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I'm a writer. I write about life with bipolar disorder - also known as manic depression - so my eponymous alter ego is MaNic Grant.

I've written more than 1 million words: it's the world's longest suicide note.

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Treatment

10 min read

This is a story about making people better...

Ward

I remember the days when I thought that there were magic buildings full of magic people with magic potions who could make magical things happen. I remember the days when I was naïvely optimistic about the abilities of people, institutions and organisations who make highly alluring claims: we can cure you!

If I had ruptured a major blood vessel, or my body was losing its battle against a bacterial infection, you can be damn sure that I'd want somebody to stop the bleeding or give me some antibiotics. If I had an operable cancer, you can be sure that I'd want somebody to cut it out of my body.

Some areas of medicine are comparatively new. Some areas of medicine don't have a great deal of success - the data doesn't show significantly better outcomes for patients who are treated, versus those who are untreated. Medicine is actively losing its battle to save lives in some areas, such as suicide and opioid addiction. Mental health problems and addiction have been declared medical emergencies; epidemics.

Sometimes I wonder if it's useful to think of myself as having a chronic illness, and to expect that problems are just around the corner. I can have a good day, a good week, a good month... maybe even a good year. However, it's probably dangerous to start thinking of myself as "cured" or "recovered" and begin to consider myself "normal". Complacency will no doubt lead to repetition of past mistakes, which can result in an incredibly fast chain of disastrous events, destroying every semblance of a normal life, which was so convincing that I and other people were completely convinced that I'm just another ordinary bloke... not some ticking time bomb.

I fought very hard to get treatment. There was a great deal of reluctance to diagnose me as bipolar, and there was further reluctance to treat me. I seemed very functional. My problems seemed acute. Everybody hoped that I'd go away and get better without intervention.

wanted treatment. I knew I was getting sicker. I knew that my situation was deteriorating. I could see the car crash that was about to happen.

I believed that treatment was effective.

I just had to find the right treatment.

I tried so many medicines. I also believed in the "magical healing powers" of hospitals and doctors. I was indoctrinated by the medical establishment's dogma: "we are the experts and we are the only ones who can cure you".

Of course, I'm not such a fool that I believe in alternative medicine. I critically examine all the claims of all charlatans, quacks, healers and others who promote themselves as miracle-workers. Desperate people are suckers. People are also lazy and gullible. Many of us will be scammed in our lifetimes, because we are so desperate to believe in the existence of things that are too good to be true.

It would have been good I could have avoided that period of my life when I was desperately searching to find the right specialist, hoping that a stay in hospital would be my salvation, or trying a heap of different medications in the hope that I would stumble upon the right one, but it was a necessary education. I needed to learn what was possible, and what was not possible. I needed to see with my own eyes and experience those things first-hand, to learn the limitations of psychiatric medicine.

Psychiatry is young. Mainstream psychiatry - the prescribing of psychiatric medications on a massive scale - is an experiment that's barely a few decades old, which is no time at all, when we consider that anatomical studies of the human body and surgery are parts of medicine which are hundreds of years old. The present-day situation, where at least half of us will take a pill for depression or anxiety at some point in our lives, and so many of us have been taking psychiatric medications for years and years... this would have been unthinkable before Prozac successfully normalised the practice of dispensing mind-altering drugs to tens of millions of people across the USA and Europe. Nobody really knew what the long-term consequences and long-term outcomes would be.

I've lost interest in having any contact with doctors now. I've lost interest in any new developments in the field of psychiatry. I've lost interest in the idea that there will ever be a miracle pill to cure depression, anxiety or to stabilise moods. The brain has proven a far more complex organ than the blunt instruments of psychoactive substances are able to have any precise effect on. Pills are useful for curing a bacterial infection, but they are of no use in an organ which has been evolved to specifically resist attempts to alter it - the brain's ability to maintain homeostasis is incredible, and all psychiatric medications are fundamentally flawed, because they affect a plastic organ, which can simply adapt itself and return to its original state.

Hospitals can offer welcome respite - sanctuary - from the unreasonable demands of the world. Hospitals have their place as a controlled, safe environment, full of caring people. However, psychiatric care has changed radically in the short time that we have been practicing it as a branch of medicine. Those who are ill-equipped to cope with life outside institutions cannot expect to live in an asylum forever, which might sound like a good thing for those who believe that people can be cured and rehabilitated. However, in my experience, it is the horror of the "real world" which is the very reason for the epidemic of mental health problems, and it's often infinitely preferable to protected with the safe confines of an institution than to be fending for oneself in the big wide world. The idea of losing your freedom might sound terrifying and unpleasant, but for those who are struggling to cope - struggling to be functional - freedom is a small price to pay, for the comforting reassurance of life inside an institution.

When you are a child and you hurt yourself, you run to your parents to "kiss it better" but often the injury remains painful for sometime and there is nothing that can be done to alleviate your discomfort. We learn that sticking plasters, stitches and plaster casts can help our bodies mend themselves, but there is nothing to be done to speed up the healing process. There is little that can be done to take away our pain. There is little that can be done when we are suffering mental anguish.

Although my life was very badly damaged, I'm now part of a large organisation where I'm known to a lot of people, and they'd be concerned if I went AWOL. My home city is still very new to me - and I know very few people locally - but I also think that somebody would ring my doorbell and check on me if I went AWOL. I have a routine. I have put things around myself that are structured and stable, even if that rebuilding process is very far from complete.

I've been here before... so very close to a fresh start; a complete life. About a year ago, in the blink of an eye I lost most of my new friends, my new girlfriend and my new job. The year before I nearly died, and I regained consciousness to find I'd lost my girlfriend, my home and my job. I'm aware that my life is very fragile. I'm aware that my existence is precarious.

I wrote positively yesterday about my life and how far I've come since the very deepest depths I sank to, but I know that I have a difficult job trying to stabilise myself and find a way of living my life that's sustainable, and tolerable... pleasant even, one hopes.

It's strange that I've been so much and ultimately reached the conclusion that I was doing a reasonably good job of looking after myself, but I simply had some very stressful life events to deal with. I thought that I could turn to doctors and hospitals to make me better - and indeed my life was certainly saved when my physical health was severely damaged - but now I feel much happier doing everything on my own: I prescribe my own medications, adjust my own dosages... but mainly I just try as best as I can to create a tolerable set of circumstances to allow myself to thrive; I've come to recognise that my family don't care about me and have abandoned me. I've been incredibly lucky to have very loyal, generous, kind, caring friends and wonderful girlfriends, who've believed in me, and looked after me, and stuck by me through the difficult times.

When you see the finished product - a functional man - then we might assume either that he never had any major difficulties in his life, or that treatment was a success. I'm grateful for the hard work, effort and dedication of those who work in psychiatry, but my ultimate conclusion is that it's a flawed branch of medicine. Things could have ended very badly, but those friends who bothered to come and visit me in hospital, check on me when I went AWOL, look after me when I was sick, believe in me, support me... that's the thing that was the key to giving me a chance at getting my life back. Those who've read my blog and are kind enough to reach out to me - to be in contact - have helped me to feel like I have some value, and to feel some self-esteem.

My colleagues don't know how sick I've been, and they don't know how much it means that I'm able to be treated like a normal person at work. My colleagues don't know how important it is that I have the structure and routine of office life. My colleagues don't know how great it is for my mental health to have the social interaction that we have, even if it's just office chit-chat.

We might conclude that the doctors I saw 11 years ago were right - I'm not really very sick and I'm quite capable of living a fully functional normal life - but they're also wrong, because everything had to get smashed to smithereens and rebuilt from nothing, before I could reach this point. I nearly died so many times. Was it avoidable though? Probably not.

That's my conclusion: I've learned a hell of a lot, but it would be wrong of me to start telling people that I have the answers, because what I discovered was that I had to learn everything first-hand. If I had a time machine and went back to tell myself everything I've learned up until now, I don't think I'd believe myself and I'd end up making exactly the same decisions, much like children have to make mistakes even though their parents warn them about everything and try to protect them.

Does this mean that I forgive my parents for abandoning me? Nope. If your kid is sick in hospital, you go and visit them. Period. No ifs. No buts. You don't abandon your children, no matter how old they are.

 

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Life Lived Publicly

7 min read

This is a story about open secrets...

Time to talk

A date asked me if she could read my blog. She already has enough information to be able to easily find it on Google: all you'd have to type would be "Nick bipolar blog Cardiff" and I pop up as both the 2nd and 3rd hits. I've decided to go "full disclosure" on my dating profile and tell people that I have bipolar disorder, because it's something pretty important to know about me. I also say that I write a blog and spend a lot of time on Twitter. That's quite a lot of information to give away, which easily leads to this absolute goldmine of everything you'd ever want to know about me, and a lot that you really would probably rather not know.

There's a great imbalance if somebody has access to a great big cache of totally candid and brutally honest writing, which confesses every single innermost thought, expresses every single insecurity and exposes all my vulnerabilities.

Usually, when getting to know somebody, each person reveals themselves little by little, and each person slowly forms an opinion - there's a limited amount of information available from which to form a judgement. Also, we present ourselves in either the way that we would like to be perceived, or in the way that we perceive ourselves. If we have pretentions, we present that image. If we have insecurities, we also make those known in subtle ways, or we attempt to hide them. If we wish to be insincere, we can lie and boast. If we wish for things from our past to be forgotten, we can omit those gory details from the account we tell.

Given that it is my well-practiced habit to write without self-censorship on a daily basis, and to use this blog as a coping mechanism during some very difficult times, I'm exposed in a way that most ordinary people are not. A glance at somebody's Instagram account is going to reveal very little about their state of mind. A glance at somebody's hand-picked photographs, selected to present an enviable glamorous adventurous lifestyle, does not in any way hint at what life's really like for the person who controls that account.

A glance at my blog reveals a fairly dismal picture of me at the moment. I'm quite overwhelmed with seemingly mundane things, such as administrative paperwork and other fairly simple tasks associated with getting a new home into good working order - assembling flat-pack furniture and suchlike. I complain about being single and lonely, and isolated: lacking in an adequate social life. I have also regularly mentioned suicidal ideation, usually triggered by minor inconveniences and frustration, borne of my unrealistic expectations of how quickly I should be able to restore my life to health, wealth and prosperity, complete with a new girlfriend, having only just very recently moved to a new city.

Because I never write with the mindset of "what if somebody from work or somebody who I wanted to date read this?" it means that I'm at risk of being judged harshly by people who might walk in on a particular chapter of my life and quickly gain an unflattering impression of me.

I don't write to impress work colleagues. I don't write to impress potential girlfriends. I write because writing is an integral part of my life, and writing publicly is now "normal behaviour" to me, although I'm well aware that most people wouldn't share what I share, because they'd see it as a risk to their reputation - it'd make them more vulnerable, less safe and secure, and they see privacy as something desirable.

I found privacy to be unhelpful. I found that privacy meant that nobody knew how close to suicide I was, which was a very dangerous state of affairs, and I found that privacy led to me becoming increasingly isolated and paranoid - I was terrified of anybody finding out that I was unwell, which spiralled out of control. The more I worried about people finding out that I was sick, the more sick it made me.

The answer, as it has turned out to be, was to write everything down and publish it so that anybody can read it. My illness was by no means "cured" overnight by taking that course of action, but over time, old friends and new ones have been able to engage with me and I've maintained a toe-hold in the land of the living. The most unusual thing - making my entire life an open book - has turned out to be one of the most important things to give my life stability, structure, routine and access to a vast number of supportive caring individuals, who've intervened at critical moments during the 4 years I've been writing... including one crucial moment which literally saved my life.

The question about whether I should allow prospective girlfriends to read this blog is perhaps bound up with the question about whether people who've had difficult life experiences are "broken" and are therefore "worthless". If you believe that people should suffer lifelong punishment for their mistakes, then perhaps this blog is perfect to share with prospective girlfriends, because I'd never want to date anybody who'd harshly judge me for things which happened in my past which I have no ability to change: my time machine is broken.

If anybody is looking to go digging for dirt with a negative mindset - hoping to discover that I'm a terrible person who's done terrible things - then I think that those people won't be disappointed. My behaviour has regularly fallen short of perfection and I'm deeply disappointed with things I've said and done in the past; I do carry regret and remorse; I've made innumerable mistakes.

I wonder how much I differ from, say, a man who abandoned his young children and wife to run away with a young woman who he was having an affair with - an utterly devastatingly despicable piece of behaviour, ruining innocent lives and making a mockery of solemn vows of lifelong monogamy and dedication to a spouse, plus the dereliction of dutiful responsibilities - versus my mistakes which bear no such hallmark of obnoxiousness. Yes, I've caused a great deal of distress during times when I was extremely sick, but I assure you that no amount of digging will unearth evidence that I'm some kind of selfish evil man, lacking in empathy and remorse. In fact, a thorough reading of my blog reveals that I often reflect upon events from my past and wish that I had acted differently, and I am critical of my own behaviour, attempting to acknowledge my own flaws and spot common mistakes, so that I might learn from them.

This is a highly defensive piece, but it's a highly stressful time. My job is going very well and I would dearly love to start another relationship. Having this vulnerability - in the guise of this blog - is highly inadvisable, but I'm loath to bury it, given how important it is to me as a coping mechanism and a way to keep concerned friends informed of my state of mind.

I might write another synopsis of "the story so far" for those who are dipping in for the first time, because it upsets me that it's impossible to see the bigger picture without reading approximately 1.1 million words, and I don't like the idea of being judged on a handful of skim-read recent blog posts, mostly complaining about mundane and trivial matters.

Of course, none of us wants to be misunderstood, and my writing is perhaps the most desperate attempt to avoid that situation, given that I've felt so close to death for so long. However, ironically, it's pretty damn hard to get to know me - to understand me - because I've written so much and for so long.

If you've read as far as this point, what can I say? Thank you. The comfort I get from knowing that my thoughts and feelings are not trapped inside my body, unseen, is immeasurably valuable to me.

 

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After The Mania, Regret

8 min read

This is a story about the consequences of a mood disorder...

Bipolar memory

Having had a mood disorder - bipolar - all my life, with its symptoms perhaps becoming indisputably obvious from adolescence onwards, I've had a lot of time to reflect upon the regrettable consequences of things that I said and did when I was experiencing hypomania or mania.

As a child I had little opportunity to do anything which had any particularly negative consequences. I took risks I suppose and I established a pattern of frenzied activity followed by melancholic lethargy. The intensity of my early hypomania was triggered by the rare event of being able to spend time with friends, when so much of my childhood was spent bored while my parents took drugs and got drunk. The excitement of escaping the boredom and oppression of being trapped in a house or a car with drugged-up or drunk dribbling morons, was so great that I would talk rapidly, be unable to sleep and I exuded so much energy that my friends and their parents were alarmed by this behaviour, which was uncharacteristic of how I acted at school, for example.

School terms were long and they were unbearable. For whatever reason, I was bullied constantly. School was something to be endured and I treated it in very much the same way that I treated my parents' negligence - I lived inside my own head, bored but attempting to entertain myself with my own imagination. I was incredibly patient, given the unpleasantness of my school days and the time I was forced to spend with my parents, who were so incredibly selfish that they destroyed most chances I would've had to form meaningful long-lasting friendships. Every school holiday, and indeed many weeks and months of term-time, my parents would remove me from the company of my peers, because they wanted to get drunk and take drugs in an isolated rural location, where they thought they would be safe from the criticism which they would draw for the neglect they were showing me; they attempted to hide their disgusting disgraceful behaviour.

My parents' folie-a-deux, which I see now was a toxic co-dependency, motivated by their addiction to alcohol and drugs, was clearly very formative and shaped my character. I became a patient plotter, who could put myself into a trancelike disconnected state to endure the interminable boredom of being trapped with a pair of dribbling moronic drug addict drunks, with no friends to play with - deliberately isolated from my peers.

This is why I do not celebrate mothers' day - because my mother is nothing more than an alcoholic drug addict with bad taste in men, and I wish I had never been born.

Luckily, modern society reveres those who have bipolar tendencies. How would anybody be expected to pass their school examinations, university finals or write a dissertation, unless they were able to cram and work hard in short and intense periods, having the academic holidays to then collapse on the brink of a nervous breakdown, to recover? How would anybody be expected to undergo the the awfulness of attempting to get a foot on the first rung of the career ladder, and the dreadfulness of the 9 to 5 office grind, unless they could muster the manic energy to be enthusiastic in numerous interviews where you're expected to lie about how excited you'd be to join Acme Corporation and their widget manufacturing business? How can you get ahead in your career, when you are so thwarted by your colleagues and the dreadful bureaucratic nature of organisations - with their "can don't" attitude - except by having periods of intense focus and effort, which no stable level-headed person would ever undertake in their right mind? How could you quit your job, start a company and make it successful, unless you had some kind of screw loose, which drives you to work 100+ hours a week and not give up on something until the results are delivered?

Nobody much cares about the periods of depression that regularly occur in the life of a person with bipolar disorder, because we celebrate achievements and we hide our failures. We pretend that we never screwed up. We pretend that we never got sick. According to our CVs and our LinkedIn pages, we are perfect infallible human beings, who are completely flawless. Because people with bipolar disorder regularly have episodes of hypomania or mania which are full of boundless creative energy, they have an impressive list of achievements under their belt. Nobody ever lists their depressions on their CV or LinkedIn.

Moving house and breaking up with my last girlfriend has left me exhausted and all alone in a new city. I have a work colleague who is reasonably friendly, but a very busy family man, and I have met one new friend, although they don't live very nearby. It's hard to describe how lonely and isolated I am - physically - because few people ever reach this point in their life without taking some kind of evasive action. It's very unnatural for humans to go to strange places and leave themselves totally cut off from social contact, beyond the minimum necessary to get money and buy food.

The flurry of activity which pre-dated me moving house was prompted by stress, and it contributed to the exhaustion and depression I'm feeling now. Also, I feel embarrassed that my grand plans to work on projects presently lie abandoned and the people who I was in contact with have been neglected for quite some time. It's very damaging to my self-esteem to know that my behaviour is so conspicuously unpredictable and unreliable, which leads people to believe that there's little value in the investment of a deeper and more meaningful friendship. When I crash, I cannot face the pressure of maintaining contact, so I disappear and I'm overwhelmed with guilt over the people and projects which are being neglected.

Sometimes, mania prompts me to say regrettable things. I particularly use Facebook as a 'safe space' to rant when I'm struggling with my mental health, because at least it keeps my regrettable words contained in a place where they're not publicly accessible. My friends can respond and calm me down, and I'm not left scrabbling to delete things which were inadvisable to write and publish publicly. My friends - if they're real friends - would take my words with a pinch of salt and not unduly categorise me as a madman and a lost cause.

It's deeply worrisome, knowing that my mental health can collapse and I can act regrettably. It's an unsettling and insecure state of affairs, knowing that I could easily destroy the good reputation I have and the respect of my colleagues, if I was to show a little bit too much of my illness. I keep things relatively neatly partitioned: my blog is where I write honestly, but always mindful that my words are subject to public scrutiny. Facebook is where I write things which are almost always a cry for help, or in some way symptomatic of the very bad mental health problems I'm dealing with. Work is where I spend a great deal of effort "acting normal" and attempting to show a reliable consistent side of myself, despite dreadful inner turmoil and very difficult events in my personal life.

One might say that this entire blog is regrettable, given that it's easily discoverable by my work colleagues, but I do not speak ill of anybody or the organisations I'm involved with, and I do not bring my profession into disrepute - I think that my conduct is perfectly acceptable, and I'm prepared to defend it on the grounds that I find it immensely therapeutic to have this outlet, and the support of people who are kind enough to read my words and send me kind messages.

I have a lot of regret. I admit that I could have made much better choices in a lot of situations. I don't hide behind my mental illness as an excuse. I'm perfectly capable of accepting that my behaviour has been regrettable and that I should have handled things differently.

Why then continue to write like this? The answer is complicated: I have no idea what would happen if I didn't have this single thread of consistency in my life. Rightly or wrongly, I credit this blog with bringing me things which have saved my life: my guardian angel, the people who got the emergency services to save my life during my most recent suicide attempt, the family who looked after me when I was jobless and homeless, and some of the friends who I speak to on a regular basis, who all only know me because I put myself out into the public domain - they reached out to me and rescued me, in their own ways.

 

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Indoor Voice

6 min read

This is a story about shouting...

Dafodils

I find myself in the thick of the action at work and I'm failing to keep my head down and my mouth shut. It would be better if I gave my opinion quietly and infrequently, after much careful consideration, but instead I shoot from the hip and engage my mouth before my brain. Most of what I say has a solid basis and imparts some useful expertise, but it would be better if my voice wasn't so often ringing out loudly across the open-plan office.

I'm not sure how received I am. I'm loud, outspoken, quick to respond, decisive, but I'm also like a flame sucking all the oxygen out of the room. I wonder how little room I'm leaving for other people.

I know that I'm not a bad manager - I'm not prone to micromanaging people or being too fussy about the details, such that there's no room for my underlings to think for themselves - but I wonder if I'm a bad team member at times. I know that I'm patient and forgiving with junior members of the team and I invest a huge amount of time in knowledge sharing and training, to help them, but I'm pretty scathing with my words when I see bad quality work done by people who call themselves fully trained and experience professionals. I sometimes wonder what my colleagues do with all their time - how do they entertain themselves if they're not busy?

I often wonder who has the right approach: my colleagues who don't do much so that their projects are never completed, or me finishing projects early? My colleagues would argue that you can make yourself redundant if you do a good job and finish your project to a high standard, such that it doesn't need much more ongoing work to maintain it. I would argue that you're not a good engineer if you never finish a project.

I went home yesterday feeling as though I'd been too outspoken and that I should apologise to one of my colleagues. My brain was badly affected by anxiety and flooded with thoughts about myriad things which needed considering. I bombarded my colleagues with a whole host of things to consider, which probably overwhelmed them and I certainly didn't make a single clear and concise point - I simply couldn't stop words from spilling out of my mouth.

This week, some ideas that I've been nursing for 6 months are coming together. A piece of work that I did in a flurry of manic activity is taking shape as something tangible, just the way I had planned it would. It seems unusual that I should have done all the hard work so long ago and then rested on my laurels, but I needed to have a holiday and move house, which were a huge distraction. The festive season is a bad time to try and do anything important. As it happens, the timing has worked out perfectly, although I have been very bored at times this year.

Having sat quietly at my desk for a very long time, thinking, I now find that I struggle to regulate the volume of my voice. I struggle to hold back in meetings. I struggle to remain quiet for the benefit of the whole team. I'm struggling not to be loud and overbearing.

I would be well advised to put my headphones in and confine myself to my own thoughts for a few days, to give my colleagues a break from the sound of my voice. It would be a good idea to make a promise to myself to say nothing in meetings, except the very bare minimum required, to make a bit more space for my colleagues. I'm like a liquid poured into a mould, filling every square inch of space and leaving no air pockets.

Having unmedicated bipolar disorder in an office environment is problematic. I trample on toes and speak too much, too loudly. I must be very annoying.

I'm aware that I can get carried away with my productivity and ability to solve hard problems, and I can start to see other people as deadweight, which can lead me to saying unkind things and being very rude and dismissive. I forget that people take pride in their work - even if it's rubbish - and can be offended when I bulldoze my way straight through it inconsiderately, in pursuit of my goals. I'm aware that my future employment depends on playing nice with others, and I should calm myself down during these periods of mania-like frenetic activity.

I forget that I'm no longer managing huge teams all across the world. I forget that I'm no longer CEO of a startup that I founded. I forget that I'm no longer the boss, but in fact I'm a consultant who's been hired for my expertise and opinions, which need to be tactfully given to the client. I forget I'm not in charge of the project. Often, my loud authoritative voice can lead to people getting into the habit of looking to me for leadership, when I'm not in charge of anything, which is a mistake on my part, because my strength is in my knowledge and experience, and my ability to solve hard problems - it's not my job to lead the team, but I always find myself naturally providing some degree of leadership, although I don't actively seek to gain power and control.

It's strange. Sometimes people are very relieved to have me working on their project, because I always have a clear sense of direction and I provide a reassuring level of seniority - people trust that I know what I'm doing - but I continuously jeopardise my job by doing things which could very badly backfire if they didn't work.

I have a colleague who's close to retirement who's been hired to do pretty much the same job as me. We couldn't be more different. He spends his days listening to the radio and reading the news. I think there's a lot I could learn from him about plodding along as slow as possible, without getting sacked. Sometimes I find the attitude to be loathsome, but what's the real harm in it - isn't he getting a lot better deal out of life than I am? What use is all my hard work? What good will it do?

I need to calm down. Arrogance will flare up and I'll start being disrespectful to people, and that will be the beginning of the end.

 

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Antipsychiatry

5 min read

This is a story about refusing help...

Pharmacy

If you spend enough time with general practitioners, general psychiatrists, specialist consultant psychiatrists, registered mental nurses, specialty doctors and all the very many other mental health professionals who are part of inpatient and outpatient clinics, community mental health teams, crisis teams and all the other apparatus which is supposed to treat mental health problems, one begins to realise a rather unsettling truth: there aren't very many treatments and they don't work very well.

Psychiatry is a young branch of medicine and it doesn't have a lot to crow about. Since the days of asylums and lobotomies, psychiatry has been dogged by scandals, including the extrapyramidal side effects of medications which have left patients with lifelong irreversible unpleasant problems. The data do not show encouraging outcomes. In fact the outlook is dismal and appears to be worsening as the toxic conditions which create mental health problems, seem to be intensifying. Rates of depression, anxiety, eating disorders, OCD, autistic spectrum disorders, attention deficit and hyperactivity... these are all soaring. Treatments are not effective and vast numbers of people are condemned to suffer with their illnesses AND the side effects of the medications.

I've been lucky enough to have access to private medical care, at times, and even with the very best professionals and medications, there is not a vast difference between what's available from the public healthcare system. It's all pretty crap and it doesn't work very well.

This is not a damning indictment of those who dedicate their lives to trying to treat mental illness, but simply a cold hard rational analysis of the facts.

The conclusion I've reached has been that there's an over-medicalisation of non-medical problems. The bulk of my problems have stemmed from the collapse of my relationships. I got divorced. I am estranged from my family. I've been forced to move to cities where I have no friends - no social support network - in order to work jobs which have been unsuitable for my health. I have the enormous pressure of having to work full-time, to pay rent, bills and service enormous debts, which is unbearable for a person who's having a crisis.

My mental health would be vastly improved if I had a partner, a social support network of local friends, financial and housing security and a job with reduced hours, until this crisis is resolved. Healthy diet, sleep hygiene, exercise, sex, physical affection, sunlight, fresh air, social contact, hobbies and interests... these things are all essential for human wellbeing. None of those things can be prescribed by a doctor.

During the worst days of my addiction and rough sleeping, I noticed that my fellow homeless alcoholics and addicts were not without some routine and social lives. Romantic relationships are not the exclusive preserve of those who live in houses and have jobs. The life of a homeless drug addict might be chaotic to the outside observer, but a less prejudiced analysis reveals no less structure, no less need for comfort, no less humanity. Those who have fallen into habits of addiction and homelessness might find the community of drug addicts, alcoholics and homeless to provide the social support network and sense of community, which they'd struggle to find living anonymously behind a front door.

Does anybody really know I'm here... in this house... in this city? In many ways I have found my contact with hospitals and the police to be of great comfort. I have found the nonjudgemental members of the NHS and police force to be incredibly kind and compassionate people. It's nonsensical, but I've been happy to be hospitalised or arrested. I've been happy to be in a cell or on a hospital ward, with somebody checking on my welfare. Behind my own front door I could be hanging by the neck, dead, and nobody would discover me for days or maybe even weeks.

My problems are mainly attributable to unmet basic needs: hugs, face-to-face conversation and a sense of belonging.

Because of the obvious things which need to be fixed in my life, it seems wrong to seek medical help, when my mood could be radically different if all the broken things were fixed. It might sound like a fun adventure, going to new cities, but the reality is very miserable and lonely. The reality of my present life is that I don't pick up the phone to speak to anybody when I'm feeling dangerously depressed - who would I phone? What would they do? It's not like anybody can nip round to check I'm OK.

Humans are social creatures, but I live on the periphery. I live on the periphery of life itself, always in danger of death or medical emergency. The state of being suicidal should be considered a medical emergency, especially in men of age 20 to 40, where suicide is the biggest cause of death. My perception of the danger is not warped, given my history of suicide attempts and hospitalisations.

There isn't a pill or some psychological therapy which would be effective... especially not when so much of my life is broken. It's not a medical problem. Sure, I have an underlying mood disorder, but the highs and lows of bipolar don't make me as unhappy as my social isolation does.

How I set about fixing things, I have no idea. The task seems insurmountable.

 

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Waiting Game

7 min read

This is a story about biding your time...

Dehydrator

One of my favourite things to make and eat is beef jerky or biltong. Mixing a marinade, lovingly covering the meat and then slowly drying it is something which can take 30 hours or more. The smell is quite tantalising throughout the process, but there's no short-cut to the end. If the beef is marinated for less time, it will be less flavoursome. If the beef is dried too quickly it will be cooked instead of dehydrated, and it will be brittle, not chewy.

My life has become a game of waiting. I'm paid for my attendance, not my contribution. I'm paid to be present, but also paid to be quiet. The more I'm present and the quieter I am, the greater my financial reward, but it's pretty unbearable. I literally just have to watch the clock and think of the money. If I tried to make myself useful, people wouldn't like it and it would cause problems.

The situation is ridiculous, because even a small child could see that I don't have to do anything and I will be handsomely rewarded with desirable things, such as cash, houses, cars, holidays, clothes, gadgets and suchlike. It's very easy to extrapolate and say that it's almost inevitable that I'm going to earn a staggering amount of money, for doing almost absolutely nothing.

The situation is hard to handle. I can see every single step in-between here and the 'finishing line'. It's as if there's a well-lit staircase that leads to the top of Mount Everest, and I know exactly how many steps there are, and also that theoretically my body is capable of climbing that many steps, but it's psychologically distressing to know exactly how many steps there are between me and the summit. Sometimes it's not a good thing to know the way. Sometimes it's not a good thing to be so aware of the journey ahead.

I'm aware that human bodies only last a finite amount of time before they fail. I can comprehend the number of sleeps that I have left before I expire from old age. A friend pointed out that 9 years is 108 months, which seemed like an interesting way to break down a decade - making it more bite-size - but the idea of living for another decade is not inviting to me. Getting to the end of this month will be an achievement.

My perception of time is warped. My sense of boredom is heightened. My attention span is ruined. I feel anxious all the time. I have terrible anhedonia.

Life's not very liveable but life must go on. I have to choose between the rat race and the endless exertion to keep my head above water, or else I will be turfed out onto the streets and will have to live a pitiful life of begging and sleeping rough.

My thoughts turn to suicide often.

Suicide is the obvious choice, because it ends the struggle completely. No more anxious waiting. No more slow plodding towards the inevitable. No more unpleasantness.

I'm aware that I'm frustratingly close to a major breakthrough. I'm aware that I've rebuilt myself fairly miraculously and I'm a completely different person from the junkie I was 2 years ago. It seems brutal that I would lose the love of my life, lose my amazing apartment, be forced out of the city I called home and end up attempting suicide, only to end up surviving and clawing my way back from almost-certain bankruptcy, only to give up at the point I was at break-even. It seems ludicrous that I'd claw my way back from so-called "rock bottom" and then decide that it wasn't worth it, except to die with a bit more pride and dignity.

I was chatting to a friend and we wondered whether we had screwed up our brains and our bodies too badly to ever recover. We both reported feeling a lot of physical discomfort and health problems, as well as terrible depression and anxiety. Ironically, he has all the things that I think I want: a girlfriend, hot weather and freedom from the rat race. The thing we have in common is bipolar disorder and substance abuse, so perhaps the evidence is pretty clear - drugs will mess you up and leave you in a miserable state.

The annoying thing is that my life isn't filled with drug abuse. My life is filled with 9 to 5 Monday to Friday commuting and office routine. My life is filled with paying rent and bills. My life is filled with supermarket shopping and doing laundry. My life is filled with mountains of paperwork. I've been well-behaved and I've made healthy choices, but it hasn't made any difference - I'm still depressed.

I suppose my depression can be explained away by events such as a breakup and a lot of stress - moving house - as well as the sustained problems I've faced in the past years, as I've attempted to restore my health and my wealth. It's hard not to lose patience though. It's hard not to give up, given the sustained effort that has been required to get where I am, and the way I feel at the end of it all.

After all the effort and the uncertainty and the horrible things I've had to endure, when I think "was it worth it?" I'm not sure that it was. In fact, I'm pretty certain that I wish I hadn't bothered. I'm pretty certain that I'd like for the pain and suffering to end sooner, rather than later. I cannot see any reason to carry on, when the reward is only more pain and suffering.

I'm kinda worried about keeping myself safe. I started thinking about places in my house where I could hang myself. I started thinking about cutting some major blood vessels in the bath. I started thinking about obtaining highly toxic poisons from the internet. I started thinking about practical considerations, such as the effect on my sister.

It's not good when a considerable part of your waking day is spent thinking about ending your own life.

I'm aware that I've probably unbalanced my delicate brain chemistry, through stressful events as well as medications. I binged on some pills. I self-medicate with other pills. The demands placed upon me by moving house and working a stressful job have driven me to feel suicidal before. I don't have any friends in the city where I live. These things are not conducive to good mental health.

I know that if I keep forcing myself to go to the office, my bank balance will continue to improve, which opens up a whole world of possibilities and reduces the amount of stress and pressure in my life. I know that as long as I stay alive, the days are getting longer, the nights are getting shorter and the weather is improving. I know that depression doesn't last forever. I know that anxiety has only ever come into my life as a result of abusing alcohol and benzodiazepines. I know these things, but it doesn't make the present day any more bearable.

There's no way to hurry things along. I either have to wait, or kill myself.

 

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I Like Taking Taxis

4 min read

This is a story about being unintelligent...

Taxi

I like eating in expensive restaurant. I like flying business class. I like staying in luxury hotels. I like not checking my bank balance; not budgeting.

What gives me the right to live so lavishly?

My grip on reality is tenuous. My sanity is questionable. I certainly have no certification to 'prove' my intellect. My curriculum vitae hides the truth of the past 6 years of my life, because I was wily enough to start a company to paper over any cracks, but closer scrutiny would reveal lots of gaps.

I should be penniless scum, abandoned by society and left to rot in the gutter.

Certainly, I've survived the unsurvivable because I'm creditworthy and I've borrowed, in order to maintain a certain standard of living. No grotty bedsit for me. No squat with newspaper covering the windows and a filthy mattress on the floor. If I've decided that I'm going to work hard and attempt to rescue myself from certain bankruptcy and destitution, then I've always demanded to have a nice place to live.

It seems spoiled and entitled.

To me, I simply can't see the point in existing in a miserable state. What's the point of being alive if it's going to be so lacking in dignity? Sure, plenty of people live in dire poverty and they go about their business quietly and without complaint. Good for them. That's not for me.

It seems like an unreasonable expectation. Why should somebody who's so heavily indebted be allowed to never check their bank balance and enjoy a high standard of living? Why should somebody who's had problems with addiction, alcoholism and mental health be allowed to have lovely holidays, live in a big house and generally spend money with gay abandon?

I have complete irreverence for money.

Money answers none of the big philosophical questions, such as: why are we here? Money contributes nothing to our fundamental understanding of the universe. Money does not figure in the big picture. Money is not even a rounding error. Money is simply an absurd transient concept, amongst a transient society of a transient species. Money is nothing in the face of death.

I suppose that's the root of my views on money - that I've faced death so many times that I have no fear of running out of money. Money is simply invented out of thin air, and is something to be laughed at as ridiculous, but death is widely regarded as a permanent and irreversible state. Why should I fear running out of money when I can always go and get some more? I can pluck money out of thin air, because it's just a fabricated human construct. Death however, is something which has certainly proven fatal to more than 100 billion souls thus far, so it deserves a certain amount of respect.

It's because I value life and respect death, that money is an irrelevance. It would have been nice to embed myself in an academic institution, where my mind could have been occupied with silly puzzles and other trivial things. I could have busied myself telling a captive audience of children incorrect things, with an air of authority. Instead I have embedded myself in massive organisations, who remunerate me excessively to compensate for the absurdity of the so-called 'work' they ask me to do. I'm paid to be bored and unfulfilled - living an inauthentic life - so my compensation is to be able to do enviable things and live relatively unconcerned with financial matters.

As you might imagine, recovering from debt, mental illness and addiction is not quick and easy. We are quick to write people off, because of the vast amount of time and money required for a person to recover. We think that junkies - in particular - are no-hopers who will not be able to overcome the adversity they face, in order to return to a normal life.

I don't want a normal life.

I had a good life before and I want to have a good life again. I'm not going to settle for simply being alive. I want it all. I want everything.

 

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Lightning Rod

6 min read

This is a story about empathy...

Clouds

I sometimes wonder whether I caused myself some long-term health damage by taking ecstasy tablets - MDMA - every weekend for approximately 18 months, when I was in my late teens. I think that whether it did or didn't affect my neurological development, it certainly affected my personality and outlook; my approach to dealing with other people. I've adopted my attitude towards openness and honesty as a response to the empathy and trust I felt, due to the effect of mind-altering substances. I liked connecting with people at a very profoundly open and unguarded level. I liked putting my faith in humans and assuming that nobody wanted to hurt me.

The net result in later adulthood has been a rather extreme set of values, by which I live my life. I've always favoured trust and a kind of blind faith that nobody's going to screw me over. Throughout my twenties and thirties, I've always had a belief that I don't need to bother protecting myself.

It seems as if I made a decision about what's important and what isn't important. Like, I spend very little time deliberating over how to save a few pennies buying a particular food item. I spend very little time doing my taxes and other administrative tasks. I spend very little time on anything which doesn't have a significant purpose. I don't understand why people spend such an extraordinary amount of time doing things which are unpaid, unprofitable and are simply busywork.

I flit between two modes: hyper-focussed, or incredibly bored and distracted. When I'm in the latter mode I feel hyper-receptive to current affairs. I feel as though world events are far more important than any of the daily nonsense in my life. I struggle to reconcile the absurdity of capitalism, rent, money, jobs and other trifling things, with climate change and the billions of people who are hungry. Entire days or weeks disappear and I seem to have done nothing more than become engrossed in the news, angered and saddened.

The circumstances of my adult life have mostly sidelined me, with me helplessly spectating from my comfortable office. However, I'm acutely aware that my position in some very large organisations means that I'm complicit in the suffering that I see. I know exactly how close I've been to the epicentre of seismic world events, which have been catastrophic for humanity.

I suppose that the physical damage that I've wrought, through pollution and war, is hard to connect with my day job, but it's not hard to see that I've been very close to the money, which has greased the wheels of capitalism. The nature of my crimes against humanity are so hard to explain and esoteric that it would be easy for me to let myself off the hook, but if ever there was a case of a global conspiracy, it would be my participation in the brain-drain which is global technology, and its abuse as a mechanism of enslaving everyone.

It seems harmless enough, all this geek stuff, but then I see the dreadful things which the internet has inspired people to do. I read the dreadful things people write and share with each other. I read the dreadful ideologies and manifestos of dreadful people. I see how the internet has connected dreadful people together, amplifying their dreadfulness.

"Guns don't kill people, people do" goes a popular slogan, but it's not true... the people who make guns are just as culpable as the people who use them. The same has got to be said of social media influencers and the platforms they use. What started as a network for academics to share research has been invaded by the masses, and they're not interested in improving their minds: they're vile hateful people who gang together with like-minded dreadful shits.

The internet has become highly efficient at refining both the best and the worst ideas. The most depraved and disgusting things exist and thrive on the internet in frighteningly huge numbers. The internet has turned one person's subconscious bad thought, which lived safely in their brain, into a collective thought which is broadcast across the globe. It's strange saying this as a libertarian left-leaning engineer, but I kinda feel like humanity is not mature enough to have the internet.

I'm very well aware that my sanity has been very questionable during the last 6 years and my grip on reality is probably tenuous at best. I'm very well aware that my mental illness means I must surely think more like a terrorist or some other enemy of society, than I do like a regular person. I read about the world's worst monsters and I check myself for similarities: delusions of grandeur, paranoia and irrational hatred of certain groups of people.

I groan and hold my face in my hands when I remember things I've said and done. I know that I've been through some periods when I was ranting and raving about things. I know that my thoughts were an incoherent jumbled mess at times. I know that during very bad episodes of mental health problems, I've struggled with delusions of grandeur and paranoia. I can remember it all very clearly and I'm very embarrassed by my own behaviour.

Today, I blend it fairly well with ordinary society. My colleagues at the office seem to have readily accepted me as 'normal'. A substantial number of people deal with me and find my behaviour to be normal.

Internally, I find it hard to process everything. My brain mostly screams that I should be doing something - anything - in reaction to the world I observe all around me, but I deliberately subdue my instincts because I've learned that if I keep still and keep my mouth shut, vast wealth floods into my pockets. I'm essentially bribed into knowingly participating in the maintenance of the status quo.

It's quite hard to sit and read the news and not react.

 

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Historically March Has Been A Terrible Month For Me

3 min read

This is a story about social media memories...

Clock tower

Facebook provides an "on this day" feature, which reminds me that March has been afflicted with madness and sadness for more years than I care to remember. I'm horribly affected by seasonal depression and I think March is the worst month of all, because it's long, dark, cold and the weather is terrible. At least in April the clocks have sprung forward. At least in April, the first pleasant month of the year - May - is within sight.

I was trying to remember what the earliest point in any year was, where I'd regained control of my sanity and been working. With the exception of the current 15-month long streak, it hasn't been earlier than May that I've managed to get myself into gainful employment and start repairing my life, and it's been as late as October and even December, which has proven pretty disastrous for my finances.

It might sound pretty incredible that I could lose my mind in one winter - usually around Christmas time - and not work until the following autumn. My life is incredibly cyclical and part of that cycle is rescuing myself from the brink of disaster. Because of my creditworthiness, I simply sink into debt, then dig myself out of the hole when my mind is more amenable to being in the workplace.

I'm pretty sick of the boom and bust, hence resolving to dig myself out of debt once and for all. I'm sick of having debt hanging around, threatening to destroy me. I'm sick of working hard, mainly to line the pockets of my creditors.

Last year was compromised because my summer was ruined, but since then I haven't got much to complain about. I managed to have two very nice holidays. If I play my cards right I can have a nice summer holiday this year and enter the autumn in a financially strong position. I had imagined that my woes would be behind me now, but I've had to balance the reality of the daily slog - commuting etc. - with the desire to get out of debt as quickly as possible. I could have lived on dry bread, tap water and lived in a hovel, but I think that would have been unbearable.

I realise that I consider this to be my sixth consecutive terrible year, but my life hasn't been anywhere near simple enough to reduce to that level. In fact, 2016 very nearly worked out for me. I'm kinda having another attempt at 2016, but hopefully not repeating the same mistakes. Every year has had a terrible winter and spring, followed by an autumn period which has been much more promising.

This year is unique, in that it started with an awesome holiday and the period that threatened to plunge me back into disaster and despair was quite short-lived. I've already managed to fend off a breakup, a house move and some brain chemistry problems, which all could have been terminal for my dreams of achieving stability, security and happiness.

I don't want to jinx it, but this year is going far better than any previous year, all things considered.

 

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Being Single Is Not Good

5 min read

This is a story about fulfilment...

Fire exit

I enjoy watching feature-length documentaries. I enjoy watching entire series in 20-hour-long Netflix marathons. I spend a great deal of time carefully choosing how I'm going to spend my waking hours. I refuse to watch a movie that's rated less than 7.0 on IMDB. Life's too short for compromises on such things.

On the other hand, I'm a realist. I mostly prefer a stable secure settled life to one where I'm constantly striving to trade up. I've ended up settling for relationships which have seemed at the time to be marginally better than being single. I've ended up putting up with pretty bad relationships, for the sake of security.

My relationships don't tend to end with a smooth parting of ways. Because I'm kind of a stubborn and frustratingly patient person, my relationships end when my mental health stability ends. It seems like only an episode of mental illness is enough for me to make necessary changes to my life - to break up and move on from relationships which are holding me back.

Of course, I admit that I'm 50% of the blame in any bad relationship scenario. I admit that if a relationship is unsuitable and it's going to end eventually, I'm holding back the other person as much as they're holding me back.

My dating process is not very refined.

I usually start from a position of panic. I usually start dating with somewhat of a campaign mentality. Singledom is something I see as a condition to be conquered and I will exhaust all avenues until my single status is subdued. I view the process of going from being single to being in a relationship as a journey which should be as short and direct as possible. I view the dating process as immensely stressful and unpleasant, and something that should last as little time as possible.

As a person with a mood disorder - bipolar - I can leverage my manic energy to achieve goals. Finding a girlfriend is just another goal with a number of prerequisite steps. It's a numbers game.

I'm not very sentimental about dating.

In fact, I'm probably a terrible human being.

There might be some underlying misogyny which drives my thoughts and behaviour. What can be said for certain is that I really don't like feeling insecure. I really don't enjoy any of the flirtation or "do they like me?" uncertainty. I view all of the preamble as thoroughly unpleasant. I want to travel from the uncertain to the certain as quickly as possible.

My life at the moment is pretty simple. Work the job, get the money, spend the money. I earn more than I spend and my job is pretty easy. I have everything I need.

I examine my thoughts regularly for any sign of entitlement or other worrying sentiments. I wonder how I really feel about the opposite sex. I wonder if I'm a bad person. I'm pretty sure I am a bad person, but I'm a product of my environment, and I'm under a lot of pressure. Pressure is a bad thing. Pressure brings out the worst in people.

I look at my friends as a reference point, and there's a mix of friends who would very much like to have a life partner, but haven't yet managed to meet that special somebody - perhaps somewhat involuntarily single - and some who have experienced a string of relationships. Nobody stands out as a fine example of somebody who's got their life perfectly right - every relationship, or absence of relationship, looks to contain a certain amount of unhappiness.

I look at my current situation: I have traded history, art, culture and food for being able to live in a big house and drive to work. I have swapped a city which made me feel at home, the more I wandered around it, for a city which makes me feel disorientated and bewildered, despite it being much smaller.

My life situation - being 39 years old and not having much to show for it - feels deeply shameful and as though I'm a failure, here in this place which places such import on owning a house and a new car. My ephemeral achievements count for nothing in this place of mortgages and car loans. I'm plunged back into the insecurity of my teens, when having a flash car was an obsession, because it seemed to be the route to getting the girl.

I can't tell whether I make things happen in my life, or whether things just fall into my lap. In fact, all of my experiences seem to suggest that things just fall into my lap more often than I make things happen. I always seem to get what I want.

Then I screw everything up.

Boom and bust. This is my life. This is bipolar.

 

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