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Habit Forming

3 min read

This is a story about breaking the cycle...

Handful of capsules

Two of these medications are addictive. Half of these tablets are dietary supplements that can be bought from a health food store. As I stop taking three prescribed medications, withdrawal side effects that I'm suffering from include: insomnia, anxiety and panic attacks. Why stop?

If you're doing something that seemingly provides no benefit to your life, but is hard to stop, then why are you doing it?

The list of things that I could be said to have enjoyed habitually has grown to an extensive list that includes sex, spending money, alcohol, stimulant drugs, benzodiazepines, sleeping pills, painkillers, pornography, computer games, reading, arguing with people, work, masturbation, driving fast, junk food, music and just about anything else that makes life liveable. Strangely, my current day-to-day life includes almost none of these things.

Given my natural tendency to binge on anything I enjoy, perhaps it is abstinence that I am now taking perverse pleasure in the over-indulgence of. I barely have the words to describe how truly dreadful it is to be withdrawing from the most addictive chemicals on the planet - abstaining from alcohol & benzodiazepines can be so hard on your body and mind, that you will die from seizures. Why on earth would I choose to go without the things that would salve the aching that my body has for anxiety & stress alleviating substances?

It was suggested to me that my choice to go without all the things that would help me feel better, is akin to a kind of self-harm. Writing this now, I'm inclined to agree. All the stress and anxiety that I have avoided for years is all hitting me like a sledgehammer. Everything I've ever enjoyed and seen as a reason for living, is barred from me for reasons of self-denial.

Perhaps this is a kind of meditation. Like a monk who takes a vow of celibacy, through this difficult period maybe I will learn something that I would not be able to whilst indulging in the terrestrial temptations.

There is a deliberate alteration of my behaviour, of course. I have decided to deny myself alcohol and my prescribed medications (yes, this is in agreement with my doctor, yawn). I could very easily continue to drink alcohol and take pregabalin, not to mention illegal narcotics and prescription drugs which I could obtain through the black market, but I choose not to. I do not stop because I have an incentive to do so; I stop because it is hard and it is interesting - I'd gotten a little bored of my wanton excesses.

I could write and write and write - perhaps the armchair psychologists amongst you will speculate that I have simply transferred all of my multiple addictions into an addiction to writing.

 

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Shepherd's Delight

3 min read

This is a story about free will...

Red sky at night

Having spent the best part of a month in hospital, I am now convalescing in the Welsh countryside. It's remote, rural, peaceful and therapeutic, which is exactly what I need. Why on earth wouldn't I stay here, when this is the very best place I could be for my health and wellbeing?

If you believe in free will, then I'm afraid you're quite deluded. Every decision we make is heavily biased by circumstantial factors.

Having experienced the stress of moving to new places, getting jobs, making friends and otherwise climbing the greasy pole, I've got nothing to prove - I know exactly what to do and exactly what to expect. I have very little motivation to repeat the same well-worn moves that I learned a long time ago - I'm sick of playing the same old game. Rebuilding my life holds no surprises; only stress and misery.

Thus, I arrived at the decision to die, some time ago.

When you've decided to die, there isn't any fear of failure, shame, embarrassment or any of the other things which would usually predispose your behaviour towards more risk-averse choices.

If you look at my life choices through the prism of depression and defeatism - I have no desire to play by fucked up rules - things make a lot more sense than any stupid over-simplifications. Perhaps you think I'm infantile, immature and irresponsible? In actual fact, I'm not inflicting this shit on children who didn't ask to be born. I'm terminating the cycle of pain: somebody's gotta stand up to the relay-race of human misery, where fathers fuck up their sons.

I'm not critical of parenthood per se, but it would be irresponsible of me to spawn offspring of my own when my kid(s) might ask me one day "if you had a miserable life, then why did you bring me into the world?". Given that my children might ask about my own unhappy childhood, it seems unconscionable to take the chance that I could perpetuate that misery.

In a world of war, famine, climate change and spiralling problems, we are clearly on collision course with disaster. I don't want to add to the world's woes. To be yet another sharp-elbowed parent, concerned with the propagation of my genes at the expense of everything else, does not seem like a good idea when there's another option: to not do that.

I can end the male lineage and bury the surname "Grant" which I inherited from a heroin addict. I can do my bit and act in accordance with a conscience that encompasses more than my animal instinct to rut like a beast and impregnate willy-nilly.

Fucked up ungrateful entitled rich spoiled know-it-all brat says my shattered brain. I think about the people who've tried to help me; who care about me. I feel guilty that I feel so bad; still feel suicidal. Countless opportunities seem to be open to me - am I rejecting them? Am I throwing the 'gifts' that I have received back in the faces of the bearers? If I am ungrateful, so what?

My charmed existence has led me to a situation that's quite wonderful, but also exquisitely painful because of it - this isn't real life I think to myself. I can't stay here. The need to earn money to pay for debt and taxes will force me back onto the treadmill. The misery of the rat race is inescapable, except through suicide.

 

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Did You See Me? (DYSM)

6 min read

This is a story about being caught on camera...

TV interview

There was a time before digital cameras and Facebook when it was thrilling to see photographs of yourself that other people had taken: this was the pre-selfie age. There was a time when creating a digital identity was hard - social media wasn't dominated by the big players, and maintaining a homebrew website required expert technical skills and a significant investment of time & effort.

Some enterprising tech boffins created free software that allowed bulletin boards to be created by relative novices - these were forums where internet users could discuss topics, under the banner of a certain hobby or interest. Originally, bulletin boards were telephone numbers you could dial up from your computer, to do the kinds of things we do on the internet today, except that these bulletin boards were isolated communities.

Facebook and Twitter have taken the bulletin board - where we build a community around a common interest - and allowed us to build a community around our personal identity, with the bait of seeing ourselves tagged in photos or mentioned in tweets. On forums, there was a thrill in seeing a thread of discussion getting many views and replies - to be the original author of a popular thread was something to take pride in. We covet 'likes' of our updated profile photographs and our pouting selfies, as we preen our digital identity.

With the ubiquity of smartphones that are capable of capturing and uploading photos and videos, making them instantly available on social media, we are amassing a huge library of images of ourselves, as well as projecting an identity that goes well beyond the people we see on a daily basis, face-to-face.

Our skill in presenting ourselves as we want to be seen - Facebragging - is something that we have had to recently learn, especially as we increasingly mix work colleagues with our close friends, online. Our digital identities can overspill unless we are careful to manage the audience with whom we share things.

A sinister and creepy cyberstalker made a horrifying boast to me:

"I know"

I'm sorry, what? What do you know?

"I've read your blog. I know"

What? What do you know? Have you really read my blog? There's the best part of three-quarters of a million words here - I seriously doubt you've read much, and I seriously doubt you know much.

Those words - "I know" - were said to me by somebody who was making a very important decision. Because of the sheer volume of noise on social media, I'm relatively hard to find. Thanks to my concerted efforts over a number of years I can laugh at anybody's attempt to "know" me - stalkers only scratch the surface. Yes, I am applauding myself for writing so much that even the most determined cyberstalker would be exhausted.

I live in fear of cyberstalking.

Don't we all live in fear of cyberstalking a little bit? There's probably a sex video of you and somebody else that's hidden somewhere on your computer or smartphone. What about all those sexts that you sent between you and your sweetheart? What about all those paedophiles who want to molest your children? What about all those rapists who are following your every move on social media? The world is out to get you.

My fear of cyberstalking is a little different.

I'm now convinced that almost everybody is far too wrapped up in their own self-centred little world, to give two fucks about much of what anybody else is doing. The cyberstalker who said "I know" in a very sinister and horrible way, was intent on harming me just as much as you'd expect of any stalker - zero fucks were given about my health and wellbeing, and a very great deal of harm was rendered to me.

Perhaps I should set my privacy settings to the maximum and erase everything that's personal and accessible to malicious attackers?

To protect myself from a determined cyberstalker would be nearly impossible. Our lives are lived online nowadays - to reject social media and not cultivate a digital identity, will leave me isolated and without access to online communities. To have to always consider how anything I share could be used against me is exhausting, and how am I supposed to ask for help or otherwise indicate to my friends that I'm in trouble? Pretending that my life is awesome and I'm totally OK is ridiculous, if I'm doing it just in case a cyberstalker goes digging.

I'm not suggesting we all post our mother's maiden name, social security number, credit card details and other data that would lay ourselves open to fraud... or maybe I am. In an open and trusting culture, the bad apples are easier to spot - nothing to hide, nothing to fear.

The fact that I've suffered significant financial loss due to a cyberstalker is akin to a kind of fraud that has been perpetrated against me. I'm no fraudster: who I am is plain for all to see. That somebody would steal my data and use it against me is criminal. Why should I be persecuted and discriminated against, because of what dirt you think you've dug on me? It's like a kind of blackmail to use my digital identity against me.

I wonder what kind of person would think that whatever I choose to write on my blog is more important than the facts, which have included things such as being in intensive care in hospital with a 50/50 chance of living or dying. Wouldn't you care about the person - i.e. me - and not about the digital identity? "Are you feeling OK because I was really worried you were going to die?" would seem like the more appropriate human response, rather than the extremely creepy and sinister "I know". I mean, what the actual fuck?

So, I've been cyberstalked, and the stalkers have caused significant harm to me. Just hearing "I know" from somebody who seems to be a respectable member of society, does show that there are some downright evil fuckers out there. However, I stand my decision to be brave and publicise who I am and what makes me tick.

In my experience, it's better to be brave and bold, even if it feels scary and nasty people try to fuck you up.

 

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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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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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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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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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Congratulations!!! YOU ARE THE MILLIONTH VISITOR TO THIS WEBSITE

5 min read

This is a story about winning a prize...

Visitor stats

This week's big climber in the UK top 40 is a new single from the National Health Service. This band has been churning out smash hits since 1948 and is loved by tens of millions of fans. Here on Top of the Pops tonight, you'll see a live performance from this sensational act. Keep watching to find out what the UK's number one hit single is, at the end of the show.

Here on this page are the dry words of a deranged individual. How will you choose to interpret them?

Language is a rather crude and imprecise tool to fully express ourselves. Ambiguity creeps in and the thoughts and feelings of the author are not communicated with high fidelity - each reader will arrive at a different impression from the text.

As a software engineer who's been building systems for some of the world's biggest companies for over 20 years, I could easily copy Uber's dastardly tactics of diverting any web requests from a certain region of the country - e.g. a specific city in the North of England - in order to display a different page.

Most of my readers are using smartphones or tablets. Readers who are using Windows XP and Internet Explorer are quite unusual, and it's easy to flag up those anomalies - they stand out in the data that I gather about my visitors.

It's not hard for tech companies and technologists to present something that has been customised and tailored for each visitor. You might think that you'd see the same Google search results as somebody else, for example, given the same search terms, but Google works very hard to identify individuals, even in their anonymised dataset.

Traditional print-media widely reports that we are living in social media bubbles, where we are fed things that we like, because we're more likely to share that content and spread it 'virally'. What is less well reported is how wedded we are to the walled gardens that we live in - Facebook, Twitter, Instagram, Snapchat et. al.

How long are you going to keep reading for? There's nearly 700,000 words here. Are you gonna read it all?

The best defence against anybody who would seek to jump to the wrong conclusions and make silly assumptions, is to present more data than can be reasonably processed - information overload - such that the farcical nature of reducing the complexities of life to some pathetic synopsis, are exposed as pure stupidity.

Of course, we would all love to feel that we understand all the laws of the universe. I've fried my mind with stacks of books and papers on theoretical physics, attempting to understand the fundamental nature of reality itself. Emotionally, I don't want to admit defeat, but digging deeper only seems to reveal even more unfathomable weirdness. Some of the quarks are called strange, charm and beauty. I love that.

Are you bored yet?

Can you not see that my intention is to create a maze of complexity that's impenetrable? It's not possible to know my mind. Even for me, I struggle to understand fully why I say and do the things I do. If it's hard for me, it's going to be impossible for you to dissect or categorise me; to judge me and to simplify me into something that can be captured by written language on a sheet of paper. What are you going to write in your report or your email?

There's mockery and disdain here, but if you dig a little deeper I hope you see that I don't have disrespect for anybody whose intention is to help and support me, and I have no intention of damaging my own treatment and recovery, nor anybody else's, nor cause any difficulty for the hard-working staff of the National Health Service and the ancillary support services.

Today, I'm a free man - an informal patient - but that puts me in an additionally vulnerable situation. I could be discharged from the hospital without a discharge plan - no place to live and no income. I'm sure some pen-pusher somewhere sees the opportunity for a quick win - am I just a statistic on a monthly report?

Tories out

It upsets me that front-line staff have been cut, while middle managers have plenty of time on their hands to justify their pointless existence. The managers have survived the cull, the pay freeze and the excessive demands placed on the over-stretched people who actually do the damn job. Police, NHS workers, teachers - to name but a few - are getting a bum rap.

The first thing that I'm excited about doing with my newfound freedom is going to a protest at Tory cuts and austerity, to co-incide with the start of the Conservative Party conference, in a certain Northern city. The establishment are coming to me, and I will thumb my nose at them and boo them. A friend suggested that I could throw eggs and if I got in trouble with the police, they'd probably just bring me back to hospital on a section 136... put that in your damn report.

"Risk to the community - possibly going to throw eggs at Theresa May, to protest against cuts to front-line services and damage to the NHS, as well as undue stress on the police and other workers who care for and protect our most vulnerable members of society".

 

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