sometimes even 200+ years old, the whole exercise is nothing more than a box-ticking exercise to be endured.

The other thing to consider is that my parents used illegal drugs on a daily basis, and had strong views about the legitimacy and usefulness of the law, certainly in the instances that suited their own addictions. As with many drug users, they were very paranoid. They viewed the police as corrupt and not to be trusted - the enemy. My father's criminal conviction for drugs not only poisoned his views on the police, but also made him very anti-American, as he believed he would never be allowed to enter the country due to his criminal record.

[I'm crying again]

It was only because of first-hand dealings with the police that my viewpoint changed from skepticism due to lack of evidence: the police had never caused me any harm, and in fact I had never had any dealings with the police at all for most of my adult life. You might be surprised to learn I adore and respect the police. My accumulated experience of police encounters has consistently shown that they are some of the most kind, patient, empathetic, forgiving, reasonable people, who have always gone out of their way to bend the rules and simply help as opposed to ever enforcing the letter of the law.

One shouldn't mistake my respect for the men and women of the police force for reverence. I would never for a minute expect that a 999 call is somehow going to be the answer to my prayers. I don't feel safer or more secure, knowing that I can call for police assistance. I wouldn't feel any more comfortable in a stressful situation if there was a police officer present. Of the very many police men and women who I have had first-hand dealings with, they have always treated me very fairly and kindly, and it's quite clear that they deal on a daily basis with a huge number of very vulnerable and damaged people, which they do so with incredible compassion - they are the living embodiment of humanity not deities who should be worshipped and revered.

[More crying]

So if I don't revere priests, vicars, teachers, headmistresses, marriage, religion, military superpowers, soldiers, the police, the law and my own parents, what else is there left for me to lack reverence for?

Cumulatively, I've spent almost 6 months having my life saved in hospital - often in high dependency and intensive treatment unit (ITU) wards. Shouldn't I revere doctors; surgeons?

I think that if there was one thing that would make almost anybody feel more secure and happy in a stressful situation, it would be knowing that there's a doctor present. It's such a clichéd question: "is there a doctor here?".

To explain my irreverence for doctors, we merely need to explore the reasons why I have ever had to deal with one, and the outcomes of those interactions.

Having been lucky enough to escape congenital abnormality, it doesn't take a rocket surgeon to figure out what I want from a doctor and why. You don't need to spend 5 or 6 years at medical school to know that the human body has been dealing with pathogens since the species first came into existence. You hardly have to be brain of Britain to figure out whether you're dealing with a viral, bacterial, fungal or parasitic infection, and furthermore, which is likely to be treatable. In actual fact, I've never been to my doctor for antibiotics: every infection has always cleared up on its own. Fungal and parasitic infections can be dealt with without a doctor obviously: head lice shampoo is available in every pharmacy, without a prescription, for example.

At the age of 28 I went to my doctor wanting treatment for depression, but I knew which specific medications I was prepared to try and which medications I didn't want because the side effects were not acceptable. Having my choices limited only to SSRIs provided firm evidence that doctors were an obstacle to be overcome, not a panacea.

When we think about the first time I was hospitalised, do you think I didn't know that I was going to end up there and what the problems were going to be? Do you think it was an accident that I ended up in hospital?

Again, you don't need to spend 5 or 6 years at medical school to know that the human body needs water, salt, glucose, proteins, amino acids, vitamins, minerals and myriad trace elements, or else the bodily functions haven't got the fuel, carrier fluid and raw materiels they need. You don't need to be a doctor to know that human body temperature needs to be homeostatic as much as possible - much like every other measurable thing in the human body - and any extreme variation too high or too low is going to have dire consequences.

When you are making choices in full knowledge of the likely consequences, medicine ceases to be lifesaving magic, and instead it becomes another simple case of what do you want and why?

One must consider the very last time I was hospitalised to truly understand my irreverence.

Not only had I quite carefully pre-planned my suicide attempt, when I arrived at hospital against my will, I gave very clear instructions: do not put activated charcoal into my stomach, do not perform gastric lavage, do not intubate, do not provide life support and most importantly of all, do not resuscitate. "Do you know what's going to happen?" the A&E doctor asked. "Yes. I'm going to die of a combination of organ failure and serotonin syndrome, with a lot of seizures" I replied. "Do you think you'll be unconscious? Do you think it'll be painless?" the doctor asked. "No. I expect that it will take a long time to die and I'll be conscious and in a lot of pain for most of it" I replied. Then I started having seizures.

Doctors see a lot of people who are scared and they don't understand what's happening to them. They're desperate for somebody who seems to know what they're doing and what they're talking about; doctors are an authority figure. I have no doubt that for feckless simpletons and those who lack access to medicine, the arrival of a doctor or a priest/shamen/witch-doctor is incredibly soothing and comforting. If you don't know what you want and why, your reverence is misplaced, but it may still ease your passage from life to death.

When shit goes bad, who are you going to turn to? If you have to pick your team of people to survive on a remote island, who are you going to pick and why?

Why revere anyone? Why kiss anyone's arse and tell them they're great because they did the study and training that you could've done if you wanted to. You could have passed those exams. You could have gained those qualifications. You could have followed that path if you wanted to. If you wanted it bad enough, you could put on that uniform; you could get that job title; you could prefix or suffix your name with the bit that tells the world just exactly why everyone should drop to their knees and worship you.

Nothing's sacred to me. I could do your job if I wanted to.

I'm not smarter than anybody. I'm not better than anybody. That's the whole point: I'm lucky enough to not have anything that's holding me back; limiting my potential.

I really don't recommend telling your kids they can follow their dreams and be anything they want to be. I really don't recommend telling your kids to question everything, and understand everything about how the universe works, to the point where they reach the very bleeding edge of scientific research. I really don't recommend raising your kids to challenge the status quo and resist the urge to fit in with wider society and their peers.

Take it from me: there's a mind-destroying kind of cold uncaring "nothing matters" bad feeling that comes from being too rational; too much of a free-thinker. Take my word for it: understanding the absurdity of existence will destroy your mental health.

You should probably experiment with hard drugs. That's probably way less likely to fuck up your life than going down the rabbit-hole of picking everything to pieces and trying to reason from first principles and pure logic.

 

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Rock Bottom

7 min read

This is a story about quality of life...

Warchalking

You would have thought that rock bottom would come when you're sleeping rough, arrested by the police, thrown into a cell, you've spent all your money on drugs, you've got a physical dependency, you end up hospitalised or locked on a psych ward. You would have thought that losing your job, your apartment and tarnishing your otherwise squeaky clean CV, credit score and other things that are important to give you access to well-paid respectable work, would be the most crushing blow. In fact it's the lead-up to the point where you lose everything that's far worse. Once you're cut adrift and tossed by the wind and the waves, then you might as well just relax and go with the flow.

I woke up this morning, having been awake since 3am, worrying about the tricky transition between two contracts that are worth six figures, annually. It's a nice problem to have, right, to have two companies offering to pay you big fat wads of cash for your time and expertise, but the reality is somewhat more complicated.

I've drained my business bank account, because I've needed to buy plane tickets, book hotel rooms, train tickets and AirBnB rooms. I've been working for three months, but I'm still waiting to be paid - these are the commercial challenges I face. You've got to speculate to accumulate.

I have borrowing facilities available to me, but a substantial portion of my income is wasted on interest, paying for the money which I've needed for cashflow. Cashflow is tight when you're only managing to work 12 weeks a year, because you've been so unwell. I was hospitalised with DVT and both my kidneys had failed. I was hospitalised after a massive overdose - a suicide attempt. I was hospitalised and sectioned for mental health reasons, for my own protection. These are considerable obstacles to earning money, despite the fact that I discharged myself from hospital against medical advice, so that I could struggle into the office and not lose my job... but I lost it anyway. After my suicide attempt I struggled into the office, but I lost my job anyway.

I'm struggling into the office every day. I'm working Tuesday to Friday, for 4 hours each afternoon. My colleagues look at me like I'm taking the piss, as I saunter in at lunchtime and leave soon after 5pm. I travel across the country on a Tuesday morning, and I travel back the other way on a Friday evening - over 3 hours each way, which some people might scoff at. I know that there are many people who do long commutes, but I doubt many of them do them in the same year they were hospitalised as many times as I've been, due to medical emergencies.

This is my rock bottom - I'm only able to work about 16 hours a week, but it's killing me. I woke up this morning and I'm properly physically sick. If it hadn't been for the fact that I had to check out of my AirBnB, I would have stayed in bed. You'd have stayed in bed too, if you felt like I do. This is rock bottom - struggling along and barely managing to survive, even if you think that my situation is not very desperate.

I'm quite qualified to tell you what's desperate and what's not, because I've slept rough on the streets; I've lived in 14-bed hostel dorms and psych ward dorms. It's not a competition. Either you accept that I know what rock bottom looks like, or you don't.

What you can't see - because you only look at the good bits - is how quickly my life could unravel. I've got no safety net; I've got no cushion. My life hangs by a few slender threads. Of course I accept that I've had a run of good luck, such that I haven't ended up bankrupt and sleeping rough again. Of course I accept that I've had a run of good luck that there are still opportunities available to me; there's still a slim chance that I might rescue myself from my desperate situation.

There's an infantile attitude that I have to constantly suffer, like life is simple and all I need to do is get a job stacking shelves in a supermarket. You don't understand how real life works. You're not acknowledging reality. In reality we can't just abandon all responsibility and pretend like it's not psychologically destructive to lose hope; to have our dreams shattered. Loss of status and having a black mark against your name is a big deal. Being chased by debt collectors and bailiffs is a big deal. Having court summonses and court judgements and being sued into oblivion is a big deal. Getting fines and charges and all the other things that get slapped onto a poor person whose life is imploding, is a big deal. Real life... REAL LIFE involves earning as much money as you can, so that you don't have to take a calculator with you to the supermarket and ration out the value-price beans. Your infantile fantasies that we can just abandon everything that society holds dear - bank accounts and credit checks - and instantly switch our lives to be free and easy... this is complete and utter horse shit.

The reality of life is that there's a great deal of precarity. It might not look like it, but I've worked very hard to get myself back on my feet and I'm still a long way off. It might not look like it, but I couldn't have put in any more effort; I couldn't have handled any more stress - it's enough to give the most stable and secure person that you know a massive nervous breakdown. Eventually, we all reach our breaking point. We can't tolerate mental torture forever.

I've got my 3+ hour train journey, then a night in one place, a night in another, a night somewhere else, then it's back on the train, back to my job, time to check into yet another AirBnB I've never set foot in before. I need to buy two birthday presents, get a haircut. I need to do some washing. None of this is beyond the wit of man, but I'm so mentally and physically sick that I need to spend at least a week in bed, but I can't. I've got to keep the plates spinning.

Yes there are parents out there who are stressed out of their minds. Yes there are starving Africans. Fuck the fuck off. You think I've only got nice problems to have? You think my life is rainbows and puppy dogs and candy floss? Fuck the fuck off.

This is my rock bottom, because I want to throw everything away. It's too much effort. It's too much stress. It's causing too much anxiety. It's too exhausting. You think what I do is easy? If it's so fucking easy why isn't everyone doing it? If it's so easy, why aren't more people bouncing back from divorce, losing their home, drug addiction, alcoholism, bankruptcy, trouble with the police, mental health problems, suicide attempts, physical health problems and all the other things that bury people? Why aren't more people pulling themselves up by their bootstraps and getting themselves back on their feet?

It feels like I'm really close to a breakthrough, and that's what makes it so hard. All the time I'm thinking "it's only another 6 weeks, 3 months, 6 months... until I'm all fixed up and back to health, wealth and prosperity". It seems like it's no time at all, but that's because you're an idiot. You just don't understand how the shortest possible time can feel like an eternity, when you're in agony; when you're in such distress.

So close but yet so far.

 

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A Few Short Words About 2017

3 min read

This is a story about the past year...

Recovery Tree

As I searched for an image that aptly represented the last year, I realised that I would struggle to find one. Should I use a photo of fireworks over London taken from my balcony? Should I use one from one of my visits to hospital? Should I use a photo that represents something abstract: addiction, travel, work, recovery or something else? Should I use a photo that reminds me where I was a year ago versus where I am today?

I've selected this picture from a psych ward. The tree is supposed to be decorated with leaves which have a handwritten message from patients who have successfully recovered and left the ward. There aren't many leaves on the tree.

I'm regularly criticised for being deliberately glum. Perhaps my negativity is a choice. Perhaps I wouldn't be so stressed, anxious and depressed, if only I decided to be fit, healthy and happy instead. Perhaps I could also decide that I'm a millionaire too, while I'm at it.

I should be happy that I survived 2017. The odds certainly weren't in my favour. Whether it was kidney failure, addiction or suicide that claimed my life, there was sure to be something that was going to kill me. I should be happy to have made it through another year, shouldn't I?

What about prospects? I start 2018 with friends, living with a family, with a roof over my head, with a job. Looking at the hard numbers, things look rosy: I earn a lot and it'll take less than a year to replenish my finances. Most people would be chuffed to bits to have the opportunities that I have.

Tonight will be my 5th night without sleeping pills and my 3rd without painkillers, having partially relapsed because the pills were helping me with stress and anxiety. I enter the New Year relatively free from drugs, medications and other substance abuse problems. Of course, I will drink. I will probably drink for the whole of 2018. I have no intention of becoming teetotal, although I do need to reduce the amount I drink.

The list of New Year's resolutions that other people are begging to make for me is endless: join a gym, do some volunteering, eat more kale, do yoga, smile, pet a dog, kiss a baby, punch the sun etc. etc.

It might seem like I'm bloody minded - intent on being miserable - but really, I'm not. It might seem like I'm ungrateful, but again, I'm not.

2017 has been what it's been. It's been a hell of a ride. I'm content just to say that I've survived it and that I have no intention of a repeat, given the choice.

 

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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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Hospital Curtains

6 min read

This is a story about modesty...

Psych ward male dorm

It took 12 days to be "discharged" from my section - that is to say, to be allowed to leave the secure psychiatric ward whenever I wanted. However, it took 21 days before I was actually discharged from hospital: no vulnerable adult can leave hospital without a discharge plan, although I could have discharged myself against the advice of the healthcare professionals who were taking care of me, because I was a free man.

I'd been assessed to see whether I needed to be detained under the Mental Health Act at least 5 times. 6th time lucky.

When you find out for the first time in your adult life, that you're about to be detained against your will, I would've thought that everybody would have a similar reaction: "oh my god, I'm now trapped somewhere I might not want to be, and I don't have any say in the matter" which is distressing.

It's not so much that I didn't want to be in hospital; it's that I couldn't leave even if I wanted to. Although I wanted to be in hospital - because I knew I was very sick and in a dreadful situation - there was still a moment where I thought "oh shit what have I done?".

To calmly accept your plight is not something that would be anybody's natural reaction. Under such stress and shock, it's hard to recognise immediately that any attempt to fight against the system will lead to further difficulties. I was least surprised out of anybody that I got sectioned, having been the one who actually phoned the police to come and get me. Of course, escape is not hard if you're determined enough. I was conflicted - I was safe, but the price I paid was my detention: I lost my liberty.

Running away from a psych ward will result in the police being called to look for you. Britain's most dangerous psychiatric patients are kept in facilities which are far more secure than anything I experienced. I could have escaped easily and the police wouldn't have tried very hard to find me - I was a danger to myself but not others.

Our natural reaction to detention is to panic and start yelling for anyone who can possibly get you out - a solicitor, a social worker, a family member - and to start demanding your rights. There's a process that's got to chew you up before it can spit you out, and once you've just started the rollercoaster ride there's no getting off until the end - scream if you want to go faster.

Despite my messed up state, I knew that I had the right to appeal my 'section' with a tribunal supposed to happen within 7 days. I knew that my dad had the right to request my release, with a decision having to be made within 72 hours. I didn't have much hope that my dad would be helpful, so I requested an appeal.

It's so damn hard to get any treatment for mental health problems, beyond some cheap patent-expired generic medications or a computer-based Cognitive-Behavioural Therapy (CBT) thing. Inpatient hospital treatment, paid for by the NHS, is only given to very unwell people or exceptionally stubborn & determined people. However, when you have been admitted to hospital once as an inpatient under a section, you might struggle to ever escape the revolving doors.

Many of my fellow patients had the same story - they were released from hospital, stopped taking their medication, went mad and were brought back into hospital, where they were forced to start taking medication again... eventually being released and starting the whole process again.

Note, when I say "forced to start taking medication" I literally mean that they were held down by a whole gang of hospital staff members and forcibly injected against their will.

It would be stupid to argue that psychiatric medication is entirely unhelpful. However, one should be mindful that a perfectly sane person who had been taking powerful antipsychotic medication, would experience extremely powerful withdrawal symptoms if they stopped. Antipsychotic withdrawal symptoms are indistinguishable from the spontaneous psychosis that occurs in a person with a mental illness - how can one distinguish between a madman and somebody who's experiencing the perturbations of a brain that's readjusting to medication-free homeostasis?

As we move towards a world where the majority of us suffer near-debilitating levels of anxiety and depression, and psychiatric medications are dished out like candy from general doctors who have no specialist training in the treatment of mental health problems, are we diagnosing disease when we should be looking at what a person's life circumstances are like?

Ironically, I was diagnosed with adjustment disorder, which is to say that I simply couldn't cope with stressful life events - a clinical label for an intolerable clusterfuck of dreadful stuff which could happen to anybody. There isn't a pill for adjustment disorder, yet, although a bottle or two of wine each night is often chosen as self-medication.

The stress of living with 20+ mentally ill men in a locked psych ward is something that most people would not adjust to particularly easily. The 4 walls of my home were replaced with a curtain, which was opened every 15 minutes by a nurse or a support worker to observe what I was doing.

I think psych wards are necessary and I'd rather have the apparatus that treats mental health problems, than not have it at all. This is not an essay that criticises mental health treatment or the hardworking professionals who care for people with mental health problems. I write merely to reflect on my journey through the mental health system, which finally ejected me yesterday. I'm coming to terms with the fact that I was discharged from hospital, and today is the first time in weeks where I have woken up somewhere I can leave without having to ask permission.

Yes, I think that sums up yet another Earth-shattering overnight change to my life: I've gone from a flimsy curtain and a locked door, to 4 solid walls and I'm free.

 

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A Tale of Ten Beds

7 min read

This is a story about how nothing really mattress...

Double bed

This is the last double bed I slept in, 27 days ago. That's my brand new bedding with brand new pillows and a brand new duvet. I moved to Manchester with nothing more than my laptop and a bag of clothes. New life - clean slate. This is the apartment where I tried to kill myself. It was a miserable place and I'm glad I never slept there again.

I woke up on Saturday 9th September, and I was miserable. I wrote a blog post in this bed, about how miserable I was and how close I was to committing suicide. It was prescient.

The next bed I lay upon was owned by a guy who I had become friends with through my girlfriend. My girlfriend at the time was of no fixed abode - sofa surfing with a guy who she met on a dating website. I'd travelled to this friend's apartment to see my girlfriend. We lay kissing and cuddling on our friend's bed. Then, we broke up.

Coming home to my miserable apartment, I didn't get into bed - I took a massive overdose and lay on the bathroom floor in the dark, waiting to die. The next bed I laid upon was in the Accident & Emergency department of the nearest hospital.

I'm presuming - because I was unconscious - that I stayed on the same hospital bed, as I was transferred from A&E resus to the Intensive Treatment Unit (ITU) and then to a High Dependency ward. I was on life support. I was having seizures. I don't remember any of this.

I vaguely remember having to scramble across onto a different bed, to move me out of the High Dependency ward and onto a general ward. I remember this because there was a bag of my piss sloshing around that had to be moved too, and there was a tube coming out of my penis, which I had to be careful not to entangle with anything. The tube that was going up my dick yanked my male member around - it wasn't a comfortable experience.

From hospital I was thrown in a police cell. There was a 'bed' made of concrete painted with light blue paint - the same glossy paint that adorned the floor and walls of the cell. To slightly soften the hard concrete, there was a thin blue foam mat, which was wipe-clean. I did not sleep.

Driven home by the two police who had interviewed me - at 2am in the morning - I finally got back home at 3:30am. My sleep medication was nowhere to be found and I'd had a traumatic day - sleep was impossible. I lay awake on my bed, waiting until the earliest possible moment I could go to the office and try to find a work colleague - I was in a desperate situation and I needed help from somebody friendly and sympathetic to my plight: alone in a strange city with no friends or family; no smartphone, laptop, debit card, credit cards, cash or driving license.

After a second dreadful day I was pretty fucked up, as one might expect of somebody abandoned in such shitty circumstances. As sleep deprivation reached the 40+ hour mark, I ended up back at the same hospital's Accident & Emergency department that I had been in 5 days earlier.

Another day, another hospital bed. This one I came round face down on, with my wrists handcuffed behind my back, after having received an intramuscular injection of 4mg of lorazepam. It was approximately 3am in the morning - now 6 days after my original hospital admission.

Sectioned first under a 136 (up to 72 hours) and then upgraded to a section 2 (up to 28 days) I was then taken to a secure psychiatric facility with airlock-type doors, to stop anybody escaping. I was given a private room that was quite nicely appointed, with a writing desk and an ensuite wet-room.

Psychiatric intensive care

Having blearily come round in the early hours of the Tuesday morning, it was now Thursday night. I finally had a single bed in a comparatively peaceful environment in which to collapse and sleep, mercifully with the assistance of some zopiclone to calm my jangled nerves and soothe me into my slumbers.

Gone were the bleeps and hisses of the machines that were keeping people alive, on the Psychiatric Intensive Care Unit (PICU), replaced with the sound of alarms, slamming doors, shouting and running in corridors, as my fellow patients were restrained by staff. I found it somewhat comforting, to know that my crisis was no longer at its peak.

After 8 days on the PICU, I was transferred to an acute psych ward. It was terrifying.

With me in hospital I had two Apple iPhones, two Apple Macbooks, a Nintendo Switch and £1,150 in £50 notes. It's not really recommended to have that amount of valuables on your person, in amongst some very poor and deprived people. The wealth disparity was vulgar.

My guardian angel facilitated the return of my surplus iPhone and Macbook - Apple were excellent and refunded me with no quibbles.

I begun life on the new ward in a private bedroom, but I didn't have an ensuite shower and the TV blasted right next door for 19 hours a day, at full volume. At first, I was too tired to care and I could sleep through the dawn chorus of utter bullshit television a million decibels, but then it started to keep me awake, leaving me less than 5 hours of shut-eye per night.

Psych ward TV torture chamber

Then, the dreaded dormitory. Dorms are a mixed bag - very dependent on the luck of the draw, in terms of your fellow occupants. Security is a massive concern, as nothing more than a privacy curtain separated my personal possessions from anybody who'd care to have a look through my bags. Snoring can be a pain in the arse, with one person able to keep everybody else awake listening to their noisy slumbers. Thankfully, my dorm buddies weren't too bad.

This morning I woke up to "second; minute; hour; power; shower" repeated over and over, as a poetic dorm buddy wrote a new rap. That was 5:15am. It was still dark. He was pretty loud. He's sleeping now - snoring.

Today, I'm bustin' out of the psych ward. Watch out, general public of the United Kingdom - I'm going to be moving among you again as a free man.

Psych ward dorm

This is my current bed. I'm lying on it as I type this. I don't know what the bed or the room I'm sleeping in tonight looks like - I've never set foot in the house I'm going to travel to this afternoon. It's a leap in the dark, as is my wont.

Some of my few remaining worldly possessions are here with me in Manchester and some are in London. I'm surprised that I haven't lost more of my valuables. I can't quite bring myself to do the maths, to figure how much money I've lost on this crazy jaunt to the North of England. What does it matter? I'm alive and about to be accepted into the fold of a kind family who are taking me in - the IT consultant who lost his mind in a city where he didn't have any friends or family. It's unlikely that I'd have ended up homeless, but I wasn't relishing the prospect of being chucked off the psych ward and into a dreadful bed & breakfast, in some shitty suburb.

The very definition of "my" home and "my" bed has been smashed to smithereens. Tonight will be the tenth bed I've lain upon in less than 28 days, including several hospital beds and the concrete slab that passes for a bed in a police cell.

Distress flares were fired off and a good samaritan is coming to rescue me from a fairly dire situation.

Tonight, I sleep in a normal house for the first time in what feels like a very long time.

 

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Care Quality

8 min read

This is a story about being inspected...

A tivities

Today the psych ward is being inspected by the Care Quality Commission (CQC) and the staff are so nervous that some of them feel physically sick. I try to reassure one nurse that they're doing their best, despite staff shortages and rampant drug use - the synthetic cannabinoid called Spice is ubiquitous throughout prisons and psych wards.

There's always somebody peering over your shoulder, sneeringly judging you. Is it any wonder that paranoia takes hold in a mind, destroying it? The United Kingdom has an exceptional ability to track the movement of its citizens, using simple conventional CCTV - no spy satellites even needed.

In the free West, we deride the Stasi and the KGB. We talk about China's vast number of people employed to snoop on their own citizens, but we don't acknowledge the work of GCHQ and the NSA. Have we forgotten Edward Snowden's revelations so quickly? The Government read your fucking emails and the police - the regular ordinary police - have a backdoor into Facebook to read all your private messages.

Nothing to hide, nothing to fear. If you believe that, why do you feel stressed if a police car is following you when you're driving, and a sense of relief when the police overtake you and disappear over the horizon? You have insurance; you've had your car's roadworthiness tested; you've paid your road tax... nothing to worry about, right?

It was only a short time ago that I was deeply indoctrinated by my schooling, that had shaped me into a meek conformist - I was fearful of defying any of society's rules and regulations. A family friend wanted to go fishing with me, and I said we needed to obtain a permit. "Our prisons are full of people who got caught fishing without a license" this friend laughed. "What are you in here for? Murder. What are you in here for? Fishing without a license" he continued jovially.

The city centre is crammed with 50,000 protestors preparing to march. I walk past a police cordon and I can hear a police officer yelling at me that I can't go the way I'm going, but I know that he'll be busy dealing with my obedient friend who will have stopped per the instructions. I keep walking, pretending to be unable to hear the entreaties to return. The policeman lets my friend go and we walk to the head of the march.

Police car

I'm sure that anarchy would be a disaster for sick and vulnerable people. I have no desire to see civilised society crumble. We can't all do whatever the fuck we want, whenever the fuck we want. Perhaps if everybody acted like I did, it would be the end of the world as we know it.

"Don't walk" says the sign in the United States. I jaywalk with gay abandon. Even in Manchester people look at me like I'm mad and suicidal, for the way I cross the road. However, it's done with such confident aplomb that nobody challenges me. I notice that people who are surrounded by plenty of steel and glass and plastic, such that they would suffer no injury at all if they killed me to death with their motor vehicle, do not give a single fuck about whether I live or die. In London, a motorist will slow down or even brake, to avoid killing a pedestrian, but these provincial plebs treat human lives with no such sanctity.

To live in a crowded city is to be humbled by humanity. To be detained against your will on an underfunded psych ward is to humbled, also. In the city, you are forced to confront your pathetic meaningless existence, as an ant crawling in its nest would be, if it had the faculties to perceive itself and its surroundings. But an ant's nest is akin to a row of gleaming skyscrapers, insofar as being a testament to what can be achieved by a society working together. On the psych ward, you are forced to confront your powerlessness over forces greater than yourself - society will exclude its troublemakers.

Perhaps you think I would endorse heroin being sold in supermarkets and that babies' pacifiers should be replaced with crack pipes?

As six police officers pinned me to the ground and my bum was injected with lorazepam, in the Accident & Emergency department of a hospital, I noticed a cleaner and a security guard nearby - some of the lowest paid people in society are often completely unacknowledged for the role they play in maintaining the division between the peasants and the aristocracy. My face was inches from the floor, but the policeman's trousered knee on my head was clean and so was the linoleum. Circles of red and green blinked at me - the police bodycams, videotaping the whole gruesome specatcle. I'd fallen from grace, but I hadn't slipped anywhere near the bottom - it's a long way down.

A friend whose judgement I trust and respect, tells me that I should drop the bad boy image of "the guy who got fucked up in Manchester". She knows that people are watching and I'm misrepresenting myself. She knows that people are lazy and won't look any deeper than the superficial image that I present.

Is my life - and the way I document it - by accident or by design? Do you imagine that when I'm writing, I don't think at all about how things are going to be perceived? The joke's on you if you don't read what I write with the prerequisite pinch of salt.

If you just dip in at random - like a care quality inspector - then you will get a random impression. On a good day you'll get a good impression. On a bad day you'll get a bad impression.

Violent restraints

Do you think the graph above shows that things are improving? No. No it does not. Things are getting worse. Much, much worse. The data above shows conclusively that during the period under examination, there was a fourfold increase in the very metric that was supposed to be cut by 80%.

Do you remember blue tablet man? Well, anyway, he assaulted a nurse for giving him a yellow tablet (5mg of diazepam) instead of a blue tablet (10mg of diazepam).

A drugs dog sweeps the ward. The patients believe the dog can sniff out cigarette lighters. I ask the handler if the dog can sniff Spice and he confirms that it can. There's Spice everywhere on the ward, despite its deleterious effect on the mental health of susceptible individuals - prodromal schizophrenia can turn into fully-blown psychosis under the influence of the powerful synthetic cannabis, making it all the more concerning that it's so widespread on an acute psychiatric ward.

The patients here are the lucky ones and they know it. Everybody agrees it's better to be here with a warm dry bed and three hot meals a day. Everybody agrees it's better to be here, where the chances of being beaten up and/or robbed are minimal. With winter on its way, months of unimaginable suffering lie ahead of Manchester's homeless population, which has increased 1,100% in just 7 years - and a huge number of them smoke Spice.

Abandon hope all ye who entered the world from the mid-1990s onwards. What are the prospects for the youth of today, and the glut of graduates who were promised that indebting themselves and spending three or four years at university would be a good move?

Does it not seem like an obvious reaction to a decline in living standards, to retreat into drugged-up oblivion?

We're sifted and sorted and dissected by tests. We're examined, inspected and measured in every conceivable way. We never have any respite from the world's desire to label us, grade us and monitor us. The pressure to meet the expectations placed upon us is relentless. Some of us will crumble and have nervous breakdowns or be paralysed by anxiety disorders. Some of us will rebel and kick back at the suffocating environment that's desperate to eject and marginalise anybody who doesn't neatly fit in a box. Lots of subcultures have sprung into existence, with members exchanging knowing looks - these people are so much happier now that they have rejected the stereotype they were supposed to embody.

It saddens me that the hard-working staff on the ward are anxious and on best behaviour, when the other 364 days a year I know that they try their very hardest. This is just one of many psych wards, where the macro problems are greater than anything that can be influenced in the microcosms.

If you're going to randomly dip in, be careful to not make a lazy judgement based on a small sample size.

 

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Promoting Health

8 min read

This is a story about being counter-productive...

Fire alarm

95% of my fellow patients smoke cigarettes. There's nothing to do on the psych ward, so I can see why they would. Cigarettes are a way to pass the time; to deal with boredom; to relieve some of the stress of being locked up with a load of mentally ill people; to self-medicate for all manner of problems.

Nicotine is fiendishly addictive and a psych ward is not the right environment to kick the habit. As a non-smoker I'm well aware that I'm not involved in the activity that dominates the lives of my fellow patients - obtaining tobacco, rolling cigarettes and harassing the staff to be let outside to smoke.

There is a small outdoor area which can be accessed via some steps, enclosed in a cage so that nobody can jump and injure themselves, or attempt to escape. Every hour, the door to the steps is opened for 15 minutes, and the smokers all cluster around the top of the steps, getting their nicotine fix. Nobody goes down the steps into the outdoor area - they remain in the cage.

I challenge the staff - why don't they leave the door open the whole time? Nobody could escape from the outdoor area, because it's surrounded by high fences. The outdoor area is well covered by CCTV, and it's no harder to keep an eye on people than any other part of the ward.

The standard response from the staff is that it's "promoting health" to deny nicotine addicts access to the only place they're allowed to smoke. I call bullshit on this, because there's no data to support the hypothesis. "Look around - everybody smokes... nobody is smoking less because of this rule" I say. The staff argue that the NHS can't be seen to be "promoting" smoking. This is a completely ridiculous idea. The nurses and support workers hand out the cigarettes and cigarette lighters - the NHS is intimately involved in the whole process of smoking, far more than if the patients were given the choice as to how they dealt with their addiction.

Steps down

I'm in a dorm with 3 other men. It's a lot quieter than the single room right next to the TV - the TV blasted out for 19 hours in every 24 at full volume. The noise was unbearable. My fellow patients in my dorm report that they're lulled off to sleep by the rhythmic tapping of my keyboard, as I pound out these words. I was concerned that I was being a noisy nuisance, but they reassure me that it's quite the opposite - it's a kind of white noise that's relaxing, like hearing raindrops falling on the roof or hitting the windows, driven by the wind.

A guy is coming out of my dorm, but he doesn't sleep in my dorm - he has his own room. What's he doing down at this end of the ward? Then, my nostrils are assaulted by the smell of smoke. I push the door to the bathroom open and it stinks - there isn't even a decent extractor fan to get rid of the smell. I write a note and secretly pass it to a nurse, pretending to pass her my laptop to be charged in the office. I scurry away down the corridor but she yells after me "tell XXXXX about the smoking in the toilet" waving the note, right in front of the guy I'm dobbing in. I cringe - does she not know that snitches get stitches?

Another nurse comes to our dorm and she starts accusing one of my dorm mates of smoking in the toilet. I leap to his defence. "Who was it?" she asks, and then bellows out his name when I whisper the answer. The fact that many of my fellow patients have a criminal past and have been in prison, does not seem to concern the staff members. Perhaps there aren't fights in here. Perhaps they never see any violence. Perhaps my fears are unfounded. Am I being paranoid?

The fire escape is padlocked shut, there are no fire extinguishers or sprinklers, the break-glass buttons are enclosed in plastic boxes that prevent the fire alarms from being set off - a fire in here would be catastrophic. Yet, I am certain that there are at least 2 cigarette lighters that are being used in my dorm. The patients smoke openly when the staff are doing their handover between shifts, when there's absolutely nobody around.

I make subtle enquiries with my fellow patients - how do they feel about the restrictions on smoking? Everybody agrees that the restriction on access to the outdoor area is more about control than it is about "promoting health" - they feel that the staff have created a system that allows them to exercise dominion over their inmates. "Smoke time!" demands one of the more aggressive patients, banging on the window of the office. "Calm down! Stop shouting!" yells back a staff member. This is an artificial and avoidable situation - why does it exist, when it's creating conflict between staff and patients, and making people stressed and unhappy?

When I was confined to the ward I would have made use of the outdoor area to walk around, get some fresh air and get some natural light. However, I couldn't get past the gaggle of smokers clustered around the top of the steps. To leave the door open all the time wouldn't create this ridiculous situation, where all the patients are fixated on this controlling aspect of their lives.

It's saddening, to see 19 men all hanging around waiting to be given a lighter and be let out, like they're animals; pets.

In defiance of the pointless draconian controlling bullshit, a handful of patients have smuggled cigarette lighters and tobacco into the ward - it's not hard when some patients are allowed unaccompanied leave from the ward. "Have you got any bottles or lighters on you?" a nurse asks me when I get back from an outing - I'm not breathalyzed or searched, even though I'm carrying a bulging bag.

I suppose the privilege of being allowed to leave the ward could be revoked, as a punishment for misbehaviour. The chance of being discharged early and allowed home is also under threat, for any patient who's troublesome. Most patients are here for a 6-month stay. It's up to 6 months, but it's more often longer, not shorter. The reaction to not being allowed to go home is rarely handled well - can you imagine that people who are unwell are able to remain calm and represent themselves clearly and articulately, when their liberty is at stake?

In terms of mental health, nothing could be more stressful, adversarial and paranoia-inducing, than having doctors and nurses discuss you behind your back, having been peeked at through the curtains every 15 minutes - patients are literally spied on and judged. Life, liberty and free-will are all interfered with in an institutional environment that's a cross between a prison and a school. Notices on the wall tell us they promote "independence and well-being" while also telling patients the very strict times that they need to be at the dispensary hatch to get their medications. At 8:54am I'm harassed by a nurse to go for my 9am meds... I'm well aware what the time is and also well aware that to be early is to be turned away empty handed. At 11:54am I'm harassed to go and stand in line for some food which is not even being served until 12 noon at the earliest, and is often delayed.

I'm aware that I'm lucky to have a sought-after psych bed - many people who are having a mental health crisis will have no access to inpatient care. To bite the hand that feeds me seems churlish, but I do feel sorry for my fellow patients who can't articulate their frustrations effectively.

The only patient I know to have attempted to file a complaint is the guy who's relentlessly trying to get 8mg more Subutex out of the doctors... unwilling to go along with the treatment that will wean him off his opiate addiction and quite determined to sabotage his recovery, perhaps.

Nobody's stopping smoking because of the "health promoting" rules around access to the outdoor area, but I'm certainly missing out on exercise and fresh air because of it.

It all looks rather counter-productive to me.

 

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Gone Fishin'

7 min read

This is a story about being observant...

ECG stickers

Where do blue tablets actually come from? Well, presumably they are pooped out by blue fish, like the ones that can be seen swimming here on the pavement and road. Can you see them - the little blue fishies?

With our Sherlock Holmes deerstalker hat on, puffing from our pipe, we might deduce from the proximity of a large hospital and the lack of water, that these are not actually fish. What could they be?

An electroencephalogram (EEG) is a graph of what's going on in our head, quite literally. En kephalé means "in head" in Greek, and the gram bit means "written down". Electro should be relatively self-explanatory.

Were these fish involved in seeing what was going on inside somebody's head? No, I don't think so.

An electrocardiogram (ECG) is a graph of our heartbeat, as denoted by the cardio part.

In order to know what our heart's doing, we are all very familiar with the stethoscope, but there's a more accurate test that doesn't depend on human hearing. The muscles that pump the 4 chambers of the heart never stop unless you go into cardiac arrest or otherwise die. Muscles give off tiny electrical impulses, and these can be measured with highly sensitive equipment - an ECG machine.

So what about these fish? Well, it looks like they're the little sticky electrodes that are put on each of your ankles, arms and across your chest around your heart. When you are hooked up to an ECG machine, you've got a stack of cables attached to you.

One of my fellow patients at the hospital was in such a big hurry to get rid of these stickers, after having the health of their heart measured, that they tore them off and discarded them onto the floor, quite possibly in a fit of rage at having been cared for by one of the finest healthcare systems in the world. It's quite understandable that having received lifesaving treatment that's free at the point of use, this individual should have ripped these electrodes off their body and tossed them onto the road and pavement - that'll teach society a lesson, now that a street sweeper will have to come along and clean up this trash!

We might note that there are only 4 stickers, and we can presume that these are the ones from the person's wrists and ankles, which would have been most conspicuous. Perhaps it wasn't until the person explored their body later, that they found 4 more on their chest - one of which was lurking around on their left hand side and might not even have been discovered until a later date.

Debate rages in the United Kingdom, about whether we should have penalties to discourage people from treating the National Health Service disrespectfully. We could charge people for a no-show to a General Practice (GP) or outpatient appointment. We could charge people for any visit to Accident & Emergency for trivial matters that could have been treated at a minor injuries clinic, or perhaps did not require medical attention at all.

There is evidence that we are starting to allow a two-tier society to emerge where none is supposed to exist. Doctors' waiting rooms have plush leather seats for 'VIP' patients - who are paying for private consultations - while the NHS patients sit on hard wooden chairs. For an operation, paying to go private might mean skipping waiting times, even though it will be the same surgical team, in the same hospital, with the same equipment and in the same operating theatre. Although it's not supposed to happen, surely some of the waiting times are because private patients are queue-jumping?

Those at the bottom struggle with zero-hours contract minimum wage jobs, with the purchasing power of their pay packet decreasing every month, due to inflation. Things are not a lot better on the next rung of the ladder - an NHS Clinical Support Worker's salary tops out at around £15,000. That's £259 a week. Ouch. My rent in London was £480 a week. The wealth disparity is disgusting, isn't it?

While the cost of housing and the cost of energy - electricity and gas - is skyrocketing with double-digit percentage increases, wages barely increase at all. One only needs to look at the use of food banks, to see that the little people are struggling - people who clean your toilet, scrub your floor, wipe your bum, cook your food, stack your shelves and scatter rose petals along the privileged path that you walk. But, these spoiled brats still vote for a ruling elite who care nothing for the wails of distress that are now becoming a deafening scream of pain.

The bulk of the BBC was moved up to Manchester a few years ago, and it's been quite evident that it's had an effect on the mindset of the people who work for the broadcaster. In London, the homelessness problem is inconspicuous in wealthy districts, but in Manchester - where homelessness has soared 1,100% in just 7 years - the problem is inescapable. The BBC has shown a number of documentaries which accurately reflect exactly what I have seen and experienced: there are vast numbers of people in dire need of assistance.

Who wants a McJob that doesn't even pay enough to be able to rent a room in a shit apartment, and have any life at all? Does it surprise you that people are smoking strong synthetic cannabinoids which allow them to escape the stress and hopelessness of a hideous reality that nobody in Government seems to want to address.

There's a crisis that's going on all around us. Pull back the covers and human tragedy is unfolding underneath.

This is not a "wake up sheeple!" alarmist or sensationalistic think-piece, but in actual fact an unfliching and painfully truthful account - I bear testament to what I've seen - of the shocking disparity between London and the South-East, where our wealth is concentrated, and the rest of the United Kingdom where things are very grim indeed.

We talk about the 'Westminster Bubble' and I can attest first hand what it's like. At the beginning of this year I was at the grand headquarters building of Her Majesty's Revenue Collectors (HMRC) and it had been refurbished to an incredibly high standard. I was taken to an extremely grand room, which was capacious enough to hold at least 50, maybe even 100 people, but only had me and the two people interviewing me. Otherwise this space was left empty and unused, so far as I could see - perhaps a metaphor for all the empty homes that have been bought by foreign investors in London.

Meanwhile, it was barely two years ago that I was in social housing apartment (council flat) in London, which was in such a poor state of repair that there was literally 2 inches of water that one had to paddle through, in order to use the toilet or a terrible shower that barely worked. It's quite clear where our tax money is going - tax breaks for millionaires, not houses for nurses.

Bursaries for nursing have now been removed, so our nurses will emerge with the best part of £60,000 of debt when they qualify, which will further reduce their take-home pay. The interest on a student loan of that magnitude is more than 12% of our nurses' starting salary of £22,000, which means they will sink deeper and deeper into debt each year.

Who will mop up your sick, piss, vomit, blood, mucous, pooh, give you a sponge-bath in bed, say soothing things and give you painkillers when you cry out in agony, come running when you press the call button and generally make you as comfortable as possible when you're unwell?

As comrade Corbyn said: a millionaire in their mansion is going to need an ambulance if they have a heart attack, just like anybody else.

 

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