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3 Graphs: My Mental Health

5 min read

This is a story about ups & downs...

Bipolar II

I used to quite enjoy my hypomanic episodes. I haven't had one for over 8 months though, and I'm beginning to miss the energy, focus, enthusiasm, fast-paced thinking, creativity and passion for something, anything.

When I average out the amount of time that I would spend hypomanic versus the amount of time I would spend depressed, you'd think that it's something you wouldn't want, because my episodes of depression were always far longer than my episodes of hypomania. However, I never wanted to give up those hypomanic highs, even though my episodes of depression have been brutal and I've nearly taken my own life.

Some people ask me "aren't you just experiencing what every human experiences? Joy and sadness?". Here is a graph that kinda explains the difference between Bipolar and 'normal':

Normal mental health

Do you see much difference?

The first thing I should draw your attention to is the range. The red line never reaches the dotted line that signifies hypomania and depression. In any given moment, you might be happy that your sports team just won a game, or you might be sad because somebody ate all the cakes, but this is a normal range of moods. In normal life, you're not spending every cent in your bank balance, taking crazy risks and undertaking insane projects at breakneck speed. In normal life, you're not unable to work or socialise, and on the brink of suicide.

The second thing that I should draw your attention to is the irregularity of it. It's unpredictable, because it's dictated by external events. Who knows when a friend is unexpectedly going to drop by and say "Hi!" which will lift your mood. Who knows when your boss is going to say something's wrong with your work, which will make you upset. These events are unpredictable, because they come from the world at large, which is also unpredictable. This is normal life. Normal life is unpredictable and exciting.

With my Bipolar II, I know that every episode of hypomania is going to be followed by a crash. I know that my hypomania is going to last a few weeks, maybe a month and a bit. I know that my depression is going to last anywhere between 6 weeks and 6 months. These episodes are monotonous. Sure, good stuff and bad stuff happens during those episodes, but it does little to affect my prevailing mood.

This year I seem to have had the longest depression of my life. It's given me somewhat of an appreciation for what it must be like for people with Unipolar Depression. Here is a graph of what my life looks like at the moment:

Unipolar Depression

Looks pretty bleak, doesn't it? Unrelenting depression, and only very brief moments where I feel OK. Look how sharp those spikes are. Surely my life can't be that bad?

Well, look at it in these terms: we are now in July. That means that in 2016, I have had 7 months of this shitty feeling. January to April, it was understandable that I was depressed, right, because it was shitty winter, I was unemployed and I was stressed about running out of money and being evicted out of my apartment onto the streets. You can surely empathise with that situation, and agree that it would be pretty depressing?

So what about May, June and July? Well, I've been working a job that I took out of desperation. My mental health really does not permit me to be working a shit job full time, because I'm exhausted and demotivated, due to the aforementioned depression. But what about all that cash I'm earning? Shouldn't I be happy - glad - to have a job again?

Well, I'm working to replenish my savings. I'm working to pay off debts that I ran up when I was unable to work. I'm working to literally stand still.

But what about fun time?

Well, look at it this way. There are 120 hours in the working week. Let's look at my lunch hour: that's about 4% of the time. So, 96% of the working week is not lunch hour. Another way of looking at it is Saturdays. Saturday is the only day of the week where I'm not working or anxious about going back to work. That means that only 1/7th of the week is somewhat free of anxiety. What about holidays? Well, 7 months have elapsed this year without a holiday. Let's say that I take a 1-week holiday. Leaving aside the fact that for the whole week I'll be dreading going back to work, we are only talking about 1 week in 30. That's right... I'm only on holiday 1/30th of the time.

Things will improve when I have money in the bank and I can afford to take more time off (I don't get paid holiday and I also have loss of earnings while I'm away) but predominantly, my life this year has been monotonous depression.

I'm dying for my mood to swing to the other 'pole' and to enter a hypomanic episode. Depression is literally killing me.

 

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Psychiatrists Hate This One Weird Trick

8 min read

This is a story about what happened next...

Shake your meds

Ordinary person discovers this one weird trick. When they saw what happened next, they were AMAZED!!!

So, I've been accused of being anti-psychiatry, but in fact I'm not. The discovery of chemicals that can cross the blood-brain barrier and affect your perception of the world, has been incredibly important for the understanding of neurological functions, as well as the pathology of mental illness. It's also true that pharmacological interventions are priceless during episodes that would otherwise be unmanageable.

For the record, my own diagnoses have included:

  • Clinical depression
  • Type II Bipolar Disorder
  • Anxiety
  • Stress
  • Borderline Personality Disorder (BPD)

I've been treated with:

  • Antidepressants
  • Antipsychotics
  • Mood stabilisers
  • Anxiolytics / hypnotic sedatives
  • Sleep aids

Then having read a meta-analysis of psychiatric treatment outcomes by Robert Whittaker in his books Mad in America and Anatomy of an Epidemic, I decided to embark upon an unethical study, with me as the test subject. I decided to go completely unmedicated.

The general public often associate unmedicated mental health patients with some wild-eyed looney, who has slipped their straightjacket, ducked the tackles of the hospital orderlies and legged it out of some mental health institution. There is an assumption that people with mental health problems are homicidal maniacs, and a danger to the public. I'm here to dispel that myth.

Going unmedicated is not something I would ever advocate. The withdrawal effects from psychiatric medication are likely to be severe and unpredictable. It's not something that should ever be done without consulting your doctor. However, I did it, and this is my account of what happened.

Firstly, coming off medication is hard. Really hard. I've had comedowns from drug abuse that haven't been as bad as coming off anxiety medications, for example. What goes up must come down, and there's no avoiding the fact that coming off a 'feel good' medication means that you are going to feel bad. Really bad.

Fundamentally, that's why many of us take medication, isn't it? To feel normal. To feel better than we would do without it. That's certainly how I got mixed up in the whole world of mental health in the first place... because I felt terrible. I was exhausted and suicidal and depressed and demotivated and I didn't enjoy anything. I needed happy pills, because all my happy had leaked away somewhere, and I was just spending 14 to 16 hours a day asleep, and the rest of it in bed hoping that the world would go away.

The thing is, the unnatural 'happy' pills destabilised me, and my mood then swung too happy, and entered a mood cycle of alternating periods of depression and hypomania. Enter the mood stabilisers. It's starting to sound like a story about the old woman who swallowed a fly, isn't it? For those who are unfamiliar with the story, she then swallowed a spider to catch the fly, and then something else to catch the spider and so on, until she swallowed something so large it killed her.

The problem with trying to treat human moods with medications is that the brain has evolved to be homeostatic. That is to say, the brain has evolved its own mechanisms to maintain stability, and anything you introduce artificially will quite naturally destabilise those systems.

Underpants on the head

The stability of your moods can also be destabilised by supposedly normal things. We are all supposed to be able to cope with the pressure of exams, work, domestic duties and so on, but for some of us, it will all become too much. Is this mental illness, or are these 'nervous breakdowns' actually something that threaten to blight the lives of every single person? Is it a lottery as to whether the stress will become overwhelming?

I self-medicated for stress for years, using copious amounts of alcohol. Of course, at work you then have to compensate for the foggy mind caused by a hangover, so you start to drink strong coffee. I was probably having the equivalent of about 12 shots of espresso every single day. The amount of caffeine contained in those shots was practically the same as being an amphetamine addict, and indeed my boss at the time - who got me into this destructive lifestyle - had the racing speech and fast jerky movements that you would associate with a speed freak.

When I moved onto harder stimulants, including a drug that would keep me awake for over a week at a time, I found that my mind was not as robust as I had assumed it would be. I managed to induce within myself, symptoms that were unmistakably schizophrenic.

Consumed with paranoid delusions, hearing and seeing things and with completely warped perceptions, I was very mentally unwell indeed. This divided medical opinion. Some professionals wanted to treat me as if I had permanently damaged my brain, and had now become a schizophreniac. Others could see that the symptoms were likely to abate, if I just got some sleep, had some food & drink and started to detox and let my frazzled brain recover. Thankfully, the latter was the correct opinion.

Does that mean that all schizophreniacs can recover and live normal unmedicated lives? No, sadly not. I've seen quite a lot of people who have been suffering acute episodes of mental illness as a result of circumstances or substance abuse, and these people have recovered as soon as they were removed from the situation that landed them in hospital. However, there are clearly some patients who are either too badly damaged, or have some other pathology that is driving their illness, and medication is necessary to control the psychosis & mania.

Hospital Note

For my own part, I have lived without caffeine for many years now, and I try to keep alcohol consumption to a minimum. I've been medication free for a few years, but I have dipped back into both sedatives, sleep aids as well as powerful stimulants, during times of crisis. It's been a few months since the last time I dabbled with anything psychoactive, and I'm still suffering rebound anxiety and depression.

Life is incredibly hard right now. I'm stalked by suicidal thoughts all the time, and stress is almost unbearable. I would dearly love the comforting embrace of a chemical security blanket. I long for intoxication. However, despite the hard, sharp edges of daily existence, at least my emotions aren't blunted and I feel like I have wonderful mental clarity.

Every day is a struggle, and my perception of time is completely warped. I feel like this depression is going to last forever, and I assume that everybody hates me and that I have nothing to offer the world, and I'm never going to be happy ever again. However, I'm able to be very rational, and I can see that my perceptions have merely been warped by my mood, which is partly because I'm still recovering from the abuse of sleeping pills, anxiety drugs and stimulants.

It would be easy to write off my tale as that of a drug addict, but that's not really the story. In actual fact, self medication with 'bad' chemicals was only very recently, and well after I was diagnosed with various mental health problems and had already been taking 'good' chemicals (i.e. medications). All psychoactive chemicals are inherently destabilising.

Self medication is a disastrous path to go down, but all attempts to force your moods to go one way or the other without changing the environment that you're in, will be doomed to failure. I wanted happy pills so that I could remain in the rat race, and maintain a standard of living that I had gotten used to. However, what I really needed was to escape that bullshit world.

Propping up my ailing mental health so that I could continue to work a job that I hated and that bored the shit out of me was a dumb choice. Mental health is too precious to fuck about with using pills and potions. If you're not feeling great, that's probably because you need to get out in green spaces more, eat healthier, get some new friends, ditch that mean abusive partner, disown those horrible parents who never congratulate you on your achievements and always give you a hard time, and quit trying so hard to impress people and be somebody you're not.

This is my prescription for life: be myself and tell everybody to shove their ill-informed opinions about my life up their arse. Nobody's an expert in my life and how to live it, and so many of the so-called experts are actually unhappy themselves, nor are they bringing happiness to the lives of the people they advise. Judge people on their results.

Fundamentally, there is an epidemic of mental health issues, and nobody is curing anyone, so trust nobody except for yourself, and do what feels right for you.

Discharged from hospital

I discharged myself, because I was in hospital voluntarily. I've had several 'section' assessments but never been sectioned under the Mental Health Act. However, I'm an unmedicated mental health patient on the loose, so look out!

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Thorn Tinted Glasses

11 min read

This is a story about viewing the world through the lens of a mood disorder...

Blue light filtering glasses

When I'm hypomanic, nothing seems impossible. Hypomania brings big ideas and grand ambitions, and the only thing standing in my way is the stupidity and myopia of other people. Nobody seems to have the guts to go for the glory, and nobody seems to be able to keep up with me. I get frustrated at a sense of dragging other people along in my wake, having to dumb things down and spoon-feed people at a painfully slow pace.

Obviously, when I'm hypomanic, I over-estimate my abilities and I'm rather rude and obnoxious about other people. Not exactly a team player. I tend to be pretty disrespectful of other people's opinions, believing that they've had their chance, and have failed to make any significant impact. Why should I listen to such gutless wimps? Why should I listen to anybody not firing on all cylinders, like I am, when I'm riding that hypomanic high?

Another thing that I overestimate when hypomanic is my stamina. I assume that I can continue at breakneck pace indefinitely. I feel like the enthusiasm and passion that I'm feeling will carry me along, despite the huge amount of energy that is being expended. I don't walk, I run. I don't speak, I shout. I don't discuss, I decide and act. It's a blur of activity, in single-minded pursuit of a goal, to the exclusion of everything else. There's no balance. There's no downtime. There isn't a second to spare: rush! rush! rush!

But, I'm not stupid. I've been through enough episodes of hypomania now to know what's happening. So why don't I modify my behaviour? Well, part of the big rush is the fact that I know that I'll hit a wall, and almost overnight, I'll hate everything and everybody, and I'll just want to curl up and die. I will have run out of energy, and suddenly be overwhelmed by the enormity of the task ahead, and with no gas left in the tank, I'll realise there's no way I can continue without sleeping off the work binge and catching up on those lost hours of rest.

Instead of trying to work at a steady pace that could last for years, instead I try to pack work into frantic periods of rushed and hectic activity, before I run out of steam and depression hits me like a sledgehammer. Instead of being discouraged from milking hypomania for all its creativity and productivity, I feel encouraged to try to achieve Herculean tasks.

When I'm in one of these moods, lots of stuff gets done, but there's lots of wastage. Instead of planning ahead or hesitating for a single moment, I'll just do whatever I can to minimise downtime and delays. If I unexpectedly need to work through the night, I'll do that and go out and buy a fresh shirt for the following day. If I need to get some rest, I'll book whichever hotel is quickest and easiest to book. If the project I'm working on needs something, I'll buy whatever I need, whatever the price, on the assumption that it would be a waste of time trying to penny pinch.

Step Count

Can you spot the pattern in my activity? Can you see any trend that would suggest ups & downs? This is actual movement data that has been gathered over a whole year. I would never have thought my mood fluctuations would look this obvious, with hard data.

I used to keep a mood diary, but of course, when you're hypomanic you can't be bothered with the faff of it, and besides, you're not sick when you're hypomanic... at least you're convinced that you're not anyway.

I'm not sure whether I'm mostly suffering from Seasonal Affective Disorder (SAD) or whether my Type II Bipolar Disorder has simply become aligned to the seasons. It's virtually impossible to unpick cause and effect anyway. There are so many seasonal factors, such as the stress of Christmas and the fact that nothing much gets done at work during the holiday season between late December and mid-January.

Anyway, I'm locked into this cycle, where I start to emerge from hibernation around March/April time. In May I start to begin to do normal things again, rather than just being completely decimated by a sense of malaise, exhaustion, demotivation and feelings of being totally overwhelmed by mundane trivial shit. By June time, I'm about ready to work again, but in danger of tipping into hypomania at any moment.

At the moment, I struggle to get out of bed in the morning. I have a feeling of dread throughout the working day. The continuous anxiety is matched only by crushing boredom and an inability to concentrate. I flit between looking at my phone and making trips to the toilet to look at Facebook and message my friends. I read documents, but the words don't sink into my head. The phrase "what the fuck am I doing here?" is on repeat in my head. I'm struck with regular impulses to commit suicide and end the relentless monotony and unending pursuit of a seemingly impossibly distant goal of my next potential holiday.

By contrast to my hypomanic state, I assume that something is going to go wrong, and I'm going to be plunged back into the stress and pressure of looking for some more work, while the bills pile up and imminent deadlines to pay my taxes and deal with debts that have built up during my winter depression. Everything looks impossible, and boring, and pointless.

When I'm depressed, I'm absolutely convinced that my skills and abilities and experience count for nothing, and that I'm only good for the scrap heap. Even when I get a job, I feel like a fraud and that I'm going to be found out. When I make a mistake, I beat myself up about it for days, weeks even. I grimace and groan at my desk as I replay something stupid I said, over and over and over again.

I sit at my desk, watching the clock, wishing I was busy, wishing I felt useful, wishing that the feeling that life was completely pointless would go away, and feeling like death wouldn't be so bad, because there's no way I'll be able to put up with months and years of just turning the pedals, over and over and over again. The same commute, the same routine, the same colleagues, the same game, the same formula.

Bipolar memory

How on earth am I going to cope with feeling so bored and unchallenged, and so uninspired and so lacking in passion and like such a fraud and like I'm wasting away, and like there's no way I can stand even the next few minutes, let alone the next few hours, let alone the whole day, let alone the whole week, let alone the whole project and the whole contract, and the whole career? How the hell am I supposed to keep doing what I do?

I could drink coffee, which aids my concentration and motivation, but as soon as I do that I'll start getting big ideas and getting really bossy and overconfident, and before you know it, I'll be hypomanic again. Coffee always stokes my hypomania up. Also coffee stops me from sleeping, so I start drinking alcohol to get to sleep... and before you know it I'm knocking back copious amounts of both caffeine and alcohol to get through the shitty work.

Once I start drinking alcohol, I start having days where I wake up massively hungover, but weirdly I can get up and go to work. I find it easier to get up with a massive hangover, and easier to sit quietly at my desk getting on with my work, when I'm just about holding down my breakfast and I've got a pounding headache.

I think that drinking lots of alcohol regularly means that I've always got booze in my system, and it works like a kind of anti-anxiety drug. I feel super sick and stuff, but it gets rid of that sense of dread. By the afternoons, I start to sober up and my hangover goes, and I'm really happy and productive. When I get home, then I start to get the sense of dread about going to work again the next day, so I start boozing all over again, and end up going to bed pissed again. The whole cycle repeats itself.

Alcohol and work seem to go hand in hand for me, and it seems to stop me from being such an obnoxious prick and pissing everybody off before finally chucking in the towel on a perfectly good job. I've gotten used to using alcohol to bring my hypomania and anxiety under control. It's a massive crutch for me, and the temptation to use it is massive, when there's such pressure on me to perform and earn money and not fuck up yet another job.

I know that I could quite easily return to a tried-and-trusted form of mood stabilisation, using caffeine to get me moving when I'm deep in an exhausted depression, and alcohol to bring my hypomania under control when my brain is starting to get a bit over-excited, or anxiety and boredom are threatening to make life unliveable. However, these things led me to a massive breakdown eventually, which I'm sure was caused in part by massive amounts of these two innocuous chemicals.

When you're drinking 12 espresso shots during the day and two bottles of wine at night, everybody's chuffed to bits with your work, but surely you're just screwing your body up for the sake of making some money while you're young enough to cope with that kind of beating.

I value my liver and my mental health now, not that I have much of the latter. I'm struggling virtually all year round with a mind that tends towards either suicidal depression or self-sabotaging and career-wrecking hypomania. I've trashed my financial security, meaning I now have extra added stress and hassle that I could really do without, but I don't think resorting to self-medication will be good in the long run.

So, I remain caffeine free and I'm trying to wean myself off alcohol. Today is my 3rd consecutive day without booze. It might not sound like much, but you probably can't imagine the kind of pressure I'm under, with life very much hanging by a slender thread.

My days pretty much start with deciding whether to kill myself or not, and they don't improve much from there. The evenings and weekends are good, when I can see friends, but possibly it's also been the excuse to drink that's also played a part.

I need to get a handle on booze, but I also want my moods to be manageable. However, I also need to earn money and be able to cope with work. It's a Catch 22.

My gut feel is that I'm just going to stick with my harsh regimen of zero caffeine and very moderate booze consumption - ideally no booze at all except on a Friday & Saturday night.

Coffee

Clearly, I'm just emerging from under the cloud of a very severe depression, especially as I slashed my own arm with a kitchen knife because the sense of hopelessness and relentless anxiety in the face of overwhelming odds stacked against me, was just so unbearable. Things look a little brighter, but now I'm starting to worry that hypomania will suddenly rear its ugly head, and I'll sabotage everything, like usual.

However, I do still refuse to medicate myself, merely to cope with the bullshit life that we're expected to live. I'll play the game as best as I can, but my brain is not for sale. Hopefully one day, I'll be able to better align my needs and my values with my work, but for now, I have to do some stuff that's pretty incompatible with good mental health.

One big thing I've learned from this rollercoaster ride, is to not expect change to happen quickly. Thinking things will change overnight has led to frustration and disappointment, which has either triggered further depression or has spurred me into regrettable actions. Thinking that I can use the blunt instruments of medication, drugs, legal highs, caffeine and alcohol to force my moods to bend to my will, has been very hard on my body and mind, and has only achieved very temporary effects, for horrific long-term costs.

Unfortunately, returning to stable mental health, a sense of wellbeing, comfort, happiness, security and an acceptable standard of living, has always required more luck, more time, more favourable conditions than I've ever been granted. I'm not complaining - we all face the same harsh and uncaring world, after all - but I recognise that modern society does little to allow people who get sick to ever re-enter the game.

Stop the world, I want to get off.

 

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Am I a Bad Person?

7 min read

This is a story about how to lose friends and alienate people...

Primrose Hill

It's remarkable what we assume, and what we're unaware of. It's remarkable how our opinions can be coloured, and prejudices triggered, which completely change our impression of a person, and the way we treat them.

I had declared myself as "fighting mental health stigma" but in actual fact, things like Clinical Depression are so damn commonplace that nobody bats an eyelid if you say you're taking powerful psychiatric medication to stop you from killing yourself. In actual fact, I get more criticism for being medication free and letting my brain achieve its own homeostasis.

When I moved back to London, one of my oldest friends was incredibly sweet and understanding about the fact that I was struggling with my mental health. He took time out to read a bit about what Bipolar Disorder was, and was actively concerned with my wellbeing.

My friends are always playing catch up. By the time I was diagnosed with Clinical Depression, I was already having hypomanic episodes that were beyond the 'healthy' and 'normal' range of moods. Spending copious amounts of money, working ridiculously long hours, hypersexuality, risk taking... these things are not conducive to good health, wealth and stable relationships.

By the time I was diagnosed with Bipolar Disorder, I was already trying various forms of self medication. Depressions had gotten so severe that suicide was a very real risk, and hypomania had reached the point where I was starting to get delusions of grandeur, and was at risk of getting into money problems.

By the time I got free from the horrible relationship that was stoking my mood disorder, substance abuse was a big threat. When my divorce sapped my energy and sucked me back into the nightmarish world that I was trying to escape, I gave up and just decided to be a total junkie.

By the time I got cleaned up and back on my feet, word had been spread by my unpleasant family, that I was somehow untrustworthy, a waste of space, a lost cause.

So, I'm pre-empting all of that. This is a pre-emptive strike. I'm telling the world my very worst things, so everybody can get all that prejudice out of the way. I'm putting my worst foot forward.

I'm still here.

My friends and family are still stuck in the position of trying to deal with their prejudice, even though I've already moved on. I'm dealing with depression and suicidal thoughts, while people think I'm probably scoring heroin on a street corner and injecting drugs in some crack den.

This 'lag' is extremely annoying. It means I have to deal with a shocked silence. It means I'm isolated, alone, with people who should know me better, thinking terrible things about me. The culture of fear that we've grown up in is powerful, and all those images that the media has put into your mind are suddenly applied to me... it wouldn't surprise me if my own family has imagined me stealing car stereos or mugging grannies.

Eat Crack

There's a lag with me too. It messes with your mind, being homeless one minute, and then working for a massive bank on a really important project, all dressed up in your suit with people giving a shit about your opinion.

How can you go from being the lowest of the low, to the point where there are people who actually think that death's too good for you, to suddenly one of the highest paid people in one of the world's most profitable enterprises, because the market value for your skills and experience is so high?

Is it any wonder that it messes with your mind? Is it any wonder that your brain doesn't know whether you're a worthless piece of shit, and the world would be better off if you were dead, or if actually you deserve a 6-figure salary, and people are telling you that what you're doing is really important and you're a key figure in the delivery of a super important project. How are you supposed to reconcile that?

Just saying that I should remain "grounded" is ridiculous. I have no frame of reference. I have no evidence to suggest that any possible conclusion I could reach would be the right one. Everything that my experience has taught me has been counter-intuitive.

Working hard, being humble, keeping my head down has gotten me nowhere. It hasn't led to greater happiness, more stable mental health, nor has it repaired damaged friendships and improved my relationship with my family.

Equally, taking reckless risks with my health & wealth has brought surprising results. Instead of being dead or destitute, I actually ended up making a fantastic group of friends, as a result of winding up homeless on Hampstead Heath, just after my birthday in 2014. In actual fact, being chucked onto the street by Camden Council ushered in one of the happiest periods of my life in many recent years, probably since I was in Cambridge in 2011.

I don't see any of what I've done as wrong. I've not resorted to lying, cheating, stealing. I've not screwed people over, manipulated them or in any way committed any offensive act against anybody.

However, people seem to take it very personally, when I apparently screw up my opportunities. One of my closest friends was absolutely besides himself when I lost my contract one Christmas. He thought I had deliberately sabotaged it. He was angry that I had seemingly chucked away a golden opportunity.

Things aren't so clear-cut. I'm rarely in a fit state to work. Either I'm suffering from depression, hypomania, or the exhaustion and cognitive impairment of recovery from stimulant abuse. I just don't have the time and money to properly prepare my mind and body for work, so my colleagues and bosses get a rather fucked up version of me, with all the weird highs and lows associated with an extreme mood disorder.

It's not a moral choice, whether I work, whether I relapse, whether I just collapse in a heap and don't do anything.

I know that people like to judge, and I've given away so much ammunition that it's really easy to think you know my character, my morality. I'm very easy to label, to criticise, and to apply your prejudices to.

I'm fed up of feeling guilty, just because people are shocked and unable to see beyond their prejudice and preconceived notions. I'm fed up of having to carry the can for a load of blame and scapegoating that doesn't even apply to me.

In some ways, I'm tempted to rob, to steal, to lie, to cheat... I'm being treated as if I do those things already. If I'm already 'the bad guy' then I guess I should act the part?

Bipolar Memory

People are more sympathetic to mental health problems like depression and bipolar than they are to substance abuse, even though the latter can be a feature of both of the former. I think the problem is the fact that people try and view it as a moral issue

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Virtually Reality

13 min read

This is a story about warped perceptions...

Oculus Rift

The world in which I inhabit is vastly different, depending on the state of my broken brain. Mood fluctuations cause me to interpret things very differently than a supposedly 'normal' healthy individual would.

I've written a lot this year about drug abuse, but I'd like to talk about a time before drugs even entered the story and made the water muddy. I'd like to talk about what it was like from 2008 through to 2012, when my brain was just doing its own thing, without drugs or medication.

If you're a person of prejudice, it won't surprise you to learn that drugs mess you up, but you might be surprised to learn that my mental health problems predated any drug abuse. You might also be surprised to learn that people can recover too, and go back to ordinary life, with nobody any the wiser as to your dark past.

But this really isn't about drug abuse, remember? We're talking about a period of 4 years that predated any psychoactive substances making things all messy and confusing. We're talking about when I first went to my doctor, because I was struggling with my mental health.

I spent just over a minute of explaining to my doctor that I felt completely exhausted, overwhelmed and unable to face friends, family, work or anything... I had drawn the curtains and switched off my phone, and retreated under the duvet, and could barely make it to the doctor's surgery.

"Have you heard of Fluoxetine?" my doctor asked. I said that I had, and that I knew that the trademarked name that it was more commonly known as was Prozac. I said that I had read very bad things about emotional blunting and ruined sex lives of those people who were taking Prozac. I had read Elizabeth Wurtzel's biography, Prozac Nation, where she didn't exactly speak highly of the 25 year old medication.

How sad that the National Health Service (NHS) would be offering some cheap generic pills after only a minute of getting to understand a patient's problems. It takes 6 weeks before an anti-depressant SSRI medication like Prozac takes effect, and it's a fairly serious decision, to put somebody on long-term medication. I think it's a little ridiculous that we don't offer more talk therapy, as a first line of defence.

So, I was diagnosed as having Clinical Depression, within just a few minutes. Something I also knew, but didn't have the time to discuss with my doctor, was that SSRIs can be very bad for people with Bipolar Disorder. I knew my moods fluctuated up as well as down, so I had my suspicions that I was Bipolar, and that was another reason to avoid Prozac.

When you're depressed, everything seems hopeless. I had decided that I was useless at my job, that I hated working in offices, that I hated computers and software, and that I couldn't handle a career in IT anymore. I also lost interest in going out, sex, food... I pretty much just slept, or lay in my bed feeling anxious about the fact that I was off work sick.

Dark Days

After a couple of months feeling like this, I hit upon the idea that I was going to write a computer game for the first generation iPhone, to be ready in time for the launch of the App Store.

Although I had decided that my office-based IT career was over, the idea of programming on my laptop in my garden in the sunshine didn't sound too bad. I knew that the early limitations of the first iPhone meant that I could make a fairly basic game, and compete with other developers. I decided that if only a few people bought my game, it was still a fun experiment.

And so began a period of intense activity. I would work for 18 hours a day, 7 days a week, in order to capitalise on those precious early days of the App Store when there were hardly any apps on there. It seems incredible now, that there were only a few hundred or few thousand apps for the iPhone. There was no Android. There was no iPad. There was just one smartphone that created a billion dollar market, overnight.

When we look at that crazy period of my life, when I was churning out apps, it's pretty clear to see that my mood had swung to another extreme. I didn't have time to explain things to people. My thoughts were racing, speech seemed like a frustratingly slow way to communicate, eating and sleeping were an inconvenience, certainly I didn't want to do anything other than work on my apps. I was single-minded to the point of obsession.

In economic terms, things paid off. I got a couple of my apps to number one in the charts, briefly. One of my apps was downloaded 8,000 times in a day once, and another one racked up 500,000 downloads in a month. This was clearly a brilliant gold rush.

I knew that the quality of the apps being released was increasing steadily, and the opportunity for one fast burning out dude in his garden were rapidly diminishing. I started to really hate the work anyway. I had a whirlwind affair as an indie games developer, and it happened so fast that I started to hate it, just like you start to hate any job that you've mastered and has become easy.

Possibly this was a sign of my mood turning again. I had managed a period of several weeks, working at a ridiculous level, and what goes up inevitably must crash down. I hadn't been able to exert myself to such an extent since the school holidays in childhood. There's no way you'd ever be given 6 to 8 weeks to concentrate and just get on and hammer out a project, in a corporate environment.

iPhone One

My mood started to alternate between depression and hypomania (as described above) and I would turn each episode of frantic activity into a period of opportunism, to make money or produce something tangible.

Getting myself back into an office environment and doing some IT contracting re-stabilised me a little bit, and getting a boat so that me and my friends could go wakeboarding was something I was passionate about, and consumed my lunchtimes, after work in the summer, and weekends. My life got back to normal, for nearly 2 years.

During that first depression, I had set certain wheels in motion, however. One particular scheme was retraining as an electrician, while I was working as a programmer still. When I had finished my training, I quickly quit my job.

Going back to an unstructured form of making money, I started working too hard again. Building a business from nothing, to breakeven and hopefully to profitability is not quick and it's not easy. I managed to start getting good clients and increasing my turnover very quickly, through some shrewd partnerships and advertising choices. However, I was extremely inexperienced, and took on way more work than I could manage, sustainably.

I got my new business to the point where it was profitable, and had paid back the initial capital expenditure on training, van, tools etc. but I was burnt out again. I had lived and breathed my business, and only because it was hard physical work, had it lasted slightly longer before my brain was finally frazzled.

Depression reared its ugly head again in 2010, and I realised that I had made a mistake in cutting away from the easy money that a career in IT had to offer. I failed to recognise the importance of a stable working environment though: restricting your hours to 40 or 50 a week, giving yourself weekends off, having the occasional holiday, working with other people who share some of the responsibility and workload... those things are important.

My hypomania started to get a bit more extreme. After reading an enormous pile of books on Particle Physics and Quantum Mechanics and other theories & models of theoretical Physics, I started to read huge amounts of academic papers from Cornell University's online library.

Some of the academic papers that I read were extremely interesting to me, and I emailed the authors to ask them questions. To my surprise, most of them responded, and we started to correspond via email.

Spurred on by this, I started to believe I could author my own paper and get it published, and I developed a hare-brained idea of my own, around a thought experiment that was particularly hard to test in the real world. I eagerly sent my paper off to several academic journals. A couple of the journals even responded... unsurprisingly to say that they wouldn't publish something that hadn't been peer reviewed.

Cavendish Lab

Obviously, it's on the border of a delusion of grandeur to imagine that you might have anything of merit to contribute to a field, after only a few months reading the literature and educating yourself about the deepest mysteries in the Universe.

These delusions are something that I've always been wary of, and I try to be self-aware, but it's fairly clear that there was a progression in the difficulties that I was having with Bipolar Disorder, and the regulation of my moods. I wasn't imagining that I was the next Einstein, but I was having to say to myself "be careful, you're not the next Einstein" and give myself regular reality checks.

I still cringe when I think about some of the emails I sent to very important academics, and how, even though they indulged me, it must have been with slight tongue-in-cheek, to respond to a complete layman such as myself.

After yet more time lost in a pit of despair and hopelessness, where I did very little except for mow the lawn and feed the cat, the iPhone App gold rush cropped up again. This time I decided to sell picks & shovels.

Depressions are very similar to one another. You sleep a lot, you don't do much, everything looks shitty and you hate yourself. My depressions were clearly getting worse, as I started to think about suicide more and more. I started to accumulate more and more paraphernalia with which I could kill myself: inert gas, razor blades, Barbiturates, Cyanide etc. etc.

Periods of hypomania are easier to tell apart, because I can tell you what I was obsessed about in each one: iPhone Apps, boat, megashed, electrical business, physics and then my picks and shovels for the iPhone App gold rush.

I formed another company - Roam Solutions - which was later to become MePublish.com and Hubflow.com. I talked a couple of friends into joining me on my mad escapade, and generally threw everything and the kitchen sink at this particular endeavour.

Roam Solutions

My new company put on an exhibition stand at London Olympia, Learning Technologies conference, only months after I first conceived the idea for the service we sold. Delivering eLearning was something I knew nothing about, but that wasn't going to stop me.

By the time the winter was over, I had managed to get the company involved with the TechStars network, and we relocated to Cambridge in order to do a 13-week technology accelerator program, where we would be introduced to billions of dollars worth of investors.

13 weeks is just longer than the sweet spot for one of my hypomanic periods, and I was really struggling by the end of the program. Suicidal thoughts were quite intrusive, and I was drinking like a fish. I hated myself, and what felt like lies that I was telling to potential investors. It was a struggle to keep going to the end of the program.

I feel bad that I let 2 co-founders and 11 investors down really badly, when I imploded in September 2011. I never got back on my feet, because of relationship problems and a number of things that eventually led to very bad life choices and a whole world of pain, destruction, devastation.

I don't feel too bad because I'm clearly unwell and because nobody risks their money and a stable job unless they want to try and get rich quick. I genuinely didn't pull the wool over anybody's eyes. There was a big opportunity there, and I'm only partly to blame for everything going tits up. The biggest part, perhaps, but still only partly.

Writing code for iPhone, iPad, Android and BlackBerry, as well as the back-end (serverside code in PHP, Linux administration, database etc. etc.) plus rebranding, raising money and everything that goes with a startup is a hell of a lot to fit into 13 weeks. A crash was inevitable for me: I was too close to the detail, too close to the coal face, too close to the customers, too honest with the potential investors.

At the end of the day, I got my arse handed to me. I was completely spent. I've never experienced such hard work and stress and pressure in my life, although there was a lot of fun too, and I had an incredible time meeting some of the most inspiring people I have ever had the good fortune to cross paths with.

The main lesson I learnt though, was that I really can't ignore my mental health. Even if I avoid clinical labels, like Bipolar Disorder, I definitely have a predisposition to mood instability if I make bad choices. I can't ignore the number of times I've swung between extreme depression and extreme 'highs' which are characterised by massive productivity, and increasingly delusional hopes of being rich and famous.

Things are obviously still very 'up and down' for me, but there is seemingly no end to things that spur on my hypomania. Most recently I ended up working on HSBC's number one project, and being made responsible for a really critical part of that project, by the CIO at the project townhall, in front of the entire team. The facts as they are presented to me, do little to discourage a kind of boom & bust lifestyle.

I guess I could reshape my life around working for 3 to 6 months, and then taking 3 to 6 months as a break to recover from my over-exertion, but I don't think it's very healthy. I'm now faced with the challenge of how to manage my own mental health in a more sustainable way, before I really run out of luck and tread on some toes that get me in super big trouble.

Wish me luck. I'm going to need it.

Tower of Dreams

I really didn't sleep very much while I was at HSBC. Naturally, this started to be detrimental to my mental health. Eventually, I was very sick indeed, and it was hard to continue... I had to go into hospital

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From Pole to Pole

10 min read

This is a story about living with a mood disorder...

Sick Note

Type II Bipolar Disorder took a long time to diagnose, despite a fairly obvious pattern of moods that can be easily traced back to adolescence. Of course, we all have mood fluctuations, but it's the extremity of those moods that qualifies something as a disorder.

I would say that hypomania was the more obvious one of of my pathological moods. Being able to concentrate and work with great intensity, with little sleep & food and a refusal to be diverted from my task, an irritability for distractions, hypersexuality, spending loads of money, risk-taking. Talking seems too slow to express your thoughts... the speed that you're thinking is too fast to explain to anybody else, to put into words. You're just a blur of activity.

It felt like driving with the hand-brake engaged for a lot of my life. I was always waiting for the next slim window of opportunity to work on something that I loved. Whether that was the Design & Technology at school, where there was never enough time to finish what I was working on before the end-of-class bell, or the lego model I was making, before it was mealtime and playtime was over.

Of course, we all have to work within a timetable, and we all have to eat & sleep, but these things always made me feel like I had to rush at everything I did as fast as I possibly could, in the hope that one day, I would complete one of my projects. I also grew incredibly frustrated with the limitations of timetables, mealtimes, bedtimes.

Switching to the world of work, there wasn't actually very much to do. Most people did very little. I ended up searching around for extra things to do.

Spaghetti

The computer network at my first full time job ran like an absolute dog. That was because AppleTalk traffic from the office Macs and their printers was polluting the Ethernet traffic from the Sun SparcStations. I managed to talk my friend Lucas into helping me to rewire all the cables one evening.

OCD Cable

I wish I could show you the actual images, but we weren't even supposed to be in the server room. This was a Ministry of Defence prime defence contractor with a high level of security clearance. The two junior programmers aren't supposed to go and fix all the networking problems in the office without any authorisation.

The next morning, everybody was commenting how amazingly well the network was running. Lucas & I obviously couldn't claim any credit, because we had acted without authority, but nobody was going to do a witch-hunt when everybody was so pleased that the most major problem affecting everybody in the office had been solved overnight.

That's pretty much how a person with Bipolar Disorder hides out in a corporation. You bumble along, bored, depressed, coming in late, demotivated... and then you suddenly pull something out of the bag that nobody else would risk their career to do, let alone the lack of sleep and unsociable hours.

Bosses seemed to just accept my erratic working patterns, knowing that when there was something that needed doing with an impossible deadline, that's normally around the time I'd wake up and start hacking something together.

Late Message

It all kind of hung together until I started at a new company in 2008 and the project they were asking me to do was so huge, I didn't know where to begin. I was just entering a depression, which was bad timing. There was also a cultural problem, where their in-house IT staff built everything using Microsoft Excel, and any 'proper' software was built by Oracle consultants or bought off the shelf... but nobody liked those big expensive systems.

My depression got so bad I couldn't even get out of bed or stop crying randomly. I knew I wasn't going to bounce back quickly from that one. After a couple of months I quit that job and started making iPhone games in my back garden. 18 hours a day, 7 days a week. I couldn't go fast enough.

And so began a completely unstructured phase of my life. I would take on a project or interest, completely immerse myself in it for as many hours as I could stay awake, and stay obsessed with that single task until I burnt out. Then I would be depressed, and with no reason to even drag myself out of bed and go and be miserable at work, I would just be depressed all day in bed. I stopped answering my phone. I stopped answering the door. I never opened the curtains.

Being self-employed after 11 or so years of 9 to 5, Monday to Friday structure and routine, is kind of a red rag to a bull, if you have a tendency towards mood instability.

I relished those periods of hypomania. I wrote a series of iPhone games. I built a wooden summer house. I read a huge pile of books on Theoretical Physics and had lengthy email conversations with professors around the world, I wrote a mobile eLearning system and launched it at Learning Technologies conference, I decided that I wanted to be a startup founder and applied for TechStars, I learnt all about Bitcoin, bought Bitcoin miners and started mining in my summer house, I traded Bitcoin for profit, I wrote my own virtual CPU so I could attack algorithms like SHA-256, I started investigating security loopholes in things like internationalised domain names and the Google and Facebook developer platforms.

It's not long before you stray into legal grey areas though, so a lot of my projects have been shelved and I've had to go on raiding missions back to the corporate world, to stay afloat financially. These are normally timed with my hypomania, so a company gets 3 months of incredible productivity, and then a month or two of me being depressed, and then we normally go our separate ways.

My depressions have gotten worse and worse. They seem to last longer, and I've actually started to harm myself more & more. It's strange, when you emerge from a depression and enter a period of hypomania though... you can't remember just how dark those previous days were. There's no rational voice that says "hey! slow down, or else you're going to crash again!". Instead, the voice says "better go as quick as you can, because we know a crash is coming again soon".

Down the Road

So how do we know that depression is the pathological mood at the other pole from my hypomania? Well, I sleep. A lot. Sometimes 16 hours a day. When I'm awake I have very low energy, low motivation. I have no interest in things I'd normally find enjoyable. I don't want to see or speak to anybody. I generally think that everything is pointless, broken, useless, hopeless. Lots of negative memories keep coming into my head, and make me think "I can't believe I said/did that" with extreme regret, embarrassment, shame. I think the world would be better off without me. I start to do pros & cons of living lists, either in my head or written down. I start to think of ways to kill myself, and what affairs I would need to set in order before I committed suicide. This goes on for weeks, months.

I've written before about trying mood stabilisers and antidepressants. The side effects just aren't compatible with good quality of life. You might think that risk to life outweighs quality of life, but it doesn't, especially when you have the waves of hypomania to surf, before crashing onto the rocks of depression.

My body and my mind seems to have decided to adapt itself to this world, to this society, to this environment. We applaud the kid who busts their balls to study for their exams, and can then collapse in a heap during the school holidays. We applaud the employee who pulls the all-nighters and comes in at weekends when work is behind schedule. We applaud the 'overnight success' stories, when an impressive project is unveiled, seemingly created out of thin air, as if by magic. There is no magic. It's just an unsustainable burst of energy, focus, determination, single-mindedness and a touch of madness.

Hospital Note

I'd like to go back to the routine I once had, pre-2009. Only I don't seem to be able to retrace my steps, yet. I know the formula that used to work, and a very dear and trusted friend urges me to take a permanent job, and he's probably right to some extent. However, if it all goes horribly wrong again, I would have earned a fraction of what I would have done in a contract.

I'm hoping I can find my little niché. Somewhere I can deliver more value than keeping a seat warm from Monday to Friday. Somewhere where the bosses are more interested in results than headcount in their empire. Pretentious? Moi?

I don't really care whether you think I should cheer the fuck up or calm the fuck down... my moods seem pretty intent on doing whatever they want to do. I've been fully aware of the calamitous consequences of not keeping my mouth shut at the right time, or not getting out of bed and doing some urgent crap. It doesn't really feel like I'm choosing even if it does look like a choice to you, as an outside observer.

This looks like a load of angst-filled teenaged immature self-centred selfish drivel. It probably is. I call it my life.

I'm probably more self-aware than you give me credit for. If you're thinking "oh my God, can you even hear what you're saying? Can you even hear yourself?" the answer is yes, yes I can. I spend a lot of time cringing and wishing things weren't so, and indeed wondering why I'm like a moth to a flame so often. I can see the train wrecks before they happen. I've plotted my mood and activity data, and the patterns are as clear as day. So what?

I'm sure there are days when you'd really like to be a bird, just soaring on the air currents above the ground, looking down on people & buildings. It doesn't matter how badly you want to be a bird. It doesn't matter how rational it seems, to become a bird and just fly right over that traffic jam that's getting in your way, it's not actually possible. That's a bit like those days when I would really like to feel normal. I can want it, but it's not actually possible. Anybody who tells you that you can stop worrying or be happy just by choosing is full of shit. You have my permission to punch them in their smug mouth.

So, I'd say my experiment with abstinence was a failed one. We need a little alcohol to calm our nerves. We need a little caffeine to perk us up. We know when we need it, and most of us know our limits. We're pretty adept creatures at tweaking our own moods. We probably need a pet for a bit of soothing oxytocin. We probably need a girl/boyfriend for a bit of serotonin and a squirt of dopamine. Other than that, we just need something to keep our minds occupied as a distraction from the inevitability of death and decay. Not God though. God is for crazy people.

Anyway, that's my two cents, on my two poles: Type II Bi-polar Disorder.

 

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Self Medication (Part Two)

4 min read

This is a story about self prescribing...

Indian Bupropion

If you know what medication you want, you can cut out the middlemen and just buy it yourself direct from a country that doesn't have a rigid system of prescriptions, provided it's not a controlled substance, and therefore illegal to import.

I wrote about self medication through non-pharmacological mechanisms in a previous blog post entitled Self Medication (Part One) if you wish to refresh your memory.

Going GP -> Psychiatrist -> Pharmacist is actually quite a slow process when you're trying to find a medication that works for you. Also, many medications are only licensed to treat certain illnesses, but there is sometimes a strong body of research that proves they are effective on other illnesses. Because of concerns about medical malpractice lawsuits, it's quite hard to get an 'off label' prescription, even if there is good data to support the use of a particular medication in your individual case.

So it was that I came to be experimenting with medications like Pramipexole (Mirapex), Bupropion (Wellbutrin), Cabergoline (Dostinex), Aripiprazole (Abilify) and even crazy ones like Piribedil (Trivastal). Results were a mixed bag.

The bottom line is this: you probably don't want to f**k with medication. Aripiprazole left me uncontrollably dribbling, and unable to speak without an unintended spray of saliva. Piribedil would cause me to fall asleep randomly, like a narcoleptic.

But, Bupropion works. It's a very effective, fast-acting antidepressant. However, it raises your anxiety levels, causes insomnia, panic attacks and exacerbates hypomania. It's not a good medication for somebody with Bipolar, unopposed by a mood stabiliser.

Messing around with medications was very dangerous, and I may have even put myself at risk of early-onset Parkinson's disease. Certainly, my later messing around with L-DOPA was on a trajectory leading to complete disaster.

It's about harm reduction though. Tea and coffee are on a stimulant continuum that leads to amphetamines and even stronger stimulants. Alcohol is on a depressant continuum that leads to benzodiazepines and even stronger 'downers'. If you have been using coffee & alcohol to self-medicate for your mood fluctuations, you will be driven to seek out stronger alternatives, when those substances no longer work anymore, or face a breakdown.

Dark Web

Eventually, you'll find that heroin is really great to help you sleep, and crystal meth is really great when you need to be awake and get stuff done. You don't want to end up there. Don't go there.

There are modern sleep aids like Zopiclone & Zolpidem, and newer wakefulness and concentration promoting agents like Methylphenidate (Ritalin) and Modafinil. Naturally, I experimented with these.

Ritalin, I found to be very much like cocaine. You want to take more but you're not sure why. You don't really feel like you're getting anything out of it, but you strangely find yourself taking loads of it. Dangerous. Elizabeth Wurtzel wrote a book called More, Now, Again which is amongst the literature that inspires my writing. However, it's simply not possible to snort 60 Ritalin pills, like she claims. That volume of powder will simply not fit into your nasal sinuses. She's right about one thing though: Ritalin is addictive.

Modafinil simply makes you awake, not happy. More time awake, unhappy, is really the very last thing that you want if you're depressed, so I discontinued its use and find no function for this wakefulness promoting agent, personally.

Zolpidem doesn't keep you asleep for long enough to be of any use. Sure, you fall asleep, but then you wake up again and spend the whole night with your usual insomnia. Useless.

Zopiclone works but it's a little too brilliant. Again, for somebody with Bipolar, waking up feeling totally refreshed simply stokes your hypomania to dangerous levels. It delays an inevitable crash, when the drug ceases to be effective at acceptable dosages, and insomnia leads to exhaustion, which leads to depression.

It's all available, out there on both the public internet and the Dark Web. It's a few clicks away for a middle class person with a computer and a postal address.

My parting advice is this: don't go there. Don't even look. Don't tempt yourself. Don't give yourself false hope. Don't experiment. I've done the experiments, and found nothing good there. The side effects just aren't worth it. The downsides outweigh the upsides.

There are no medicinal cures. There are no medications that 'fix' Unipolar Depression and Bipolar. It's an avenue not worth pursuing.

Sorry about that.

 

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Advent Calendar (Day Three)

12 min read

This is a story about three amigos...

Three Amigos

You need some fire in your belly if you're going to achieve great things. The three handsome gentlemen above have all bucked the trend and excelled at what they do, in their own unique ways.

It's not my place to share other people's stories, but we all had events in our lives that have had an influence on the passions we have pursued. You never know what somebody else has been through, so it's always the best policy to be non-judgemental.

I'm not saying that we had it harder than anybody else. It's not a pissing contest. It's not a competition. And this isn't going to be a tear-jerking tale of woe is me. In fact, I'm not even going to tell you anything more than what I have already stated: behind every driven ambitious person, there is usually an unseen reason.

So, have we got chips on our shoulders? No, we have each others arms on our shoulders. We stand in solidarity, brotherhood. We are positive can-do people who act with energy and enthusiasm, not negativity and bitterness. If we have a reason to put more effort into things, to try harder than Average Joe, then it's because we are channelling our feelings in positive ways.

My friends aren't always immune from gossip, rumour and prejudice. However, they have been good enough to reserve judgement of my character. Yes, I have been pleasantly surprised that my friends have been good enough to listen to my story, now that I'm becoming well enough to tell it.

Writing somebody off, writing off a life, declaring somebody a 'lost cause' is never good. It's a death sentence. You never know just how close somebody is to the edge of the abyss.

Something happened yesterday that really struck a chord. Somebody was pushed in front of a tube train, at Kentish Town station, where I used to live, until very recently. I would travel every day from that very station platform. That's what is happening in our society. People don't jump, they're pushed.

Nobody chooses to jump off a building or in front of a train. Nobody chooses to slash their wrists or eat poison. Nobody chooses to suffocate themself or slit their own throat. Nobody chooses to blow their brains out or electrocute themself. Nobody chooses to hang themself or overdose.

Yes, it's more obvious when you can physically see somebody else pushing the person to their death, but it also happens in unseen ways too.

Every ignorant comment, every bit of gossip you pass on, every time you pass judgement and assume that you even have the faintest idea of what's going on beneath the surface of a person's life, you are slowly killing that person. You are driving them inwards, you are isolating them, you are killing them.

3 Friends

Yes, talking about somebody behind their back might feel like helping. Wringing your hands and saying to each other "what can we do?" while you exchange your guesswork, your ignorant speculation... it's not getting to the heart of the problem. It might be making things worse, by making that person feel alone and not understood.

It's hard, I know, trying to help somebody who has stopped communicating, clammed up. But I have no words that can possibly express the difficulty of trying to communicate with a far greater number of people who are talking to each other about you. The numbers just don't stack up. There's only one of me, so there's no way I can keep everybody informed, especially when I'm very sick.

Please don't think this is a criticism of my friends. The fact that they have reserved some judgement and they're slowly coming back into my life is spurring me on in recovery. You have to have hope and optimism to fight back from the brink of suicide, and you need friends. You need to feel like there's some chance of escaping depressed isolation, which is a death-spiral downwards.

People might think I'm pedantic. I am, but only on things that matter. If I correct you on the difference between mania and hypomania, it's because it's an important distinction that allows me to maintain hope of having some kind of quality of life. If I point out the research that shows better long term outcomes for unmedicated patients, in my situation, then it's important to know that I've had many discussions with many doctors and you telling me to follow doctors orders is not helpful, because you have no idea which doctor you're talking about.

Oh snap it sounds like I'm ticking people off. I'm really not. I just want friends in my life, not amateur psychologists, amateur psychiatrists, amateur doctors. It's really sweet of you if you've done any reading about Unipolar Depression, Type II Bipolar and other issues affecting my life, but it's really not necessary. I've done all the reading and the best possible thing would be to just judge my character and trust me... I'm working on the illness thing.

The thing that I'd like to reassure people about is, insofar as me and the docs can tell, the illness is acute not chronic. That means there's a chance I can get better if I'm given a window of opportunity.

Two Amigos

Looking backwards to move forwards is 'wrong' apparently, but I tend to ignore the advice of anybody who hasn't been to hell and back. I've tried doing things the way that ignorant people have suggested, and I can tell you first hand that your oversimplified version of reality doesn't work.

There are no short cuts and you have to use stepping stones. Sometimes the path might double back on itself, but as long as it's the right path, you have to keep following it. I went up a cul-de-sac and I could have raged and stormed and sulked and generally allowed myself to be trapped in a dead end - indeed many people wanted to trap me in the dead end - but in the end I had to just ignore all the haters, travel back down the one-way street from the dead end and find the correct path.

Everybody boos and jeers you when you have taken a wrong turn. Nobody congratulates you on having figured out you have made a mistake, and pats you on the back for being strong enough to retrace your steps, rather than just kill yourself. Nobody says, hey, you've had to travel twice as far as everybody else, let me give you a hand. Nope, people will expect you to work three times as hard, because you made a mistake. You already have to work twice as hard, but that's not good enough for people. They want to put the boot in and make you work three times as hard, because having to work twice as hard is not enough punishment as it is.

Yes, it's easy to end up hating the world, because the world is looking to scapegoat you. The world is looking for easy answers. The world is looking for convenient members of society to isolate and blame. Adults are not really very grown up. Adults have never really left the playground, where they liked to pick on children who were different. Bullying is rife in society.

When somebody gets weak, they're such an easy target. And the best part of all is that they get weaker and weaker until they die. Yup, it's great fun being an adult bully, because you get to kill people and then deny all knowledge, because you're smart now. You can cover your arse with plausible deniability. You can point the finger at all kinds of things that were symptoms of that victim's distress.

One Amigo

If it looks like I'm stuck in the past, it's because I've waited 10 years for the opportunity to be able to move on from a fateful mistake. It's a messy story, and it's not like I can point to a single error, but there was a significant life priority change in 2005 that threw my world into chaos.

I left London to live by the beach, but that wasn't a mistake necessarily. However, it put me in a precarious position. New town, new friends. I was rebuilding my life fairly quickly, but things were still fragile. Plus my circle of friends were all starting to leave London anyway. Lots of people came to visit. It could have worked.

I played for the title. I took a shot at the top. I tried to have it all. I thought I had found the girl of my dreams and I had it all. Turns out, I wasn't as mature as I thought I was. I made the mistake that nearly every adult must surely make at least once or twice. I picked the wrong girl.

Because I was in a fragile place, I had one or two attempts at correcting my mistake. I tried to break up with her, when I could see that my quality of life was being destroyed. It was my mistake. It was my lack of strength. It was my neediness and insecurity, being relatively young and inexperienced and in a strange new town and in a new job... I couldn't just walk away so easily. I don't blame her for not letting me go. It was my fault for getting trapped.

If you love them, let them go. I loved her. She didn't love me. You live, you learn. My parents taught me to never give up on a relationship, so I didn't. I kept going. I don't give up on things. It's not in my nature to give up on things. I'm the guy who fixes things. I'm the guy who makes things work.

Yes, I've read Men are from Mars, Women are from Venus and I know that women aren't after a Mr Fix-it, but it's more romantic than that. I'm a soppy loved-up kind caring sort of guy who just wants to make things work, patch things up, move forward together. I'm a diplomat, I'm a pacifist, I'm a lover not a fighter.

Did I deserve to have my face beaten to a pulp for the way I felt? Did I deserve to be driven to the brink of suicide? There has to be some shared responsibility somewhere, but I'm over it now. I know that I'll never get an apology. I know that she'll always think she was justified for battering both sides of my face when I turned the other cheek. I didn't lift a finger in self defence or retaliation, because I'm an open hearted person.

Three strikes though. Three strikes and you're out. Nobody has hit me in my adult life except for my ex-wife. Probably because they can see that there is anger just waiting to be unleashed if you mistreat me. Yes, it's really not advisable to hit me. You can try, and you might get away with it a couple of times, but I really wouldn't advise you to test the three strike rule. You might get a knuckle sandwich.

Why would you hit somebody who is kind and caring and open hearted anyway? What's it going to achieve? I'm a lover not a fighter. Just be nice and kind and caring and then we'll get along just fine. If you abuse me, my response is going to be predictable. Yes, abuse has predictable results. Bullying has predictable results.

My Dad raised me as a pacifist. I was raised to ignore bullying. I was raised to not rat people out. I was raised not to complain about abuse. I'm very good at calming myself down. I'm very good at absorbing blow after blow that is rained down on my head. I'm like a giant abuse sponge. I soak up all that abuse.

However, there is a saturation point. When the abuse sponge has become completely soaked with your rage and agression that you have taken out on me, you'd better be a little worried. When the punching bag can't take any more, you'd better not take another cheap shot.

I can tell you a lot about de-escalating situations. I can tell you a lot about anger management. I can tell you a lot about dissipating negative feelings. I can tell you a lot about de-fusing a ticking time bomb. Blaming me - the abuse victim - is not a successful strategy for helping somebody to get over their mistreatment.

Am I hamming myself up too much as this big victim? Am I too self pitying? Poor me, poor me, pour me another drink? Well, people have to find a way to cope somehow. Presently, that's this blog for me.

Yes, you can follow my progress right here, as I work through a bunch of stuff, in public. I'm not holding back. I'm staying true to my values of honesty and openness. I'm baring my soul as I'm working through this stuff. It's weird that I'm still carrying this stuff around, right? But where's it supposed to have gone? How do you get rid of all the crap you've taken, all the abuse you've absorbed? How do you dump it?

People have got a zillion and one techniques, suggestions. I've got a suggestion for you. Fuck off unless you want to be my friend. I need friends not therapists, carers.

I want friends. I need friends. I miss friends.

Table of Friends

Before everything went to hell in a hand-cart (April 2005)

 

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An Ode to my Sister

6 min read

This is a story about my best friend...

Pob

The first 10 years of my life were pretty lonely. Then along came my best friend in the whole world.

Naturally, my parents were harshly critical of me for not being some male nanny, perfect parent type figure. I was, strangely, more of a brother to my sister. That was a disappointment to them. They thought that having more children meant more free time to get drunk and take drugs.

Anyway, let's ignore my parents. They were very much of the Victorian mindset that children should be not seen and not heard. Maybe it would have been better if children were not born, but I'm very glad that my sister was. Having a sister is the reason why I'm clinging onto life with my fingernails.

Having a 10 year age gap is a bit strange, but I think it's kinda got advantages. My parents can't be bothered to imagine how hard it is being a young person today, and they get a particularly warped view because I was always very independent and a high-earner from the age of 17. Sadly, the opportunities for the majority of young people are rather bleak.

Yes, the challenges faced by me and my sister in day to day life are really chalk and cheese. While I battle with my mental health, in order to be able to work, my sister also has to battle a highly competitive job market and low pay. While I have to ensure that I earn enough during my hypomania in order to survive during my depression, my sister has to stretch her budget beyond any feasible limit.

Yes, our parents generation really screwed things up, and life is very hard for my sister. I went through a horrible divorce that nearly killed me, but that was due to a single vicious and mean person who had not a care in the world for human life, and couldn't act with a single shred of decency. My sister not only has to deal with a horrible divorce, but her rent & bills as a proportion of her income are totally unmanageable. That's not her fault. She works 6 days a week.

So, tomorrow, during the Chancellor's Autumn Statement, tax credits and other benefits are going to be cut. People like my sister are going to be horribly affected, and there's no way she could possibly work any harder to fix her own finances. She rents a very modest property for her & my niece, she works 6 days a week, she's very dedicated to her job, there are no better paid jobs... she is being shafted by politicians and society.

Walton Crescent

As a working mum, who did nothing wrong and is doing everything right, why should she have even more financial woe and stress heaped on top of her? She's working her arse off but she is being destroyed through exhaustion and stress, by a government that just doesn't care about the wellbeing of its citizens.

The net result is pretty much what the Tories want. My parents will have to work for longer and have less money in retirement, in order to support their daughter and granddaughter, despite the fact that they've worked hard all their life and their daughter is already working 6 days a week. That's bullshit.

Our family has not racked up huge debts buying crap. Our family has saved money and bought property and done all the things we were supposed to do. We've played by the rules of society, and my parents and sister have ended up diddled by the system. They paid in, with their income tax and their national insurance and their council tax... they're not acting like they're entitled.

My parents just want to have their pension. My sister just wants to work. My niece just wants to be a toddler. It's outrageous that my parents' pension goes to pay my sister's bills. My sister's 6-day-a-week job is not enough to pay for her bills. My niece hardly gets to see my sister because she's working so hard. Is that the kind of society you want, Tories?

Throughout Britain we see examples of how people are being asked to fend for themselves. While the richest members of society contribute a pittance of their net wealth, so many are having to dip into their life savings, their pensions, just to survive. I actually phoned JPMorgan's pension scheme administrator to ask if I could have any money released for hospital treatment I desperately needed, when Camden council bungled my case yet again.

I've managed to limp through and get myself to the point where I have survived an ordeal that would have killed most people. However, I had to borrow money to do that. Why am I borrowing money to pay for lifesaving treatment, when I have paid staggering sums in tax and National Insurance? It's all been pissed away on tax breaks for the wealthy.

Why should the National Health Service be facing a funding crisis, because we wanted to line the pockets of the super-rich? Why should state schools suffer? Why should our brightest children be cutting short their eduction and looking for crap jobs because we wanted to make the rich richer?

We are asking each generation to work a lot harder than the last. Our grandparents lived through a war, so they knew about austerity. They knew about make do & mend. Unfortunately, too few of those people are in positions of authority now. Their kids - my parents generation - think that life is easy, because they lived through the post-war boom. They are wrong. Life is hard.

So, take a note of the date and remember that today was the day that the government went too far. They cut too deep and they hurt people who were already hurting. They scapegoated the wrong people.

Anger will rise up. It will start with the young people who have been frozen out of the job market, who are marginalised and demonised by the media. It will spread to the hard working mums who are struggling to balance the books already, struggling to stretch their budgets. Then it will hit the grannies who are providing free childcare and cash handouts from their pensions in order to keep their kids and grandkids afloat.

There will be a groundswell of public opinion against being told how to live our lives with more frugality from some vintage wine swilling toffs who like nothing more than to admire each other's art collections, and ponce around the country telling the great unwashed masses to stop complaining. Let them eat cake, right?

Things are a lot worse than you can see from within the echo-chamber. Get your head out of the statistics. Get your arse out of your Tory party circle of friends. You're out of touch with reality and it will come and bite your ass.

The problems in society are being masked and things will come crashing down quicker than you can say "Poll Tax Riots".

That is all.

 

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Anatomy of an Epidemic

5 min read

This is a story about the rise and rise of mental illness...

Dib Dib Dib

I used to be a Sea Scout. The motto of the Scouts is "Be Prepared".

When I suspected that I was becoming mentally unwell, I read every book, website, academic paper and journal that I could find that I felt related to my mental health and its potential treatment. I educated myself.

I'm an educated patient. Because I'm an educated patient, I avoided being medicated with a Selective Serotonin Re-uptake Inhibitor (SSRI) which would have caused greater mood instability than I was already suffering with.

SSRIs are also linked to emotional blunting and the destruction of the sex lives and relationships of many couples. My relationship was already on the rocks, hence going to the doctor to see if there were some magic beans or a silver bullet, that could cure my ills.

Fundamentally, I believe that some mental health issues are risk not destiny. There don't seem to be any genes that are clearly faulty in individuals who suffer from Unipolar Depression and Bipolar Disorder. They are complex spectrum disorders. Some people are really dysfunctional when they are unwell, and others find ways of coping, sometimes to the point that people around them don't even know they are suffering.

However, out of desperation, I have tried the following medications, prescribed to me:

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Mirtazepine

This was well tolerated (no nasty side effects that made me want to stop taking it). It certainly seemed to reduce my stress levels and get some sleep. I think I might have rebounded though and started to go hypomanic fairly quickly.

Quetiapine

Unless you like weight gain, constipation, dry mouth and feeling like a drugged zombie for the few hours that you are awake, before your next dose knocks you out and you start the whole miserable 24 hour cycle all over again... I can't say this medication gives much quality of life beyond dribbling at daytime TV.

Aripiprazole

This is useful to see if your head is held straight. If your head is leaning to the left, then you will dribble out of the left side of your mouth. If your head is leaning to the right, then you will dribble out of the right side of your mouth. If you are holding your head perfectly straight, then you will dribble out of both sides of your mouth.

Lithium

This is hardcore. You need to have regular blood tests. It will shorten your life. Avoid if you can tolerate other meds or manage without.

Sodium Valproate & Depakote

Do you plan on working again? In an office? 9 to 5? Not really compatible with going back to work full time. If you're not completely manic (psychotic) then best avoided.

Lamotrogine

Just takes so damn long to get up to a therapeutic dose, you go through another hypomanic episode, decide that you're fine, and then stop taking your medication anyway. It's pretty subtle. Apparently it improves REM sleep. I dream a lot anyway. My sleep quality is more a function of good sleep hygiene.

Olanzapine

Fast acting. Good to calm you down if you're having an unmanageable moment. Makes you sleepy though... couldn't really work 9 to 5 on it.

Bupropion

Fast acting. Incredible antidepressant. It did give me a panic attack once though. Also stokes my hypomania pretty bad. Although it's a nicotinergic agonist, it actually shares many characteristics of stimulants like caffeine and amphetamine. Makes you pretty horny. Helps you quit smoking too (I don't smoke though).

Diazepam

Mother's little helpers (Valium). This powerful long-acting GABA agonist is an amazing anxiolytic. You could literally stand in the middle of a highway and not give a sh1t about the cars whizzing past you at 70mph. Super addictive. Horrible to taper off.

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Fundamentally, do any of these medications work? Well, I can vouch for Bupropion, Olanzapine, Mirtazepine and Diazepam for their short term efficacy. However, the body soon gets used to the effects and builds tolerance, which means you forever need to increase the dose to get the same therapeutic effect... welcome to homestasis, b1tches!

In my anecdotal experience, it's better to tough out the storm and not mess with the ridiculously complex organ that is a brain. When the psychopharmacologists imagined how Prozac (Fluoxetine) was having its antidepressant effect they expected to see higher serotonin levels in spinal fluids. They told the world that depressed people had "low serotonin". They just guessed and they guessed wrong.

Type I Bi-Polar Disorder was also known as Manic Depression. This is a serious illness that requires serious treatment. It's not my place to comment on whether medication plays a part in that. I'm no expert on Type I BPD.

Type II Bipolar means that you have hypomanic episodes, not fully blown mania. That means risk taking, spending money, hypersexuality, racing thoughts and pressured speech... amongst other symptoms, such as reduced need for sleep & food, and intolerance of slow-witted fools.

I'm Type II. I think it's a very important distinction. If I can control my mood disorder with good diet, good routine, good sleep and abstinence from alcohol & drugs (including prescribed drugs) then my brain has the best possible chance of finding homeostasis.

If I can remove unnecessary stress in my life, caused by complete ass-hats, and I'm empowered to just get the f**k on with my life, then my symptoms will abate. It's as simple as that.

What's the White Stuff?

This was the first time that Frankie had ever seen snow. His brain adapted to the change in environment (December 2010)

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