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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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On Loneliness

1 min read

This is a story about the odd one out...

Pink flower

I'm trapped in a prison of my own mind. My internal monologue chatters away incessantly. When social norms don't constrain me, I talk to myself. Sometimes my brain tells me to do stupid stuff, like kiss a male work colleague who's talking to me in the middle of a busy office - the most inappropriate thing that my subconscious can imagine. Often times, agonisingly cringeworthy memories pop into my head, that are so awful that I wince and whisper "fuck!" under my breath.

 

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The White Wolf and the Black Sheep

4 min read

This is a story about storytelling...

Meat

I'm stood in a sunny garden, sheltered from the wind by mature shrubs. Beyond the confines of the walls and fences are lush green fields; rolling hills leading down to the sea. The air is fresh and clean, blowing in off the Atlantic. There's a smell of mown grass, which has been cut for the last time before winter - the trimmed blades clump on the lawn. Gravel crunches under my feet - I'm stood on the driveway where the cars are parked. There's a sound of a 2-stroke engine which powers a hedge trimmer, being used to tame the runaway growth in the hedgerows; the exhaust fumes blown away by the prevailing wind.

I'm throwing a ball for the white wolf. Eyes on the front of his head, not the side - that's how you know he's an apex predator; he's not worried about anybody creeping up behind him, although his ears are pricked up, listening intently. He's a smart wolf - anticipating me throwing the ball but not so eager to run and collect it that he would be fooled by a dummy. Besides, why would I want to trick a wolf? What satisfaction would I get by proving I'm smarter than an animal with a much smaller brain?

The wolf pants and drops his ball some distance away from me. The game is over. I fetch a water bowl for the wolf and he laps up the cool liquid with his long pink tongue. He brings his ball to me again, ready to play - the game starts over.

My throwing gets erratic and the ball lands on a rockery. I'm fearful that the wolf will injure himself. I stop throwing the ball.

A running sheep; a chasing wolf - he's found a new game.

Clambering over fences, the farmer holds the wolf while he strains to get at the flock which has retreated into a corner of the field, unable to flee further because the sheep are enclosed by a fence. The wolf has to learn that this is not a game.

I feel guilty. Did I get the wolf over-excited by throwing the ball for him? Was I the immature adult who gets the children over-excited before bedtime? Was I irresponsible; inconsiderate of the consequences?

I want to tell stories but not everybody wants to feature. I want to tell stories but invariably people will wonder if it's about them. I want to tell stories, but I have to be careful that I respect the need for peaceful private family life.

I'm lying on a bed with sunlight in my eyes, telling a story. It's warm and quiet and I'm very comfy and calm. My brain buzzes with thoughts; ideas - I've written a list of 49 stories that I want to tell, and I have another list with 70 more, some of which I've already told. There are more words than there are waking hours in the day to type them. Now that there is some calm around me, the dam has burst and I'm struggling to not be swamped by the deluge.

I think about tenses - why is this told in the present tense if it's a story?

So much has happened in the past and it's hard to not relive and refine the story. I do not embellish or exaggerate, but stories improve with retelling. With each iteration, a more accurate and engrossing account emerges. I have a mountain of material, and the temptation is to weave it all into a captivating patchwork quilt of tales; adventures.

Here in the present there's plenty going on but I'm a guest in somebody else's story, and it's not my place to tell it. It's strange for me to observe quietly and not pass comment. In all honesty, I swing between "where did it all go wrong [in my life]?" and gawping in awe at what's been built; forged - the achievements of the loving, kind, generous and humble family who've taken me in are breathtaking.

Outside, there's a well. It's blocked, but it's obvious what's down there - a dark cavern filled with cold water. To fall into the well would be deadly: you could never climb out. Why unblock it? Why go down there?

Obviously, the well is a metaphor for my past. I have an aquifer of hair-raising tales that I could never drain, even with a million buckets. I can draw upon my dark murky past, but perhaps I shouldn't - perhaps to plumb those depths will lead nowhere new. Haven't I written enough already, about the past?

I'm planning on writing another novel in November.

 

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28 Days Later

3 min read

This is a story about mortality...

Black cab ride

I can't bring myself to read the comments on Twitter from approximately this time 4 weeks ago. For some reason it makes me feel physically sick and psychologically overwhelmed, to take myself back to that time.

I have no idea why I've taken the photos I've taken.

Usually, photos are taken from scenic panoramic views, or at tourist attractions. Our friends and families smile back at us from our photos - happy children and kissing couples. Our photos help us recall social gatherings and other pleasant occasions.

For over 2 years I've documented my lonely and erratic life. I haven't photographed my breakfast cereal, but instead I've photographed things that are like a breadcrumb trail, that will perhaps lead me back to wherever I misplaced my marbles.

Pictured above is the cab ride I took where I decided to kill myself.

It seems apt that there would be a gap where I was without my smartphone. If anybody's read Finsbury Park Fun Run, then they'll know that our smartphones are recording where we are all the time (part 3 is where you can see the geolocation data I downloaded from my phone).

It seems apt that there would be a gap where I was without a camera.

What you might find surprising is that the only hole in my memory is the part where I was in a coma on life support. I remember exactly what it felt like to have a seizure. I remember almost everything. You'll have to take my word for it though. I do also have the documentary evidence I've been able to gather: things like hospital discharge summaries and other bits of paper I collected on my erratic journey through the last 28 days.

I've started to think about my life in terms of 'pre' and 'post' the events of 9th September 2017.

You might think that you'd be flooded with relief if you found yourself unexpectedly alive after a near-death experience. Certainly, a man who survived a suicide attempt from the Golden Gate Bridge said that he felt regret the moment he jumped off. I did not feel regret at any point.

I'm sad that I traumatised friends and Twitter followers. I haven't really had a chance to speak to some important people in my life. I can't really face ringing round. I know it'll be good when I do though - I'm immensely grateful for the phonecalls I received soon after I got my phone back.

If we consider hospitalisation for somebody who's experiencing a life-threatening crisis, 28 days seems like the usual minimum amount of time that somebody would take to get well - we'd hold people in a safe environment for 4 weeks, to make sure they're not going to fall flat on their face.

Perhaps Wednesday/Thursday is the bigger milestone, because that'd be 4 weeks since my mind finally fractured and I became so unwell that I had to be hospitalised for psychiatric reasons.

It's as if my body needed to be synchronised with my brain - there weren't any physical feelings that matched what was going on in my mind.

Today, things feel a bit more lined up.

 

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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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Why do I Still Want to Die?

7 min read

This is a story about subservience...

Back alley

It's grim up North. I didn't think it would be but it is. Here's Coronation Street. Beautiful, isn't it? Presently, that discarded sofa would be where I'd sleep if I discharged myself from hospital.

Without the crutches of alcohol, benzodiazepines and sleeping pills, I feel overwhelmed by stress and anxiety, because of the precarity of my position. Without a home; without a job; without financial security - there's plenty of rational reasons to be distressed.

People implore me to sit back and relax, but they don't realise that I've got loan payments to make; credit card payments to make; overdraft interest to be paid. To have to spell this out multiple times is frustrating.

"Why don't you just go bankrupt?"

Yeah, nice one, Einstein. Did you know that I do a lot of consultancy for financial services organisations? It's imperative that I have a clean credit record - prospective employers will do credit checks on me. You might as well suggest that I go out and commit a crime and add a criminal record to my list of woes.

"It's too soon to be thinking about going back to work"

Well, unless I'm accepting that I'm abandoning all hope of ever repaying my creditors and suffering a life of poverty at the mercy of the state, then no, it's not too soon. There's a concept called runway that I talked about at length during the first half of this year. I was unwell, but during my convalescence I was running out of runway. What happens when a plane runs out of runway?

In short, I'm driven to seek income, to prop up my depleted finances and keep servicing my debts.

If you're really wanting to poke your nose into the darkest recesses of my life, then you should know that I can easily earn enough to replenish my savings and get onto an even keel, with just 5 or 6 months of contract work in London. That I ever left London seems like a mistake, but I had few options - what I did was the right thing in the circumstances.

Today, I'm detoxed from alcohol and benzodiazepines - the physical dependency has been treated - but it quite literally nearly killed me. In addition to the massive deliberate tramadol overdose, my hospitalisation meant I abruptly stopped drinking and taking benzos, which caused me to have loads of seizures - in short, you should never suddenly stop heavy drinking or taking large doses of benzos, because you could die.

So, one might argue that I'm in a better place than when I attempted suicide. Yeah, I guess the biggest threat to my life has gone - my physical dependency on medications and alcohol.

Now, the biggest threat to my life is me - the desire to be dead is an insistent nagging thought that won't go away. It makes so much sense to commit suicide: all I have ahead of me is stress.

The rebound anxiety - having ceased taking medications and drinking alcohol - is causing me to suffer an intolerable amount of unpleasant feelings. It feels like I'm going to feel awful forever, and who would want that?

Of course, my perceptions are probably warped - nothing lasts forever. However, should I really be living my life just hoping to die of natural causes?

I could be writing about how pleased and happy I am to have a second chance - I survived a very large overdose and other medical complications that really should have killed me: the team at the Intensive Care Unit (ICU) were very surprised that I survived. Shouldn't I embody every trite contrived platitude you've ever heard? Shouldn't I be carpe diem'ing? Shouldn't I be counting my blessings? Shouldn't I be thanking my lucky stars?

Without stopping to consider all the reasons I tried to kill myself, my problems are not going to go away on their own, are they?

If my suicide attempt was an impulsive thing that I had any regrets about, then perhaps surviving would give me some long-lost appreciation for life. However, I'm spine-chillingly cold and rational about the biggest decision that anybody can ever make: the decision to die. Having been stuck in a never-ending cycle of attempts to get my life back together again, I was exhausted and unable to face rebuilding everything again. I'm still exhausted.

There was a fleeting chance that my suicide attempt could have been a minor setback, but I was completely shafted by the company I was working for. The mistreatment I suffered was inhumane; monstrous. I'm almost speechless that I could have been treated so badly.

I'm stuck between three things:

  1. To act positively, and go and earn some more money
  2. To act negatively, and pursue my legal rights
  3. To simply attempt to kill myself again

To follow the first option is to repeat the behaviours I mastered a very long time ago. It was 20 years ago I got my first full-time job; rented my first apartment. It was 20 years ago that I learned about office politics and how to get ahead in life - a life of corporate conformity.

Instinctively, I reject the bullshit that made me unwell. For 20 years I've observed the rats in the rat race, and for 20 years I've observed the world become a shitter place - an exploding population is on collision course with mass starvation; unrestrained fossil fuel burning has led to runaway climate change, which is causing parts of the world to become uninhabitable, killing and displacing billions of people; deregulated free-market capitalism has raped the globe's finite resources and created a culture of wealth-worship where nobody gives a fuck about anything.

To be a principled, ethical man, is a kind of disadvantage - my political philosophies about social justice and a more fair and equal world, are exploited. I find myself screwed over by people who are willing to trample on anybody and everybody, in a desperate and disgusting scramble up the slippery sides of a mountain of dead bodies.

I've proven that I can play by the rules, but the whole game is bullshit and most people are cheating. I don't have anything to prove to anybody anymore; I've shown that I can wear the corporate mask and fit in with the herd; I've shown that I can live a life of subservient conformity, but it drove me to point of taking my own life.

I don't wanna play anymore, and the only way I can see to call time on this bullshit is to kill myself.

I think to myself that I've suffered and that I must turn that suffering into a piece of art - a monument to the stupidity of humanity. It's grandiose and ridiculous to think that a piece of writing could have any useful effect on the world, but this is my only legacy. Do you deny me the facts? To think that I would no longer live & breathe was a shock to many who've stuck with me and followed my story.

Of course, I'm sick and I've got "insight" into my illness - that is to say that I can consider an objective point of view. It's natural that I'd be feeling terrible, only 24 days after I very nearly managed to kill myself. It's natural that I'd be feeling terrible, given the clusterfuck of issues I've got to sort out if I want to go on living. I can see that I may very well be feeling unnaturally anxious, because my brain is re-adjusting to life without booze and benzos to soothe the stresses that are ever-present in the world.

A doctor suggests that I avoid the news, political protests and other things that I might get worked up about. Is this akin to a lobotomy? I think I would very much like a lobotomy... that's how I arrived at the brain-numbing chemical lobotomy that I swallowed every single day. Unfortunately, my brain is very much intact.

Why am I still so painfully conscious?

 

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Therapy¿

6 min read

This is a story about being overwhelmed...

Park bench

I sit sunning myself in the park. It all looks very idyllic, doesn't it? How enviable my life is - I have not a worry in the world. Wouldn't you too, love to be as footloose and fancy free as I am? Wouldn't it be great if you were unburdened from all your responsibilities and worries, and could just cavort around doing whatever the fuck you wanted, just like me?

A friend phones me. He tells me that all my problems are all my own fault. I can't disagree with him. He tells me that I'm self-centred. I can't disagree with him. He tells me some stories about some problems in his own life. I can't say that my woes are worse than anything he's been through. He tells me about how tough things are in the developing world. I can't disagree.

My head buzzes with thoughts. My thoughts aren't racing; they're quite rational, reasonable, structured and logical. My thoughts aren't warped by a broken ability to correctly perceive reality - I corroborate how I'm feeling with people who are considered to be sane, to validate that I'm not thinking what I'm thinking because I'm unwell.

I've been seriously unwell before. I sat in ice-cold bathwater for hours with a sharp knife at my throat, keeping my elbow on the bathroom door so that if it was opened it would drive the blade into my jugular vein and carotid artery - that was unwell.

I've been seriously unwell before. I've imagined people abseiling down the side of my apartment block who were going to smash in my windows and come into my bedroom. I've imagined that I'm being spied upon. I'll leave it to the reader to conclude what psychiatric label is usually attached to such thoughts.

I've been seriously unwell before. I spent 12 or even 18 hours at a time, trying to make something out of cardboard, string, plastic, rubber, metal, wicker, cloth or whatever else was lying around. I was once convinced I was building a house around myself, but when I had a moment of lucidity, I realised I had simply been moving the same cushion around in a small circle, in a trancelike state.

Of course, I'm not claiming to be well at the moment.

It's been suggested to me by a few people that I could be malingering - that I took an overdose that was very likely to kill me in circumstances where I was very unlikely to be saved, fully knowing that I would survive... somehow; that I managed to fake mental illness so well that I was brought to hospital under a section 136 by the police, and that I continued to fake mental illness so well with the team who assessed me, that I was detained in hospital under section 2 of the Mental Health Act. It's either the greatest ruse - a masterful piece of deception and death-defiance - or maybe it's really easy to abuse the few brain cells I still have left, for nefarious purposes.

Anyway, I'm not supposed to be writing about myself. Think about the starving African children.

Where do you think I live? How do you think I eat?

I'm dependent on charity.

Park bench.

Yeah, damn straight I'm glad I was born in Northern Europe, in a wealthy country where we have a welfare state. Damn straight I'm glad I don't live in some hot dusty shithole, where hunger and disease are rife.

"I want to go home"

My home is this park bench. It's true, I have received kind offers to live with a couple of very charitable people. It's a big deal, to invite a mentally ill, recovering alcoholic, recovering addict, into your home. I bet you wouldn't do it, would you? I probably eat newborn babies and stomp on kittens' heads, just for my own sick amusement.

"I want to go home"

I hear people asking to go home a lot. Every day I hear people shouting that they want to go home. I don't ask to go home. I wonder why?

I chat to somebody about living in a caravan and hiding from debt collectors. My heart leaps. I yearn to escape the relentless pressure I feel to get back to work and start turning the pedals again, but I'm conflicted - I'm a principled man and I want to service my debts; I want to play by society's rules.

Nobody plays by society's rules, except those at the bottom who are trapped into poverty - they have no choice. I've played by the rules for long enough, and it's made me so miserable that I tried to kill myself. People urge me to take a break from the rat race, but they don't understand that the house of cards is going to collapse - there's a lot of money riding on me being able to get back on my feet.

Like a sportsman who chokes at the critical moment, I feel immense pressure to perform and it affects me.

It sounds like I'm pointing the finger of blame everywhere other than myself. Is that your signature on a contract that says you would accept Payment Protection Insurance (PPI) on that loan? Why didn't you read the contract? Did you take out that endowment mortgage or didn't you? How come you didn't understand something that was completely straightforward? Why won't you take responsibility for your obligations?

My friend is right. My life is a problem of my own making.

This whole fucked up mess is a problem of our own making. We are joint and severally liable - do you understand what that fucking means? Do you own up to your part that you've played in all of this?

I'm trying to do my bit and it's making me unwell. So unwell in fact that I tried to kill myself. I mean proper kill myself - dead, forever, gone, finito, sayōnara, the end.

Either I'm the most devious bastard that ever disgraced the surface of the Earth, or circumstances are somewhat out of my control - I'm not fully responsible for the gigantic mess I'm in. Of course, I'm a very convenient scapegoat though.

Although it seems very disjointed and jumbled, this blog does not write itself effortlessly. This blog is not unimportant. This blog is important to me, so that's at least one reason why it's important - I don't need any more than that. Call me selfish and self-centred all you like but I've tried to remove myself from the picture, and I failed. Am I supposed to be sorry that I'm not dead, and I'm still wasting your precious oxygen? Am I supposed to apologise for writing something that you could choose not to read, if you wanted to?

Think about the starving African children. Wow I'm cured!

 

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